cardiac rupture

心破裂

WordNet

1. state of being torn or burst open
2. the act of making a sudden noisy break
3. a personal or social separation (as between opposing factions); "they hoped to avoid a break in relations" (同)breach, break, severance, rift, falling out
4. of or relating to the heart; "cardiac arrest"
5. the opening into the stomach and that part of the stomach connected to the esophagus

PrepTutorEJDIC

1. 〈U〉〈C〉(…の)破裂《+『of』+『名』》 / 〈U〉〈C〉(友好的関係などの)決裂,仲たがい / 〈C〉裂け目 / 〈C〉脱腸,ヘルニア / …‘を'破裂させる / 〈友好関係など〉‘を'断ち切る / 破裂する
2. 心臓の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/08 20:29:08」(JST)

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Myocardial rupture
Classification and external resources
ICD-10	I23.3-I23.5, S26.8
DiseasesDB	8569
eMedicine	med/1571
MeSH	D006341

Myocardial rupture (or heart rupture) is a laceration or tearing of the walls of the ventricles or atria of the heart, of the interatrial or interventricular septum, of the papillary muscles or chordae tendineae or of one of the valves of the heart. It is most commonly seen as a serious sequela of an acute myocardial infarction (heart attack).

It can also be caused by trauma.

Etiology

The most common cause of myocardial rupture is a recent myocardial infarction, with the rupture typically occurring three to five days after infarction. Other causes of rupture include cardiac trauma, endocarditis (infection of the heart), cardiac tumors, infiltrative diseases of the heart, and aortic dissection.^{[citation needed]}

Risk factors for rupture after an acute myocardial infarction include female gender, advanced age of the individual, and a low body mass index. Other presenting signs associated with myocardial rupture include a pericardial friction rub, sluggish flow in the coronary artery after it is opened i.e. revascularized with an angioplasty, the left anterior descending artery being often the cause of the acute MI, and delay of revascularization greater than 2 hours.

Incidence

The incidence of myocardial rupture has decreased in the era of urgent revascularization and aggressive pharmacological therapy for the treatment of an acute myocardial infarction. However, the decrease in the incidence of myocardial rupture is not uniform; there is a slight increase in the incidence of rupture if thrombolytic agents are used to abort a myocardial infarction. On the other hand, if primary percutaneous coronary intervention is performed to abort the infarction, the incidence of rupture is significantly lowered. The incidence of myocardial rupture if PCI is performed in the setting of an acute myocardial infarction is about 1 percent.

Classification

Myocardial ruptures can be classified as one of three types.

• Type I myocardial rupture is an abrupt slit-like tear that generally occurs within 24 hours of an acute myocardial infarction.
• Type II is an erosion of the infarcted myocardium, which is suggestive of a slow tear of the dead myocardium. Type II ruptures typically occur more than 24 hours after the infarction occurred.
• Type III ruptures are characterized by early aneurysm formation and subsequent rupture of the aneurysm.

Another method for classifying myocardial ruptures is by the anatomical portion of the heart that has ruptured. By far the most dramatic is rupture of the free wall of the left or right ventricles, as this is associated with immediate hemodynamic collapse and death secondary to acute pericardial tamponade. Rupture of the interventricular septum will cause a ventricular septal defect. Rupture of a papillary muscle will cause acute mitral regurgitation.

Signs and symptoms

Symptoms of myocardial rupture are recurrent or persistent chest pain, syncope, and distension of jugular vein.

Diagnosis

Due to the acute hemodynamic deterioration associated with myocardial rupture, the diagnosis is generally made based on physical examination, changes in the vital signs, and clinical suspicion. The diagnosis can be confirmed with echocardiography.

Treatment

The treatment for myocardial rupture is supportive in the immediate setting and surgical correction of the rupture, if feasible.^{[citation needed]} A certain small percentage of individuals do not seek medical attention in the acute setting and survive to see the physician days or weeks later. In this setting, it may be reasonable to treat the rupture medically and delay or avoid surgery completely, depending on the individual's comorbid medical issues.

Prognosis

The prognosis of myocardial rupture is dependent on a number of factors, including which portion of the myocardium is involved in the rupture. In one case series, if myocardial rupture involved the free wall of the left ventricle, the mortality rate was 100.0%. Even if the individual survives the initial hemodynamic sequelae of the rupture, the 30 day mortality is still significantly higher than if rupture did not occur.

References

UpToDate Contents

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• 1. 急性心筋梗塞の器質的合併症 mechanical complications of acute myocardial infarction
• 2. 心タンポナーデ cardiac tamponade
• 3. 鈍的外傷による心損傷 cardiac injury from blunt trauma
• 4. 心筋梗塞の心膜合併症 pericardial complications of myocardial infarction
• 5. 急性心筋梗塞後の左室瘤および仮性左室瘤 left ventricular aneurysm and pseudoaneurysm following acute myocardial infarction

English Journal

• AT2 Receptors Targeting Cardiac Protection Post-Myocardial Infarction.

• Kaschina E1, Lauer D, Schmerler P, Unger T, Steckelings UM.
• Current hypertension reports.Curr Hypertens Rep.2014 Jul;16(7):441. doi: 10.1007/s11906-014-0441-0.
• The angiotensin AT2-receptor mediates tissue protective actions. Its regenerative potential has been tested in multiple disease models including models of myocardial infarction. These studies used different experimental approaches in order to detect AT2-receptor-related effects such as AT2-receptor
• PMID 24792092

• Parturition in horses is dominated by parasympathetic activity of the autonomous nervous system.

• Nagel C1, Erber R2, Ille N3, von Lewinski M4, Aurich J3, Möstl E5, Aurich C2.
• Theriogenology.Theriogenology.2014 Jul 1;82(1):160-8. doi: 10.1016/j.theriogenology.2014.03.015. Epub 2014 Mar 27.
• External and internal stressors prolong parturition in different species. At parturition, sympathoadrenal activation should be avoided because an increased sympathetic tone may cause uterine atonia via β2-receptors. We hypothesized that at physiological parturition, horses are under parasympathetic
• PMID 24767599

• Imaging aortic aneurysmal disease.

• Evangelista A.
• Heart (British Cardiac Society).Heart.2014 Jun 15;100(12):909-915. doi: 10.1136/heartjnl-2013-305048.
• Imaging techniques play a crucial role in the diagnosis, follow-up and management of aortic aneurysms. Ultrasound, CT and MRI have strengths and limitations in the assessment of this disease depending on the aorta segment involved, reason for the study (screening, follow-up or surgical indication) a
• PMID 24842834

Japanese Journal

• 症例 Oozing型虚血性左室自由壁破裂術後に乳頭筋断裂をきたした1例

• 胸部外科 = The Japanese journal of thoracic surgery 68(12), 1019-1022, 2015-11
• NAID 40020630853

• 症例 鈍的交通外傷による右房破裂の1例

• 胸部外科 = The Japanese journal of thoracic surgery 68(7), 520-522, 2015-07
• NAID 40020521883

• Improvement of Severe Heart Failure after Endovascular Stent Grafting for Thoracic Aortic Aneurysm

• International Heart Journal 56(6), 682-685, 2015
• NAID 130005113054

Related Links

• Myocardial Rupture: Background, Pathophysiology, Etiology

Myocardial rupture occurs in the setting of acute myocardial infarction (AMI), blunt and penetrating cardiac trauma, primary cardiac infection, primary and secondary cardiac tumors, infiltrative diseases of the heart, and ...

• Cardiac rupture | definition of cardiac rupture by Medical ...

cardiac rupture A tearing of the heart muscle that may occur after severe chest trauma (or in about 2% of patients who have suffered a myocardial infarction). It typically results in sudden cardiac death or tamponade. Synonym: myocardial rupture

Related Pictures

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★リンクテーブル★

リンク元	「心破裂」「心臓破裂」「heart rupture」
関連記事	「rupture」「cardiac」

「心破裂」

　　[★]

英

cardiac rupture、heart rupture

同

心臓破裂、心室破裂 ventricular rupture

関

心損傷

[show details]

cardiac rupture : 約 47,300 件
heart rupture : 約 45,300 件

「心臓破裂」

　　[★]

英

cardiac rupture

関

心破裂

「heart rupture」

　　[★]

• 心破裂

関

cardiac rupture

「rupture」

　　[★]

• n.

• 破裂、破断、破壊。(医)破裂、断裂。(医)ヘルニア
• 決裂、断絶。仲違い、不和(between, with)

• vt.

• 破る、裂く、破裂させる。断裂させる、決裂させる。仲たがいさせる
• (医)～にヘルニアを起こさせる。

関

abolish、break、breakdown、burst、destroy、destruction、dismantle、disrupt、disruptant、disruption、explode、explosion、laceration、lesion、subversion、subvert

　 　 　 　

「cardiac」

　　[★]

• adj.

• 心臓の、心の、心臓性、強心の

関

cardio、cardiotonic、heart、mind