心破裂

関: cardiac rupture

WordNet

a plane figure with rounded sides curving inward at the top and intersecting at the bottom; conventionally used on playing cards and valentines; "he drew a heart and called it a valentine"
the courage to carry on; "he kept fighting on pure spunk"; "you havent got the heart for baseball" (同)mettle, nerve, spunk
an inclination or tendency of a certain kind; "he had a change of heart" (同)spirit
a playing card in the major suit that has one or more red hearts on it; "he led the queen of hearts"; "hearts were trumps"
the locus of feelings and intuitions; "in your heart you know it is true"; "her story would melt your bosom" (同)bosom
the hollow muscular organ located behind the sternum and between the lungs; its rhythmic contractions move the blood through the body; "he stood still, his heart thumping wildly" (同)pump, ticker
a firm rather dry variety meat (usually beef or veal); "a five-pound beef heart will serve six"
able to perceive sound
an opportunity to state your case and be heard; "they condemned him without a hearing"; "he saw that he had lost his audience" (同)audience
(law) a proceeding (usually by a court) where evidence is taken for the purpose of determining an issue of fact and reaching a decision based on that evidence
the ability to hear; the auditory faculty; "his hearing was impaired" (同)audition, auditory sense, sense of hearing, auditory modality
a session (of a committee or grand jury) in which witnesses are called and testimony is taken; "the investigative committee will hold hearings in Chicago"
state of being torn or burst open
the act of making a sudden noisy break
a personal or social separation (as between opposing factions); "they hoped to avoid a break in relations" (同)breach, break, severance, rift, falling out
receive a communication from someone; "We heard nothing from our son for five years"
examine or hear (evidence or a case) by judicial process; "The jury had heard all the evidence"; "The case will be tried in California" (同)try
perceive (sound) via the auditory sense
a form of whist in which players avoid winning tricks containing hearts or the queen of spades (同)Black_Maria

PrepTutorEJDIC

〈C〉『心臓』;胸 / 〈C〉(感情の中心をなす)『心』,気持ち / 〈U〉愛情,同情 / 〈U〉『勇気』,元気,熱意 / 《the ~》『中心』,内部,(物事の)本質,核心 / 〈C〉ハート形の物;(カードの)ハートの札
〈U〉『聴力』,聴覚〈U〉〈C〉(…を)『聞くこと』,(…の)聞き取り《+『of』+『名』》・〈C〉聞いてもらう機会,聞いてやること・聴取・聴聞会〈C〉(法廷などでの)尋問,審問,;(刑罰の減免を求める)釈明,意見陳述 / 〈U〉聞こえる距離(範囲)
〈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
〈音〉‘が'『聞こえる』,‘を'聞く(進行形にできない) / 〈人の言うこと〉‘に'『耳を傾ける』,‘を'注意深く聞く(listen);(裁判官などが)…の申し立てを聞く / 〈うわさ・ニュースなど〉‘を'『耳にしている』,聞いている / 『耳が聞こえる』 / 《しばしば命令形で》耳を傾ける,注意を向ける / 『うわさ』(『消息』)『を聞く』

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/09/21 22:46:18」(JST)

wiki en

[Wiki en表示]

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

It can also be caused by trauma.^[1]

Causes

The most common cause of myocardial rupture is a recent myocardial infarction, with the rupture typically occurring three to five days after infarction.^[2] Other causes of rupture include cardiac trauma, endocarditis (infection of the heart),^[3]^[4] cardiac tumors, infiltrative diseases of the heart,^[3] and aortic dissection.^{[citation needed]}

Risk factors for rupture after an acute myocardial infarction include female gender,^[5]^[6] advanced age of the individual,^[5]^[6] first ischemic event, and a low body mass index.^[5] 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,^[5]^[6]^[7] and delay of revascularization greater than 2 hours.^[6]

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.^[8] On the other hand, if primary percutaneous coronary intervention is performed to abort the infarction, the incidence of rupture is significantly lowered.^[6] The incidence of myocardial rupture if PCI is performed in the setting of an acute myocardial infarction is about 1 percent.^[5]

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.^[9]

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.

The rupture will most often occur near the edge of the necrotic myocardium where it abuts healthy (but hyperemic) myocardium where the inflammatory response is at its greatest. Further, the rupture will occur in an area of greatest shear stress. Within the left ventricle, these areas are adjacent to both anterior and posterior papillary muscles (regardless of whether the papillary muscle is involved in the infarction).

Left ventricular free wall rupture almost always results in hemopericardium (the exception being in the scenario where the patient has had prior open heart surgery and has obliterative fibrous pericardial adhesions; these would prevent egress of blood) and pericardial tamponade. An accumulation of as little as 75 ml of blood, acquired acutely in a patient without pre-existing pericardial effusion, is sufficient to produce tamponade (wherein the ventricles are incapable of filling and are thus incapable of producing adequate stroke volume).

Signs and symptoms

Symptoms of myocardial rupture are recurrent or persistent chest pain, syncope, and distension of jugular vein. Sudden death caused by a myocardial rupture is sometimes preceded by no symptoms.^[10]

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. The diagnosis is ultimately made at autopsy.

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%.^[5] The chances of survival rise dramatically if the patient: 1. has a witnessed initial event; 2. seeks early medical attention; 3. has an accurate diagnosis by the emergentologist; and 4. happens to be at a facility that has a cardiac surgery service (by whom a quick repair of the rupture can be attempted). 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.^[5]

References

^ Nan YY, Lu MS, Liu KS, et al. (September 2009). "Blunt traumatic cardiac rupture: therapeutic options and outcomes". Injury. 40 (9): 938–45. PMID 19540491. doi:10.1016/j.injury.2009.05.016.
^ Figueras J, Alcalde O, Barrabes JA, Serra V, Alguersuari J, Cortadellas J, et al. Changes in Hospital Mortality Rates in 425 Patients with Acute ST-Elevation Myocardial Infarction and Cardiac Rupure Over a 30-Year Period. Circulation. 2008;118:2783–9.
^ ^a ^b Lin TH, Su HM, Voon WC, Lai HM, Yen HW, Lai WT, Sheu SH (2006). "Association between hypertension and primary mitral chordae tendinae rupture.". Am J Hypertens. 19 (1): 75–9. PMID 16461195. doi:10.1016/j.amjhyper.2005.06.020.
^ de Diego C, Marcos-Alberca P, Pai RK (2006). "Giant periprosthetic vegetation associated with pseudoaneurysmal-like rupture." (PDF). Eur Heart J. 27 (8): 912. PMID 16569654. doi:10.1093/eurheartj/ehi540.
^ ^a ^b ^c ^d ^e ^f ^g Yip HK, Wu CJ, Chang HW, Wang CP, Cheng CI, Chua S, Chen MC (2003). "Cardiac rupture complicating acute myocardial infarction in the direct percutaneous coronary intervention reperfusion era." (PDF). Chest. 124 (2): 565–71. PMID 12907544. doi:10.1378/chest.124.2.565.
^ ^a ^b ^c ^d ^e Moreno R, Lopez-Sendon J, Garcia E, Perez de Isla L, Lopez de Sa E, Ortega A, Moreno M, Rubio R, Soriano J, Abeytua M, Garcia-Fernandez MA (2002). "Primary angioplasty reduces the risk of left ventricular free wall rupture compared with thrombolysis in patients with acute myocardial infarction.". J Am Coll Cardiol. 39 (4): 598–603. PMID 11849857. doi:10.1016/S0735-1097(01)01796-X.
^ Sugiura T, Nagahama Y, Nakamura S, Kudo Y, Yamasaki F, Iwasaka T (2003). "Left ventricular free wall rupture after reperfusion therapy for acute myocardial infarction.". Am J Cardiol. 92 (3): 282–4. PMID 12888132. doi:10.1016/S0002-9149(03)00625-8.
^ Becker RC, Gore JM, Lambrew C, Weaver WD, Rubison RM, French WJ, Tiefenbrunn AJ, Bowlby LJ, Rogers WJ (1996). "A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction.". J Am Coll Cardiol. 27 (6): 1321–6. PMID 8626938. doi:10.1016/0735-1097(96)00008-3.
^ Becker AE, van Mantgem JP (1975). "Cardiac tamponade. A study of 50 hearts.". Eur J Cardiol. 3 (4): 349–58. PMID 1193118.
^ http://emedicine.medscape.com/article/156455-clinical%7C date retrieved January 2017

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 急性心筋梗塞の器質的合併症 mechanical complications of acute myocardial infarction
2. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
3. 心タンポナーデ cardiac tamponade
4. 成人における鈍的胸部外傷の初期評価およびマネージメント initial evaluation and management of blunt thoracic trauma in adults
5. 鈍的外傷による心損傷 cardiac injury from blunt trauma

English Journal

Human HDL containing a novel apoC-I isoform induces smooth muscle cell apoptosis.

McNeal CJ, Chatterjee S, Hou J, Worthy LS, Larner CD, Macfarlane RD, Alaupovic P, Brocia RW.SourceDepartment of Internal Medicine and Department of Pediatrics, Scott & White Healthcare, Temple, TX, USA.
Cardiovascular research.Cardiovasc Res.2013 Apr 1;98(1):83-93. doi: 10.1093/cvr/cvt014. Epub 2013 Jan 25.
AIMS: We discovered that some adults with coronary heart disease (CHD) have a high density lipoprotein (HDL) subclass which induces human aortic smooth muscle cell (ASMC) apoptosis in vitro. The purpose of this investigation was to determine what properties differentiate apoptotic and non-apoptotic
PMID 23354389

Transapical closure of mitral paravalvular leakage.

Guler A, Tavlasoglu M, Kadan M, Barcin C.SourceDepartment of Cardiovascular Surgery, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Apr;43(4):861-3. doi: 10.1093/ejcts/ezs608. Epub 2012 Nov 23.
Paravalvular leakage after mitral valve surgery is a rare complication. The cause is usually the rupture of sutures. Although it may be asymptomatic, serious haemodynamic changes, heart failure and even death may be observed. Surgical treatment modalities have considerable morbidity rates. Over the
PMID 23178816

Innovations and novel technologies in TAVI. Second generation transcatheter heart valves.

Sinning JM, Werner N, Vasa-Nicotera M, Ghanem A, Hammerstingl C, Grube E, Nickenig G.SourceHerzzentrum Bonn, Medizinische Klinik und Poliklinik II, , Universitätsklinikum Bonn, Germany - georg.nickenig@ukb.uni-bonn.de.
Minerva cardioangiologica.Minerva Cardioangiol.2013 Apr;61(2):155-63.
Transcatheter aortic valve implantation (TAVI) is the new standard-of-care for inoperable patients with superior outcome compared to conservative management including balloon valvuloplasty. In high-risk patients, TAVI has shown non-inferiority compared with surgical aortic valve replacement. Althoug
PMID 23492599

Japanese Journal

Deletion of CD28 Co-stimulatory Signals Exacerbates Left Ventricular Remodeling and Increases Cardiac Rupture After Myocardial Infarction

Circulation journal : official journal of the Japanese Circulation Society 80(9), 1971-1979, 2016-09
NAID 40020916004

超音波検査が診断に有用であった非瘢痕子宮に発症した子宮破裂の2例

超音波医学 43(4), 587-592, 2016
NAID 130005166191

Deletion of CD28 Co-stimulatory Signals Exacerbates Left Ventricular Remodeling and Increases Cardiac Rupture After Myocardial Infarction

Circulation Journal advpub(0), 2016
NAID 130005163369

Related Pictures

★リンクテーブル★

リンク元	「心破裂」
関連記事	「rupture」「hearing」「hear」「heart」

「心破裂」

Myocardial rupture
Classification and external resources
Specialty	cardiology
ICD-10	I23.3-I23.5, S26.8
DiseasesDB	8569
eMedicine	med/1571
MeSH	D006341
	[edit on Wikidata]

　　[★]

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

「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

「hearing」

　　[★]

n。

聴力、聴覚。聞くこと、聴取。聞こえる距離/範囲。聞いてやること、傾聴。聞いてもらうこと、発言の機会。(委員会などの)聴聞会、ヒアリング。(法)審問、尋問。

「hear」

　　[★]

v.

聞く、聞こえる

「heart」

　　[★] 心臓

[pmid19540491-1] Nan YY, Lu MS, Liu KS, et al. (September 2009). "Blunt traumatic cardiac rupture: therapeutic options and outcomes". Injury. 40 (9): 938–45. PMID 19540491. doi:10.1016/j.injury.2009.05.016.

[2] Figueras J, Alcalde O, Barrabes JA, Serra V, Alguersuari J, Cortadellas J, et al. Changes in Hospital Mortality Rates in 425 Patients with Acute ST-Elevation Myocardial Infarction and Cardiac Rupure Over a 30-Year Period. Circulation. 2008;118:2783–9.

[Lin-2006-3] Lin TH, Su HM, Voon WC, Lai HM, Yen HW, Lai WT, Sheu SH (2006). "Association between hypertension and primary mitral chordae tendinae rupture.". Am J Hypertens. 19 (1): 75–9. PMID 16461195. doi:10.1016/j.amjhyper.2005.06.020.

[de_Diego-2006-4] Diego C, Marcos-Alberca P, Pai RK (2006). "Giant periprosthetic vegetation associated with pseudoaneurysmal-like rupture." (PDF). Eur Heart J. 27 (8): 912. PMID 16569654. doi:10.1093/eurheartj/ehi540.

[Yip-2003-5] ^ ^a ^b ^c ^d ^e ^f ^g Yip HK, Wu CJ, Chang HW, Wang CP, Cheng CI, Chua S, Chen MC (2003). "Cardiac rupture complicating acute myocardial infarction in the direct percutaneous coronary intervention reperfusion era." (PDF). Chest. 124 (2): 565–71. PMID 12907544. doi:10.1378/chest.124.2.565.

[Moreno-2002-6] Moreno R, Lopez-Sendon J, Garcia E, Perez de Isla L, Lopez de Sa E, Ortega A, Moreno M, Rubio R, Soriano J, Abeytua M, Garcia-Fernandez MA (2002). "Primary angioplasty reduces the risk of left ventricular free wall rupture compared with thrombolysis in patients with acute myocardial infarction.". J Am Coll Cardiol. 39 (4): 598–603. PMID 11849857. doi:10.1016/S0735-1097(01)01796-X.

[Sugiura-2003-7] Sugiura T, Nagahama Y, Nakamura S, Kudo Y, Yamasaki F, Iwasaka T (2003). "Left ventricular free wall rupture after reperfusion therapy for acute myocardial infarction.". Am J Cardiol. 92 (3): 282–4. PMID 12888132. doi:10.1016/S0002-9149(03)00625-8.

[Becker-1996-8] Becker RC, Gore JM, Lambrew C, Weaver WD, Rubison RM, French WJ, Tiefenbrunn AJ, Bowlby LJ, Rogers WJ (1996). "A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction.". J Am Coll Cardiol. 27 (6): 1321–6. PMID 8626938. doi:10.1016/0735-1097(96)00008-3.

[Becker-1975-9] Becker AE, van Mantgem JP (1975). "Cardiac tamponade. A study of 50 hearts.". Eur J Cardiol. 3 (4): 349–58. PMID 1193118.

[10] ttp://emedicine.medscape.com/article/156455-clinical%7C date retrieved January 2017

v t e Chest injury, excluding fractures (S20–S29, 860–862)
Cardiac and circulatory system injuries	vascular: Traumatic aortic rupture Thoracic aorta injury heart: Myocardial contusion/Commotio cordis Cardiac tamponade Hemopericardium Myocardial rupture
Lung and lower respiratory tract injuries	Pneumothorax Hemothorax Hemopneumothorax Pulmonary contusion Pulmonary laceration Tracheobronchial injury Diaphragmatic rupture

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案内

heart rupture