New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction
Ventricular free wall rupture (FWR) is a catastrophic complication after acute myocardial infarction (AMI). However, patients with FWR die of cardiac tamponade secondary to intrapericardial hemorrhage that can be treated if properly diagnosed. Unfortunately, FWR was still not diagnosed and classifie...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Cardiovascular Therapeutics |
| Online Access: | http://dx.doi.org/10.1155/2021/1716546 |
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| author | Wei Gong Shaoping Nie |
| author_facet | Wei Gong Shaoping Nie |
| author_sort | Wei Gong |
| collection | DOAJ |
| description | Ventricular free wall rupture (FWR) is a catastrophic complication after acute myocardial infarction (AMI). However, patients with FWR die of cardiac tamponade secondary to intrapericardial hemorrhage that can be treated if properly diagnosed. Unfortunately, FWR was still not diagnosed and classified quickly and accurately. The aim of this study was to present a new clinical classification for FWR. Seventy-eight patients with FWR after STEMI were enrolled in the study. We classified FWR, according to clinical situations after onset, into the cardiac arrest type, unstable type, and stable type. The cardiac arrest type was the most common type, accounting for about 83.3%. 90.8% of patients of this type were complicated with electromechanical dissociation at the time of FWR onset, and 100% of patients of this type died in the hospital. The unstable type was characterized by sudden clinical condition changes with moderate/massive pericardial effusion. In this study, 9.0% of patients were diagnosed as the unstable type. The average time from onset to death was 4.5 hours. This period was the “golden time” to rescue such patients. The stable types usually have stable hemodynamics, but may worsen, requiring rigorous detection of pericardial effusion and vital signs. In this study, 7.7% of patients were diagnosed as the stable type, and 83.5% of them survived in the hospital. The new clinical classification provides a basis for clinical diagnosis and treatment of FWR. The clinical application of the new classification is expected to improve the prognosis of FWR patients. |
| format | Article |
| id | doaj-art-da19d88642e04e8d9c397b4f862fafd7 |
| institution | Kabale University |
| issn | 1755-5914 1755-5922 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiovascular Therapeutics |
| spelling | doaj-art-da19d88642e04e8d9c397b4f862fafd72025-02-03T00:58:47ZengWileyCardiovascular Therapeutics1755-59141755-59222021-01-01202110.1155/2021/17165461716546New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial InfarctionWei Gong0Shaoping Nie1Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaEmergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaVentricular free wall rupture (FWR) is a catastrophic complication after acute myocardial infarction (AMI). However, patients with FWR die of cardiac tamponade secondary to intrapericardial hemorrhage that can be treated if properly diagnosed. Unfortunately, FWR was still not diagnosed and classified quickly and accurately. The aim of this study was to present a new clinical classification for FWR. Seventy-eight patients with FWR after STEMI were enrolled in the study. We classified FWR, according to clinical situations after onset, into the cardiac arrest type, unstable type, and stable type. The cardiac arrest type was the most common type, accounting for about 83.3%. 90.8% of patients of this type were complicated with electromechanical dissociation at the time of FWR onset, and 100% of patients of this type died in the hospital. The unstable type was characterized by sudden clinical condition changes with moderate/massive pericardial effusion. In this study, 9.0% of patients were diagnosed as the unstable type. The average time from onset to death was 4.5 hours. This period was the “golden time” to rescue such patients. The stable types usually have stable hemodynamics, but may worsen, requiring rigorous detection of pericardial effusion and vital signs. In this study, 7.7% of patients were diagnosed as the stable type, and 83.5% of them survived in the hospital. The new clinical classification provides a basis for clinical diagnosis and treatment of FWR. The clinical application of the new classification is expected to improve the prognosis of FWR patients.http://dx.doi.org/10.1155/2021/1716546 |
| spellingShingle | Wei Gong Shaoping Nie New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction Cardiovascular Therapeutics |
| title | New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction |
| title_full | New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction |
| title_fullStr | New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction |
| title_full_unstemmed | New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction |
| title_short | New Clinical Classification for Ventricular Free Wall Rupture following Acute Myocardial Infarction |
| title_sort | new clinical classification for ventricular free wall rupture following acute myocardial infarction |
| url | http://dx.doi.org/10.1155/2021/1716546 |
| work_keys_str_mv | AT weigong newclinicalclassificationforventricularfreewallrupturefollowingacutemyocardialinfarction AT shaopingnie newclinicalclassificationforventricularfreewallrupturefollowingacutemyocardialinfarction |