What are the clinical features, diagnosis, and treatment of mechanical complications of acute myocardial infarction?
Clinical features
Diagnosis
Treatment
Clinical features include ventricular septal rupture, papillary muscle rupture, and acute mitral regurgitation.
Diagnosis is made through echocardiography, which provides information on ventricular geometry, valvular anatomy, and potential mechanisms of insufficiency.
Initial management aims to improve ventricular filling through intravascular volume expansion, and in some cases, vasopressors and inotropes may be necessary.
The treatment of choice is surgery for free and contained rupture, as well as coronary artery bypass grafting.
The mortality rate of patients undergoing surgery can be as high as 40%, but long-term survival of survivors can be up to 60-70% at five years.