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ABSTRACT. Broken hearts are usually associated with love stories and, even if they invite our empathy, they make us smile. But in cardiology they refer us to myocardial ruptures which are often deadly complications of myocardial infarctions (AMI), occurring in approximately 2% of cases (Moreno et al 2000), less frequently when primary percutaneous interventions can be performed. In order to assess the current incidence and risk factors for cardiac ruptures, AMI patients admitted between January and December 2013 in the Georgescu Institute of Cardiovascular Diseases were under scrutiny. Of these, 17 had cardiac ruptures, most of them with a delayed presentation and anterior AMI. Chest pain was the most frequent symptom at presentation (in all men and 62.8% of women). Myocardial rupture occurred between the first and the eighteenth day, with a mean of 4.7 days. Conventional coronary angiography was performed in all patients and showed that more than half of the patients had the two-vessel disease and only one patient had normal coronary arteries (the Tako-Tsubo syndrome). Our patients had such traditional risk factors of myocardial rupture as older age, female sex, previous hypertension, and a first lateral or anterior wall AMI. They were rather more likely to have a reserved prognostic induced by newly sustained cardiac arrhythmias, especially atrial fibrillation. In a clinical context, newly sustained cardiac arrhythmias should be evaluated as a prognostic factor of cardiac rupture in acute myocardial infarction.

Keywords: myocardial rupture; acute myocardial infarction; atrial fibrillation; prognostic factor.

Liviu Macovei
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Grigore T. Popa University of Medicine, Romania
Larisa Anghel
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Grigore T. Popa University of Medicine, Romania
Catalina Arsenescu Georgescu
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Grigore T. Popa University of Medicine, Romania

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