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European Heart Journal Advance Access originally published online on June 21, 2005
European Heart Journal 2005 26(17):1693-1694; doi:10.1093/eurheartj/ehi353
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Free wall rupture in the elderly: deleterious effect of fibrinolytic therapy on the ageing heart

Ellen C. Keeley and James A. de Lemos*

Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9047, USA

* Corresponding author. Tel: +1 214 645 7528; fax: +1 214 645 7501. E-mail address: james.delemos@utsouthwestern.edu

This editorial refers to ‘Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction’{dagger} by H. Bueno et al., on page 1705

The first 10% of the full text of this article appears below.

Free wall rupture (FWR) is a catastrophic mechanical complication of ST segment elevation myocardial infarction (STEMI), which occurs in up to 8% of patients and is responsible for nearly 20% of all infarction-related deaths. In fact, next to cardiogenic shock due to pump failure, FWR is the most common mechanical cause of death in STEMI patients, occurring eight to 10 times more frequently than rupture of a papillary muscle or rupture of the interventricular septum. Although the vast majority of FWRs occur within the first week following symptom onset, up to half occur within the first 24 h. FWR primarily affects the left ventricle and complicates anterior and inferior infarctions similarly. When FWR occurs, the clinical presentation is dramatic, with the rapid development of hypotension, cardiac tamponade, pulseless electromechanical activity, and death. Unfortunately, the mortality rate is >90%, and few . . . [Full Text of this Article]


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Related articles in EHJ:

Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction
Héctor Bueno, Manuel Martínez-Sellés, Esther Pérez-David, and Ramón López-Palop
EHJ 2005 26: 1705-1711. [Abstract] [Full Text]  



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S. Polic, Z. Rumboldt, and K. Novak
Mechanisms of death in elderly patients with acute myocardial infarction exposed to fibrinolytic therapy
Eur. Heart J., January 2, 2006; 27(2): 246 - 246.
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