Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 126

Mechanical complications occur within the first 14 days of STEMI and have two peaks (24 hours and 3–5 days). They are responsible for 12% of cases of cardiogenic shock (severe mitral regurgitation, 7%; ventricular septal rupture, 3.9%).¹⁰² Myocardial rupture usually results from the shear stress at the border between the live and the infarcted area. In the reperfusion era, myocardial rupture is most frequently seen in the first 24 hours (SHOCK registry).^121,122 It may occur at 3–5 days, particularly in non-reperfused patients, when the forming scar thins, expands, and exerts excessive tension at the border. In the second week, the rupture may involve the thin necrotic area itself.