Heart attack recovery pitfalls. Risk of heart wall rupture looms large in first week

The rupture of the heart's free wall is a rare yet serious consequence, constituting as one of the potential complications of a heart attack. It transpires in 85% of patients within the first week after a heart attack. Generally, beyond the initial 10 days post-attack, it is believed that the risk of a rupture diminishes.

Ischemia, during a heart attack, damages and kills heart muscle cells, consequently weakening the heart wall. If this weakened wall ruptures, an immediate threat to life is formed, requiring instantaneous medical intervention.

Risk factors for the rupture of the free wall of the heart are:

- Advanced age

- Hypertension

- Female gender

- Anterior location of the myocardial infarction

- Extensive heart attack covering at least 20% of the left ventricle

- Absence of prior hypertrophy of the left ventricular muscle

- Long time from initial symptoms onset to coronary angioplasty

- History of ischemic heart disease

- Chronic kidney disease

The rupture of the heart's free wall presents suddenly and can be dramatic. Patients may suffer from intense chest pain, a sudden drop in blood pressure, loss of consciousness, and cardiogenic shock caused by the heart's sudden inability to pump blood.

Diagnosis is typically based on medical imaging, such as echocardiography, and clinical observation.

The need for treatment becomes urgent due to the immediate threat to life and typically requires surgical intervention. The ruptured heart wall is usually repaired by cardio-surgical surgery to close the rupture and stabilize the patient. Only 37% of patients diagnosed with a rupture survive the first 30 days.

Early diagnosis of a heart attack and appropriate treatment - such as the use of anticoagulant drugs and angioplasty procedures - can help minimize the risk of rupture.