[Rupture of the cardiac wall during the course of acute myocardial infarction. Personal observations]. / Pekniecia wolnej sciany serca w przebiegu swiezego zawalu miesnia sercowego. Obserwacje wlasne.

Out of 3673 patients with myocardial infarction treated between 1989 and 1998, 128 (54 males and 74 females) deceased due to left ventricle wall rupture (death rate: 18.5%). Thrombolytic therapy started to be used in 1992. It was administered in 36.0% patients with myocardial infarction in the years 1992-1998. Out of the patients deceased due to left ventricle wall rupture thrombolytic was carried out in 24.2%, predominantly in males (31.5%) as compared to females (18.8%). Left ventricle wall rupture during acute myocardial infarction occurred mainly in females (57.7%), in patients with first infarction (89.8%), in the case of anterior wall infarction (66.4%), hypertension (80.5%), in patients aged 61-80 and more (86.7%). Majority of the patients (83.6%) deceased because of this condition between 1 and 7 hospitalisation day, mainly during the first 48 hours (48.4%).

[Right ventricle myocardial infarction from personal observations]. / Zawal prawej komory serca w obserwacjach wlasnych.

In 2514 patients with myocardial infarction (1961 male and 823 female) hospitalized between 1991 and 1997 right ventricle myocardial infarction was diagnosed based on of V3R-V5R electrocardiographic leads tracing in 147 patients aged 35-86 (105 male and 42 female), which means 5.4% of treated patients. Only one case of isolated right ventricle infarction was observed. In other cases it coexisted with left ventricle infarction--most often with inferior myocardial infarction (118 cases, which means 10.7% cases with this localization). Streptokinase was administered to 64 patients with right ventricle infarction, which means 43.5% treated. 10 patients, including 5 female, deceased during the hospitalization, hospital mortality was 6.8%. Cardiogenic shock was the reason of death in all cases. The frequency of concomitant chronic diseases (hypertension, congestive heart failure, diabetes mellitus) and hyperlipidaemia (hypercholesterolaemia and/or hypertriglyceridaemia), as well as arrhythmia and conduction disturbances, in patients with right ventricle myocardial infarction did not differ from the ones estimated in people with left ventricle infarction. According to the analysis of our own material (the most numerous group of patients as juxtaposed to ones observed by other authors) inferior myocardial infarction is most commonly accompanied by right ventricle infarction. Low hospital mortality in these patients is connected with fibrinolytic therapy. The performance of V3R-V5R electrocardiographic leads tracing is indispensable in patients with acute myocardial infarction. The diagnosis of right ventricle infarction is highly important because of the specific treatment of these patients.