[Rupture of the interventricular septum in acute myocardial infarct]. / O razryve mezhzheludochkovoi peregorodki pri ostrom infarkte miokarda

The authors examined ruptures of the interventricular septum in 12 patients with acute myocardial infarction. Septal ruptures comprise 8% of all cardiac ruptures that occur within the early days of infarction, they are poorly diagnosed, and most of such patients die before the end of the 1st--5th week due to acute left-ventricular insufficiency. Characteristic features suitable for making the diagnosis are lacking. A transverse systolic murmur and "cat's purr" are important, but rare signs. Systolic murmur, maximum at the apex, is seen more often than of transverse, which makes the differential diagnosis of papillary muscle rupture still more complicated.

[Acute circulatory insufficiency in the early phase of myocardial infarct: its frequency, clinical forms and the outcomes with 1400 patients]. / Ostra tsirkulatorna nedostatuchnost v nachalnata faza na miokardniia infarkt--chestota, klinichni formi i izkhodi pri 1400 bolni

The authors found acute circulatory insufficiency (cardiac asthma, pulmonary edema or cardiogenic shock in 26.2 per cent of the patients among the followed up 1400 patients with myocardial infarction. Insufficiency is more frequently met among women (36 per cent) while among men it is 22 per cent and grows with age advancing of the patients. A substantial number of the patients with acute circulatory insufficiency were admitted to the hospital in grave states, and failed to be affected by the complex therapeutic approach, and 62 per cent of them died. Total mortality rate in all 1400 patients is 28 per cent and in the patients without circulatory insufficiency- 13 per cent. In spite of the fact that of serious morphological picture was established in the deceased with acute circulatory insufficiency- the authors find it necessary to apply the following in the patients with acute myocardial infarction: simultaneity in the performance of diagnostic and therapeutic measures; attempt to detect the "signal signs" of the acute circulatory insufficiency as early as possible, and effective treatment with inclusion of new methods, offered by the modern science.