Mechanical Complications of Acute Myocardial Infarction

Mechanical complications of acute myocardial infarction (AMI) result in some of the deadliest outcomes. It is difficult to assess the true incidence of these complications as both clinical and autopsy series differ considerably, though they are thought to be responsible for about 15% of all AMI deaths [1]. In general, patients at increased risk include elderly women, first AMI, and hypertension. Mechanical complications can be subdivided into two basic categories: the acute phase and the chronic phase. The acute phase usually involves rupture of damaged myocardium. This can take the form of rupture of the ventricular free wall, the interventricular septum, or a papillary muscle. The chronic phase usually involves formation of a ventricular aneu-rysm. This results in either a true aneurysm or a pseudoaneurysm. The following chapter will discuss how to detect, diagnose, and treat each of these entities.