![]() ![]() The right ventricle (RV), LV, right atrium (RA), and left atrium (LA), in the decreasing order of frequency, are the cardiac chambers involved. Another rare cause is sarcoidosis through transmural noncaseating granulomas. Myocardial tumors, including lymphoma and acute myeloblastic leukemia, can cause the rupture of the myocardium of any chamber. Myocardial abscess rupture may occur in infective endocarditis, whereas the rupture may also occur in infections like tuberculosis and echinococcal cysts. Iatrogenic causes include penetrating or blunt trauma from diagnostic catheterization, transcatheter aortic valve replacement (especially transapical approach), placement of temporary or permanent pacing catheters, balloon valvuloplasty, cardiac surgeries such as mitral valve replacement, and pericardiocentesis. On the other hand, LV hypertrophy, congestive heart failure (CHF), history of previous infarcts, chronic ischemic heart disease, early use of beta-blockers post-AMI, and timely intervention have protective action. Pericardial effusion of 10 mm or more is correlated with an increased risk of free wall rupture. ![]() ![]() The most common cause of left ventricular rupture is post-AMI. Risk factors associated with left ventricular free wall rupture are no prior history of angina or myocardial infarction, ST elevation in the initial EKG, peak CK-MB above 150 IU/L, female sex, age more than 70 years, anterior location, transmural infarction, and first infarction. ![]()
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