Mechanical Complications of Acute Myocardial Infarction: A Scientific Statement from the American Heart Association

Abdulla A. Damluji, Sean Van Diepen, Jason N. Katz, Venu Menon, Jacqueline E. Tamis-Holland, Marie Bakitas, Mauricio G. Cohen, Leora B. Balsam, Joanna Chikwe

Research output: Contribution to journalReview articlepeer-review

Abstract

Over the past few decades, advances in pharmacological, catheter-based, and surgical reperfusion have improved outcomes for patients with acute myocardial infarctions. However, patients with large infarcts or those who do not receive timely revascularization remain at risk for mechanical complications of acute myocardial infarction. The most commonly encountered mechanical complications are acute mitral regurgitation secondary to papillary muscle rupture, ventricular septal defect, pseudoaneurysm, and free wall rupture; each complication is associated with a significant risk of morbidity, mortality, and hospital resource utilization. The care for patients with mechanical complications is complex and requires a multidisciplinary collaboration for prompt recognition, diagnosis, hemodynamic stabilization, and decision support to assist patients and families in the selection of definitive therapies or palliation. However, because of the relatively small number of high-quality studies that exist to guide clinical practice, there is significant variability in care that mainly depends on local expertise and available resources.

Original languageEnglish (US)
Pages (from-to)E16-E35
JournalCirculation
DOIs
StateAccepted/In press - 2021

Keywords

  • AHA Scientific Statements
  • ST-segment-elevation myocardial infarction
  • aging
  • heart rupture
  • heart septal defects
  • mitral valve insufficiency
  • percutaneous coronary intervention
  • reperfusion
  • ventricular

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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