[Characteristics of cardiac insufficiency in myocardial infarction in the pre-rupture period].

Of 61 patients with myocardial infarction (MI), complicated by cardiorrhexis (CR), 72% had heart failure (HF) in the prerupture period. A small MI zone (35.8 +/- 2.6% of the left ventricular area) was marked in 29 cases of instantaneous CR. Coronary arteries (CA) outside the necrotic zone were slightly necrosed (up to 50%). These factors as well as the hyperdynamic syndrome in 75% of the patients with instantaneous CR on the 1st day and a high frequency of left ventricular aneurysms made it possible to associate HF development with myocardial dyskinesia. In prolonged MI there were several HF causes: a large MI zone (47.9 +/- 3.1%), noticeable CA stenosis outside the MI zone. However, early CR development (on the 4th day) and a high frequency of aneurysms (62%) could be indicative of a considerable contribution of dyskinesia to HF development. A variant of prolonged CR combined with dysfunction of the papillary muscles was attended by HF development in 100% of cases in an intermediate value of a MI zone and the CA state. However, dysfunction of the papillary muscles was one of the variants of myocardial dyskinesia. A conclusion was made of an important role played in HF genesis by myocardial dyskinesia binding HF and CR by the single mechanism.