[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-533639-105":59,"doc-detail-533639-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","mechanical-complications-of-myocardial-infarction-educational-objective","Mechanical complications of myocardial infarction - Educational objective","","Mechanical complications of acute myocardial infarction often appear within the first days because the healing myocardium is most vulnerable to rupture. The document emphasizes papillary muscle rupture causing acute mitral regurgitation, typically developing acutely or within 3–5 days after infarction. It contrasts expected findings for papillary muscle rupture versus interventricular septal rupture, left ventricular free wall rupture, and other causes, including the typical echocardiographic and hemodynamic presentations such as pulmonary edema, new systolic murmur, and cardiogenic shock.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mechanical-complications-of-myocardial-infarction-educational-objective/533639/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mechanical-complications-of-myocardial-infarction-educational-objective/533639.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"When do mechanical complications after myocardial infarction typically occur?","Question",{"text":112,"@type":113},"They most often develop within the first few days, during the period when healing myocardium is prone to rupture. For several entities, the window extends to about 3–5 days and can be longer for some ruptures.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What is the most likely cause of sudden dyspnea, pulmonary edema, a new soft systolic murmur, and hypotension after an MI?",{"text":117,"@type":113},"Acute mitral regurgitation due to papillary muscle rupture. The typical timing is acutely or within 3–5 days after the infarction.",{"name":119,"@type":110,"acceptedAnswer":120},"How does interventricular septum rupture usually present compared with papillary muscle rupture?",{"text":121,"@type":113},"Septal rupture often produces a holosystolic murmur best at the left sternal border with a thrill and pulmonary edema that develops less rapidly. Papillary muscle rupture more classically causes an early soft systolic murmur at the cardiac apex.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},533639,1791786972,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Settings  \nA 65-year-old woman comes to the emergency department due to 24 hours of chest pain.The patient describes substernal pain accompanied bydiaphoresis that began yesterday,persisted all night,and started to clear only this morning.Her son insisted that she go to the emergencydepartment even though the pain is now \"almost gone.\"The patient has a history of hypertension and diet-controlled diabetes mellitus.She ispoorly compliant with her antihypertensive regimen.In the emergency department,ECG shows sinus rhythm with ST-segment elevation in leadsII,II,and aVF.Cardiac catheterization shows total occlusion of the proximal right coronary artery;intervention is deferred due to the patient'sdelayed presentation.On the third day of hospitalization,she suddenly develops severe shortness of breath and hypotension.On examination,the patient is diaphoretic and tachypneic.Bibasilar crackles are present.A soft,early systolic murmur is heard at the apex.Which of the followingis the most likely cause of this patient's current symptoms?  \n○ A.Acute aortic dissection○ B.Coronary artery dissection○ C.Left ventricular free wall rupture○ D.Papillary muscle rupture○ E.Pericardial tamponadeO F.Pulmonary embolism  \nSubmit  \n三×  \n\n| Mechanical complications of acute myocardial infarction   |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| Complication   | Time course   | Involved coronary  \u003Cbr>artery   | Clinical findings   | Echocardiography  \u003Cbr>findings   |\n| Papillary  \u003Cbr>muscle  \u003Cbr>rupture/  \u003Cbr>dysfunction   | Acutely or 3-5 days after MI   | RCA   | ·Severe pulmonary edema,  \u003Cbr>respiratory distress  \u003Cbr>·New soft systolic murmur  \u003Cbr>·Hypotension/cardiogenic  \u003Cbr>shock   | Severe MR   |\n| Interventricular  \u003Cbr>septum  \u003Cbr>rupture   | Acutely or 3-5 days after MI   | LAD (apical septal)or  \u003Cbr>RCA (basal septal)   | ·Chest pain  \u003Cbr>● New harsh holosystolic  \u003Cbr>murmur with thrill  \u003Cbr>·Hypotension/cardiogenic  \u003Cbr>shock   | Left-to-right  \u003Cbr>ventricular shunt*   |\n| Free wall  \u003Cbr>rupture   | Acutely or within 5 days;can occur  \u003Cbr>up to 2 weeks after MI**   | LAD   | ·Chest pain  \u003Cbr>·Distant heart sounds  \u003Cbr>·Shock,rapid progression  \u003Cbr>to cardiac arrest   | Pericardial effusion  \u003Cbr>with tamponade   |\n| Left ventricular  \u003Cbr>aneurysm   | Up to several months   | LAD   | ·Heart failure  \u003Cbr>·Angina  \u003Cbr>·Ventricular arrhythmias   | Thin&dyskinetic  \u003Cbr>myocardial wall   |\n| *Right heart catheterization shows step-up in O2 concentration from right atrium to right ventricle.  \u003Cbr>**50%of cases occur within 5 days of MI.  \u003Cbr>LAD=left anterior descending;MI=myocardial infarction;MR=mitral regurgitation;RCA=right coronary artery.   |  |  |  |  |\n\nHemodynamic compromise within the first few days following myocardial infarction(MI)should raise suspicion for a mechanical complicationof MI,as the healing myocardium is most prone to rupture during this time.The 3 major mechanical complications of MI include:  \n·left ventricular (LV)free wall rupture  \n·interventricular septum rupture  \n# ·interventricular septum rupture\n\n·mitral regurgitation (MR)due to papillary muscle rupture  \nDelayed (or absent)reperfusion increases the risk of these complications.  \nThis patient's presentation is most consistent with acute MR due to papillary muscle rupture,which typically occurs acutely or within 3-5 days ofMI.The posteromedial papillary muscle is most commonly affected due to single-vessel blood supply from the right coronary artery (incontrast,the anterolateral papillary muscle receives dual blood supply from the left circumflex and left anterior descending [LAD]arteries).  \nAffected patients commonly have a dramatic presentation,with sudden-onset dyspnea and pulmonary edema,an early systolic murmur at thecardiac apex(a holosystolic murmur is more typical of chronic MR),and possible cardiogenic shock.In up to 50%of cases,patients may have noaudible murmur(silent MR)due to the severity of the acute MR causing rapid equalization of left atrial and L","cbCaianL0U4tznii","https://ap.wps.com/l/cbCaianL0U4tznii","pdf",40479976,139,"English","# Mechanical complications of acute myocardial infarction\n## Papillary muscle rupture/ dysfunction\n## Interventricular septum rupture\n## Free wall rupture\n## Left ventricular aneurysm\n## Clinical rationale and differential diagnosis","[{\"question\":\"When do mechanical complications after myocardial infarction typically occur?\",\"answer\":\"They most often develop within the first few days, during the period when healing myocardium is prone to rupture. For several entities, the window extends to about 3–5 days and can be longer for some ruptures.\"},{\"question\":\"What is the most likely cause of sudden dyspnea, pulmonary edema, a new soft systolic murmur, and hypotension after an MI?\",\"answer\":\"Acute mitral regurgitation due to papillary muscle rupture. The typical timing is acutely or within 3–5 days after the infarction.\"},{\"question\":\"How does interventricular septum rupture usually present compared with papillary muscle rupture?\",\"answer\":\"Septal rupture often produces a holosystolic murmur best at the left sternal border with a thrill and pulmonary edema that develops less rapidly. Papillary muscle rupture more classically causes an early soft systolic murmur at the cardiac apex.\"}]","Mechanical complications of myocardial infarction - Educational objective | PDF",1791593504,350]