Mechanical Complications of Myocardial Infarction

Am J Med. 2022 Dec;135(12):1401-1409. doi: 10.1016/j.amjmed.2022.08.017. Epub 2022 Sep 6.


Mechanical complications of myocardial infarction include rupture of a papillary muscle, ventricular septum, and free wall. Since the advent of acute coronary reperfusion, there has been a significant reduction in the incidence of these complications. One must have a high index of suspicion for a mechanical complication in any patient who develops cardiogenic shock in the days following a myocardial infarction. The most important diagnostic investigation in evaluation of these complications is echocardiography. Although there is a role for mechanical circulatory support, urgent surgical repair is required in most cases. We will review the predictors, clinical features, diagnostic, and management strategies in patients with these complications.

Keywords: Cardiogenic shock; Free wall rupture; Myocardial infarction; Papillary muscle rupture; Ventricular septal rupture.

Publication types

  • Review

MeSH terms

  • Echocardiography
  • Humans
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / therapy
  • Myocardial Reperfusion
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy
  • Ventricular Septum*