Left ventricular dysfunction following acute myocardial infarction. A clinicopathologic and hemodynamic profile of shock and failure

Karl Weber, Robert A. Ratshin, Joseph S. Janicki, Charles E. Rackley, Richard O. Russell

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

The clinical, historic, hemodynamic and pathologic observations on 41 patients with shock following acute myocardial infarction are presented and compared with those on 38 patients in failure without shock. Patients with shock were divided into groups according to the presence or absence of ventricular or papillary muscle rupture (6 patients). Although over-all mortality for the 35 patients in shock without rupture was 77 per cent, subsets with varying survival rates could be identified based on the assessment of the hemodynamic state and heart size on roentgenograms. In survivors, mean cardiac index was 2. 1 liters/min/m2, stroke work index 25 g-m/m2 and left ventricular filling pressure 14 mm Hg; in nonsurvivors, these mean values were 1.3, 10 and 24, respectively. Heart size on roentgenograms and postmortem was increased in all those who died in both shock and failure groups whereas only 50 per cent of those who survived had cardiac enlargement. The patients who died in shock were found at autopsy to have major losses of left ventricular myocardium (approximately 40 per cent) from previous infarctions and the acute injury. Prognostic indices which accurately identify these high risk patients for aggressive therapy were derived based on discriminant analysis of the hemodynamic data. The various forms of circulatory and surgical support currently available and their potential usefulness are discussed. Finally, the comparison of ventricular performance for shock and failure groups describes a spectrum of impairment existing postinfarction which has been characterized by a three-dimensional analysis.

Original languageEnglish (US)
Pages (from-to)697-705
Number of pages9
JournalThe American journal of medicine
Volume54
Issue number6
DOIs
StatePublished - Jan 1 1973

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Left Ventricular Dysfunction
Shock
Hemodynamics
Myocardial Infarction
Rupture
Papillary Muscles
Discriminant Analysis
Ventricular Pressure
Infarction
Survivors
Autopsy
Myocardium
Survival Rate
Stroke
Mortality
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Left ventricular dysfunction following acute myocardial infarction. A clinicopathologic and hemodynamic profile of shock and failure. / Weber, Karl; Ratshin, Robert A.; Janicki, Joseph S.; Rackley, Charles E.; Russell, Richard O.

In: The American journal of medicine, Vol. 54, No. 6, 01.01.1973, p. 697-705.

Research output: Contribution to journalArticle

Weber, Karl ; Ratshin, Robert A. ; Janicki, Joseph S. ; Rackley, Charles E. ; Russell, Richard O. / Left ventricular dysfunction following acute myocardial infarction. A clinicopathologic and hemodynamic profile of shock and failure. In: The American journal of medicine. 1973 ; Vol. 54, No. 6. pp. 697-705.
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