A heart rupture or tear is a rare complication of a heart attack. Most cases have a high risk of being fatal. However, surgery can help some people survive and go on to live many years. If surgery isn’t possible, a minimally invasive option can work for some. Medicines and medical devices can provide a short-term treatment until surgery.
Heart rupture is a heart attack complication in which your heart’s walls, muscles or valves come apart. It can occur during a heart attack or the first month after a heart attack. Most of the time, it happens in the first five to 10 days after a heart attack.
A heart rupture can occur if a heart attack causes a lot of damage to your heart. Heart rupture is more likely to affect people who:
One study found that about 30% of people who had a heart attack and sudden death also had a myocardial rupture.
Between 10% and 20% of people who have a heart attack have a rupture in their left ventricular free wall (outer wall of the heart). The left ventricle is the lower chamber of your heart that pushes blood out to your aorta, which takes it to your whole body.
Less than 0.4% of people who have a heart attack have a rupture in the wall between their ventricles, or lower heart chambers.
It depends on where the rupture occurs.
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Heart rupture symptoms may include:
When a heart attack injures your heart muscle, it weakens it. In rare cases, the force of your pumping heart can cause a rupture or tear in a weak area of your heart.
Your healthcare provider will listen to your heart and order tests. They may hear a murmur through their stethoscope.
Your healthcare provider will most likely do a transthoracic echocardiogram (TTE). If they need more information, they can do other tests, such as:
Medicines can help temporarily, but surgery is the best treatment for a myocardial rupture. Depending on your condition, your provider may need to do surgery right away or help you with temporary mechanical devices until surgery day.
Since the risk of death from surgery to fix a ruptured ventricle wall is lower when waiting seven days, providers prefer to wait if they can. This allows the muscle to heal enough that stitches will hold and allow for a good repair. However, if you’re not in a stable condition, it’s risky to wait to do surgery because the tear can get worse.
Your provider and your family may need to discuss the pros and cons of the various treatment options and decide what’s best for your situation.
Heart rupture treatments include:
Surgery, the preferred treatment for myocardial rupture, is risky. However, you can live many years after a successful surgery.
If you’re having a heart attack, get help quickly. This will improve your chances of surviving a heart attack and avoiding complications like heart rupture. Never wait to be evaluated if you think you may be having a heart attack as time is of the essence.
Your prognosis depends on which part of your heart has a rupture.
A heart rupture is serious. It’s fatal for half of the people who have it. Many of these deaths happen when people have sudden death outside of a hospital. Without surgery, your prognosis isn’t good.
After surgery, many people have complications such as bleeding or low cardiac output. However, people were doing well five years after surgery when researchers followed up with them.
Yes, you can survive a ruptured heart if you get a quick diagnosis and treatment. You can have a better survival rate after having open-heart surgery.
Go to all scheduled follow-up appointments with your healthcare provider. Be sure to take any medicines they prescribed for you. Get help right away if you think you’re having another heart attack.
A note from Cleveland Clinic
If your loved one has a heart rupture, you may need to consider the risks and benefits of various treatments. Don’t be afraid to ask questions so you can get a better understanding of treatments and what they may or may not be able to do. If your loved one isn’t able to participate in these conversations, think about what they would want.
Last reviewed by a Cleveland Clinic medical professional on 07/18/2022.
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