Cardiac Rupture
A rare, life-threatening tear of the heart muscle
Quick Facts
- Type: Cardiac emergency
- Most common cause: Complication of a heart attack
- Urgency: Medical emergency — call emergency services
- Timing: Often within days of a heart attack
Overview
Cardiac rupture is a rare but extremely serious condition in which part of the heart tears. It most often happens as a complication of a heart attack, when an area of heart muscle has been damaged and weakened by a lack of blood supply. The tear can involve the outer wall of the heart, the wall between the two pumping chambers, or the structures that support a heart valve.
Cardiac rupture is a medical emergency. When the heart wall tears, blood can leak out and rapidly press on the heart or cause the circulation to fail, which is often fatal within minutes to hours without immediate treatment. Although uncommon, it is one of the reasons heart attacks must always be treated promptly. This page explains what cardiac rupture is and why urgent care is essential, but it is not something a person can manage at home.
Symptoms
Cardiac rupture usually causes a sudden, severe deterioration, often in someone who has recently had a heart attack. Symptoms can come on very quickly.
- Sudden, severe chest pain
- Sudden, extreme shortness of breath
- Fainting or collapse
- A rapid drop in blood pressure causing weakness, confusion, and pale, clammy skin (shock)
- A racing or irregular heartbeat
- Sudden cardiac arrest
These are emergency symptoms. Anyone with sudden severe chest pain, collapse, or extreme breathlessness needs emergency services called immediately. This is especially urgent in someone recovering from a recent heart attack.
Causes
Cardiac rupture occurs when heart tissue is weakened enough to tear under the pressure of the pumping heart.
- Heart attack (myocardial infarction): The most common cause; damaged, dying heart muscle can become weak and tear, usually within the first several days.
- Chest trauma: A severe blow to the chest, such as in a car crash, can tear the heart.
- Infection or inflammation: Rarely, infections that damage heart tissue.
- Other rare causes: Tumors or certain medical procedures involving the heart.
Risk Factors
- A recent, large heart attack, especially a first heart attack
- Delay in treating a heart attack
- Older age and female sex, which are associated with higher risk after heart attack
- High blood pressure
- Severe chest trauma
Diagnosis
Because cardiac rupture is an emergency, it is diagnosed rapidly in a hospital setting, often while the person is being resuscitated.
- Echocardiogram: An ultrasound of the heart that can quickly show a tear, fluid around the heart, or a hole in the heart wall.
- Clinical assessment: Recognizing sudden collapse, shock, or signs of fluid compressing the heart in an at-risk patient.
- Other tests: ECG, blood tests, and imaging used in the overall evaluation of a heart attack and its complications.
Treatment
Cardiac rupture requires immediate emergency hospital treatment, and outcomes depend heavily on how quickly it is recognized and managed.
- Emergency stabilization: Urgent measures to support blood pressure and circulation, sometimes including draining fluid compressing the heart.
- Emergency surgery: Open-heart surgery to repair the tear is often the only chance of survival for many types of rupture.
- Intensive care: Close monitoring and support in an intensive care unit.
- Treatment of the underlying heart attack: Restoring blood flow and managing the heart condition.
Even with the best care, cardiac rupture is frequently fatal, which is why prevention through prompt heart attack treatment is so important.
Prevention
The most effective prevention is rapid, complete treatment of a heart attack and good cardiovascular care.
- Call emergency services immediately for possible heart attack symptoms, since fast treatment limits heart muscle damage
- Follow medical advice and take all medications after a heart attack
- Control blood pressure, cholesterol, and diabetes
- Avoid smoking and maintain a heart-healthy lifestyle
- Attend cardiac rehabilitation and follow-up after a heart attack
When to See a Doctor
Cardiac rupture is a medical emergency. Call emergency services immediately for sudden severe chest pain, sudden extreme shortness of breath, fainting or collapse, or signs of shock such as pale, clammy skin and confusion, especially in someone who recently had a heart attack. Do not wait or attempt to drive yourself. More broadly, treat any possible heart attack symptoms, such as chest pressure, pain spreading to the arm or jaw, or breathlessness, as an emergency, since prompt treatment is the best way to prevent this complication.
Frequently Asked Questions
What is cardiac rupture?
It is a rare, life-threatening tearing of the heart muscle or its structures, most often happening as a complication of a heart attack when damaged heart tissue weakens and tears. It is a medical emergency requiring immediate treatment.
What are the warning signs?
Signs include sudden severe chest pain, extreme shortness of breath, fainting or collapse, and signs of shock such as pale, clammy skin and confusion, often in someone recovering from a recent heart attack. Call emergency services immediately if these occur.
When does cardiac rupture usually happen?
When it follows a heart attack, it most often occurs within the first several days, while the damaged heart muscle is weakest. This is one reason people are monitored closely after a heart attack.
Can cardiac rupture be treated?
It requires immediate emergency hospital care, often including emergency open-heart surgery to repair the tear, along with measures to support the circulation. Even with prompt treatment it is frequently fatal, which is why fast heart attack care to prevent it is so important.
How can it be prevented?
The best prevention is rapid, complete treatment of a heart attack, so calling emergency services at the first signs of a heart attack is essential. Controlling blood pressure, cholesterol, and diabetes, not smoking, and following all post-heart-attack care also help.
References
- American Heart Association. Heart Attack.
- MedlinePlus, U.S. National Library of Medicine.
- National Heart, Lung, and Blood Institute (NHLBI).
- Mayo Clinic. Heart attack — Symptoms and causes.