Cardiologia Clínica e Experimental
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"Swiss-Cheese" Ventricles in Acute Myocardial Infarction

Ramachandran Muthiah

Myocardial rupture is a catastrophic complication of acute myocardial infarction with an incidence of 10% of cases and most often occurs near the edge of the necrotic myocardium. It involves the free walls of ventricles, interventricular septum and the linear tears may resemble the Emmantel cheese in Switzerland and so described as “Swiss-Cheese” ventricles. Two–dimensional transthoracic echocardiography is the modality of choice at bedside to detect the defects. 50 % of rupture occurs within 3 days and 89% within 2 weeks of infarction and carries high in-hospital mortality. When primary PCI was performed, its incidence was decreased to 2-3% and the prognosis was grave in patients presented with cardiogenic shock. Surgery is superior to conservative management and when multiple defects are present, endocardial patch repair to restore the geometry of myocardium has been performed, ideally between 2-3 weeks after the rupture when the edges of the defect got fibrosed.