When does an infarcted heart rupture? A pathological study of 148 out-of-hospital sudden death cases

We evaluated the histopathologic age of ruptured left ventricular acute myocardial infarction (AMI) in 148 out-of-hospital sudden death cases (93 men and 55 women; aged 42–94 years; mean age 68.9 years). Most of the ruptures (90%) occurred within 9 days of infarction, with 27% occurring within 24 h and 26 % occurring at 6–9 days, showing two peaks of incidence. In cases of super-acute myocardial infarction, the cardiac ruptures can not be solely explained by thinning and softening of the infarcted myocardium.