Ventricular Free-Wall Rupture, Ventricular Pseudoaneurysm, and Papillary Muscle Rupture Complicating Acute Myocardial Infarction

This multisociety European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) consensus statement addresses three mechanical complications of acute myocardial infarction: ventricular free-wall rupture, pseudoaneurysm, and papillary muscle rupture. Now occurring in under 1 percent of cases owing to prompt revascularization, these still carry significant hemodynamic risk. Once treatable only by surgery, transcatheter options now offer alternatives for high-risk patients. The authors emphasize the prognostic threat of recurrence, the unresolved role of concomitant revascularization, mechanical circulatory support, and multidisciplinary heart team management incorporating palliative care.