Rupture of heart arteries is caused by these reasons!

The incidence of heart artery rupture is rising sharply, and millions of people lose their ability to work due to this disease every year. According to experts, there are many causes of this disease, the most common ones are gender and age, hypertension, myocardial infarction, etc.

1. Causes

(1) Gender and age. Heart rupture often occurs in older women, and the incidence rate in women is four times that in men. It mostly occurs in elderly patients over 60 years old. Foreign literature reports that most of them occur in elderly patients over 70 to 80 years old, which may be related to the thinner and increased fragility of the ventricular wall myocardium in the elderly.

(2) Hypertension. In the acute stage of myocardial infarction, if blood pressure continues to rise to above 20/12kPa (150/90mmHg), it is prone to rupture. The incidence of heart rupture is three times that of people with normal blood pressure.

(3) Rupture often occurs in the first acute transmural myocardial infarction. The patient had no history of significant angina pectoris or heart failure. Due to sudden coronary artery thrombosis or severe coronary artery spasm without sufficient collateral circulation, penetrating transmural myocardial infarction often occurs. Patients with this type of first myocardial infarction usually have no myocardial ischemia and no old scar tissue as a scaffold, and the contractile function of the myocardium in the non-infarcted area is better. When the surrounding myocardium contracts, it cuts the myocardium in the necrotic area, making it prone to rupture.

(4) Heart rupture rarely occurs in myocardium with good collateral circulation. Because collateral circulation protects the subepicardial myocardium, even if acute blockage of the coronary artery causes acute myocardial infarction, it may be limited to the subendocardial myocardium, or abnormal Q waves may appear, and the R wave may only become smaller but not disappear. By protecting the myocardium under the epicardium, the heart shape is prevented from expanding outward, thus preventing heart rupture.

2. Symptoms

1. Severe chest pain

Before aortic dissection ruptures, the patient will experience severe chest pain in the chest and back. The pain will radiate to the neck, jaw, shoulder blade area, left arm or upper abdomen, and last for tens of minutes to hours. Taking nitroglycerin sublingually cannot relieve the pain, and the patient will appear in shock: pale face, sweating, cold and clammy skin, and a sense of impending death. The most important thing is that the patient's blood pressure does not drop, but remains stable or slightly rises.

2. Compression symptoms

Aortic dissection rupture is the result of the false lumen continuing to expand, which makes the body's blood vessels unable to withstand it, thus producing a series of compression characteristics before rupture. When the dissection compresses the true lumen, it causes acute occlusion of the arteries, which will cause ischemia of tissues and organs, insufficient blood supply to the heart and brain, causing myocardial infarction, intestinal infarction and cerebral stroke, and affecting the blood supply to the kidneys, causing hemiplegia or paraplegia of the lower limbs.

3. Palpation characteristics

When aortic dissection ruptures, the patient will experience weakened or even absent pulsations in the brachial and femoral arteries on both sides. The pulsations may also be strong or weak at times, and a pulsating mass can be palpated in the suprasternal fossa and abdomen.