Renin-angiotensin system and cardiac rupture after myocardial infarction.

Of all the mechanical complications after acute myocardial infarction (MI), cardiac rupture remains the most devastating, dramatic, and deadly. Continued improvements in the care of patients with acute MI have decreased the incidence of cardiac rupture over the past decade to under 3% in patients receiving reperfusion therapy,1 although autopsy evaluation of patients who died suddenly with acute MI has suggested a higher incidence.2,3 Without extremely prompt surgical intervention, patients with cardiac rupture rarely survive.