Ventricular free wall rupture (FWR) is a catastrophic complication after acute myocardial infarction (AMI). However, patients with FWR die of cardiac tamponade secondary to intrapericardial hemorrhage that can be treated if properly diagnosed. Unfortunately, FWR was still not diagnosed and classified quickly and accurately. The aim of this study was to present a new clinical classification for FWR. Seventy-eight patients with FWR after STEMI were enrolled in the study. We classified FWR, according to clinical situations after onset, into the cardiac arrest type, unstable type, and stable type. The cardiac arrest type was the most common type, accounting for about 83.3%. 90.8% of patients of this type were complicated with electromechanical dissociation at the time of FWR onset, and 100% of patients of this type died in the hospital. The unstable type was characterized by sudden clinical condition changes with moderate/massive pericardial effusion. In this study, 9.0% of patients were diagnosed as the unstable type. The average time from onset to death was 4.5 hours. This period was the “golden time” to rescue such patients. The stable types usually have stable hemodynamics, but may worsen, requiring rigorous detection of pericardial effusion and vital signs. In this study, 7.7% of patients were diagnosed as the stable type, and 83.5% of them survived in the hospital. The new clinical classification provides a basis for clinical diagnosis and treatment of FWR. The clinical application of the new classification is expected to improve the prognosis of FWR patients.

中文翻译：

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急性心肌梗死后室壁游离破裂的新临床分类

心室游离壁破裂（FWR）是急性心肌梗塞（AMI）后的灾难性并发症。但是，FWR患者死于心包填塞，继发于心包内出血，如果正确诊断，可以治疗。不幸的是，FWR仍未得到快速准确的诊断和分类。这项研究的目的是为FWR提供一种新的临床分类。研究纳入了STEMI后的78名FWR患者。根据发作后的临床情况，我们将FWR分为心脏骤停型，不稳定型和稳定型。心跳骤停是最常见的类型，约占83.3％。该类型患者中有90.8％的患者在FWR发作时并发了机电分离，并且100％的此类患者在医院死亡。不稳定型的特征是临床状况突然改变，伴有中度/大量心包积液。在本研究中，9.0％的患者被诊断为不稳定型。从发病到死亡的平均时间为4.5小时。这个时期是抢救此类患者的“黄金时间”。稳定型通常具有稳定的血液动力学，但可能恶化，需要严格检测心包积液和生命体征。在这项研究中，7.7％的患者被诊断为稳定型，其中83.5％的患者在医院幸存。新的临床分类为FWR的临床诊断和治疗提供了基础。新分类的临床应用有望改善FWR患者的预后。9.0％的患者被诊断为不稳定型。从发病到死亡的平均时间为4.5小时。这个时期是抢救此类患者的“黄金时间”。稳定型通常具有稳定的血液动力学，但可能恶化，需要严格检测心包积液和生命体征。在这项研究中，7.7％的患者被诊断为稳定型，其中83.5％的患者在医院幸存。新的临床分类为FWR的临床诊断和治疗提供了基础。新分类的临床应用有望改善FWR患者的预后。9.0％的患者被诊断为不稳定型。从发病到死亡的平均时间为4.5小时。这个时期是抢救此类患者的“黄金时间”。稳定型通常具有稳定的血液动力学，但可能恶化，需要严格检测心包积液和生命体征。在这项研究中，7.7％的患者被诊断为稳定型，其中83.5％的患者在医院幸存。新的临床分类为FWR的临床诊断和治疗提供了基础。新分类的临床应用有望改善FWR患者的预后。需要严格检测心包积液和生命体征。在这项研究中，7.7％的患者被诊断为稳定型，其中83.5％的患者在医院幸存。新的临床分类为FWR的临床诊断和治疗提供了基础。新分类的临床应用有望改善FWR患者的预后。需要严格检测心包积液和生命体征。在这项研究中，7.7％的患者被诊断为稳定型，其中83.5％的患者在医院幸存。新的临床分类为FWR的临床诊断和治疗提供了基础。新分类的临床应用有望改善FWR患者的预后。