The diagnosis of free wall rupture is based on clinical and echocardiographic signs of pericardial tamponade . The echocardiogram typically shows pericardial effusion with evidence of chamber compression and may also be able to show the rupture itself. Emergency pericardiocentesis, when performed in a patient with acute cardiogenic shock and suspected free wall rupture, may confirm the diagnosis. In selected stable patients with subacute or covered rupture, cardiac magnetic resonance imaging may be used for differential diagnosis and preoperative planning.
Survival depends primarily upon the early recognition and provision of immediate therapy. In patients with suspected or diagnosed free wall rupture, emergency pericardiocentesis is indicated if fluid is visualized. If the patient stabilizes and bleeding stops, a conservative approach might be justified in selected cases; however, immediate cardiac surgery should be considered. Many patients do not survive the acute phase because of the development of immediate cardiogenic shock and pulseless electrical activity.
Papillary muscle rupture is a life-threatening complication that accounts for approximately 5 percent of deaths in these patients. It usually occurs two to seven days after the infarct. Prompt initiation of medical therapy and emergent surgery are necessary for a favorable outcome in patients with papillary muscle rupture. Initial medical therapy may include afterload reduction using nitrates, sodium nitroprusside, and diuretics in case of adequate blood pressure.
| Codes | Code Description |
|---|---|
| I23.0 | Hemopericardium as current complication following acute myocardial infarction |
| I23.1 | Atrial septal defect as current complication following acute myocardial infarction |
| I23.2 | Ventricular septal defect as current complication following acute myocardial infarction |
| I23.3 | Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction |
| I23.4 | Rupture of chordae tendineae as current complication following acute myocardial infarction |
| I23.5 | Rupture of papillary muscle as current complication following acute myocardial infarction |
| I23.6 | Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction |
| I23.7 | Postinfarction angina |
| I23.8 | Other current complications following acute myocardial infarction |
DocCharge: Be productive again! Practice analytics, mobile charge capture, HIPAA compliant messaging, and tools for billers.
DocCharge is a mobile physician productivity platform enabling physicians and clinicians to save time by efficiently capture patient billings, communicate with back office and maximize revenue by avoiding lost charges using real-time analytics on a mobile device. Designed by a physician for fellow physicians, residents/fellows, and mid-level providers, DocCharge maximizes one’s productivity. Practice Administrators and outsourced billing companies find the application very intuitive, thus improving practice efficiency and revenue.
DocCharge is transforming healthcare data into useful and actionable insights, thereby allowing partner subscribers to focus their resources on the core business of providing high quality patient care. For more information, visit www.DocCharge.com, email: contact@DocCharge.com.
