Table 3

Types of free wall rupture according to time of occurrence or form of presentation

Time of occurrence
 1. Early rupture (⩽ 48 hours)–delayed hospital admission
–persistent pain (> 4–6 hours)
–acute arterial hypertension
–frank and persistent ST segment elevation (except in lateral infarctions)
 2. Late rupture (> 48 hours)–recurrent chest pain
–persistent ST segment elevation
–“undue” physical exercise
–infarct extension
–infarct expansion
Form of presentation
 1. Acute rupture–acute tamponade with sudden electromechanical dissociation or severe hypotension
 2. Subacute rupture–moderate to severe pericardial effusion:
 (a) with tamponade and haemodynamic compromise  with modest or progressive hypotension
 (b) without tamponade