Table 4

Management of acute and subacute free wall rupture

1.  Acute phase (sequential course according to response)
Oxygenation/ventilation
Colloid infusion
Dobutamine
Pericardiocentesis (start with 10–50 ml)
Cardiac massage
Surgical treatment
2.  Maintenance phase
Withdrawal of dobutamine (progessive)
Blood pressure control with β blockers (systolic
 100–120 mm Hg)
Prolonged rest (5–10 days)
Avoidance of physical exercise
Echocardiography (every 2–3 days)