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Myocardial Rupture and Hemopericardium Associated with Anticoagulant Therapy — A Post-Mortem Study

List of authors.
  • Barzillia R. Waldron, M.D.†,
  • Robert H. Fennell, Jr., M.D.‡,
  • Benjamin Castleman, M.D.§,
  • and Edward F. Bland, M.D.

A DISTURBING feature of the occasional case of fatal hemopericardium following anticoagulant therapy for myocardial infarction is the absence of an obvious explanation for the hemorrhage. Heretofore, a pericardium distended with blood in a patient with myocardial infarction has usually been the result of a ruptured myocardium. However, Hammarsten1 reported in 1949 a case with massive hemopericardium that followed Dicumarol treatment in which low levels of prothrombin activity (10 per cent or less) were obtained; 800 cc. of blood was found in the pericardium and yet no rupture of the heart or a vessel could be demonstrated. Nichol,2 Goldstein and . . .

Funding and Disclosures

* From the departments of Medicine and Pathology, Harvard Medical School, and the Medical Service and Department of Pathology, Massachusetts General Hospital.

Author Affiliations

BOSTON

†Formerly, graduate student in medicine (cardiology), Harvard Medical School and Massachusetts General Hospital.

‡Instructor in pathology, Harvard Medical School; assistant pathologist, Massachusetts General Hospital.

§Clinical professor of pathology, Harvard Medical School; chief, Department of Pathology, Massachusetts General Hospital.

¶Associate clinical professor of medicine, Harvard Medical School; physician, Massachusetts General Hospital.

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