| Mechanical complications | Echocardiogram | Cardiac Magnetic Resonance | Computed Tomography | Others |
| Papillary Muscle Rupture | The Gold Standard TEE has the highest sensitivity 92% - 100% TTE sensitivity 65% - 85% Free moving echo densities that prolapse into the LA Mitral regurgitation Normal or mildly reduced LVEF | Increased mitral valve motion Abnormal movement of the LV related to the infarction Brings valuable information for the surgical procedure | Only used when echocardiogram and magnetic cardiac resonance are not available | Chest X-ray Pulmonary edema Angiography Helps to determine the extension of the infarction |
| Left Ventricular Free Wall Rupture | Sensitivity and specificity over 90% Demonstrate cardiac tamponade, hemopericardium, reduction of the myocardial wall thickness | Ruled out due to the severity of the complication | Helps to confirm the diagnosis Provides an entire visualization of the heart Helps to differentiate between pericardium, myocardium and fat Shows the contained LVFWR, pericardial effusion, cardiac tamponade, site of the infarction Contrast-enhanced CMR Useful for planning a surgical approach | |
| Ventricular Septal Rupture | Can identify the severity and size of the rupture Demonstrates the presence of a shunt, chamber enlargement, biventricular disfunction and pulmonary hypertension | Shows left to right shunt, thinning of the septum Provides detailed information about tissue integrity, site, size and location of the infarcted area and location of the lesion | Shows lesion in the interventricular septum, regional akinesia, reduction in the myocardial thickening | Angiography Demonstrates the interventricular shunt as the contrast goes through it |
| Left Ventricular Aneurysm | It is the first tool to make the diagnosis Doppler color shows abnormal flow within the Aneurysm and oscillatory movement (fro-motion) | Allows better differentiation between fat, thrombus, myocardium and pericardium It is preferable for evaluating biventricular function and morphologic structures, such as the wide neck and its transition to the thin wall of the aneurysm. | Focal thinning of LV wall with aneurysmal dilation showing the wide neck, calcification and fatty replacement of the infarcted myocardium | |
| The ratio between the maximum and maximum inner diameters (0.9 - 1.0). Possible calcifications or fatty replacement of the myocardium. Adherent thrombus at the aneurysm site. Dyskinesia of the infarcted myocardium. | Contrast CT shows an anomalous opacified cavity posterolateral to the dilated LV that connects with the LV lumen through a wide neck | |||
| Left Ventricular Pseudoaneurysm | Low accuracy for the diagnosis Turbulent flow within the LVP is observed with color Doppler. Spectral Doppler shows bidirectional intraventricular flow. | Sensitivity 100% Specificity 83% Demonstrates akinetic wall, outpouching of the left ventricle, hemopericardium, tamponade, destruction of the myocardium, delayed enhancement of the pericardium overlaying it Allows better differentiation between tissues | Anatomic assessment of the LV Contrast-enhanced CT Hyperdense cavity with distal dilatation greater than the proximal neck | Angiography Helps to distinguish between false aneurysms Brings information for the surgical procedure Allows to assess the severity and location of the coronary lesions |