{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:03:56Z","timestamp":1789718636075,"version":"4.0.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Cardiac rupture (CR) remains among the most lethal mechanical complications of acute myocardial infarction (AMI), with in-hospital mortality exceeding 50%. Although primary percutaneous coronary intervention has reduced CR incidence to 1%\u20132%, mortality has not declined proportionally because the abrupt onset of rupture limits the opportunity for intervention. The early post-infarction period\u2014particularly the first 72\u2005h for free wall rupture and extending through day 7 for ventricular septal and papillary muscle rupture\u2014represents the critical window for detection. This mini review synthesizes clinical warning signs, point-of-care imaging findings, and circulating biomarker trajectories that may herald impending CR, organized by temporal window and rupture subtype. We evaluate emerging biomarkers reflecting inflammatory, extracellular-matrix-degradation, and myocardial-stress pathways, as well as artificial intelligence\u2013assisted prediction tools. Building upon the prediction model synthesis by Mao et al. within this Research Topic, we propose a four-step risk stratification algorithm integrating baseline clinical predictors, dynamic three-track surveillance (clinical, imaging, and biomarker), red-flag\u2013triggered risk re-classification, and subtype-specific diagnostic pathways. This framework is designed to bridge the translational gap between statistical risk estimation and actionable bedside recognition during the critical post-AMI period.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1813572","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:39:37Z","timestamp":1789717177000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early recognition and risk stratification of cardiac rupture after acute myocardial infarction: from clinical red flags to emerging biomarkers"],"prefix":"10.3389","volume":"13","author":[{"given":"Dan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Wuhan Asia General Hospital, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Wuhan Asia General Hospital, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wuhan Asia General Hospital, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingdan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wuhan Asia General Hospital, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Wuhan Asia General Hospital, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e000984","DOI":"10.1161\/JAHA.114.000984","article-title":"Trends in the clinical and pathological characteristics of cardiac rupture in patients with acute myocardial infarction over 35 years","volume":"3","author":"Honda","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1161\/CIR.0000000000000985","article-title":"Mechanical complications of acute myocardial infarction: a scientific statement from the American Heart 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