Complications of MI Flashcards
acronym for MI complications
Death Passing PRAED st.
- Death
- Pump Failure
- Pericarditis
- Rupture
- Arrthymias/Aneurysm
- Embolism
- Dressler’s syndrome
cause of death from MI
- Ventricular fibrillation
- Left ventricular failure
- stroke (Cerebrovascular accident)
presentation of pericarditis following MI
- Occurs early
- Mild fever
- Central chest pain / change in pain
- Relieved by sitting forward
- Pericardial friction rub
ECG changes of pericarditis following MI
- Saddle-shaped ST elevation
- ± PR depression
Treatment of pericarditis following MI
- NSAIDs (ibuprofen)
- Echo to exclude effusion
types of rupture following MI
- Cardiac tamponade
- Papillary muscle/chordae → Mitral Regurgitation
- Septum
features of cardiac tamponade
- Left ventricular free wall rupture
- Beck’s triad (↓BP, ↑JVP, muffled heart sounds)
- Pulsus paradoxus
features of muscle/chordae rupture
- mitral regurgitation
- pansystolic murmur
- pulmonary oedema
features of septum rupture
- pansystolic murmur
- ↑JVP
- Heart failure
types of tachycardias following MI
- SVT
- ventricular
features of SVT following MI
- Sinus tachycardia – give O2 + analgesia
- AF or flutter:
> Compromised → DC cardioversion
> Otherwise → rate control: digoxin ± β-Blockers
features of ventricular tachycardia following MI
- Frequent Premature Ventricular Contraction common after acute MI: no Rx
- Sustained VT
- Compromised → DC cardioversion
- Else → amiodarone or lignocaine
- May need pacing - Ventricular Fibrillation
- Early (<48hrs): reperfusion (good prog)
- Late (>48hrs): extensive heart damage
- Rx: DC shock
types of bradycardia following MI
- Sinus bradycardia
- esp. in inferior MI.
- Rx: atropine 0.6 – 1.2mg - AV block
- Pace Mobitz II - Ventricular bradycardia
- Suggests SA and AV node damage
Presentation of ventricular aneurysm following MI
- 4-6wk
- LVF
- Angina
- Recurrent VT
- Systemic emboli
ECG changes consistent with ventricular aneurysm
persistent ST elevation
treatment for ventricular aneurysm following MI
- Anticoagulate
- consider excision
features of embolism following MI
- Arise from LV mural thrombus
- Consider warfarin for 3mo after large anterior MI
causes of Dressler’s syndrome
- Pleuropericarditis
- due to auto-antibodies vs myocyte sarcolemma
presentation of Dressler’s syndrome
- 2-6wks
- Recurrent pericarditis
- Pleural effusions
- Fever
- Anaemia
- ↑ESR
treatment of Dressler’s syndrome
- NSAIDs
- steroids if severe
