FN: MI complications

Question 1

MI complications

Answer 1

Death Passing PRAED st.

Question 2

D

Answer 2

Death

Question 3

P

Answer 3

Pericarditis

Question 4

P

Answer 4

Pump failure

Question 5

R

Answer 5

Rupture: myomalacia cordis

Question 6

A

Answer 6

Arrythmias, Aneurysm

Question 7

E

Answer 7

Embolism

Question 8

D

Answer 8

Dressler’s syndrome: pleuro=pericarditis

Question 9

DEath from

Answer 9

VF
LVF
CVA

Question 10

Pericarditis presentation

Answer 10

1. Occurs early
2. Mild fever
3. Central chest pain/change in pain
4. Relieved by sitting forward
5. Pericardialfriction rub

Question 11

Pericarditis ECG shows

Answer 11

Saddle-shaped ST elevation

±PR depression

Question 12

Pericarditis treatment

Answer 12

NSAIDS: ibuprofen

Echo to exclude effusion

Question 13

Rupture

Answer 13

Myomalacia cordis

1. Cardiac tamponade
2. Papillary muscle/chordae –> MR: PSM, pulmonary oedema
3. Septum: PSM, raised JVP, HEart failure

Question 14

Cardiac tamponade

Answer 14

Left ventricular free wall rupture

1. Becks triad
2. Pulsus paradoxus

Question 15

Becks triad

Answer 15

Dropped BP
Raised JVP
Muffled heart sounds

Question 16

Arrythmias type
Tachy types
Brady types

Answer 16

Tachy:

1. SVT
2. Ventricular

Brady:

1. Sinus bradycardia
2. AV block
3. Ventricular bradycardia

Question 17

SVT

Answer 17

Sinus tachycardia - give Oxygen + analgesia

AF or flutter - comprimised - DC cardioversion or rate control - digoxin ± beta-blocker

Question 18

Ventricular

Answer 18

1. Frequent PVC common after acute MI: no Rx
2. Sustained VT
   a. Comprimised - DC cardioversion
   b. Else - amiodarone or lignocaine
   c. May need pacing
3. VF
   a. Early (48 hrs): extensive heart damage
   c. Rx: DC shock

Question 19

Bradycardia

Answer 19

Sinus bradycardia

1. esp. in inferior MI
2. Rx: atropine 0.6-1.2mg

AV block - pace mobitz II
Ventricular bradycardia - suggests SA and AV node damage

Question 20

Aneurysm: ventricular presentation

Answer 20

4-6 weeks
LVF
Angina
Recurrent VT
Systemic emboli

Question 21

Aneurysm ECG

Answer 21

persistent ST elevation

Question 22

Aneurym: ventricular Rx

Answer 22

Anticoagulate

Consider Excision

Question 23

Embolism description

Answer 23

Arise from LV mural thrombus

consider warfarin for 3mo after large anterior MI

Question 24

Dresslers syndrome

Answer 24

pleuro pericarditis - due to auto-antibodies vs. myocyte sarcolemma

Question 25

Dresslers syndrome presentation

Answer 25

2-6weeks
Recurrent pericarditis
Pleural effusions
Fever
Anaemia
raised ESR

Question 26

Treatment

Answer 26

NSAIDS

Steroids if severe