MI Complications

Question 1

Cardiac Arrythmia

Answer 1

Important cause of death before reaching hospital and within first 24-hours post-MI

V tach and V fib = life threatening

Occurs within first few days after MI

Question 2

Postinfarction fibrous pericarditis

Answer 2

Friction rub

Occurs 1-3 days post MI

Question 3

Papillary Muscle Rupture

Answer 3

acute, severe mitral regurgitation (holosystolic murmur)

posteromedial papillary muscle more common (due to single arterial blood supply (usually RCA)

Question 4

Cardiogenic Shock

Answer 4

Inadequate tissue perfusion

Severely decreased CO + Hypotension (<90 mmHg)

Mortality 50-80%
Incidence 8%

Question 5

Cardiogenic Shock Treatment

Answer 5

Intraaortic Balloon Pump (IABP)

Question 6

Mechanical Complications of MI (3)

Answer 6

1. (Mitral) Papillary muscle rupture (3-5 days post)
2. Ventricular septal rupture (3-7 days post)
3. Ventricular free wall rupture (within 14 days post)

Note: ALL are SURGICAL EMERGENCIES

Question 7

Ventricular septal rupture

Answer 7

Forms “holes” in interventricular septum, with shunting from LV –> RV.

Holosystolic murmur

Diagnosis: echo

Leads to HF bc pulmonary circulation overloaded

Question 8

Ventricular free wall rupture

Answer 8

Blood fills pericardial space –> cardiogenic shock (tamponade)

Can form “pseudoaneurysm” if thrombus forms “plug” in the rupture

Question 9

Pericarditis

Answer 9

Inflammation of pericardial surfaces

Question 10

Acute Pericarditis

Answer 10

Early (in hospital)

Inflammation extending from injured myocardium to pericardium

Tx: Aspirin (no coags)

Question 11

Dressler syndrome

Answer 11

develops weeks later (pericarditis)

-autoimmune process directed against necrotic myocardium, resulting in fibrinous pericarditis

Tx: aspirin, NSAIDs

Question 12

Thromboembolism

Answer 12

requires ANTICOAGULATION