MI Complications Flashcards
What is the most common cause of death following MI?
Ventricular fibrillation
What can ventricular fibrillation lead to?
Cardaic arrest
How are patients with cardiac arrest post MI managed?
ALS protocol with defibrillation
How can cardiogenic shock result post MI?
Large part of the ventricular myocardium is damaged in the infarction- ejection fraction decreases to the point of cardiogenic shock
What is the other possible cause of caridogenic shock post MI?
Left ventricular free wall rupture
When does left ventricular free wall rupture occur post MI?
1-2 weeks afterward
How does a patient with left ventricular free wall rupture present?
Acute heart failure secondary to cardiac tamponade
What are the symptoms of acute heart failure secondary to cardiac tamponade?
Raised JVP
Pulsus paradoxus
Diminished heart sounds
What is the management of left ventricular free wall rupture?
Urgent pericardiocentesis and thoracotomy
How can a patient end up with post MI chronic heart failure?
Ventricular myocardium may be dysfunctional
What medication can be used in the management of post MI chronic heart failure?
Furosemide- decrease fluid overload
ACE-inhibitors and beta-blockers- improve the long-term prognosis
When can pericarditis present post MI?
Within 48 hours following a transmural MI
What are the main features of a post MI pericarditis?
Pain- worse on lying flat
Pericardial rub on ausculttaion
Pericardial effusion on echocardiogram.
When does Dressler’s syndrome typically occur?
2-6 weeks following a MI.
What is Dressler’s syndrome due to?
Autoimmune reaction against antigenic proteins formed as the myocardium recovers
What are the characteristic features of Dressler’s syndrome?
Fever
Pleuritic pain
Pericardial effusion
Raised ESR
How is Dressler’s syndrome managed?
NSAID’s
How can the ventricular septum be affected by a MI?
The interventricular septum can be ruptured
When can the rupture of the interventicular septum occur?
In the first week
How can a ruptured interventricular septum present?
Acute heart failure associated with a pan-systolic murmur
What is diagnostic investigation for a ruptured interventricular septum?
Echocardiogram
What is the advantage of using an echocardiogram for someone with a ruptures interventricular septum?
Can differentiate from mitral regurgitation which can present in a similar way
What is the management of a ruptured interventricular septum?
Urgent surgical correction
What type of MI is acute mitral regurgitation a more common complication of?
Infero-posterior infarction
What can acute mitral regurgitation be due to?
Ischaemia or rupture of the papillary muscle.
How can acute mitral reguritation present?
Acute hypotension
Pulmonary oedema
Early-to-mid systolic murmur
How is acute mitral regurgitation managed?
Vasodilator therapy
Often requires emergency surgical repair.
How can a left ventricular anneurysm occur post MI?
The ischaemic damage sustained may weaken the myocardium resulting in aneurysm
What is a left ventricular anneurysm associated with?
Persistent ST elevation and left ventricular failure.
What can form within the left ventricular anneurysm?
Thrombus- increases risk of stroke
