myocardial infarction complications Flashcards
What is the most common cause of death following an MI?
cardiac arrest
management of cardiac arrest
ALS protocol with defibrillation
cardiogenic shock
if a large part of the ventricular myocardium is damaged in the infarction the ejection fraction of the heart may decrease to the point where patients develop cardiogenic shock.
treatment of cardiogenic shock
patients may require inotropic support and/or an intra-aortic balloon pump.
treatment of chronic heart failure
loop diuretics such as furosemide will decrease fluid overload.
Both ACE-inhibitors and beta-blockers have been shown to improve long-term prognosis of patients with chronic heart failure.
When is atrioventricular block (bradyarrhythmias) more common
following an inferior myocardial infarction
left ventricular aneurysm
ischaemic damage sustained may weaken the myocardium resulting in aneurysm formation.
This typically associated with persistent ST elevation and left ventricular failure.
thrombus may form within the aneurysm increasing the risk of stroke.
how to treat left ventricular aneurysm
anticoagulants
left ventricular free wall rupture
this is seen in around 3% of MIs and occurs around 1-2 weeks afterwards. Patients presents with acute heart failure secondary to cardiac tamponade.
ventricular septal defect
rupture of the inter-ventricular septum usually occurs in the first week and is seen in around 1-2% of patients.
features of ventricular septal defect
acute heart failure associated with a pain-systolic murmur.
an echocardiogram is diagnostic and will exclude acute mitral regurgitation which presents in a similar fashion. Urgent surgical correction is needed.
acute mitral regurgitation
more common with infero-posterior infarction and may be due to ischaemia or rupture of the papillary muscle.
Acute hypertension and pulmonary oedema may occur. An early-to-mid systolic murmur may be heard
how to treat acute mitral regurgitation
vasodilater therapy but often require emergency surgical repair.
