MYOCARDIAL INFARCTION e.g.

STROKE

Inadequate Reperfusion Therapy

Infarction Peripheral Organs
Inadequate Coronary Blood Flow
↓ Contractility of the Ventricles Intracavity Thrombus Formation THROMBOEMBOLISM

RECCURRENT ISCHEMIA
S3 Heart Sound
Systolic Dysfunction Diastolic Dysfunction

↑ Risk for Reinfarction Ventricular Hypertrophy

↑ Ventricular Pressure Abnormal Atrial Contraction

Pressure is conveyed to the Atria Pressure is conveyed back to the

Vena Cava

Pressure is conveyed back to the

Pulmonary Veins ↑ Venous Pressure
↓ Contractility of the Ventricles

Pulmonary Congestion Pulmonary Rales KUSSMAULS’ SIGN

↑ Ischemia CARDIO
↓ Cardiac Output (Jugular Vein Distension)
-GENIC
SHOCK ↓ Lung Compliance
↓ Coronary Blood
Flow Hypotension RIGHT-SIDED HEART FAILURE
Stimulation of
Juxtacapillary Receptors
↓ Coronary Perfusion Pressure CONGESTIVE HEART FAILURE
Reflex of Rapid &
Shallow Breathing

Dyspnea

Electrical Instability
Transient
(≤48 hrs Post MI)
Reentrant Circuits /
Enhance Automaticity of
Ventricular cells
PVC / V-Tach / V-Fib
MYOCARDIAL INFARCTION ARRHYTHMIA
Prolonged
Use of ArrhythmogenicDrugs
(>48 hrs Post MI)
e.g. Dopamine
Left Ventricular Dysfunction Atrial Ischemia & Distension
Sinus Tachycardia
Ventricular Fibrillation PAC / A-Fib
Interruption of Arterial Supply
of the Conduction Pathways
SA Node - RCA AV Node - RCA Bundle of His - LAD RBB – LAD (Proximal) LBB – LAD (Anterior)
RCA (Distal) PDA (Posterior)
SA Nodal Ischemia
AV Nodal / BB Ischemia
↑ Vagal Stimulation
↑ Vagal Stimulation
Sinus Bradycardia
HEART BLOCKS
AV Nodal Block / BB Block
 Inflammation extends from MYOCARDIAL INFARCTION
Myocardium to Pericardium

Inflammation of Damaged Myocardial Phagocytic Clearance of Necrotic Tissue

Acute PERICARDITIS
Tissue extends to the Pericardium

Weakening of Ventricular Wall

Sharp Pain Fever DRESSLERS’ SYNDROME Malaise

↑ ESR Dyskinesia
Pericardial Friction Rub Pericardial Effusion Leukocytosis

Sharp & Pleuritic

Chest Pain VENTRICULAR ANEURYSM

Filling of Aneurysm Cavity

Intracavity Thrombus Formation
Stretched Myofibers During Systole

Thromboembolism
↓ Cardiac Output
Ventricular Arrhythmias

Emboli of Peripheral Organs

Heart Failure
e.g. Cerebrovascular Embolism
STROKE
 MYOCARDIAL INFARCTION

Extension of the Ischemic Necrosis

Papillary Muscle Interventricular Septum

Left Ventricular Free Wall

Weakening of Papillary Muscle VENTRICULAR SEPTAL RUPTURE

Tearing of the Necrotic Myocardium

Shunting of Blood from LV to the RV
PAPILLARY MUSCLE RUPTURE
VENTRICULAR FREE WALL RUPTURE
Volume Overload of the
Loss of Valve Anchorage Pulmonary Capillaries
Hemorrhage into the Pericardium

Acute Severe Mitral Congestive Heart Failure

Regurgitation Cardiac Tamponade

↓ AP ↑ VP Distant Heart Sounds Loud systolic murmur @ the ↑ Oxygen Saturation in the
Heart Failure Pulmonary Edema
Left Parasternal Border RV than in RA.

Incomplete Tearing

PSEUDOANEURYSM