What is the most common Complication of Myocardial Dysrhythmias Infarction?

Co!aborative Care: Acute Coronary Syndrome

➢ Most common complication
➢ Present in 80% of MI patients
Emergency management
➢ Most common cause of death in the prehospital period
➢ Initial interventions
➢ Life-threatening dysrhythmias seen most often with anterior MI, heart failure, or shock
➢ Ongoing monitoring
• Heart failure
Emergent PCI
➢ A complication that occurs when the pumping power of the heart has diminished
➢ Treatment of choice for con#rmed MI
➢ Ba!oon angioplasty + drug-eluting stent(s)

Fibrinolytic therapy
Complications of Myocardial Infarction ➢ Indications and contraindications
• Cardiogenic shock ➢ Best marker of reperfusion: return of ST segment to
➢ Occurs when inadequate oxygen and nutrients are supplied to the tissues because of severe LV failure baseline
➢ Requires aggressive management ➢ Rescue PCI if thrombolysis fails
• Papi!ary muscle dysfunction ➢ Major complication: bleeding
➢ Causes mitral valve regurgitation
➢ Condition aggravates an already compromised LV Coronary surgical revascularization
• Ventricular aneurysm ➢ Coronary artery bypass graft (CABG) surgery
➢ Results when the infarcted myocardial wa! becomes thinned and bulges out during contraction • Requires sternotomy and cardiopulmonary bypass (CPB)
Dressler syndrome • Uses arteries and veins for grafts
➢ Minima!y invasive direct coronary artery bypass
(MIDCAB)
Complications of Myocardial Infarction
• Alternative to traditional CABG
• Acute pericarditis
• An in"ammation of visceral and/or parietal pericardium
Drug therapy
• May result in cardiac compression, ↓ LV #!ing and emptying, heart failure
➢ IV nitroglycerin
• Pericardial friction rub may be heard on auscultation
➢ Morphine sulphate
• Chest pain di$erent from MI pain
➢ β-Adrenergic blockers
➢ Angiotensin-converting enzyme inhibitors
Dressler syndrome
➢ Antidysrhythmia drugs
➢ Cholesterol-lowering drugs
• Characterized by pericarditis with e$usion and fever that develop 4 to 6
➢ Stool softeners
weeks after MI
• Pericardial (chest) pain
Pericardial friction rub may be heard on auscultation
➢ Arthralgia