ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel
  • »
  • Health»
  • Diseases, Disorders & Conditions

Clincial Complications And Diagnosis Of Acute Myocardial Infarction

Updated on January 17, 2014

Heart Attack

Several arrhythmias develop. These include frequent ventricular ectopics, ventricular tachycardia, ventricular fibrillation, sudden cardiac arrest, atrial fibrillation and several grades of heart block
Several arrhythmias develop. These include frequent ventricular ectopics, ventricular tachycardia, ventricular fibrillation, sudden cardiac arrest, atrial fibrillation and several grades of heart block | Source

Complications

In the majority of cases, acute myocardial infarction is accompanied by complications and in many cases these account for mortality.

Arrhythmias: Several arrhythmias develop. These include frequent ventricular ectopics, ventricular tachycardia, ventricular fibrillation, sudden cardiac arrest, atrial fibrillation and several grades of heart block. Fatal arrhythmias such as ventricular fibrillation and cardiac arrest are more prone to develop in the presence of bradycardia, especially during the first few hours after onset. With the passage of time, this risk comes down.

Cardiac Failure: This may take the form of acute left ventricular failure or congestive cardiac failure.

Cardiogenic shock: Infarction of 40% or more of the ventricular myocardium leads to cardiogenic shock. If the shock is not relieved by the usual measures, mortality exceeds 50-80%.

Pericarditis: This develops in 15-20% of patients, 24-36 hours after the onset of the infarction. It is seen in full thickness infarcts. It subsides spontaneously without further complications.

Phlebothrombosis and Pulmonary Embolism: These develop as a result of prolonged recumbency, venous stasis and tendency for venous thrombosis.

Arterial Embolism: Mural thrombi develop on the infracted endocardium and these may embolise into arterial trunks. This risk starts a day or two after the infarction and persists for a few weeks.

Papillary Muscle Dysfunction and rupture: Ischemia and infarction of the papillary muscles lead to mitral regurgitation. Rupture of the papillary muscles results in the development of acute mitral incompetence which tips the patient into acute cardiac failure.

Cardiac rupture: This may develop by the third to the fifth day. The infracted area gives way giving rise to hemopericardium, cardiac tamponade and death in the majority of cases.

Delayed Complications:

  1. Cardiac aneurysm: Weakening of the scar leads to bulging out of the ventricle and the development of ventricular aneurysm. The common sites are the anterior and apical regions. This leads to persistent congestive failure, recurrent embolism and ventricular tachycardia. On palpation of the precordium, the aneurysm can be felt as a see-saw pulsation in relation to the apex beat. The condition can be confirmed by X-ray examination, echocardiography and angiocardiography.
  2. Dessler’s syndrome: This is probably an immune-mediated reaction in which pericarditis, pleurisy, fever, arthritis and elevation of ESR develop 1-6 weeks after the infarction.

Diagnosis On ECG

Source

S-T Elevation On ECG

Source

Diagnosis

Myocardial infarction is a serious disease with an overall immediate mortality ranging up to 25%. Maximum mortality is in the first 6 hours of onset, and death is due to fatal arrhythmias (Ventricular fibrillation or cardiac arrest) or other complications such as shock and cardiac failure. For the first six months after infarction, the risk of developing sudden death is still high, but this risk falls after this period. Anterior infarction carries a grave prognosis if accompanied by conduction disturbances. All the major complications worsen the prognosis. Age above 70 years, hypertension, diabetes mellitus and heavy cigarette smoking worsen the outlook further.

© 2014 Funom Theophilus Makama

Comments

    0 of 8192 characters used
    Post Comment

    No comments yet.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: "https://hubpages.com/privacy-policy#gdpr"

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)