2011/05/24

Myocardial Infarction Complications

Here we will discuss Myocardial infarction Complications, to understand the possible complications following the myocardial complications. the possible complications following the myocardial infarction are:


Heart Failure
Heart failure occurs in approximately two thirds of hospitalized patients with acute myocardial infarction. Left verticular dysfunction is usually predominant; hence the findings include dyspnea, inspiratory rales at the lung bases, and hypoxia. Clinical signs depend upon the size of the infarction, the elevation of left venticular filling pressure, and the extent to which cardiac output is reduced. The mortality rate varies directly with the severity of left venticular failure.

Hypoxia
Hypoxia is a common in acute Myocardial infarction and is usually secondary to increased left atrial pressure with alternation of pulmonary ventilation-perfusion relationships, pulmonary interstitial edema, alveolar collapse, and physiologic shunting.

The primary cause of cardiogenic shock in acute Myocardial infarction is inadequate performance of the left ventricle as a pump due to extensive damage. The incidence of cardiogenic shock appears to have decreased in recent years, perhaps due to early recognition and treatment of heart failure. Shock is diagnosed when systolic pressure is <90 mm Hg and when the patient is restless and has reduce mental awareness, cyanosis oliguria (les than 20 ml urine/h) and cool, moist extremities.

When blood pressure falls, the patient should be thoroughly evaluated and a treatable cause sought. If the patient remains alert, warm and has good urine output, shock is not present and treatment may be expectant. Hypotension may be caused by drugs, especially narcotics, sedatives, or diuretics. The most common precipitating factor is the use of potent diuretic agent, especially in older patients, intial intensive diuresis may be followed hours later by hypovolemia and hypotension.

Arrhythmia or Heart Block
Some of arrhythmia with ventricular ectopic beats occurs in over 90 percent of patients with myocardial infarction. Disturbances in condition reflect damage to the sinus node. Recognition and management of arrhythmia is based on a thorough understanding of electrophysiology, electrocardiography, and pharmacology

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