COMPLICATIONS OF Acute Myocardial Infarction (AMI) AND TREATMENT -2

Some other COMPLICATIONS OF AMI AND TREATMENT

  1. ARRHYTHMIAS
  2. RECURRENT ANGINA
  3. PERICARDITIS
  4. THROMBOEMBOLISM
  5. LV ANEURYSM

Other measures:

  • – Control of Hypertension
  • – Physical activity
  • – Avoid physical emotional stress.
  • – Cessation of smoking
  • – Control of blood lipids

AND OTHER COMPLICATIONS ARE  complications-of-ami-and-treatment-1

COMPLICATIONS OF AMI

Some other COMPLICATIONS OF AMI AND TREATMENT

 

1. COMPLICATIONS OF AMI ARRHYTHMIAS

  • Ventricular premature beats (VPB) : No prophy­lactic treatment required
  • Treatment:
  • Ventricular tachycardia and fibrillation: Occurs within 24 hours and can be fatal
  • Treatment:
    • IV lidocaine – 1 mg/kg bolus, 50 IJg/kg/min infu­sion.
    • Electrical cardioversion.
    • Amiodarone bolus 75 -150 mg in 10 minutes followed by 1 mg / min for 6 hours and then 0.5 mg / min.
    • VT not responding to shock may respond after 1 mg IV epinephrine or 10 ml of 1 : 10,000 solu­tion intra cardia!.
    • Bretylium
    • For torsade de pointes treat hypoxia! hypokale­mia and other electrolyte disturbances.
    • Late VF that develops due to pump failure has a very poor prognosis.
  • Accelerated idioventricular rhythm: at a rate of 60 to 100 beats per minutes can occur during throm­bolytic therapy during reperfusion.
  • Treatment: Not required
    • Sinus bradycardia
    • If there is hemodynamic upset atropine is given 0.5mg IV and additional 0.2mg repeated.
    • Pacing may be required.
    • Supraventricular Arrhythmias
    • · Sinus tachycardia
    • · SVT – Supraventricular tachycardia
    • ·Accelerated junctional rhythms.
  • Atrioventricular and Intraventricular conduction disturbances
    • If there is anterior wall MI the AV block may be per­manent and requires permanent pacing.
    • If there is inferior wall MI, AV block is temporary due to increased vagal tone and requires only temporary pacing.

 

2. COMPLICATIONS OF AMI RECURRENT ANGINA –

  • Post MI unstable An­gina
    • May require coronary angiography and reperfusion.
    • Repeat thrombolysis.
    • Add GP IIb / IIIa antagonist.

 

3. COMPLICATIONS OF AMI PERICARDITIS

    • There is pericardial rub and pericardial pain. Anticoagulant should not be used as it can re­sult in hemopericardium and cardiac tamponade.
  • Treatment:
    • Steroids NSAIDs Aspirin.

 

4. COMPLICATIONS OF AMI THROMBOEMBOLISM

  • Occurs in 10% and can go to systemic arteries from LV and pulmonary from leg veins.

 

5. COMPLICATIONS OF AMI LV ANEURYSM

    • Occurs due to scarring and do not rupture. Complications of LV aneurysm are CHF, arterial embolism and ventricular arrhythmias.
    • Pseudoaneurysm is myocardial rupture contained by local area of pericardium.
  • Treatment
    • Should be surgically repaired.
    • Aspirin
    • Clopidogrel – ADP receptor antagonist ACE inhibitors
    • Beta Blockers
Related Posts:
You May Also Like::