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

1. COMPLICATIONS OF AMI ARRHYTHMIAS

• Ventricular premature beats (VPB) : No prophy­lactic treatment required
• Treatment:
  • Beta blockers Correct potassium and magnesium levels.
• 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