Some other COMPLICATIONS OF AMI AND TREATMENT
- RECURRENT ANGINA
- LV ANEURYSM
- – 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
- Beta blockers Correct potassium and magnesium levels.
- Ventricular tachycardia and fibrillation: Occurs within 24 hours and can be fatal
- 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!.
- 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.
- 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.
- Should be surgically repaired.
- Clopidogrel – ADP receptor antagonist ACE inhibitors
- Beta Blockers