Complications of myocardial infarction

Myocardial infarction (MI) due to coronary artery disease is a leading cause of death in the United States.

Complications of MI include:
-Arrhythmic
-Mechanical
-Inflammatory

-Thrombo-embolic
-Circulatory/Shock



Arrhythmic Complications of MI:


About 90% of patients with MI develop some form of cardiac arrhythmia. These arrhythmias can be broadly classified into the following categories:

Supraventricular tachyarrhythmias
Accelerated junctional rhythms
Bradyarrhythmias
Atrioventricular (AV) blocks
Intraventricular block
Ventricular arrhythmias
Reperfusion arrhythmias

Mechanical Complications:

-Ventricular free wall rupture and pericardial tamponade
-Ventricular septal rupture
-Papillary muscle rupture with severe mitral regurgitation
-Left Ventricular Aneurysm

Inflammatory complications:

-Pericarditis: Occurs in 10% patients within the first 4 days of MI)
-Post-MI syndrome (Dressler syndrome): Occurs in 1-5% after MI and can present 2-3 weeks after MI.


Thrombo-embolic complications:

Occur secondary to regional myocardial hypokinesia and stasis as well as secondary to arrhythmias such as atrial fibrillation.

Circulatory/Shock:


Can be seen in right ventricular infarction (treatment is IVF) and in massive left ventricular infarction (treatment is supportive with careful administration of IVF.