Myocardial infarction complications - Revision history

ClaireLewis: /* Left ventricular free wall rupture */

2019-09-26T15:34:58Z

Left ventricular free wall rupture

← Older revision		Revision as of 15:34, 26 September 2019
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	*5-14 days after MI, earlier in thrombolysis patients		*5-14 days after MI, earlier in thrombolysis patients
	*Leaking of fluid outside can cause [[tamponade]]		*Leaking of fluid outside can cause [[tamponade]]
	**Look for JVD, pulsus paradoxus, diminished sounds		**Look for JVD, [[pulsus paradoxus]], diminished sounds
	*Emergent [[echocardiography\|echo]] if stable		*Emergent [[echocardiography\|echo]] if stable
	*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis]] and thoracotomy		*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis]] and thoracotomy

ClaireLewis: /* Inferior MI Complications */

2019-09-25T15:50:42Z

Inferior MI Complications

← Older revision		Revision as of 15:50, 25 September 2019
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	===Inferior MI Complications===		===Inferior MI Complications===
	*Look at II, III, aVF		*Look at II, III, aVF
	*[[~~Bradycardias~~]] and [[AV block]]		*[[Bradycardia]]s and [[AV block]]
	**Increased vagal tone		**Increased vagal tone
	**Sinus Node supplied by RCA in 60% of patients		**Sinus Node supplied by RCA in 60% of patients

ClaireLewis at 15:50, 25 September 2019

2019-09-25T15:50:24Z

← Older revision		Revision as of 15:50, 25 September 2019
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	==MI Complications==		==MI Complications==

	===Left ventricular free wall rupture===		===[[Cardiac rupture\|Left ventricular free wall rupture]]===
	*5-14 days after MI, earlier in thrombolysis patients		*5-14 days after MI, earlier in thrombolysis patients
	*Leaking of fluid outside can cause [[tamponade]]		*Leaking of fluid outside can cause [[tamponade]]
	**Look for JVD, pulsus paradoxus, diminished sounds		**Look for JVD, pulsus paradoxus, diminished sounds
	*Emergent ~~Echo~~ if stable		*Emergent [[echocardiography\|echo]] if stable
	*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis]] and thoracotomy		*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis]] and thoracotomy

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	*Usually chronic and can persis for >6 weeks after MI		*Usually chronic and can persis for >6 weeks after MI
	*Tends to occur with ant MI		*Tends to occur with ant MI
	*Emergent ~~Echo~~ if stable		*Emergent [[echocardiography\|echo]] if stable
	*Treat [[cardiogenic shock]], [[anticoagulant\|anticoagulate]] if mural thrombus		*Treat [[cardiogenic shock]], [[anticoagulant\|anticoagulate]] if mural thrombus
	*Defibrillate [[ventricular dysrhythmias]]		*Defibrillate [[ventricular dysrhythmias]]
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	*Blood fills RV		*Blood fills RV
	**Listen for holosystolic [[murmur]]		**Listen for holosystolic [[murmur]]
	*Emergent ~~Echo~~ if stable		*Emergent [[echocardiography\|echo]] if stable
	*Reduce afterload with vasodilators (e.g. ~~nitrand~~ consult cardiovascular surgery		*Reduce afterload with vasodilators (e.g. [[nitroglycerin]]) and consult cardiovascular surgery
	*Consider IABP		*Consider IABP

	===Papillary muscle rupture===		===Papillary muscle rupture===
	*2-7 days after MI		*2-7 days after MI
	*Listen for murmur at apex		*Listen for [[murmur]] at apex
	*Emergent ~~Echo~~ if stable		*Emergent [[echocardiography\|echo]] if stable
	*Reduce afterload with vasodilators and consult cardiovascular surgery		*Reduce afterload with vasodilators and consult cardiovascular surgery
	*Consider IABP		*Consider IABP

	===Dressler's ~~Syndrome~~===		===[[Dressler's syndrome]]===
	*1-8 weeks after MI		*1-8 weeks after MI
	*Thought to be immune-mediated injury		*Thought to be immune-mediated injury
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	*[[Bradycardia]]		*[[Bradycardia]]
	**Bundles thru septum knocked out leading to wide complex		**Bundles thru septum knocked out leading to wide complex
	*Myocardial tissue rupture		*[[Cardiac rupture\|Myocardial tissue rupture]]
	*LV aneurysm		*[[LV aneurysm]]

	===Inferior MI Complications===		===Inferior MI Complications===
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	*Papillary muscle rupture		*Papillary muscle rupture
	**RCA supplies inferior septum		**RCA supplies inferior septum
	**[[Myocardial infarction]] + new murmur + CHF think valve injury		**[[Myocardial infarction]] + new [[murmur]] + [[CHF]] think valve injury

	===Right Ventricle MI Complications===		===Right Ventricle MI Complications===
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	*[[Hypotension]]most severe complication		*[[Hypotension]]most severe complication
	**Volume load		**Volume load
	**AVOID vasodilators, do ''not]] give [[nitro]]		**AVOID vasodilators, do ''not'' give [[nitro]]

	==See Also==		==See Also==
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	==External Links==		==External Links==

	==~~Refences~~==		==References==
	<references/>		<references/>

	[[Category:Cardiology]]		[[Category:Cardiology]]

Rossdonaldson1: Text replacement - " wks " to " weeks "

2019-03-30T13:26:08Z

Text replacement - " wks " to " weeks "

← Older revision		Revision as of 13:26, 30 March 2019
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	===[[Left ventricular aneurysm]]===		===[[Left ventricular aneurysm]]===
	*Usually chronic and can persis for >6 ~~wks~~ after MI		*Usually chronic and can persis for >6 weeks after MI
	*Tends to occur with ant MI		*Tends to occur with ant MI
	*Emergent Echo if stable		*Emergent Echo if stable
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	===Dressler's Syndrome===		===Dressler's Syndrome===
	*1-8 ~~wks~~ after MI		*1-8 weeks after MI
	*Thought to be immune-mediated injury		*Thought to be immune-mediated injury
	*Listen for pericardial rub, [[chest pain]]/[[dyspnea]] improved with leaning forward, [[fever]]		*Listen for pericardial rub, [[chest pain]]/[[dyspnea]] improved with leaning forward, [[fever]]
	*[[ECG]] may show [[pericarditis]], Echo with [[pericardial effusion]]		*[[ECG]] may show [[pericarditis]], Echo with [[pericardial effusion]]
	*Treat with [[ASA]], if > 4 ~~wks~~ from MI can use [[NSAIDS]] or [[corticosteroids]]		*Treat with [[ASA]], if > 4 weeks from MI can use [[NSAIDS]] or [[corticosteroids]]

	==Complications Based on MI Location==		==Complications Based on MI Location==

ClaireLewis: /* MI Complications */

2019-01-27T19:42:25Z

MI Complications

← Older revision		Revision as of 19:42, 27 January 2019
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	**Look for JVD, pulsus paradoxus, diminished sounds		**Look for JVD, pulsus paradoxus, diminished sounds
	*Emergent Echo if stable		*Emergent Echo if stable
	*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis][ and thoracotomy		*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis]] and thoracotomy

	===[[Left ventricular aneurysm]]===		===[[Left ventricular aneurysm]]===

ClaireLewis at 19:42, 27 January 2019

2019-01-27T19:42:07Z

← Older revision		Revision as of 19:42, 27 January 2019
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	===Left ventricular free wall rupture===		===Left ventricular free wall rupture===
	*5-14 days after MI, earlier in thrombolysis patients		*5-14 days after MI, earlier in thrombolysis patients
	*Leaking of fluid outside can cause tamponade		*Leaking of fluid outside can cause [[tamponade]]
	**Look for JVD, pulsus paradoxus, diminished sounds		**Look for JVD, pulsus paradoxus, diminished sounds
	*Emergent Echo if stable		*Emergent Echo if stable
	*Give IVF and consult cardiovascular surgery for pericardiocentesis and ~~thoractomy~~		*Give [[IVF]] and consult cardiovascular surgery for [[pericardiocentesis][ and thoracotomy

	===[[Left ventricular aneurysm]]===		===[[Left ventricular aneurysm]]===
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	*Tends to occur with ant MI		*Tends to occur with ant MI
	*Emergent Echo if stable		*Emergent Echo if stable
	*Treat cardiogenic shock, anticoagulate if mural thrombus		*Treat [[cardiogenic shock]], [[anticoagulant\|anticoagulate]] if mural thrombus
	*Defibrillate ventricular ~~arrythmias~~		*Defibrillate [[ventricular dysrhythmias]]

	===Septum rupture===		===Septum rupture===
	*3-7 days after MI		*3-7 days after MI
	*Blood fills RV		*Blood fills RV
	**Listen for holosystolic murmur		**Listen for holosystolic [[murmur]]
	*Emergent Echo if stable		*Emergent Echo if stable
	*Reduce afterload with vasodilators ~~and~~ consult cardiovascular surgery		*Reduce afterload with vasodilators (e.g. nitrand consult cardiovascular surgery
	*Consider IABP		*Consider IABP

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	*1-8 wks after MI		*1-8 wks after MI
	*Thought to be immune-mediated injury		*Thought to be immune-mediated injury
	*Listen for pericardial rub, pain/dyspnea improved with leaning forward, fever		*Listen for pericardial rub, [[chest pain]]/[[dyspnea]] improved with leaning forward, [[fever]]
	*[[ECG]] may show ~~pericardidits~~, Echo with pericardial effusion		*[[ECG]] may show [[pericarditis]], Echo with [[pericardial effusion]]
	*Treat with ASA, if > 4 wks from MI can use NSAIDS or corticosteroids		*Treat with [[ASA]], if > 4 wks from MI can use [[NSAIDS]] or [[corticosteroids]]

	==Complications Based on MI Location==		==Complications Based on MI Location==
	===Anteroseptal MI Complications===		===Anteroseptal MI Complications===
	*Look at V2-V4,5		*Look at V2-V4,5
	*[[CHF]]/Cardiogenic shock		*[[CHF]]/[[Cardiogenic shock]]
	**Large area of myocardium involved		**Large area of myocardium involved
	*Bradycardia		*[[Bradycardia]]
	**Bundles thru septum knocked out leading to wide complex		**Bundles thru septum knocked out leading to wide complex
	*Myocardial tissue rupture		*Myocardial tissue rupture
	*LV ~~aneursym~~		*LV aneurysm

	===Inferior MI Complications===		===Inferior MI Complications===
	*Look at II, III, aVF		*Look at II, III, aVF
	*Bradycardias and AV block		*[[Bradycardias]] and [[AV block]]
	**Increased vagal tone		**Increased vagal tone
	**Sinus Node supplied by RCA in 60% of patients		**Sinus Node supplied by RCA in 60% of patients
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	*[[Hypotension]]most severe complication		*[[Hypotension]]most severe complication
	**Volume load		**Volume load
	**AVOID vasodilators, do not give ~~SLNG~~		**AVOID vasodilators, do ''not]] give [[nitro]]

	==See Also==		==See Also==

Rossdonaldson1: /* MI Complications */

2018-02-27T13:56:44Z

MI Complications

← Older revision		Revision as of 13:56, 27 February 2018
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	==MI Complications==		==MI Complications==

	===~~LV Free Wall Rupture~~===		===Left ventricular free wall rupture===
	*5-14 days after MI, earlier in thrombolysis patients		*5-14 days after MI, earlier in thrombolysis patients
	*Leaking of fluid outside can cause tamponade		*Leaking of fluid outside can cause tamponade
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	*Give IVF and consult cardiovascular surgery for pericardiocentesis and thoractomy		*Give IVF and consult cardiovascular surgery for pericardiocentesis and thoractomy

	===~~LV Aneurysm~~===		===[[Left ventricular aneurysm]]===
	*Usually chronic and can persis for >6 wks after MI		*Usually chronic and can persis for >6 wks after MI
	*Tends to occur with ant MI		*Tends to occur with ant MI

Ostermayer: Text replacement - "Hypotension " to "Hypotension"

2017-03-10T14:02:45Z

Text replacement - "Hypotension " to "Hypotension"

← Older revision		Revision as of 14:02, 10 March 2017
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	**Lead III and V1 looks most at right side of heart		**Lead III and V1 looks most at right side of heart
	*RV mostly supplied by RCA		*RV mostly supplied by RCA
	*Hypotension most severe complication		*[[Hypotension]]most severe complication
	**Volume load		**Volume load
	**AVOID vasodilators, do not give SLNG		**AVOID vasodilators, do not give SLNG

Neil.m.young at 16:22, 1 March 2017

2017-03-01T16:22:45Z

← Older revision		Revision as of 16:22, 1 March 2017
Line 59:		Line 59:
	===Right Ventricle MI Complications===		===Right Ventricle MI Complications===
	*Inf MI with ST elev III>II, ST elev V1>V2, ST dep V2		*Inf MI with ST elev III>II, ST elev V1>V2, ST dep V2
	**Lead III and V1 looks most at ~~rightside~~ of heart		**Lead III and V1 looks most at right side of heart
	*RV mostly supplied by RCA		*RV mostly supplied by RCA
	*Hypotension most severe complication		*Hypotension most severe complication
	**Volume load		**Volume load
	**AVOID vasodilators, do not give SLNG		**AVOID vasodilators, do not give SLNG


	==See Also==		==See Also==

Neil.m.young: Text replacement - " R " to " right"

2017-02-27T23:15:21Z

Text replacement - " R " to " right"

← Older revision		Revision as of 23:15, 27 February 2017
Line 59:		Line 59:
	===Right Ventricle MI Complications===		===Right Ventricle MI Complications===
	*Inf MI with ST elev III>II, ST elev V1>V2, ST dep V2		*Inf MI with ST elev III>II, ST elev V1>V2, ST dep V2
	**Lead III and V1 looks most at ~~R side~~ of heart		**Lead III and V1 looks most at rightside of heart
	*RV mostly supplied by RCA		*RV mostly supplied by RCA
	*Hypotension most severe complication		*Hypotension most severe complication