Myocardial Infaction Complications: Difference between revisions
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==Anteroseptal MI Complications== | |||
*Look at V2-V4,5 | |||
*CHF/Cardiogenic shock | |||
**Large area of myocardium involved | |||
*Bradycardia | |||
**Bundles thru septum knocked out leading to wide complex | |||
*Myocardial tissue rupture | |||
==Inferior MI Complications== | ==Inferior MI Complications== | ||
*Bradycardias | *Look at II, III, aVF | ||
*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 | ||
| Line 6: | Line 15: | ||
*Papillary muscle rupture | *Papillary muscle rupture | ||
**RCA supplies inferior septum | **RCA supplies inferior septum | ||
**MI + new murmur + CHF think valve injury | |||
==Right Ventricle MI Complications== | |||
*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 | |||
*RV mostly supplied by RCA | |||
*Hypotension most severe complication | |||
**Volume load | |||
**AVOID vasodilators, do not give SLNG | |||
*LV Free Wall Rupture | |||
**5-14 days after MI, earlier in thrombolysis pts | |||
**Leaking of fluid outside can cause tamponade | |||
***Look for JVD, pulsus paradoxus, diminished sounds | |||
**Emergent Echo if stable | |||
**Give IVF and consult CV surgery for pericardiocentesis and thoractomy | |||
*Septum rupture | |||
**Blood fills RV | |||
**Reduce afterload and consult CV surgery | |||
**Consider IABP | |||
**consult CV surger | |||
*Papillary muscle rupture | |||
**Reduce afterloadconsult CV surgery | |||
==See Also== | |||
* [[ACS - Anatomical Correlation]] | |||
* [[ST-Elevation Myocardial Infarction (STEMI)]] | |||
* [[NSTEMI]] | |||
==External Links== | |||
==Sources== | |||
<references/> | |||
Revision as of 22:48, 15 May 2016
Anteroseptal MI Complications
- Look at V2-V4,5
- CHF/Cardiogenic shock
- Large area of myocardium involved
- Bradycardia
- Bundles thru septum knocked out leading to wide complex
- Myocardial tissue rupture
Inferior MI Complications
- Look at II, III, aVF
- Bradycardias and AV block
- Increased vagal tone
- Sinus Node supplied by RCA in 60% of patients
- AV node supplied by RCA in 90% of patients
- Papillary muscle rupture
- RCA supplies inferior septum
- MI + new murmur + CHF think valve injury
Right Ventricle MI Complications
- 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
- RV mostly supplied by RCA
- Hypotension most severe complication
- Volume load
- AVOID vasodilators, do not give SLNG
- LV Free Wall Rupture
- 5-14 days after MI, earlier in thrombolysis pts
- Leaking of fluid outside can cause tamponade
- Look for JVD, pulsus paradoxus, diminished sounds
- Emergent Echo if stable
- Give IVF and consult CV surgery for pericardiocentesis and thoractomy
- Septum rupture
- Blood fills RV
- Reduce afterload and consult CV surgery
- Consider IABP
- consult CV surger
- Papillary muscle rupture
- Reduce afterloadconsult CV surgery