Myocardial Infaction Complications
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