Heart Failure & Valvular Diseases Q 4

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What is the most common complication of an MI?

  

     A. Cardiogenic shock

     B. Heart failure

     C. Arrhythmias

     D. Pericarditis

    

    

Correct Answer: C. Arrhythmias

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Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common complication of an MI. About 90% of patients who have an acute myocardial infarction (AMI) develop some form of cardiac arrhythmia during or immediately after the event. In 25% of patients, such rhythm abnormalities manifest within the first 24 hours. In this group of patients, the risk of serious arrhythmias, such as ventricular fibrillation, is greatest in the first hour and declines thereafter.

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Option A: Cardiogenic shock, another complication of an MI, is defined as the end stage of left ventricular dysfunction. This condition occurs in approximately 15% of clients with MI. Cardiogenic shock is a physiologic state in which inadequate tissue perfusion results from cardiac dysfunction, most often systolic. It is a major, and frequently fatal, complication of a variety of acute and chronic disorders, occurring most commonly following acute myocardial infarction (MI).

Option B: Because the pumping function of the heart is compromised by an MI, heart failure is the second most common complication. Myocardial infarction (MI) remains the most common cause of heart failure (HF) worldwide. For almost 50 years HF has been recognized as a determinant of adverse prognosis after MI, but efforts to promote myocardial repair have failed to translate into clinical therapies.

Option D: Pericarditis most commonly results from a bacterial or viral infection but may occur after the MI. Pericardial inflammation after myocardial infarction can be either acute seen after 3 to 10 days after large transmural myocardial infarction, termed as peri-infarction pericarditis, or immune-mediated inflammation after 1 to 8 weeks termed as post-myocardial infarction syndrome (Dressler syndrome). The pain of pericarditis may be confused as resulting from post-infarction angina or recurrent infarction.

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