Skip to main content

Complications of Myocardial Infarction and Cardiovascular Emergencies

  • Chapter
  • First Online:
Cardiology Consult Manual
  • 1216 Accesses

Abstract

Immediate recognition of cardiovascular emergencies leads to less delays in treatment and a lower risk of morbidity and mortality. In this chapter, we will focus on complications of acute myocardial infarction (arrhythmia, inflammatory, and mechanical), symptomatic bradycardia, and cardiac arrest. Detailed discussion on tamponade, aortic dissection, and symptomatic tachyarrhythmia can be found in separate, dedicated chapters in this pocket manual.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. French JK, Hellkamp AS, Armstrong PW, Cohen E, Kleiman NS, O’Connor CM, Holmes DR, Hochman JS, Granger CB, Mahaffey KW. Mechanical complications after percutaneous coronary intervention in ST-elevation myocardial infarction (from APEX-AMI). Am J Cardiol. 2010;105:59–63.

    Article  PubMed  Google Scholar 

  2. Anderson JL, Morrow DA. Acute myocardial infarction. N Engl J Med. 2017;376:2053–64.

    Article  CAS  PubMed  Google Scholar 

  3. Bloch Thomsen PE, Jons C, Raatikainen MJP, et al. Long-term recording of cardiac arrhythmias with an implantable cardiac monitor in patients with reduced ejection fraction after acute myocardial infarction: the cardiac arrhythmias and risk stratification after acute myocardial infarction (CARISMA) study. Circulation. 2010;122:1258–64.

    Article  PubMed  Google Scholar 

  4. O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice guidelines: developed in collaboration with the American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2013;82:E1–27.

    Article  PubMed  Google Scholar 

  5. Wolfe CL, Nibley C, Bhandari A, Chatterjee K, Scheinman M. Polymorphous ventricular tachycardia associated with acute myocardial infarction. Circulation. 1991;84:1543–51.

    Article  CAS  PubMed  Google Scholar 

  6. Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH, Arensberg D, Baker A, Friedman L, Greene HL. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The cardiac arrhythmia suppression trial. N Engl J Med. 1991;324:781–8.

    Article  CAS  PubMed  Google Scholar 

  7. Pratt CM, Moye LA. The cardiac arrhythmia suppression trial: casting suppression in a different light. Circulation. 1995;91:245–7.

    Article  CAS  PubMed  Google Scholar 

  8. Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R, Fain E, Gent M, Connolly SJ, Investigators DINAMIT. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004;351:2481–8.

    Article  CAS  PubMed  Google Scholar 

  9. Steinbeck G, Andresen D, Seidl K, et al. Defibrillator implantation early after myocardial infarction. N Engl J Med. 2009;361:1427–36.

    Article  CAS  PubMed  Google Scholar 

  10. Feldman AM, Klein H, Tchou P, et al. Use of a wearable defibrillator in terminating tachyarrhythmias in patients at high risk for sudden death: results of the WEARIT/BIROAD. Pacing Clin Electrophysiol. 2004;27:4–9.

    Article  PubMed  Google Scholar 

  11. Epstein AE, Abraham WT, Bianco NR, Kern KB, Mirro M, Rao SV, Rhee EK, Solomon SD, Szymkiewicz SJ. Wearable cardioverter-defibrillator use in patients perceived to be at high risk early post-myocardial infarction. J Am Coll Cardiol. 2013;62:2000–7.

    Article  PubMed  Google Scholar 

  12. Piccini JP, Al-Khatib SM, Hellkamp AS, Anstrom KJ, Poole JE, Mark DB, Lee KL, Bardy GH. Mortality benefits from implantable cardioverter-defibrillator therapy are not restricted to patients with remote myocardial infarction: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Heart Rhythm. 2011;8:393–400.

    Article  PubMed  Google Scholar 

  13. Klein HU, Goldenberg I, Moss AJ. Risk stratification for implantable cardioverter defibrillator therapy: the role of the wearable cardioverter-defibrillator. Eur Heart J. 2013;34:2230–42.

    Article  PubMed  Google Scholar 

  14. Berman J, Haffajee CI, Alpert JS. Therapy of symptomatic pericarditis after myocardial infarction: retrospective and prospective studies of aspirin, indomethacin, prednisone, and spontaneous resolution. Am Heart J. 1981;101:750–3.

    Article  CAS  PubMed  Google Scholar 

  15. Kutty RS, Jones N, Moorjani N. Mechanical complications of acute myocardial infarction. Cardiol Clin. 2013;31:519–31, vii–viii.

    Article  PubMed  Google Scholar 

  16. Birnbaum Y, Chamoun AJ, Anzuini A, Lick SD, Ahmad M, Uretsky BF. Ventricular free wall rupture following acute myocardial infarction. Coron Artery Dis. 2003;14:463–70.

    Article  PubMed  Google Scholar 

  17. Hochman JS, Buller CE, Sleeper LA, Boland J, Dzavik V, Sanborn TA, Godfrey E, White HD, Lim J, LeJemtel T. Cardiogenic shock complicating acute myocardial infarction—etiologies, management and outcome: a report from the SHOCK Trial Registry. Should we emergently revascularize occluded coronaries for cardiogenic shocK? J Am Coll Cardiol. 2000;36:1063–70.

    Article  CAS  PubMed  Google Scholar 

  18. Lavie CJ, Gersh BJ. Mechanical and electrical complications of acute myocardial infarction. Mayo Clin Proc. 1990;65:709–30.

    Article  CAS  PubMed  Google Scholar 

  19. Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm. J Am Coll Cardiol. 1998;32:557–61.

    Article  CAS  PubMed  Google Scholar 

  20. Nihoyannopoulos P, Smith GC, Maseri A, Foale RA. The natural history of left ventricular thrombus in myocardial infarction: a rationale in support of masterly inactivity. J Am Coll Cardiol. 1989;14:903–11.

    Article  CAS  PubMed  Google Scholar 

  21. Werdan K, Gielen S, Ebelt H, Hochman JS. Mechanical circulatory support in cardiogenic shock. Eur Heart J. 2014;35:156–67.

    Article  CAS  PubMed  Google Scholar 

  22. Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. Circulation. 2008;117:686–97.

    Article  PubMed  Google Scholar 

  23. van Diepen S, Katz JN, Albert NM, et al. Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation. 2017;136:e232–68.

    Article  PubMed  Google Scholar 

  24. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med. 1999;341:625–34.

    Article  CAS  PubMed  Google Scholar 

  25. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–200.

    Article  Google Scholar 

  26. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction. J Am Coll Cardiol. 2004;44:E1–E211.

    Article  PubMed  Google Scholar 

  27. Levy B, Perez P, Perny J, Thivilier C, Gerard A. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit Care Med. 2011;39:450–5.

    Article  CAS  PubMed  Google Scholar 

  28. Klein T, Ramani GV. Assessment and management of cardiogenic shock in the emergency department. Cardiol Clin. 2012;30:651–64.

    Article  PubMed  Google Scholar 

  29. Rihal CS, Naidu SS, Givertz MM, et al. 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care: endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d’intervention. J Am Coll Cardiol. 2015;65:e7–e26.

    Article  PubMed  Google Scholar 

  30. Hoefer D, Ruttmann E, Poelzl G, Kilo J, Hoermann C, Margreiter R, Laufer G, Antretter H. Outcome evaluation of the bridge to bridge concept in patients with cardiogenic shock. Ann Thorac Surg. 2006;82:28–33.

    Article  PubMed  Google Scholar 

  31. Thiele H, Akin I, Sandri M, et al. PCI strategies in patients with acute myocardial infarction and cardiogenic shock. N Engl J Med. 2017. https://doi.org/10.1056/NEJMoa1710261.

  32. Levine GN, Bates ER, Blankenship JC, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with st-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol. 2016;67:1235–50.

    Article  PubMed  Google Scholar 

  33. Corpus RA, House JA, Marso SP, et al. Multivessel percutaneous coronary intervention in patients with multivessel disease and acute myocardial infarction. Am Heart J. 2004;148:493–500.

    Article  PubMed  Google Scholar 

  34. American Heart Association. Web-based Integrated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care—Part 7: Adult Advanced Cardiovascular Life Support. ECCguidelines.heart.org

  35. American Heart Association. Web-based Integrated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care—Part 8: Post-Cardiac Arrest Care. ECCguidelines.heart.org.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nai-Lun Chang .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chang, NL., Budzikowski, A.S. (2018). Complications of Myocardial Infarction and Cardiovascular Emergencies. In: Mieszczanska, H., Budzikowski, A. (eds) Cardiology Consult Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-89725-7_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-89725-7_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-89724-0

  • Online ISBN: 978-3-319-89725-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics