Myocardial infarction complications - wikipedia Myocardial infarction complications Main article : Myocardial infarction Myocardial infarction complications may occur immediately following a heart attack ( in the acute phase ), or may need time to develop ( a chronic problem ). After an infarction, an obvious complication is a second infarction, which may occur in the domain of another atherosclerotic coronary artery, or in the same zone if there are any live cells left in the infarct. Contents 1 Congestive heart failure 2 Myocardial rupture 3 Arrhythmia 4 Pericarditis 5 Cardiogenic shock 6 References Congestive heart failure Main article : Congestive heart failure A myocardial infarction may compromise the function of the heart as a pump for the circulation, a state called heart failure. There are different types of heart failure ; left - or right - sided ( or bilateral ) heart failure may occur depending on the affected part of the heart, and it is a low - output type of failure. If one of the heart valves is affected, this may cause dysfunction, such as mitral regurgitation in the case of left - sided coronary occlusion that disrupts the blood supply of the papillary muscles. The incidence of heart failure is particularly high in patients with diabetes and requires special management strategies. Myocardial rupture Main article : Myocardial rupture Myocardial rupture is most common three to five days after myocardial infarction, commonly of small degree, but may occur one day to three weeks later. In the modern era of early revascularization and intensive pharmacotherapy as treatment for MI, the incidence of myocardial rupture is about 1 % of all MIs. This may occur in the free walls of the ventricles, the septum between them, the papillary muscles, or less commonly the atria. Rupture occurs because of increased pressure against the weakened walls of the heart chambers due to heart muscle that can not pump blood out effectively. The weakness may also lead to ventricular aneurysm, a localized dilation or ballooning of the heart chamber. Risk factors for myocardial rupture include completion of infarction ( no revascularization performed ), female sex, advanced age, and a lack of a previous history of myocardial infarction. In addition, the risk of rupture is higher in individuals who are revascularized with a thrombolytic agent than with PCI. The shear stress between the infarcted segment and the surrounding normal myocardium ( which may be hypercontractile in the post-infarction period ) makes it a nidus for rupture. Rupture is usually a catastrophic event that may result a life - threatening process known as cardiac tamponade, in which blood accumulates within the pericardium or heart sac, and compresses the heart to the point where it can not pump effectively. Rupture of the intraventricular septum ( the muscle separating the left and right ventricles ) causes a ventricular septal defect with shunting of blood through the defect from the left side of the heart to the right side of the heart, which can lead to right ventricular failure as well as pulmonary overcirculation. Rupture of the papillary muscle may also lead to acute mitral regurgitation and subsequent pulmonary edema and possibly even cardiogenic shock. Arrhythmia A 12 lead electrocardiogram showing ventricular tachycardia. Since the electrical characteristics of the infarcted tissue change ( see pathophysiology section ), arrhythmias are a frequent complication. The re-entry phenomenon may cause rapid heart rates ( ventricular tachycardia and even ventricular fibrillation ), and ischemia in the electrical conduction system of the heart may cause a complete heart block ( when the impulse from the sinoatrial node, the normal cardiac pacemaker, does not reach the heart chambers ). Pericarditis Main article : Pericarditis As a reaction to the damage of the heart muscle, inflammatory cells are attracted. The inflammation may reach out and affect the heart sac. This is called pericarditis. In Dressler 's syndrome, this occurs several weeks after the initial event. Cardiogenic shock A complication that may occur in the acute setting soon after a myocardial infarction or in the weeks following is cardiogenic shock. Cardiogenic shock is defined as a hemodynamic state in which the heart can not produce enough of a cardiac output to supply an adequate amount of oxygenated blood to the tissues of the body. While the data on performing interventions on individuals with cardiogenic shock is sparse, trial data suggests a long - term mortality benefit in undergoing revascularization if the individual is less than 75 years old and if the onset of the acute myocardial infarction is less than 36 hours and the onset of cardiogenic shock is less than 18 hours. If the patient with cardiogenic shock is not going to be revascularized, aggressive hemodynamic support is warranted, with insertion of an intra-aortic balloon pump if not contraindicated. If diagnostic coronary angiography does not reveal a culprit blockage that is the cause of the cardiogenic shock, the prognosis is poor. References Jump up ^ Canto JG, Shlipak MG, Rogers WJ, Malmgren JA, Frederick PD, Lambrew CT, Ornato JP, Barron HV, Kiefe CI ( 2000 ). `` Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain ''. JAMA. 283 ( 24 ) : 3223 -- 9. PMID 10866870. doi : 10.1001 / jama. 283.24. 3223. ^ Jump up to : Yip HK, Wu CJ, Chang HW, Wang CP, Cheng CI, Chua S, Chen MC ( 2003 ). `` Cardiac rupture complicating acute myocardial infarction in the direct percutaneous coronary intervention reperfusion era '' ( PDF ). Chest. 124 ( 2 ) : 565 -- 71. PMID 12907544. doi : 10.1378 / chest. 124.2. 565. Jump up ^ Becker RC, Gore JM, Lambrew C, Weaver WD, Rubison RM, French WJ, Tiefenbrunn AJ, Bowlby LJ, Rogers WJ ( 1996 ). `` A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction ''. J Am Coll Cardiol. 27 ( 6 ) : 1321 -- 6. PMID 8626938. doi : 10.1016 / 0735 - 1097 ( 96 ) 00008 - 3. Jump up ^ Moreno R, Lopez - Sendon J, Garcia E, Perez de Isla L, Lopez de Sa E, Ortega A, Moreno M, Rubio R, Soriano J, Abeytua M, Garcia - Fernandez MA ( 2002 ). `` Primary angioplasty reduces the risk of left ventricular free wall rupture compared with thrombolysis in patients with acute myocardial infarction ''. J Am Coll Cardiol. 39 ( 4 ) : 598 -- 603. PMID 11849857. doi : 10.1016 / S0735 - 1097 ( 01 ) 01796 - X. Jump up ^ Shin P, Sakurai M, Minamino T, Onishi S, Kitamura H ( 1983 ). `` Postinfarction cardiac rupture. A pathogenetic consideration in eight cases ''. Acta Pathol Jpn. 33 ( 5 ) : 881 -- 93. PMID 6650169. Jump up ^ Podrid, Philip J. ; Peter R. Kowey ( 2001 ). Cardiac Arrhythmia : Mechanisms, Diagnosis, and Management. Lippincott Williams & Wilkins. ISBN 0 - 7817 - 2486 - 4. Jump up ^ Sung, Ruey J. ; Michael R. Lauer ( 2000 ). Fundamental Approaches to the Management of Cardiac Arrhythmias. Springer. ISBN 0 - 7923 - 6559 - 3. Jump up ^ Josephson, Mark E. ( 2002 ). Clinical Cardiac Electrophysiology : Techniques and Interpretations. Lippincott Williams & Wilkins. ISBN 0 - 683 - 30693 - 6. ^ Jump up to : Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, Buller CE, Jacobs AK, Slater JN, Col J, McKinlay SM, LeJemtel TH ( 1999 ). `` 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. 341 ( 9 ) : 625 -- 34. PMID 10460813. doi : 10.1056 / NEJM199908263410901. Cardiovascular disease ( heart ) ( I00 -- I52, 390 -- 429 ) Ischaemic Coronary disease Coronary artery disease ( CAD ) Coronary artery aneurysm Spontaneous coronary artery dissection ( SCAD ) Coronary thrombosis Coronary vasospasm Myocardial bridge Active ischemia Angina pectoris Prinzmetal 's angina Stable angina Acute coronary syndrome Myocardial infarction Unstable angina Sequelae hours Hibernating myocardium Myocardial stunning days Myocardial rupture weeks Aneurysm of heart / Ventricular aneurysm Dressler syndrome Layers Pericardium Pericarditis Acute Chronic / Constrictive Pericardial effusion Cardiac tamponade Hemopericardium Myocardium Myocarditis Chagas disease Cardiomyopathy Dilated Alcoholic Hypertrophic Restrictive Loeffler endocarditis Cardiac amyloidosis Endocardial fibroelastosis Arrhythmogenic right ventricular dysplasia Endocardium / valves Endocarditis infective endocarditis Subacute bacterial endocarditis non-infective endocarditis Libman -- Sacks endocarditis Nonbacterial thrombotic endocarditis Valves mitral regurgitation prolapse stenosis aortic stenosis insufficiency tricuspid stenosis insufficiency pulmonary stenosis insufficiency Conduction / arrhythmia Bradycardia Sinus bradycardia Sick sinus syndrome Heart block : Sinoatrial AV 1 ° 2 ° 3 ° Intraventricular Bundle branch block Right Left Left anterior fascicle Left posterior fascicle Bifascicular Trifascicular Adams -- Stokes syndrome Tachycardia ( paroxysmal and sinus ) Supraventricular Atrial Multifocal Junctional AV nodal reentrant Junctional ectopic Ventricular Accelerated idioventricular rhythm Catecholaminergic polymorphic Torsades de pointes Premature contraction Atrial Junctional Ventricular Pre-excitation syndrome Lown -- Ganong -- Levine Wolff -- Parkinson -- White Flutter / fibrillation Atrial flutter Ventricular flutter Atrial fibrillation Familial Ventricular fibrillation Pacemaker Ectopic pacemaker / Ectopic beat Multifocal atrial tachycardia Pacemaker syndrome Parasystole Wandering pacemaker Long QT syndrome Andersen -- Tawil Jervell and Lange - Nielsen Romano -- Ward Cardiac arrest Sudden cardiac death Asystole Pulseless electrical activity Sinoatrial arrest Other / ungrouped hexaxial reference system Right axis deviation Left axis deviation QT Short QT syndrome T wave alternans ST Osborn wave ST elevation ST depression Strain pattern Cardiomegaly Ventricular hypertrophy Left Right / Cor pulmonale Atrial enlargement Left Right Other Cardiac fibrosis Heart failure Diastolic heart failure Cardiac asthma Rheumatic fever Retrieved from `` https://en.wikipedia.org/w/index.php?title=Myocardial_infarction_complications&oldid=722386565 '' Categories : Aging - associated diseases Causes of death Ischemic heart diseases Medical emergencies Talk Contents About Wikipedia فارسی Edit links This page was last edited on 27 May 2016, at 19 : 34. 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Question: what is the most common complication of acute myocardial infarction
Answer: second infarction