PMID: 32150366Mar 10, 2020Paper

Acute Coronary Syndrome: Common Complications and Conditions That Mimic ACS

FP Essentials
Darrell E JonesDavid Kassop

Abstract

Complications after acute myocardial infarction (MI) can be serious and potentially life-threatening. Coronary reperfusion therapy and revascularization can reduce the risk of these complications, but they still occur. Arrhythmias and conduction abnormalities are among the most common complications, and occur most often in hemodynamically unstable patients. Patients with ventricular arrhythmias should be treated with beta blockers and sometimes amiodarone, along with cardioversion and defibrillation if unresponsive to medical therapy. Patients with bradyarrhythmias initially can be treated with atropine but may need pacemaker therapy. Atrial fibrillation (AF) is managed with standard pharmacotherapy; cardioversion is indicated if the patient is hemodynamically unstable and has persistent AF. Anticoagulation should be started based on the CHA2DS2-VASc score. Cardiogenic shock requires prompt diagnosis with echocardiography and urgent revascularization. Mechanical complications include ventricular aneurysm (managed medically with anticoagulation or surgically if the aneurysm is large), papillary muscle rupture (managed with mitral valve replacement), and ventricular septal rupture (which requires surgical repair). Conditions that...Continue Reading

Related Concepts

Related Feeds

Cardiac Aneurysm

Aneurysm refers to a bulge of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septum or within the aorta. In the heart, it usually arises from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. Discover the latest research on cardiac aneurysm here.

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.