Complications Of Mi 2

Front 1

What are some of the morphologically based complications of MI?

Back 1

Mural Thrombus, MV regurg (weakening of papillary muscle), Myocardial rupture, Pericaritis, infarct expansion, Ventricular Aneurysm

Front 2

Gross pathologic features of heart associated with chronic ischemic disease?

Back 2

CA athero, Dilation of all 4 chambers, Large scar, Fibrosis, Aneurysm

Front 3

What are some mechanisms in which ischemic heart disease causes CHF?

Back 3

Myocyte hypertrophy, Vent dilation, progressive ischemic injury, Hibernating myocardium, Vavlular insufficiency

Front 4

Long term complications of acute MI's mostly accompany what type of acute MI?

Back 4

STEMI

Front 5

Early and late complications of acute MI result from what respectively?

Back 5

Early - necrosis; Late - scarring, healing process;

Front 6

MI complications fall into which for categories?

Back 6

Electrical, Mechanical, Pericardial, Muscular

Front 7

Electrical complications from acute MI's?

Back 7

Arrythmias

Front 8

Mechanical complications from acute MI's?

Back 8

VSD, Papillary muscle dysfunction, Cardiac rupture

Front 9

Pericardial complications from acute MI's?

Back 9

pericarditis, tamponade

Front 10

Muscular complications from acute MI's?

Back 10

Pump failure, aneurysm, pseudoaneurysm

Front 11

What types of ventricular arrythmias can result from MI's?

Back 11

PVC's, VTAC, VFIB

Front 12

What is the temporal significance of post MI vtac/PVCs/VFIB?

Back 12

If within 72 hours of MI, no biggie; If after, then heralds risk of sudden death;

Front 13

Tx of post MI PVCs?

Back 13

just beta blockers

Front 14

Tx of post MI VTAC?

Back 14

if unstable, cardiovert; If stable Beta blockers, Lidocaine, amiodarone;

Front 15

What types of supraventricular arrythmias can develop post MI?

Back 15

2nd or 3rd degree AV block

Front 16

3rd degree AV block can be caused by what two types of MI's?

Back 16

Inferior, Anterior MI

Front 17

Mechanism, prognosis and tx of 3rd degree heart block caused by Inferior MI?

Back 17

AV Node ischemia; almost always recover; temporary pacemaker;

Front 18

Mechanism, prognosis and tx of 3rd degree heart block caused by anterior MI?

Back 18

Necrosis of LV septum and His purkinjie; almost never recover; Permanent pacemaker;

Front 19

When is post MI cardiac tissue rupture most likely to occur and why?

Back 19

4-5 days post MI; that’s when tisue necrosis has made the muscle the softest;

Front 20

In which part of the cardiac tissue is a post MI rupture most likely to occur?

Back 20

free wall LV rupture

Front 21

Blood supply of the two papillary muscles?

Back 21

Anterlateral - dual supply (LAD or RCA); Posteromedial - single supply (RCA)

Front 22

Which papillary muscle is most vulnerable to damage during an acute MI and why?

Back 22

Posteromedial, only one source of blood;

Front 23

What would the PE of a patient with recent papillary muscle damage show?

Back 23

a new heart murmur post AMI;

Front 24

Tx of papillar muscle dysfunction due to both ischemia or infarction?

Back 24

ischemia - reperfuse; Infarction - probably needs surgical correction;

Front 25

What will rupture of one of the papillary muscles do to the valve?

Back 25

cause a wide open flail valve; severe regurge

Front 26

Dx of papilllary muscle uses what?

Back 26

Echo

Front 27

Clinical presentation of someone with acute papillary muscle rupture?

Back 27

Signs of pulmonary congestion, respiratory distress;

Front 28

Tx of papillary muscle rupture?

Back 28

immediate surgical repair; While waiting for OR, IV vasodilator, Balloon pump;

Front 29

What is a post MI VSD more likely to occur in anterior or inferior MI?

Back 29

both equally likely

Front 30

Clinical presentation of post MI VSD?

Back 30

new holosystolic murmur; CHF (RV overload so peripheral edema)

Front 31

Dx of post MI VSD rupture made by what?

Back 31

echo, right heart cath

Front 32

Tx of post MI VSD?

Back 32

same as papillary muscle rupture

Front 33

What are big differentiators between papillary muscle rupture and post MI VSD?

Back 33

Pap - pulmonary Edema, resp distress; VSD - JVD, O2 step up in right heart;

Front 34

What is the use of an IABP?

Back 34

Inflates after aortic valve closes, increases flow out the coronary arteries; Deflates during systole to reduce afterload

Front 35

Why is LV free wall rupture so deadly?

Back 35

proceeds almost immediately to pericardial tamponade;

Front 36

Risk factors for LV free wall rupture?

Back 36

Female, 1st MI, older than 60, HTN

Front 37

Minutes before LV free wall rupture what might patients feel?

Back 37

agitation, sharp pain, tachy, brady

Front 38

Tx of LV free wall rupture?

Back 38

pericardiocentesis on the way to the OR;

Front 39

You've got an EKG that looks like MI happening everywhere at once. What is it?

Back 39

Pericarditis

Front 40

How can pericarditis be caused by MI?

Back 40

the transmural infarct causes a lot of inflammation, hence pericarditis;

Front 41

Clinical features of pericarditis?

Back 41

Pleuritic pain, Fever, Friction rub on auscultation

Front 42

Tx of acute post MI pericarditis?

Back 42

High dose ASA, Indomethacin, Steroids

Front 43

Cardiogenic shock usually occurs secondarily to what?

Back 43

massive myocardial necrosis

Front 44

Prognosis of cardiogenic shock?

Back 44

very poor

Front 45

Tx of cardiogenic shock?

Back 45

IABP, Inotropic therapy

Front 46

Lv aneurysm will usually occur how long after an MI?

Back 46

days to weeks

Front 47

Complications of LV aneurysm?

Back 47

Thromboembolism, Arrythmias, CHF

Front 48

Dx of LV aneurysm?

Back 48

Persistent ST elevation; Seen on Echo or MRI;

Front 49

Tx of LV aneurysm?

Back 49

Warfarin, surgical repair;

Front 50

What is an Lv pseudoaneurysm?

Back 50

Break in the LV free wall covered by fibrous tissue;

Front 51

Prognosis of LV pseudoaneurysm?

Back 51

fatal if it ruptures so correct ASAP