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10 Cards in this Set
- Front
- Back
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Mobitz I (Wenckebach) accounts for 90 percent of second-degree AV block. It generally occurs within the AV node, is associated with narrow QRS complexes, and results from ischemic injury. It is more common
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with inferior than with anterior AMI, is intermittent usually during the first 72 h after infarction, and rarely progresses to complete heart block
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Mobitz II second-degree heart block originates from
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conduction lesions below the His bundle, is associated with a wide QRS complex, is usually associated with anterior AMI, and does progress to complete heart block.
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Sinus tachycardia is quite prominent in patients with
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anterior wall AMI.
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When ventricular tachycardia occurs late in the course of AMI, it is usually associated with
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transmural infarction and left ventricular dysfunction, induces hemodynamic deterioration, and is associated with a mortality rate approaching 50 percent.
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Free wall rupture occurs in 10 percent of AMI fatalities, usually
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1 to 5 days after infarction
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Rupture of the interventricular septum is more often detected clinically by these characteristic
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Clinically, interventricular septal rupture presents with chest pain, dyspnea, and sudden appearance of a new holosystolic murmur. The murmur is usually accompanied by a palpable thrill and is heard best at the lower left sternal border. Doppler echocardiography is the diagnostic procedure of choice. Demonstration of left-to-right shunt by pulmonary catheter blood sampling may be useful. An oxygen step-up of more than 10 percent from right atrial to right ventricular samples is diagnostic. Rupture of the interventricular septum is more common in patients with anterior wall myocardial infarction and patients with extensive (three-vessel) CAD.
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Papillary muscle rupture occurs in approximately 1 percent of patients with AMI, is more common with
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inferior myocardial infarction, and usually occurs 3 to 5 days after AMI.
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what papillary muscle is most commonly ruptured, because it receives blood supply from one coronary artery, usually the right coronary artery
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posteromedial papillary muscle
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posteromedial papillary muscle is most commonly ruptured b/c
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what papillary muscle is most commonly ruptured, because it receives blood supply from one coronary artery, usually the right coronary artery
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Post-AMI pericarditis occurs in 10 to 20 percent of patients. It is more common in patients with transmural AMI. It results from inflammation adjacent to the pericardium on the epicardial surface of a transmural infarction. It generally occurs
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It results from inflammation adjacent to the pericardium on the epicardial surface of a transmural infarction. It generally occurs 2 to 4 days after AMI. Pericardial friction rubs are detected more often with inferior wall and right ventricular infarction, because the right ventricle lies immediately beneath the chest wall. The pain of pericarditis can be confused with that of infarct extension or post-AMI angina. Classically, the discomfort of pericarditis becomes worse with a deep inspiration and may be somewhat relieved by sitting forward.
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