myocardial infarction followed by dying off myocardial tissue. Because of the processes occurring in the tissues of the background of this pathological condition, complications of heart attack infarction may occur in a few days after the onset of an attack, and after a few months. The emergence of complications of acute disorders worsens the prognosis and increases the risk of death. The most common complications arise in cases where the treatment of heart attack was initiated 1-2 days after symptom onset.
When talking about the complications of myocardial infarction, the classification divides all possible violations, depending on the time of their occurrence on:
It is believed that the more time has passed since the start of the attack, the less the risk of life-threatening disorders associated with damage to myocardial tissue. Thus, early complications of myocardial infarction are the most dangerous. They can occur in the first days after the attack. The early complications include severe violations of rhythm and conduction.
In addition, a potentially dangerous complications include early mechanical damage during heart attack. The early complications of this pathological condition includes cases of pericarditis and thromboembolism. Often in the first few weeks after the attack, there are signs of acute heart failure and cardiogenic shock. The early complications of a heart attack are also gastrointestinal bleeding.
Disorders of heart rhythm
The first arrhythmia in myocardial infarction are divided into the following categories:
- non-hazardous to life;
- prognostically unfavorable;
For non-hazardous for the life of cardiac arrhythmias, nearly 100% was observed during heart attacks include:
- sinus arrhythmia;
- tachycardia (<110 / min);
- bradycardia (heart rate> 50);
- ventricular and atrial extrasystoles;
- pacemaker migration;
- transient AV-block I degree.
To prognostically unfavorable conditions arising against the background of this pathological condition are:
- bradycardia (<50 / min);
- sinus tachycardia (heart rate> 110 / min);
- idioventikulyarny rhythm;
- sinoauricular block;
- atrial fibrillation;
- AV-block II-III degrees;
- supraventricular paroxysmal tachycardia;
- sick sinus syndrome.
For life-threatening arrhythmia include paroxysmal ventricular fibrillation. Hazards are asystole and subnodalnaya complete AV-block.
Acute heart failure - a common complication of ischemic damage to the heart tissue. The degree of dysfunction of the left and right ventricular necrosis depends on the size of the region. In cases where the affected small areas of infarction, the remaining healthy tissue can compensate for the damaged work. However, if affected by large amounts of tissue, there is a deterioration of the heart blood output.
Often the development of complications of a heart attack occurs against a background of necrotic damage is less than ¼ of the mass of the left ventricle. In addition, such a complication may arise against the withering away of papillary muscles tissues. The appearance of such a violation may contribute to severe arrhythmias that disrupt the heart's ability to contract normally. This state is shown rales and pulmonary edema.
Cardiogenic shock develops in the coronary artery disease and heart attack often. This is the last phase of development of acute heart failure. This condition may occur when the death of more than 40-50% of myocardial tissue when the remaining healthy parts can not make up for the work of dead cells.
This condition is characterized by a sharp drop in blood pressure, which leads to disruption of blood microcirculation in all vital organs and causes the development of multiple organ failure. Patients often lose consciousness and fall into a coma, because the brain from lack of oxygen and nutrients suffers most severely. Later it begins to impair the operation of other bodies.
Deterioration of the digestive tract against the backdrop of a heart attack is an acute reaction to stress and the disruption of the central nervous system due to lower saturation of brain tissue oxygen levels. Often there is rapid development of paresis, accompanied by stagnant processes. Often against the background of a heart attack quickly develop ulcers on the walls of the intestines and stomach. There may be massive bleeding.
Development of complications after a heart attack may occur in the first minutes of the attack, and after a few days or even weeks. In severe this complication can cause perforation of the wall of the stomach or intestines and the development of peritonitis. Almost 95% of patients who have recently suffered a heart attack, this complication causes of death.
Acute myocardial ischemic injury can create conditions for stretching and protrusion pathological tissues in the walls of the chambers or ventricles. Formation of such a defect causes a decrease in blood output. It is a violation of the balance of the efforts made by the heart muscles and heart rate, which in this case will be low.
An aneurysm is associated with a high risk of lacerations. In addition, such a defect creates conditions for aggravation of existing heart failure function. May be present arrhythmias and severe manifestations of stagnation of blood in the cavity formed. The development of the aneurysm creates conditions for thrombus formation.
Among the dangerous consequences of myocardial infarction gap is allocated in the region where the formed fibrous scar can not withstand the load pressure existing inside the heart. wall rupture in the rumen, in most cases occurs within the first 2 weeks after the attack. Most often this complication occurs in women. Contribute to the emergence of problems can exercise after the attack.
Gaps heart wall may be external and internal. Exterior gaps are accompanied by the flow of blood to the pericardium and lead to the formation of the heart hemotamponade. Internal gaps are accompanied by damage to the papillary muscle or interventricular septum. All forms of heart failure in the majority of cases are fatal without prompt surgical intervention.
Myocardial infarction complications associated with impaired blood clotting, occur frequently. It promotes the formation of blood clots heart failure, accompanied by stagnant processes. In addition, the appearance of blood clots may contribute to increasing the size of the aneurysm. Against the background of a heart attack is often observed worsening congestion in the lower extremities and the development of thrombophlebitis.
Separation of blood clot formation is associated with a high risk of thromboembolism, ie the migration of thrombus through the blood vessels in the lungs, kidneys, brain and other organs. Going through the blood vessels, blood clots stuck in their places of contraction, clogging the bloodstream. This causes large areas of dying tissue for prevention of admission to them of nutrients and oxygen.
Pericarditis most often occurs 3-4 days after the onset of an attack. This condition is characterized by a pathological process involving the outer lining of the heart, i.e. pericardium. The development of this complication after myocardial infarction in men occurs far more often than women. However, women often pericarditis leads to rapid death.
When this complication is a rapid loss of the pericardium inflammation. This leads to intense pain, exacerbated by any movement, coughing or breathing deeply.
Early and late complications of myocardial infarction differ in the length of time in which they occur after the attack. For later characterized by the appearance of the first symptoms in 2-3 weeks after the start of the attack. Late complications can become a cause of death.
This complication of a heart attack as a chronic aneurysm occurs in approximately 6-8 weeks after the formation of the scar. A gradual stretching rumen even after stabilization of the pressure inside the heart. In this case, the aneurysm does not cease to grow in size, causing the progression of disorders of blood ejection.
The development of this complication of myocardial observed between 2 and 6 weeks after the attack. This condition occurs due to the receipt of large amounts into the bloodstream myocardiocytes decay products. These substances act as Autogenes that provoke a malfunction of the immune system and the development of autoimmunity. The first manifestation of the syndrome serves fever. In the future may appear in autoimmune disorders such as:
- synovitis, etc.
Autoimmune reactions complicate the process of restoration of the damaged myocardium and worsen the prognosis of survival.