49  MI Complications

49.1 Arrhythmia complications

• Manage acute arrhythmias as you would in ACLS

• If post-STEMI, a pt has sustained VT/VF > 48 hrs, then they should get an ICD if VT/VF are not due to reversible ischemia, reinfarction or metabolic cause

49.2 Mechanical complications

• anteroseptal MI → rupture of ventricular septum → acute VSD

  • will occur 3-7 days after MI event

• inferior MI → papillary mm. rupture → acute MR

  • will occur 3-7 days after MI event

• anterior MI → free wall rupture

  • will occur 3-7 days after MI event