5-14 days after MI, earlier in thrombolysis patients
Leaking of fluid outside can cause tamponade
Look for JVD, pulsus paradoxus, diminished sounds
Emergent echo if stable
Give IVF and consult cardiovascular surgery for pericardiocentesis and thoracotomy
Look for JVD, pulsus paradoxus, diminished sounds
Usually chronic and can persis for >6 weeks after MI
Tends to occur with ant MI
Emergent echo if stable
Treat cardiogenic shock, anticoagulate if mural thrombus
Defibrillate ventricular dysrhythmias
3-7 days after MI
Blood fills RV
Listen for holosystolic murmur
Emergent echo if stable
Reduce afterload with vasodilators (e.g. nitroglycerin) and consult cardiovascular surgery
Consider IABP
Listen for holosystolic murmur
2-7 days after MI
Listen for murmur at apex
Emergent echo if stable
Reduce afterload with vasodilators and consult cardiovascular surgery
Consider IABP
1-8 weeks after MI
Thought to be immune-mediated injury
Listen for pericardial rub, chest pain/dyspnea improved with leaning forward, fever
ECG may show pericarditis, Echo with pericardial effusion
Treat with ASA, if > 4 weeks from MI can use NSAIDS or corticosteroids
Myocardial infarction complications
CVC catheter problems
Angiogram complications
Phrenic nerve/diaphragmatic stimulators complications
The difficult airway
Left ventricular assist device complications
Heart transplant complications
Lower gastrointestinal bleeding