Late Complications of Myocardial Infarction

           Postinfarction complication rates have fallen dramatically since the advent of early reperfusion strategies. Nevertherles, many patients (large infarction, silent infarction, late presentation, delayed or incomplete reperfusion) remain at high-risk for life-threatening late complications of myocardial infarction. The role of an urgent beside echocardiogram for a rapid diagnosis cannot be overemphasized. The mnemonic "FEAR A MI" is a logical way to remember and respect these potentially life-threatening complication while caring for a patient in the ICU, as demontrated below:

Symptomatic Tachycardia in Cardiovascular Emergencies

      Patients who are pulseless or clinically unsable with the tachycardia require immediet defibrillation  with unsynchronized high-energy shocks (200, 300, 360 Joule) followed by appropriate ABC attention of ACLS. The cardiac rhythm is briefly assessed between shocks.