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.

Symptomatic Bradycardia in Cardiovascular Emergencies

          Bradycardia in Cardiovascular Emergencies is when heart rate < 60 beats per minute and inadequate for clinical condition. So what would you do as a Doctor or paramedic to treat this condition? There are step which must done: SSSSSlow

Cardiac Tamponade

Cardiac tamponade occurs with an increase in intrapericardial pressure due to a pericardial effusion, which is characterized by

               1. Elevation of intrapericardial pressure

               2. Limitation of Right Ventricle Diastolic Filling

               3. Reduction of Stroke Volume and Cardiac Output.

The presence of a pericardial effusion does not necessarily mean tamponade physiology is present.

Cardiogenic Shock

Patients with the highest immediate mortality (>50%) are those with cardiogenic shock: a low-output state with signs and symptoms of organ underperfusion.

Hypertensive Emergency

Hypertensive crises should be differentiated into Hypertensive emergency or urgency, based on evidence of end-organ damage. Severe hypertensiion specifically affects the renal (elevated serum creatinin, hematuria (angina, heart failure, aortic dissection), and neurologic (headache, mental status changes), cardiovascular

How to Make Diagnosis of Heart Failure

History or Anamnesis

              There are three primary objectives of the history when interviewing a patient with Heart Failure:

           1. Identify etiology of Heart Failure

           2. Asses progression and severity of illness

           3. Assess volume status