Congestive Heart Failure resulting From Acute MI

What Can Go Wrong After a Heart Attack?

Cardiovascular

Written by the doctors and editors at UpToDate
Why can problems happen after a heart attack? — Problems can happen because part of the heart is damaged or dies during a heart attack. This can cause the heart to beat abnormally. The damage can also lead to problems with the heart walls or valves (figure 1).
Whether or not problems happen after a heart attack and how serious they are depends on:
How serious the heart attack was, how much of the heart was damaged, and which part of the heart was damaged
How quickly the heart attack was treated
What problems can happen after a heart attack? — Different problems can happen in the days to weeks after a heart attack. Some problems are not too serious and can be treated, but others can cause death.
The most common problems that can happen after a heart attack are:
Abnormal heart rhythms – Each person has a built-in electrical system in the heart that controls his or her heartbeat. After a heart attack, the electrical signals that control the heartbeat can become abnormal and cause an abnormal heart rhythm. Abnormal heart rhythms are also called "arrhythmias."
An abnormal heart rhythm can cause people to feel like their heart is racing, skipping beats, or beating out of sync. An abnormal heart rhythm can also cause dizziness, fainting, or even death.
Treatment depends on the type of abnormal rhythm and the person's symptoms and can include:
•"Watching and waiting" – If your abnormal heart rhythm isn't too serious, the doctor might watch it to see if it goes away on its own.
•Different types of medicines
•A procedure called "cardioversion," which involves applying a mild electrical current to the heart to fix its rhythm
•Catheter ablation – Ablation procedures use heat ("radiofrequency ablation") or cold ("cryoablation") to destroy the small part of the heart that is sending abnormal electrical signals. After this, the heart can beat normally again.
•A device called an implantable cardioverter-defibrillator ("ICD") – The device goes under a person's skin near his or her heart (figure 2) and can sense and treat certain abnormal heartbeats.
Heart failure – Heart failure is a condition in which the heart does not pump as well as it should. This can cause symptoms such as swelling (figure 3), trouble breathing, and feeling tired. Sometimes, heart failure after a heart attack lasts only for a short time. Other times, heart failure after a heart attack becomes a long-term problem.
Doctors can treat heart failure with different types of medicines. The medicines can improve symptoms and help people feel better. Some medicines help people live longer. Most people need to take more than one medicine every day. (See "Medicines for heart failure with reduced ejection fraction".)
Inflammation of the lining around the heart – When the lining around the heart gets inflamed or irritated, doctors call it "pericarditis." Pericarditis can cause chest pain that gets worse when you cough or take a deep breath. Sometimes, it also causes a fever.
If you have pericarditis, your doctor will probably first treat it by increasing your daily dose of aspirin. (After a heart attack, most people take aspirin every day.) He or she might also prescribe another NSAID. NSAIDs are a large group of medicines that includes aspirin, ibuprofen (sample brand names: Advil, Motrin), indomethacin (sample brand names: Indocin, Indocid), and naproxen (sample brand names: Aleve, Naprosyn).
If the inflammation causes fluid to collect around your heart, your doctor might drain the fluid.
Other problems can happen after a heart attack, but they are much less common. These problems usually happen within the first few days after a heart attack and can be life-threatening. They include:
Tears in the heart muscle or heart walls
Problems with the heart valves
Blood clots in the lung
Strokes
These problems usually cause sudden and severe symptoms, such as sudden trouble breathing or passing out. They need emergency treatment, which might include medicines, surgery, or other procedures. But these problems can't always be treated and sometimes lead to death.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16434 Version 9.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

Heart Attack, What Can Go Wrong After

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