Complications of a heart attack

The effects of a heart attack can often be felt long after your condition has stabilized. About half of all people who have a heart attack will experience a serious complication that may cause many different symptoms and sometimes death.

Complications of a heart attack

Complication

Symptoms

How diagnosed

Treatment

Ventricular tachycardia—a rapid heartbeat in the heart's lower chambers
  • Racing heart (palpitations)
  • Shortness of breath
  • Chest pain
  • Weakness
  • Dizziness
  • Fainting
  • If no symptoms: intravenous antiarrhythmic medicines; possibly electric shock to the chest (cardioversion)
  • With symptoms: electric shock (cardioversion)
Ventricular fibrillation—a rapid, disorganized heartbeat in the heart's lower chambers
  • Loss of consciousness
  • Absence of blood pressure
  • Sudden death if not reversed
  • ECG
  • Electric shock to the chest (defibrillation)

Atrial fibrillation —a rapid, irregular heartbeat in the heart's upper chambers

  • Racing heart (palpitations)
  • Shortness of breath
  • Chest pain
  • Weakness
  • Fainting
  • ECG
  • If chest pain, breathlessness, or low blood pressure: electric shock to the chest (cardioversion) and/or medicines
  • If no symptoms: intravenous medicines to slow heart rate

Recurrent chest pain because of reduced blood flow and oxygen supply to the heart

  • Recurrence of angina and heart attack symptoms (chest pain, shortness of breath, nausea, or vomiting)
  • ECG
Extension or worsening of heart attack—further damage to the heart
  • Recurrence of angina and heart attack symptoms (chest pain, shortness of breath, nausea, or vomiting)
  • Anticoagulants , nitrates, beta-blockers
  • Consider use of clot-dissolving (thrombolytic) medicines.
  • If blockages are found: consider angioplasty/stenting or coronary artery bypass graft surgery.

Heart failure

  • Weakness
  • Fatigue
  • Shortness of breath
  • Low blood pressure
  • Weak pulse
  • Evidence of fluid buildup in the neck, lungs, abdomen, and ankles
  • Echocardiography
  • Chest X-ray
  • Low blood oxygen level
  • Blood tests
  • ACE inhibitors, digoxin, angiotensin II receptor blockers (ARBs)
  • Diuretics to remove excess fluid from body
  • If blockages are found: consider angioplasty/stenting or coronary artery bypass graft surgery.

Cardiogenic shock

  • Shortness of breath
  • Very low blood pressure
  • Bluish skin (cyanosis)
  • Confusion
  • Poor kidney function
  • Medications to increase blood pressure
  • Oxygen
  • Intra-aortic balloon pump
  • Mechanical ventilation
  • Consider heart transplant.
  • Consider coronary angiography/stenting, and if indicated, bypass surgery.

Mitral valve regurgitation

  • Shortness of breath
  • Low blood pressure
  • Rapid heart rate
  • Heart murmur heard using stethoscope
  • Echocardiography
  • Intravenous medication to decrease the workload on heart
  • Placement of intra-aortic balloon pump
  • Emergency valve surgery
Ruptured free wall of the heart—a hole in the wall of the heart that develops from the heart attack
  • Sudden drop in blood pressure
  • Loss of consciousness
  • Insert a needle through chest wall and remove blood around heart (pericardiocentesis).
  • Stop all blood-thinning medicines.
  • Emergency surgery to repair the ruptured heart
Ventricular septal rupture—a hole in the middle wall of the heart
  • Sudden heart failure
  • Low blood pressure
  • Chest pain
  • Shortness of breath
  • Loud heart murmur heard using stethoscope
  • Echocardiography
  • Sample of right ventricle blood that reveals more oxygen than usual
  • pulmonary artery catheter
  • Intravenous medicine to decrease the workload on heart
  • Placement of intra-aortic balloon pump to pump blood forward
  • Emergency surgery to repair hole in ventricular septum and coronary bypass surgery, if needed.

Pericarditis

  • Sharp chest pain made worse by breathing, coughing, or changing position
  • Rubbing sound heard with stethoscope
  • ECG
  • Echocardiography
  • Oral anti-inflammatory medicines like aspirin or ibuprofen
  • Oral steroid medicines can be used if symptoms persist.
Thromboembolus—a blood clot that forms inside the heart and travels to the brain or other body parts, cutting off blood flow
  • Symptoms of stroke
  • Loss of circulation to an extremity or organ
  • Anticoagulant medicine in hospital
  • Warfarin (such as Coumadin) as an outpatient

Heart block

  • Lightheadedness
  • Shortness of breath with exertion
  • Fainting
  • Seizures
  • ECG
  • Medication to increase heart rate
  • Temporary or permanent pacemaker

Last Updated: May 5, 2009

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