Ischemic: complication of AMI

There are several type of AMI (acute myocardial Infarction) complication.

complication of MI

Today we focus on Ischemic.

Ischemic complications can include

  • infarct extension,
    • progressive increase in the amount of myocardial necrosis within the infarct zone of the original MI.
  • recurrent infarction,
    • cause by reocclusion of the same vessel or other area
  • postinfarction angina.
    • define as angina from a few hours to 30 days after acute MI.
    •  highest in patients with non–ST-elevation MI (approximately 25%), and in those treated with fibrinolytics rather than with PCI.
    • The pathophysiologic mechanism of postinfarction angina is similar to that of unstable angina—plaque rupture—and should be managed in a similar manner. Patients with postinfarction angina have a worse prognosis with regard to sudden death, reinfarction, and acute cardiac events, compared with those without such symptoms.


Signs and Symptoms

Patients with infarct extension or postinfarction angina usually have continuous or intermittent chest pain, with protracted elevation in the creatine kinase (CK) level and occasionally, new electrocardiographic changes.


CK-MB is a more useful marker for tracking ongoing infarction than troponin, given its shorter half-life. Re-elevation and subsequent decline in CK-MB levels suggest infarct expansion or recurrent infarction. Elevations in the CK-MB level of more than 50% over a previous nadir are diagnostic for reinfarction.



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