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What're the complications of a heart attack?

Ventricular tachycardia (VT) and ventricular fibrillation (VF): A heart attack can damage the ventricles (the heart chambers that pump blood to the lungs and to the rest of the body) and trigger the development of a rapid heartbeat called ventricular tachycardia (VT). In ventricular tachycardia, the heart often beats very fast. As a result, the ventricles do not pump effectively, which can cause low blood pressure, heart failure, loss of consciousness, and sudden death.Ventricular fibrillation (VF) is

also a rapid heartbeat. In ventricular fibrillation, however, the lower chambers of the heart beat in such a disorganized way that no significant amount of blood is pumped to the rest of the body. Ventricular fibrillation is an extremely dangerous condition and generally leads to loss of consciousness within a matter of seconds and without immediate treatment, death.Ventricular tachycardia and ventricular fibrillation occur most commonly within the first 12 hours after a heart attack and account for most of the deaths occurring during this interval.

Atrial fibrillation: Decreased blood flow to the heart and overfilling of the atria (the heart's upper chambers) after a heart attack can trigger atrial fibrillation, an irregular heartbeat. Since the heart's electrical signal travels from the atria to the pumping chambers of the heart (ventricles), atrial fibrillation in turn produces a rapid and irregular ventricular heartbeat. The fast heart rate may be difficult to control and can prevent the heart from pumping effectively, leading to heart failure. In addition, blood clots can form in the atria during atrial fibrillation and travel to your brain, causing a stroke, or travel to other organs and often cause damage.

Cardiogenic shock: People with cardiogenic shock after a heart attack have very low blood pressure and heart failure, and may experience confusion, lethargy, and kidney problems due to poor blood flow to the brain and kidneys. Cardiogenic shock is a particularly dangerous complication that is associated with a very high risk of death. Patients with cardiogenic shock are treated with medications that either increase the amount of blood pumped or reduce the pressure the heart is pumping against. Some individuals may receive a device called an intraaortic balloon pump. The pump is inserted into the aorta, the major blood vessel that supplies blood to the body from the heart. Inflation of the pump increases the blood pressure in the aorta, which, in turn, increases blood flow to the coronary arteries and peripheral (far away) body tissues.

Arrhythmias (abnormal heart rhythms): The heart is normally driven by electrical impulses that follow specific pathways through the heart muscle. A heart attack damages heart muscle and often disrupts these electrical pathways. Other stimulation of the body's nervous system and certain heart medications can also disturb the heart's electrical impulses. These changes cause abnormal heart rates and rhythms, called "arrhythmias."

Rupture of the heart wall: On occasion, the damage to the heart muscle is so severe that one of the walls of the heart breaks down and ruptures; this is extremely serious and life-threatening. If the rupture occurs in the muscle between the left and right ventricles (ventricular septum), you may develop recurrent chest pain, low blood pressure, and heart failure. A new loud heart sound may also develop as the left ventricle squeezes blood through the hole in the septum into the right ventricle with each heartbeat. A suspected hole in the ventricle septum can be diagnosed using an echocardiogram and usually requires emergency surgery to correct the problem. Rupture of the "free wall" of the heart is a complication in which the muscular outer wall of the left ventricle becomes severely damaged and breaks open. This allows blood within the ventricle to leak out into the space surrounding the heart (pericardial space). The condition usually is fatal, and opportunities for surgical repair are rare.

Heart failure: Damage to heart muscle from a heart attack may leave the heart unable to pump effectively. If 30 percent or more of the heart muscle in the wall of the left ventricle has been affected, it is likely the patient will develop congestive heart failure. These patients may experience shortness of breath because of fluid in lung airways. This is caused by the fact that the heart cannot effectively pump blood forward through the body. This condition can usually be treated effectively with medications but may require cardiac bypass surgery.

Valve regurgitation: Damage to the structures of the heart that support the mitral valve can cause blood to leak back into your left atrium (the chamber above the left ventricle), rather than flowing forward to the rest of your body. This is known as mitral regurgitation. If you suffer a large heart attack, your left ventricle may start to enlarge (dilate), pulling the leaflets of the mitral valve apart so that they do not close completely, which also causes the valve to leak. If you develop mitral valve regurgitation after a heart attack, you may develop heart failure and feel short of breath.

Recurrent chest pain: The most common and most serious cause of recurrent chest pain is a reduction in the blood supply to the heart (ischemia), which usually occurs because the artery that was blocked and caused the initial heart attack has become blocked again, or there are blockages in other blood vessels of the heart. Ischemia can be a temporary problem and simply cause chest pain, or the blockage may continue and damage your heart muscle further.

Pericarditis: Pericarditis refers to inflammation of the outer lining of the heart (pericardium). The damaged heart muscle triggers inflammation that may also affect the pericardium. People with pericarditis commonly complain of sharp chest pain that worsens with breathing, coughing, or changing position. Pericarditis is rarely life-threatening. However, if fluid or blood builds up inside the pericardial space, heart function might be impaired, causing shortness of breath, lightheadedness, and low blood pressure.

More information on heart attack (myocardial infarction)

What's a heart attack (myocardial infarction)? - A heart attack (myocardial infarction) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot.
What're the signs and symptoms of a heart attack? - Symptoms of a heart attack include pain and pressure in the chest, which often spread to the shoulder, arm, and neck.
What're the women's heart attack symptoms? - A woman's heart attack has more varied symptoms than a man's. Women are more likely to have nausea and pain high in the abdomen.
What're the warning signs of a heart attack? - Warning signs of a heart attack include uncomfortable pressure, fullness, squeezing, or pain in the center of the chest, cold sweat or paleness.
What causes a heart attack? - Heart attack is caused by a lack of blood supply to the heart for an extended time period. The most common cause of heart attack is atherosclerosis.
What're the complications of a heart attack? - Complications of a heart attack include ventricular tachycardia, ventricular fibrillation, cardiogenic shock, arrhythmias, heart failure.
What're the risk factors for heart attack? - Heart attack risk factors can be devided into two groups: Inherited (or genetic) risk factors and acquired risk factors.
How is a heart attack diagnosed? - The most important factor in diagnosing and treating a heart attack is prompt medical attention. For a complete diagnosis, the medical history is vital.
What're the treatments for heart attack? - The goal of treatment for heart attack is to quickly open the blocked artery and restore blood flow to the heart muscle, a process called reperfusion.
What drugs are used to cure heart attack? - Medications used to treat heart attacks include blood vessel dilators, clot busters, beta blockers, antiarrhythmic drugs, pain relievers.
What surgeries treat heart attacks? - Surgeries to treat heart attacks include coronary angioplasty, coronary artery bypass surgery, transmyocardial revascularization, and atherectomy.
Aspirin and heart attacks - Aspirin is taken daily following a heart attack to reduce the risk of another heart attack. Aspirin reduces heart attacks and improve survival in the patients.
How to survive a heart attack? - In wilderness first aid, a possible heart attack justifies medical evacuation by the fastest available means. Heart attacks are survivable.
How to prevent a heart attack? - Heart attack can be prevented with a healthy liestyle. Daily aspirin therapy or other medical treatment help prevent heart disease and heart attack.
How to recover after a heart attack? - Following discharge from the hospital, patients continue their recovery at home. Lowering cholesterol can reduce the risk for another heart attack.
Heart & cardiovascular disorders Mainpage

Topics in heart disease and cardiovascular disorders

Coronary circulation disorders
Myocardium disorders
Heart valve disorders
Arrhythmias (abnormal heart rhythms)
Heart inflammation and infection
Congenital heart disease
Valvular disease (blood vessels disorders)
Procedures done for coronary artery disease
Devices used in cardiology
Diagnostic tests and procedures for heart diseases
Heart transplant

Featured articles on heart disease and cardiovascular disorders

Coronary artery disease
Heart attack (myocardial infarction)
Cardiac arrhythmia
Heart valve replacement
Congestive heart failure
Aortic aneurysm
Atrial fibrillation

All information is intended for reference only. Please consult your physician for accurate medical advices and treatment. Copyright 2005,, all rights reserved. Last update: July 18, 2005