What are the most common complications of myocardial infarction? (Select all that apply)
(Select All that Apply.)
Percutaneous coronary intervention
Sudden death
Dysrhythmias
Congestive hearts failure
Correct Answer : B,C,D
A. Percutaneous coronary intervention: Percutaneous coronary intervention (PCI) is a treatment used to open blocked coronary arteries during a myocardial infarction but is not a complication of the event itself. It is a therapeutic procedure aimed at restoring blood flow and is not a direct consequence of myocardial infarction.
B. Sudden death: Sudden death can occur as a complication of myocardial infarction due to severe dysrhythmias or cardiac arrest resulting from electrical instability in the heart. This complication is critical and can occur shortly after the onset of an MI or during recovery.
C. Dysrhythmias: Dysrhythmias are common complications following myocardial infarction, often arising from ischemic damage to the heart muscle, which disrupts the normal electrical conduction pathways. These irregular heartbeats can range from benign to life-threatening.
D. Congestive heart failure: Congestive heart failure can develop as a complication of myocardial infarction due to the loss of functional cardiac muscle, resulting in decreased cardiac output and the heart's inability to pump effectively. This complication can develop acutely or progressively over time following an MI.
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Correct Answer is D
Explanation
A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.
B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.
C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.
D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.
Correct Answer is B
Explanation
A. Thoracotomy: Thoracotomy involves opening the chest cavity to access the heart and lungs; this surgical approach is not the first-line treatment for pericardial effusion and is more invasive than necessary, potentially leading to increased recovery time and complications.
B. Pericardiocentesis: Pericardiocentesis involves inserting a needle into the pericardial space to remove excess fluid; this procedure is a common and effective treatment for symptomatic large pericardial effusions, providing rapid relief of symptoms such as dyspnea and chest pain while also allowing for diagnostic evaluation of the fluid.
C. Heart catheterization: Heart catheterization involves a diagnostic procedure to assess heart function and blood flow through the coronary arteries; while it provides valuable information regarding cardiac conditions, it is not indicated for treating pericardial effusion and does not address the underlying fluid accumulation.
D. Pericardiectomy: Pericardiectomy involves removing part or all of the pericardium; this surgical procedure is typically reserved for chronic cases or constrictive pericarditis, as it is more invasive and not the immediate treatment option for an acute pericardial effusion, where less invasive options are preferred.
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