Complications in Acute Myocardial Infarction: Navigating Challenges in Diagnosis and Management

Hearts Pub Date : 2024-03-13 DOI:10.3390/hearts5010009
Errol C. Moras, Shreyas Yakkali, K. Gandhi, H. H. Virk, Mahboob Alam, Syed Zaid, Nitin Barman, Hani Jneid, S. Vallabhajosyula, Samin K. Sharma, C. Krittanawong
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Abstract

In recent decades, significant advancements in pharmacological, catheter-based, and surgical reperfusion technologies have markedly improved outcomes for individuals undergoing acute myocardial infarction. Despite these remarkable progressions, a segment of patients, particularly those with extensive infarctions or delays in revascularization, remains vulnerable to the onset of mechanical complications associated with myocardial infarction. These complications, spanning mechanical, electrical, ischemic, inflammatory, and thromboembolic events, pose substantial risks of morbidity, mortality, and increased utilization of hospital resources. The management of patients experiencing these complications is intricate, necessitating collaborative efforts among various specialties. Timely identification, accurate diagnosis, hemodynamic stabilization, and decision-making support are crucial for guiding patients and their families in choosing between definitive treatments or palliative care. This review underscores the critical importance of promptly identifying and initiating therapy to reduce prolonged periods of cardiogenic shock and the potential for fatality. By presenting key clinical and diagnostic insights, this review aims to further improve early diagnosis and offer an updated perspective on current management strategies for the diverse range of complications associated with acute myocardial infarction.
急性心肌梗死并发症:驾驭诊断和管理中的挑战
近几十年来,药物、导管和外科再灌注技术取得了重大进展,明显改善了急性心肌梗死患者的预后。尽管取得了这些令人瞩目的进步,但仍有一部分患者,尤其是大面积心肌梗死或血管再通术延迟的患者,很容易出现与心肌梗死相关的机械性并发症。这些并发症包括机械性、电击性、缺血性、炎症性和血栓栓塞性事件,对发病率、死亡率和医院资源的使用率都构成了巨大风险。对这些并发症患者的管理错综复杂,需要各专科的通力合作。及时发现、准确诊断、稳定血流动力学和决策支持对于指导患者及其家属在确定性治疗或姑息治疗之间做出选择至关重要。本综述强调了及时发现和启动治疗以减少长期心源性休克和潜在死亡的至关重要性。通过介绍关键的临床和诊断见解,本综述旨在进一步改善早期诊断,并为急性心肌梗死相关的各种并发症的当前管理策略提供最新视角。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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