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Myocardial infarction - Complications of a heart attack

NHS Choices Medical Reference

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Potential complications arising from a heart attack can vary widely, from mild to life threatening.

Some people experience what is sometimes referred to as a 'minor' heart attack (although it is still very serious) with no associated complications. This is also known as an uncomplicated heart attack.

Other people experience a major heart attack, which has a wide range of complications and may require extensive treatment.

Some common complications of a heart attack are discussed in more detail below.

Arrhythmia

An arrhythmia is an abnormal heartbeat, such as beating too quickly (tachycardia), too slowly (bradycardia) or irregularly (atrial fibrillation).

Arrhythmias can develop after a heart attack as a result of damage to the muscles. Damaged muscles disrupt electrical signals used by the body to control the heart. Some arrhythmias, such as tachycardia, are mild and cause symptoms such as:

  • palpitations (the sensation of your heart racing in your chest or throat)
  • chest pain
  • dizziness
  • light-headedness
  • fatigue (tiredness)
  • breathlessness

Other arrhythmias can be life threatening, such as:

  • complete heart block, where electrical signals are unable to travel from one side of your heart to the other so your heart cannot pump blood properly
  • ventricular arrhythmia, where the heart begins beating faster before going into a spasm, stopping pumping altogether; known as sudden cardiac arrest - see symptoms of a heart attack for more information on cardiac arrest

These life-threatening arrhythmias can be a major cause of death during the 24 hours after a heart attack.

However, survival rates have improved significantly since the invention of the portable defibrillator, an external device that delivers an electric shock to the heart and 'resets' it to the right rhythm.

Mild arrhythmias can usually be controlled with medication, such as beta-blockers. More troublesome arrhythmias that cause repeated and prolonged symptoms may need to be treated with a pacemaker.

pacemaker is an electric device surgically implanted in the chest which is used to help regulate the heartbeat.

Heart failure

Heart failure is where your heart is unable to effectively pump blood around your body. It can develop after a heart attack if muscles in your heart are extensively damaged. This usually occurs in the left side of the heart (the left ventricle). Symptoms of heart failure include:

  • shortness of breath
  • fatigue
  • swelling in your arms and legs due to a build-up of fluid

Heart failure can be treated with a combination of medications and, in some cases, surgery.

Read more about the treatment of heart failure.

Cardiogenic shock

Cardiogenic shock is similar to heart failure but more serious. It develops when the heart's muscles have been damaged so extensively it can no longer supply enough blood to maintain many of the functions of the body.

Symptoms include:

  • mental confusion
  • cold hands and feet
  • decreased or no urine output
  • rapid heartbeat and breathing
  • pale skin

Cardiogenic shock can be treated using blood-thinning medication, which makes the blood easier to pump. A type of medication called vasopressors may be used. Vasopressors help constrict (squeeze) the blood vessels, which increases the blood pressure and improves blood circulation.

Once the initial symptoms of cardiogenic shock have been stabilised, surgery may be required to improve the function of the heart. One option is to implant a small pump, known as an intra-aortic balloon pump. This can help improve the flow of blood away from the heart.

Another option is a coronary artery bypass graft (where a blood vessel from another part of your body is used to bypass any blockage).

Heart rupture

A heart rupture is a serious and relatively common complication of heart attacks. Heart ruptures occur in around 1 in 10 cases.

A heart rupture is where the heart's muscles, walls, or valves rupture (split apart). A rupture can occur if the heart is significantly damaged during a heart attack. It usually happens one to five days after a heart attack.

Symptoms are the same as those of cardiogenic shock. Open heart surgery is usually required to repair the damage.

The outlook for people who have a heart rupture is not good, and an estimated half of all people die within five days of the rupture occurring.

Aneurysm
An aneurysm is a blood-filled sac that forms in a weakened part of a blood vessel.
Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Depression
Depression is when you have feelings of extreme sadness, despair or inadequacy that last for a long time.
Heart
The heart is a muscular organ that pumps blood around the body.
Heart Attack
A heart attack happens when there is a blockage in one of the arteries in the heart.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Lungs
Lungs are a pair of organs in the chest that control breathing. They remove carbon dioxide from the blood and replace it with oxygen.
Oxygen
Oxygen is an odourless, colourless gas that makes up about 20% of the air we breathe.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign it has been damaged.
Rupture
A rupture is a break or tear in an organ or tissue.
Tissue
Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.
Veins
Veins are blood vessels that carry blood from the rest of the body back to the heart.
Medical Review: March 13, 2012
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