Dr Sunil Kapoor
Managing complications of myocardial infarction
The most common complications from myocardial infarctions are damage to the heart muscle and abnormal heart rhythms. The longer it takes to open a blocked artery with medications or coronary angioplasty, the more likely it is for these complications to occur. However, even after the blocked artery has been opened, patients remain at risk for these complications, especially in the first several days after a myocardial infarction. Thus, MI patients are usually admitted to the hospital and observed for several days in a specialised unit called the coronary care unit, which has staff specifically trained to care for patients with MI.
In addition to admission to the coronary care unit and testing, various medications are also given to patients who have had an MI in order to minimise complications and prevent future myocardial infarctions:
Anti platelet medications: Anti-platelet medications inhibit the clotting action of platelets, and thus are very useful in preventing future myocardial infarctions.
- Lipid lowering agents: Cholesterol-lowering medications, such as statins, and other lipid therapies have been associated with marked reduction in future cardiac events by stabilising the remaining cholesterol containing plaques.
- Beta-blockers: Beta-blockers slow the heart rate and decrease the adverse effect of excessive adrenaline on the heart.
- ACE inhibitors: ACE inhibitors and ARBs are medications that reduce the resistance the heart has to pump against.
- Coronary artery procedures: Finally, depending on the number and distribution of blockages in the coronary arteries, procedures to open or bypass these blockages may be useful, in addition to the medications, in preventing future myocardial infarctions. These procedures include coronary angioplasty, or coronary artery bypass grafting (CABG) surgery.
(The writer is a senior consultant cardiologist at Care Hospital)