Embolism | Prognosis after myocardial infarction

Embolism

Embolisms, i.e. blood clots (thrombi) carried in the bloodstream, can enter the arterial vascular system after a heart attack and lead to a stroke, for example, by closing a vessel in the brain. The risk of developing thrombi in the heart is particularly increased when rhythm disturbances occur during a heart attack and coagulation is activated due to the altered flow velocity of the blood. Often, the periods of stasis (standing of the blood column) during arrhythmias result in thrombi in the atrium, which can detach from the heart wall and be flushed out.

Aneurysm of the heart

Later complications, which can occur with some delay to the infarction, are cardiac wall aneurysms, Dressler syndrome and recurrences (renewed heart attacks). An aneurysm of the heart is a bag-like expansion of the heart wall in the area of the heart attack site where muscle cells have died. At the affected area, the movement of the heart wall is disturbed and the ECG shows a continuous ST segment elevation. The consequences of these cardiac changes may be increasing pumping failure of the heart, arrhythmia of the heart and embolisms, which may form on the restricted movable heart wall due to changes in blood flow. A surgical procedure to remove the aneurysm is indicated if the pumping failure of the heart progresses, thrombus formation occurs despite medication-based blood clotting, or repeated cardiac arrhythmias occur.

Dressler Syndrome

The Dressler syndrome is an autoimmune event in which the patient develops pericarditis 6-8 weeks after the heart attack. The body forms antibodies against its own heart muscle cells, these antibodies are detectable in the blood.Infection signs are present: The patient has fever and the inflammatory mediators in the blood are elevated. Autoimmune pericarditis is treated with the administration of analgesic and anti-inflammatory drugs such as acetylsalicylic acid (e.g. Aspirin ®) or indomethacin (e.g. Indometacin Sandoz ®). If the course of the disease is severe, cortisone can be given to inhibit inflammation.