Acute and long-term complications of acute STEMI
Acute and long-term complications of acute myocardial infarction are summarized in Figure 3 (below). Ventricular tachycardia and ventricular fibrillation may occur any time after the coronary artery is occluded. These arrhythmias, which are due to ischemia, are particularly common during the first few hours after artery occlusion. They cause the vast majority of deaths in the acute phase. The risk then rapidly abates within 6 hours. However, myocardial infarction (particularly if extensive and in presence of heart failure) may result in chronic remodeling of the myocardium; such remodeling can cause ventricular tachycardia and ventricular fibrillation. The most common mechanical complication of acute STEMI (and myocardial infarction in general) is papillary muscle rupture. Wall rupture (septum or left ventricular free wall) is less common. Ischemic bradyarrhythmia (bradycardia) is also common, especially with inferior infarctions.


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