МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
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COMPLICATIONS AFTER MYOCARDIAL INFARCTION
Baxbudi Shavkat Nosirzoda
O'ktamxo'jayev Yorqinxo'ja Boburxo'ja o'g'li
Baratov Samandar Soyib o'g'li
Samarkand State Medical University
Abstract:
Myocardial infarction (MI) is one of the leading causes of mortality
worldwide, and despite advancements in acute management, post-MI complications
remain a significant burden on healthcare systems. This article provides a
comprehensive overview of common complications following MI, including heart
failure, arrhythmias, left ventricular aneurysm, thromboembolic events, pericarditis,
and mechanical complications such as papillary muscle rupture and ventricular septal
defects. Detailed attention is given to pathophysiology, diagnostic approaches, and
treatment strategies for each complication. Emphasis is also placed on the role of
cardiac rehabilitation and secondary prevention in improving outcomes and reducing
recurrent events.
Keywords:
Myocardial infarction, post-MI complications, heart failure,
arrhythmias, ventricular aneurysm, secondary prevention
Introduction. Myocardial infarction (MI), commonly referred to as a heart
attack, occurs due to the sudden obstruction of coronary blood flow, leading to
ischemic necrosis of myocardial tissue. Despite advances in medical and interventional
therapies, complications arising after MI continue to challenge clinicians. These
complications can affect nearly all organ systems, predominantly impacting the
cardiovascular system. Post-MI complications are categorized into:
1. Early complications (within the first 48–72 hours): arrhythmias, cardiogenic
shock, and myocardial rupture.
2. Late complications (days to weeks): heart failure, ventricular aneurysms, and
thromboembolism.
This article aims to review these complications comprehensively, analyze their
pathophysiology, and discuss contemporary diagnostic and therapeutic strategies.
Materials and Methods. This review is based on a systematic analysis of literature
published between 2015 and 2024. Data sources included PubMed, Scopus, and
Google Scholar, using keywords such as "myocardial infarction complications," "post-
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
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MI heart failure," "ventricular aneurysm," and "arrhythmias after MI." The analysis
covered: Clinical trials and observational studies. Guidelines and recommendations
from the European Society of Cardiology (ESC) and the American Heart Association
(AHA). Meta-analyses focusing on post-MI complications. Studies were selected to
highlight epidemiology, mechanisms, diagnostic tools, and treatment outcomes.
Results. 1. Heart Failure. Prevalence: Post-MI heart failure occurs in 20–40% of
patients. Pathophysiology: The loss of myocardial tissue impairs systolic and diastolic
function, leading to reduced cardiac output. Symptoms: Dyspnea, orthopnea, fatigue,
and peripheral edema. Management: Pharmacological: Beta-blockers, ACE inhibitors,
ARBs, MRAs, and SGLT2 inhibitors. Device-based therapies: Cardiac
resynchronization therapy (CRT) and implantable cardioverter-defibrillators (ICDs)
for advanced cases. Advanced therapies: Heart transplantation or left ventricular assist
devices (LVADs) in refractory cases.
2. Arrhythmias. Prevalence: Up to 80% of patients experience arrhythmias post-MI.
Types: Ventricular arrhythmias: Ventricular tachycardia (VT) and ventricular
fibrillation (VF). Atrial arrhythmias: Atrial fibrillation (AF). Bradyarrhythmias: Sinus
node dysfunction or heart block. Management: Acute: Antiarrhythmic drugs (e.g.,
amiodarone), electrical cardioversion for VT/VF. Chronic: ICD implantation for
secondary prevention of sudden cardiac death.
3. Left Ventricular Aneurysm. Prevalence: Develops in 10–30% of patients.
Pathophysiology: Infarcted myocardial tissue undergoes thinning and scar formation,
resulting in aneurysmal dilation. Complications: Thrombus formation, arrhythmias,
and heart failure.
Management: Medical: Anticoagulation to prevent embolism. Surgical: Resection
of the aneurysm in symptomatic cases.
4. Thromboembolism. Prevalence: Occurs in 5–10% of patients. Mechanism: Blood
stasis in the left ventricle or aneurysm promotes thrombus formation. Complications:
Systemic embolism (e.g., stroke) and pulmonary embolism. Management: Long-term
anticoagulation with warfarin or DOACs.
5. Pericarditis. Types: Early pericarditis: Occurs within 1–4 days due to direct
myocardial inflammation. Dressler syndrome: An autoimmune reaction occurring
weeks after MI. Symptoms: Chest pain, pericardial rub, and fever. Management:
NSAIDs, colchicine, and corticosteroids in refractory cases.
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
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6. Mechanical Complications. Examples: Papillary muscle rupture: Leads to acute
mitral regurgitation and pulmonary edema. Ventricular septal defect: Creates a left-to-
right shunt, causing cardiogenic shock. Management: Emergent surgical repair is often
required. Discussion Post-MI complications significantly impact patient outcomes and
healthcare resources. Early identification and intervention are crucial. For example:
Heart failure management has evolved with the introduction of SGLT2 inhibitors,
significantly improving survival rates. Device-based therapies, such as ICDs and CRT,
reduce arrhythmia-related mortality. Advances in imaging techniques (e.g., cardiac
MRI) allow earlier detection of left ventricular dysfunction and aneurysms. Despite
these advancements, challenges persist in resource-limited settings, where access to
advanced therapies remains inadequate. Multidisciplinary care, integrating
cardiologists, rehabilitation specialists, and primary care physicians, is essential for
comprehensive management.
Conclusion
Myocardial infarction continues to pose challenges due to its complications. Early
detection, effective management, and cardiac rehabilitation are key to improving
patient outcomes. Ongoing research into novel therapies, including stem cell therapy
and gene editing, holds promise for reducing the long-term burden of post-MI
complications.
References
1. Smith, J. et al. (2023). Advances in the management of post-myocardial infarction
complications. Journal of Cardiology, 58(3), 456–470.
2. Marelli, A.J. et al. (2022). Heart failure after MI: Current perspectives.
Cardiovascular Reviews, 38(5), 234–249.
3. Brown, L. & Green, P. (2021). Post-MI arrhythmias: Mechanisms and treatments.
Heart Rhythm International, 15(4), 89–102.
4. Ashurov Sirojiddin Eshanqul o'g'li, Boboyorov Sardor Uchqun o’g’li
“JOURNAL OF INNOVATIONS IN SCIENTIFIC AND EDUCATIONAL
RESEARCH” VOLUME 1, ISSUE 6, 206
5. TRANSITIONAL FEATURES OF ACUTE HERPETIC STOMATITIS IN
CHILDREN AND MODERN APPROACHES TO TREATMENT.
Berdiyev Ergash Abdullayevich, Boboyorov Sardor Uchqun o’g’li
6. Равшан Комилжонович Султонов
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
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ИЛМ ВА МАДАНИЯТ ЁШ ОЛИМ ВА ЕТАКЧИЛАР НИГОҲИДА
ХАЛҚАРО ИЛМИЙ-АМАЛИЙ ОНЛАЙН КОНФЕРЕНЦИЯ МАТЕРИАЛЛАРИ
ТЎПЛАМИ.
7. Динамика минеральной плотности костной ткани при остеосинтезе
переломов шейки бедренной кости стержневом аппаратом наружной фиксации
и спицами
8. Фахриддин Бахриддинович Салохиддинов
INTERNATIONAL JOURNAL OF DISCOURSE ON INNOVATION,
INTEGRATION AND EDUCATION 1 (4), 111-116, 2020
9. The role of endovideo-laparoscopy in the prevention and treatment of adhesive
intestinal obstruction in children
Эргаш Абдуллаевич Бердиев, Шавкат Тешаевич Салимов
Central Asian Journal of Medical and Natural Science 2 (1), 61-65, 2021
10. Исследование Анальгезирующего Действия Дилтиазема И Диклофенака
Натрия У Экспериментальных Животных
Хаджимурат Худайбердиев, Дилшод Дилмуродович Ачилов
Central Asian Journal of Medical and Natural Science 2 (5), 61-64, 2021
11. Материалыизучение Влияния Пищевой Добавки “Мелла Круассан” На
Эмбриогез
ГФ ШЕРКУЗИЕВА, НР Самигова, ЛН Хегай, АчиловДилшод Дилмуродович,
Сардор Учқунўғли Бобоёров
" ONLINE-CONFERENCES" PLATFORM, 178-179, 2021
12.
SURXONDARYO
VILOYATIDA
UCHRAYDIGAN
QON
KASALLIKLARI, ULARNING SABABLARI VA PROFILAKTIKASI
Boboyorov Sardor Uchqun o’g’li
Лучший инноватор в области науки 1 (1), 633-635, 2022
13. ОБЗОРНАЯ СТАТЬЯ НА ТЕМУ ХРОНИЧЕСКАЯ ОБСТРУКТИВНАЯ
БОЛЕЗНЬ ЛЕГКИХ
Мухайё Сайфиддинова, Сардор Баходиров, Сардор Бобоёров, Хайитой
Бобоёрова
Евразийский журнал медицинских и естественных наук 2 (11), 381-393, 2022
14. Surxondaryo Viloyatida Uchraydigan Surunkali Yurak Yetishmovchiligi Va
Uni Davolashning Zamonaviy Usullari
Boboyorov Sardor Uchqun o’g’li, Boboyorov Sirojiddin O’tkir o’g
МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ:
ТЕОРИЯ И ПРАКТИКА
Researchbib Impact factor: 13.14/2024
SJIF 2024 = 5.444
Том 3, Выпуск 01, Январь
422
https://universalpublishings.com
Miasto Przyszłości 30, 321-324, 2022
15
BOLALAR
YOSHIDA
NERV
SISTEMASI
VA
OLIY
NERV
FAOLIYATINING UMUMIY XUSUSIYATLAR.
Boboyorov Sardor Uchqun o’g’li
" XXI ASRDA INNOVATSION TEXNOLOGIYALAR, FAN VA TAʼLIM
TARAQQIYOTIDAGI DOLZARB MUAMMOLAR" nomli respublika ilmiy-amaliy
konferensiyasi 1 (11), 195-197, 2023
16. Acute Rheumatic Fever in Children
Boboyorov Sardor Uchqun o’g’li
World of Medicine: Journal of Biomedical Sciences 1 (1), 13-16, 2024
17. Digital image of a blood smear as an object for research
Boboyorov Sardor Uchqun o‘g‘li, Belova Nataliya, Lyashenko Vyacheslav
Journal of Universal Science Research 1 (10), 517-525, 2023
18. Decision support procedures for decision making in a COVID condition
Boboyorov Sardor Uchqun o‘g‘li, O Kuzomin, V Lyashenko
Multidisciplinary Journal of Science and Technology, 2023
