Complications of a heart attack

The effects of a heart attack can often be felt long after your condition has stabilized. About half of all people who have a heart attack will experience a serious complication that may cause many different symptoms and sometimes death.

Complications of a heart attack

Complication	Symptoms	How diagnosed	Treatment
Ventricular tachycardia—a rapid heartbeat in the heart's lower chambers	Racing heart (palpitations) Shortness of breath Chest pain Weakness Dizziness Fainting	Electrocardiography (EKG, ECG)	If no symptoms: intravenous antiarrhythmic medicines; possibly electric shock to the chest (cardioversion) With symptoms: electric shock (cardioversion)
Ventricular fibrillation—a rapid, disorganized heartbeat in the heart's lower chambers	Loss of consciousness Absence of blood pressure Sudden death if not reversed	ECG	Electric shock to the chest (defibrillation)
Atrial fibrillation—a rapid, irregular heartbeat in the heart's upper chambers	Racing heart (palpitations) Shortness of breath Chest pain Weakness Fainting	ECG	If chest pain, breathlessness, or low blood pressure: electric shock to the chest (cardioversion) and/or medicines If no symptoms: intravenous medicines to slow heart rate
Recurrent chest pain because of reduced blood flow and oxygen supply to the heart	Recurrence of angina and heart attack symptoms (chest pain, shortness of breath, nausea, or vomiting)	ECG	Anticoagulant medicines, nitrates, beta-blockers, or calcium channel blockers If no response to medicines or if blockages: angioplasty/stenting or coronary artery bypass graft surgery
Extension or worsening of heart attack—further damage to the heart	Recurrence of angina and heart attack symptoms (chest pain, shortness of breath, nausea, or vomiting)	ECG Blood tests Echocardiography	Anticoagulants, nitrates, beta-blockers Consider use of clot-dissolving (thrombolytic) medicines. If blockages are found: consider angioplasty/stenting or coronary artery bypass graft surgery.
Heart failure	Weakness Fatigue Shortness of breath Low blood pressure Weak pulse Evidence of fluid buildup in the neck, lungs, abdomen, and ankles	Echocardiography Chest X-ray Low blood oxygen level Blood tests	ACE inhibitors, digoxin, angiotensin II receptor blockers (ARBs) Diuretics to remove excess fluid from body If blockages are found: consider angioplasty/stenting or coronary artery bypass graft surgery.
Cardiogenic shock	Shortness of breath Very low blood pressure Bluish skin (cyanosis) Confusion Poor kidney function	Low blood pressure Weak pulse Chest X-ray Echocardiography Swan-Ganz catheter	Medications to increase blood pressure Oxygen Intra-aortic balloon pump Mechanical ventilation Consider heart transplant. Consider coronary angiography/stenting, and if indicated, bypass surgery.
Mitral valve regurgitation	Shortness of breath Low blood pressure Rapid heart rate	Heart murmur heard using stethoscope Echocardiography	Intravenous medication to decrease the workload on heart Placement of intra-aortic balloon pump Emergency valve surgery
Ruptured free wall of the heart—a hole in the wall of the heart that develops from the heart attack	Sudden drop in blood pressure Loss of consciousness	Echocardiography Pericardial tap	Insert a needle through chest wall and remove blood around heart (pericardiocentesis). Stop all blood-thinning medicines. Emergency surgery to repair the ruptured heart
Ventricular septal rupture—a hole in the middle wall of the heart	Sudden heart failure Low blood pressure Chest pain Shortness of breath	Loud heart murmur heard using stethoscope Echocardiography Sample of right ventricle blood that reveals more oxygen than usual Swan-Ganz catheter	Intravenous medicine to decrease the workload on heart Placement of intra-aortic balloon pump to pump blood forward Emergency surgery to repair hole in ventricular septum and coronary bypass surgery, if needed.
Pericarditis	Sharp chest pain made worse by breathing, coughing, or changing position	Rubbing sound heard with stethoscope ECG Echocardiography	Oral anti-inflammatory medicines like ASA (Aspirin) or ibuprofen (Advil or Motrin) Oral steroid medicines can be used if symptoms persist.
Thromboembolus—a blood clot that forms inside the heart and travels to the brain or other body parts, cutting off blood flow	Symptoms of stroke Loss of circulation to an extremity or organ	Echocardiography CT scan	Anticoagulant medicine in hospital Warfarin (such as Coumadin) as an outpatient
Heart block	Light-headedness Shortness of breath with exertion Fainting Seizures	ECG	Medication to increase heart rate Temporary or permanent pacemaker

Author:	Douglas Dana Robin Parks, MS	Last Updated August 15, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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