Post procedural myocardial infarction
Post Procedural Myocardial Infarction: What You Need to Know
Post procedural myocardial infarction (PPI) is a potentially serious complication of certain invasive cardiovascular procedures. It is a type of myocardial injury following a procedure. The diagnosis is derived from clinical and laboratory tests, and requires timely management to reduce the risk of long-term complications and improve patient outcomes.
PPI occurs in 0.9-13% of patients who undergo procedures, such as percutaneous coronary intervention (PCI), cardiac ablation, pacemaker/defibrillator implantation, and valve repair or replacement.
What Are the Signs and Symptoms of PPI?
The most common symptom is chest pain. Other symptoms may include:
- Shortness of breath
- Fatigue
- Fainting
- Excessive sweating
- Palpitations
- Nausea
The patient may also experience irregular heart rhythms, rhythm disturbances, or arrhythmias.
What Are the Causes of PPI?
PPI can result from a range of causes, such as incorrect electrode placement during a procedure, trauma to the heart tissue during an ablation or procedure, and prolonged periods when the heart is not beating due to pacemaker/defibrillator implantation.
However, it is important to note that PPI may not be caused by anything related directly to the procedure. Other causes include:
- Atherosclerosis (hardening of the arteries)
- Coronary artery disease
- Coronary vasospasm
- Renal dysfunction
- Pre-existing medical conditions
- Medication side effects
How Is PPI Diagnosed?
PPI is diagnosed using a combination of clinical and laboratory tests. It is important to note that the diagnosis of PPI must be made within 48 hours of the procedure to be considered valid. Tests may include:
- Electrocardiogram (ECG)
- Blood tests to check for elevated levels of troponin
- Echocardiogram
- Coronary angiography
How Is PPI Treated?
Treatment of PPI depends on the cause and symptoms. The goal of treatment is to reduce the risk of long-term complications, and improve patient outcomes.
Treatment may include antiplatelet therapy, anticoagulation, and/or revascularization procedures. In some cases, a medical device may be used to reduce the risk of PPI recurrence.
Conclusion
Post procedural myocardial infarction is a serious condition that can lead to long-term complications and decreased patient outcomes. It is important to diagnose and treat PPI as soon as possible to reduce the risk of further complications and improve patient outcomes.