Heart attack
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Complications after a heart attack

The most common problems that develop after a heart attack often happen because your heart is no longer working correctly. Developing complications may mean you have more tests, get more intensive treatment and stay in the hospital longer.

Abnormal heart rhythm
It's very common for a heart attack to disrupt the normal way your heart beats. Your heart may beat too fast, too slow or in an uneven way. Having an irregular heartbeat means that instead of beating evenly (thump thump thump) like the ticking of a watch, it might beat like this: thump thump thumpthump thump.

The most dangerous kinds of abnormal rhythms stop your heart from pumping properly. Or they may make your heart work so hard it can't get enough oxygen. Very fast heart rhythms are more common and more dangerous than very slow ones. They can cause your heart to stop, a condition doctors call cardiac arrest.

Abnormal heart rhythms are also called arrhythmias.

Sometimes the rhythm goes back to normal without treatment. If it doesn't, you'll need medication. If your heart's rhythm is dangerously abnormal, particularly if it's very fast, doctors can reset it quickly by passing an electric current through it. This is called cardioversion. If you need to have this operation, you will have an anesthetic first. Then a machine called a
 
 
 
 
 
defibrillator
A defibrillator is an electronic device that is used to restore normal heart rhythm. It works by giving electric shocks to your chest.
 
 
 
 
 
defibrillator will be used to find the abnormal rhythm and give an electric shock to your heart.

Heart failure
If your heart attack is severe, your heart muscle may be left too weak to pump correctly. When it's no longer able to move blood around your body, pressure builds up behind the damaged part of your heart. If the damage is mainly on the left side of your heart, pressure builds up in your lungs. Fluid is forced out of your blood vessels, and you may become short of breath. There are many treatments available. To learn more, see our article on Heart failure.

Low levels of oxygen in your blood
Doctors call this condition hypoxemia. Usually it means that blood isn't flowing through your lungs very well. If this happens, you'll be given extra oxygen to breath through a face mask. Many people are given oxygen after a heart attack whether or not levels of oxygen in their blood are low.

Low blood pressure
Your blood pressure may be low after a heart attack for several reasons. For example,
 
 
 
 
 
low blood pressure
If your blood pressure is about 100/60 or less, your doctor may say that you have low blood pressure. Low blood pressure is usually not a problem unless it becomes too low to push blood to your brain and the rest of the body. If you have low blood pressure, you may sometimes feel dizzy when you stand up. To find out what these numbers mean, see blood pressure.
 
 
 
 
 
low blood pressure is a side effect of some of the drugs that are taken for heart failure. But it also can be a sign that your heart attack was serious, and that your heart can no longer pump blood properly. Which treatment you get depends on what is causing the problem. If you have very low blood pressure, you'll be admitted to an intensive care unit and given drugs by injection to increase your blood pressure.

Cardiogenic shock
Cardiogenic shock is a dangerous form of low blood pressure that happens when the heart's main pumping chamber is severely damaged. About 7 out of every 100 people admitted to the hospital with heart attacks have cardiogenic shock.
 
 
 
 
 
Source:
Goldberg RJ, Samad NA, Yarzebski J, et al.
Temporal trends in cardiogenic shock after thrombolytic therapy for acute myocardial infarction.
Journal of the American College of Cardiology. 2000; 35: 136-143.
 
 
 
 
 
1 Between 50 percent and 80 percent of these patients die before they leave the hospital. Patients with cardiogenic shock are treated in an intensive care unit. Treatments include drugs that make the heart beat more strongly and operations to repair your
 
 
 
 
 
coronary arteries
Coronary arteries are the vessels that supply blood to the heart muscle. If yours are blocked, you may have a pain in your chest (known as angina) or a heart attack because parts of the heart are not getting enough blood and oxygen.
 
 
 
 
 
coronary arteries if they are affected by disease. (Your coronary arteries supply blood to your heart muscle.)

Chest pain
 
 
 
 
 
angina
Angina is the name that doctors use for a pain in your chest that you get when your heart muscle isn't getting enough oxygen.
 
 
 
 
 
Angina is chest pain that occurs when your heart doesn't get enough oxygen. It's often set off by exercise or emotional stress. If your angina gets worse or you develop it after a heart attack, you m ay be heading for another heart attack. Your doctor will suggest treatment with drugs, heart operations or surgery to keep your angina under control.

Abnormal bulging of the heart wall
Scar tissue in the heart's wall can balloon out, creating a bulge. Doctors call this an aneurysm. An aneurysm can cause abnormal heart rhythms, low blood pressure or blood clots in the heart. If you develop an aneurysm, you'll need to have drugs to keep your blood from clotting. If you still have the problem after drug treatment, your doctor may suggest surgery.

Sources for the information on this page:
  1. Goldberg RJ, Samad NA, Yarzebski J, et al.Temporal trends in cardiogenic shock after thrombolytic therapy for acute myocardial infarction.Journal of the American College of Cardiology. 2000; 35: 136-143.
This information was last updated on Apr 09, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.