[Prognosis of the acute stage of myocardial infarction. Rhythm factors].
At the present time, it is still difficult to determine the real prognostic significance of cardiac arrhythmias in the acute phase of myocardial infarction. The metabolic and electrogenic consequences of myocardial ischaemia are responsible for the principal mechanisms involved in the development of arrhythmias in the ICU: conduction disorders and/or ventricular arrhythmias. Based on a review of the literature, the author analyses the prognostic value of the principal arrhythmias: branch block, atrio-ventricular block, primary ventricular fibrillation and repetitive or isolated ventricular extrasystoles. A number of conclusions can be drawn from this study: isolated arrhythmias in the acute phase are a sign of metabolic and electrolyte disorders and only influence the immediate prognosis. The same arrhythmias, associated with anatomical damage, altered myocardial function or heart failure, may be the sign of severe, long term complications. The development of arrhythmias in the acute phase of infarction should not be interpreted in isolation, but together with the results of further investigations to test the value of the myocardium and the electrical instability. The patient's real risk can only be evaluated on the basis of all of these findings.
D001145:Arrhythmias, Cardiac / Q000150:complications / Q000209:etiology / Q000503:physiopathology*; D003645:Death, Sudden / Q000209:etiology; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D011379:Prognosis
Pronostic au stade aigu de l'infarctus myocardique. Facteurs rythmiques.