Myocardial perfusion and cardiac function affect blood flow to the entire body. As a result, any end organ can be damaged when cardiac pump function is decreased. In this section, discussion of the complications of acute coronary syndromes is limited to the direct effects on the heart. The systemic effects of cardiac function are discussed in organ-appropriate chapters of this book. The treatment of these complications is discussed in the following chapter.
The genesis, diagnosis, and treatment of dysrhythmias are presented in Chap..24. The effect dysrhythmias have in complicating the course of patients with acute coronary syndromes is the subject of this section.
Dysrhythmias occur in 72 to 100 percent of AMI patients treated in the coronary care unit. I§b]e.,..4Z.-8. shows the approximate frequency of the various dysrhythmias observed in patients with AMI. Many of these dysrhythmias occur in the prehospital and ED setting. The main consequence of these dysrhythmias is that they may impair hemodynamic performance, compromise myocardial viability by increasing myocardial oxygen requirements, and predispose to even more serious rhythm disturbances by diminishing the ventricular fibrillation threshold.
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