Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research
Mechanical reperfusion with primary angioplasty, as the treatment of choice in acute myocardial infarction (MI), is associated not only with a high percentage of full epicardial and tissue reperfusion but also with a very good immediate and long-term clinical outcome. However, the Achilles heel of M...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/24/5904 |
| _version_ | 1797503452793798656 |
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| author | Jaroslaw Zalewski Karol Nowak Patrycja Furczynska Magdalena Zalewska |
| author_facet | Jaroslaw Zalewski Karol Nowak Patrycja Furczynska Magdalena Zalewska |
| author_sort | Jaroslaw Zalewski |
| collection | DOAJ |
| description | Mechanical reperfusion with primary angioplasty, as the treatment of choice in acute myocardial infarction (MI), is associated not only with a high percentage of full epicardial and tissue reperfusion but also with a very good immediate and long-term clinical outcome. However, the Achilles heel of MI treatment is its ensemble of complications, such as cardiogenic shock due to severe systolic and/or diastolic dysfunction or MI mechanical complications, including perforation of the left ventricular free wall, papillary muscle rupture with acute mitral regurgitation and ventricular septal rupture. They are associated with an increased or, sometimes, with an extremely high mortality rate, determining the overall mortality in an MI patient population. In this review we summarize the mechanisms of MI complications, current therapeutic management and alternative directions for overcoming their devastating consequences. Moreover, we have sought to indicate gaps in the evidence on current treatments as the potential targets for further clinical research. From the perspective of mortality trends that are not improving, the forthcoming therapeutic management of complicated MI will require an individualized and novel approach based on their thorough pathobiology. |
| first_indexed | 2024-03-10T03:50:52Z |
| format | Article |
| id | doaj.art-7e72f66516994c9c974015d66bc07423 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:50:52Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7e72f66516994c9c974015d66bc074232023-11-23T08:57:56ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-011024590410.3390/jcm10245904Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent ResearchJaroslaw Zalewski0Karol Nowak1Patrycja Furczynska2Magdalena Zalewska3Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, 80 Pradnicka Street, 31-202 Krakow, PolandDepartment of Coronary Disease and Heart Failure, Jagiellonian University Medical College, 80 Pradnicka Street, 31-202 Krakow, PolandDepartment of Coronary Disease and Heart Failure, Jagiellonian University Medical College, 80 Pradnicka Street, 31-202 Krakow, PolandDepartment of Emergency Medicine, Faculty of Health Science, Jagiellonian University Medical College, Michalowskiego 12 Street, 31-126 Krakow, PolandMechanical reperfusion with primary angioplasty, as the treatment of choice in acute myocardial infarction (MI), is associated not only with a high percentage of full epicardial and tissue reperfusion but also with a very good immediate and long-term clinical outcome. However, the Achilles heel of MI treatment is its ensemble of complications, such as cardiogenic shock due to severe systolic and/or diastolic dysfunction or MI mechanical complications, including perforation of the left ventricular free wall, papillary muscle rupture with acute mitral regurgitation and ventricular septal rupture. They are associated with an increased or, sometimes, with an extremely high mortality rate, determining the overall mortality in an MI patient population. In this review we summarize the mechanisms of MI complications, current therapeutic management and alternative directions for overcoming their devastating consequences. Moreover, we have sought to indicate gaps in the evidence on current treatments as the potential targets for further clinical research. From the perspective of mortality trends that are not improving, the forthcoming therapeutic management of complicated MI will require an individualized and novel approach based on their thorough pathobiology.https://www.mdpi.com/2077-0383/10/24/5904myocardial infarctioncardiogenic shockventricular septal ruptureventricular free wall rupturemitral regurgitationmechanical circulatory support |
| spellingShingle | Jaroslaw Zalewski Karol Nowak Patrycja Furczynska Magdalena Zalewska Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research Journal of Clinical Medicine myocardial infarction cardiogenic shock ventricular septal rupture ventricular free wall rupture mitral regurgitation mechanical circulatory support |
| title | Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research |
| title_full | Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research |
| title_fullStr | Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research |
| title_full_unstemmed | Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research |
| title_short | Complicating Acute Myocardial Infarction. Current Status and Unresolved Targets for Subsequent Research |
| title_sort | complicating acute myocardial infarction current status and unresolved targets for subsequent research |
| topic | myocardial infarction cardiogenic shock ventricular septal rupture ventricular free wall rupture mitral regurgitation mechanical circulatory support |
| url | https://www.mdpi.com/2077-0383/10/24/5904 |
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