Embolism

• Non-rhythmic complications of acute MI - Pulmonary emboli and pulmonary infarction:

  • in the 1930's and 40's, 6 - 8 weeks of strict bed rest was routinely recommended post- acute MI
  • As a consequence of this protocol pulmonary embolism and death from pulmonary infarction were common
  • Since then medical opinion has changed radically
  • It is now standard practice for most patients to sit out and mobilise at day 2
  • Standard discharge is at 5 - 9 days post-cardiac event; unless there are complications
  • As a result of early mobilisation, the incidence of pulmonary embolism post-MI is now rare
• Non-rhythmic complications of acute MI - Systemic Arterial Embolisms:

  • Arterial embolisms may occur post-infarct as a result of thrombus formation in the cardiac chambers, known as mural thrombi, which occur as a result of disturbed chamber haemodynamics during the MI or during periods of post-infarct atrial fibrillation (AF)
  • Mural thrombi occur most frequently in the left side of the heart often resulting in a cerebrovascular accident (Stroke)