The most common complication after acute myocardial infarction is :

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

Dysrhythmias are the most frequent complication following an acute myocardial infarction (MI), affecting 80-90% of patients.
They are caused by electrical instability of the heart muscle due to ischemic injury to the conduction system.
Contributing factors include electrolyte imbalances (like potassium leakage from damaged cells) and metabolic changes (like lactate accumulation).

Option A: Cardiac tamponade is a rare complication, occurring in less than 5% of AMI cases. It is caused by the rupture of the heart wall, leading to blood accumulation in the pericardial sac.
Option B: While cardiac failure is a very common and serious complication, affecting about half of MI patients, its incidence is lower than that of dysrhythmias.
Option C: Pulmonary embolism is a type of thromboembolism, which occurs in 15-45% of MI patients. This is significantly less frequent than dysrhythmias.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Acute Myocardial Infarction (AMI) as background academic context rather than a clinical decision trigger.
Continuous ECG monitoring is a critical nursing intervention for all patients with acute MI to detect and manage life-threatening arrhythmias promptly.
Nurses in cardiac care units must be proficient in arrhythmia interpretation and ready to initiate Advanced Cardiac Life Support (ACLS) protocols, including defibrillation for Ventricular Fibrillation (VF).
Patient education should include symptoms of arrhythmias, such as palpitations, dizziness, or syncope, and the importance of reporting them immediately.

How to Approach the Question

First, identify the keywords in the question stem: "most common complication" and "acute myocardial infarction".
This is a factual recall question that requires knowledge of the relative frequencies of different post-MI complications.
Mentally categorize the complications of MI: electrical (arrhythmias), mechanical/pump function (heart failure, shock), structural (rupture, aneurysm), and embolic (pulmonary or systemic embolism).
Recall that myocardial ischemia directly causes electrical instability in the heart cells, making arrhythmias an almost immediate and widespread consequence.
Compare the known incidence rates: Dysrhythmias occur in the vast majority (80-90%), while heart failure is around 50%, and others like rupture are much rarer (<5%).
Based on this comparison, conclude that dysrhythmias are the most common complication.

Concept Tested & Keywords

QTrFnoqN-0XTTQ1If1Tosm

E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 197-199

E6 Medicine Davidson Principles Practice 24e p. 516-518