- Bradiaritmia. Imbalance can be caused by sympathetic - parasympathetic, heart disease, especially in the inferior wall IMA. This disorder is temporary, but if the cause hemodynamic obstraction, it necessary to treat. Medical sulfas tested given atropine 0.5 mg IV, repeated every 5 minutes until a total dose of 2 mg. When the pulse response does not increase, the installation of temporary pacemaker (temporary) is the primary choice. If bradiaritmia is permanent, especially in the anterior wall of Acute Myocardial Infarction, may require a permanent pacemaker.
- Takiaritmia. Can be derived from supraventrikuler or ventricular. Takiaritmia ventricular happened to Acute Myocardial Infarction categorized malignant arrhytmias. Ventricular Takiaritmia most responsive to therapy Lidocaine IV. Recurrent small part can be given Amiodraone IV. In the event of ventricular fibrillation conducted according to standart protocol defibrilasi. Prophylactic lidocaine on the Acute Myocardial Infarction routinely is not recommended.
Complications of heart disease is the second commonest, especially in anterior wall myocardial, large anterior because contractile elements damaged. In the anterior Acute Myocardial Infarction to watch, a sign :
- Tachycardia is not clear why (> 110 x / min).
- Tend hypotension
- Patient anxiety, decreased tissue perfusion
- Breathing frequency increased
- Decreased urine production
- Physical examination found bilateral ronki wet, Gallop, noisy mitral regurgitation
All the above signs is a sign of left heart failure.
Heart disease mortality Acute Myocardial Infarction with cardiogenic shock 80 %. The principle of treatment is to increase coronary flow, reduced cardiac work and improve the flow of systemic. Besides the general resuscitation measures on heart disease remain to be done that is oxygen - ventilation, correction of electrolyte, acid base, eliminate pain and maintain sinus rhythm. Dopamine and dobutamin used to improve contractility and to maintain blood pressure.