Occur due to ischaemic injury or irritation to the conduction system which leads to abnormal rhythm (Sinus bradycardia, Atrial fibrillation, Heart block, Tachycardia, Ventricular Tachycardia, and Ventricular Fibrillation)
Mural thrombus
Combination of local abnormality in contractility (causing stasis) and endocardial damage (creating thrombogenic surface) leads to mural thrombus.
Mural thrombi often form thromboemboli
May cause occlusion of the pulmonary, renal, mesenteric, splenic, pancreatic or cerebral arteries and cause infarcts there
Myocardial rupture
Occurs when there is transmural necrosis of ventricle
Rupture of the ventricular free wall producing hemopericardium and cardiac tamponade
Rupture of the ventricular septum producing acute VSD leading to left-to-right shunt
Papillary muscle rupture leading to acute onset of severe mitral regurgitation
Risk factors – >60 , first MI, large, transmural & anterior MI and preexisting hypertension
Ventricular aneurysm
Late complication of large transmural infarcts that undergo early expansion
Thin scar tissue wall of an aneurysm paradoxically bulges during systole
Complications – mural thrombus, arrhythmias, and heart failure
Pericarditis
Fibrinous or fibrinohemorrhagic pericarditis due to myocardial inflammation