Reperfusion injury natural history
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Editors-In-Chief: Anjan K. Chakrabarti, M.D. [1]; C. Michael Gibson, M.S., M.D. [2]; Associate Editors-In-Chief: Kashish Goel, M.D.
Overview
Hypothetical assessment of reperfusion injury and change in its natural history with myocardial protective methods is presented in medical therapy section. Animal studies have shown that reperfusion injury may be responsible for about 50% of the total infarct size after an acute myocardial infarction.
Complications
- Myocardial stunning: Delayed recovery, usually 2-3 days, of the viable myocardium after reperfusion is termed as "myocardial stunning". It is mainly due to the release of reactive oxygen species and intracellular calcium overload.
- Myocardial infarction: Irreversible myocyte cell death secondary to reduced oxygen delivery for more than 20-30 minutes, will lead to infarction. Reperfusion helps prevent complete loss of the involved area, however oxidative stress due to this may prevent complete resolution.
- Acute heart failure: Loss of myocardial contractility and systolic dysfunction associated with ischemia/reperfusion injury may lead to development of acute heart failure. Early reperfusion in the course of STEMI prevents myocardial necrosis and may lead to complete recovery of function.
- Ventricular arrhythmias: