Left ventricular failure following myocardial infarction

The cause of left ventricular failure following myocardial infarction is most commonly a large infarct, or infarction in patients with a prior history of left ventricular dysfunction. Mechanical complications must also be considered, particularly when haemodynamic decompensation is abrupt and unexpected. Ventricular septal defect or mitral regurgitation are suggested by a prominent systolic murmur, often with pulmonary oedema, right heart failure, hypotension or shock.

A mild episode of acute pulmonary congestion in a patient with a recent myocardial infarction usually responds to a diuretic. For more severe episodes, see Initial treatment of acute cardiogenic pulmonary oedema in the prehospital setting for management.