Different heart rhythm disorders occur in almost all patients with myocardial infarction (MI). Arrhythmias in setting of MI are caused by electrical instability of myocardium as a result of metabolic and microcirculatory disorders. However, the presence of even severe heart rhythms disorders does not provide a basis for diagnosis of arrhythmic MI. In arrhythmic variant of infarction heart rhythm disorders and associated symptoms should prevail in clinical presentation. Supra ventricular or ventricular paroxysmal tachycardia, less often atrial fibrillation or flutter, and high degree AV block are registered most commonly. Pain may be absent or slight. Loss of consciousness is possible, due to cerebral blood circulation disorder. Arrhythmic variant may be accompanied by acute heart failure or significant arterial hypotension, up to arrhythmogenic shock. This variant of MI often occurs in older people who have anamnesis of structural heart diseases. In MI patients, reduction of cerebral blood circulation due to tachyarrhythmia and hypotension can cause ischemic stroke.
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