My left arm hurts after a heart attack. How to alleviate the patient's condition

myocardial infarction- a disease that occurs as a result of damage to the heart muscle (myocardium) due to blockage coronary artery or one of its branches. Atherosclerosis can lead to complete blockage of the artery, as well as the formation of a blood clot or the separation of a piece of cholesterol plaque that gets stuck in the artery. As a result, the part of the heart muscle that is served by this artery does not receive oxygen and nutrients, and this leads to its weakening or death, that is, to a heart attack. In other words, during a myocardial infarction, there is a violation coronary circulation(the heart has its own branched vascular system, resembling a crown in appearance).
I must say that the cells of the heart muscle, which were fed by the blocked artery, will have enough oxygen supply for about 10 seconds. For about 30 minutes, the heart muscle remains viable. Then the process of irreversible changes in the heart muscle begins and after 3-6 hours from the onset of the attack, the heart muscle in this area dies. Therefore, treatment for a heart attack must begin immediately. In addition, it is important to know that the first hours and days after a heart attack are critical.

Symptoms of myocardial infarction
In most cases, a heart attack causes severe pain in the heart, which is similar to pain during coronary disease hearts. However, it must be said that some people experience mild heart attacks without even knowing it or simply not paying attention to their symptoms.
Most typical manifestation Myocardial infarction is chest pain. Moreover, this pain radiates along the inner surface of the left hand, causing a tingling sensation in the left hand, wrist, fingers. Also, in some patients, heart pain radiates to the shoulder, neck, jaw, interscapular space, mainly on the left. Thus, it can be seen that the pain of a heart attack is not much different from an angina attack.
With myocardial infarction, there is a dagger, tearing, burning, pain in the heart, as if the patient had a "stab in the chest." Sometimes there is an unbearable heartache that makes you scream. And it may not be pain, but discomfort in the chest: the patient seems to have something compressed in the chest, a feeling of pressure is tormented chest, a feeling of heaviness - as if "pulled together with a hoop, squeezed in a vise." Some people only have Blunt pain in the region of the heart, numbness of the wrists, which is combined with severe and prolonged retrosternal pain.
It should be noted that with myocardial infarction, patients feel a sudden pain in the heart, which often occurs at night or early in the morning. Pain in the heart develops in waves, periodically decreases, but does not completely stop. Moreover, with each new wave, pain or discomfort in the chest intensifies, quickly reaches a maximum, and then declines.
Pain or discomfort in the chest during a heart attack lasts more than 30 minutes, sometimes even hours. And for the formation of myocardial infarction, it is enough that anginal pain lasts more than 15 minutes. Another important hallmark myocardial infarction is that the pain in the heart does not decrease when taking nitroglycerin, even repeated, and also the heart pain does not stop even at rest.

Diagnosis of myocardial infarction
The first stage of diagnosing myocardial infarction is carried out on the basis of the symptoms of the disease: the attack lasts more than 30 minutes and does not go away under the influence of medications, and there are also severe chest pains, shortness of breath, and heart rhythm disturbances. If there is a suspicion of a heart attack, then the patient should be urgently hospitalized. In the hospital, in order to confirm the diagnosis of myocardial infarction, the patient undergoes additional examinations, which include:
- ECG (the most accessible and informative method diagnosing a heart attack), the electrocardiogram of a patient with a heart attack reveals specific signs of damage to the heart muscle, which make it possible to establish not only the fact of the presence of the heart attack itself, but also to suggest its size and localization.
- Determination of blood enzymes (LDH, ALT, AST) and proteins specific to the heart muscle (troponins) - is sensitive, but more expensive and less accessible method diagnosis of a heart attack. The fact is that during a heart attack from the heart muscle into the blood certain types enzymes and proteins, the concentration of which can determine the presence of a heart attack.
Further methods for diagnosing a heart attack, as a rule, are carried out if it is necessary to clarify certain features of the disease.

Treatment of myocardial infarction
As mentioned above, treatment of myocardial infarction should be started as soon as possible. Moreover, it often happens that the patient himself must provide first aid to himself. If a severe attack of angina pectoris occurs, which is a pre-infarction condition, the patient should put a nitroglycerin tablet under the tongue. If the pain in the heart does not go away, then after 5 minutes the patient should take a second tablet, and if pain persists for the next 5 minutes, another tablet (3 tablets in total). If, after taking nitroglycerin three times, the pain in the heart does not go away, you need to urgently call an ambulance.
The fact is that the time from the onset of a painful attack to the necessary operation lasts no more than 6 hours. At this time, doctors can still dissolve the clot and save heart cells. However, many patients call an ambulance too late, when time is lost. Before the arrival of the ambulance, the patient must take comfortable posture- half-sitting-reclining. In this case, the load on the heart will be less than in the supine position. You also need to unbutton your clothes, open the window. Nitroglycerin under the tongue will begin to work in about 2 minutes. It will dilate the blood vessels and alleviate the condition. You also need to take 1/4 aspirin tablet (0.5 g each), and better pill chew - so the medicine is absorbed faster. Relief is also brought by heating pads on the legs or arms.
In a hospital, a person with a heart attack is usually placed in the intensive care unit in order to be able to fully control the work of the heart, blood vessels and internal organs. Drugs are immediately applied that dissolve blood clots and restore blood flow in the coronary artery. Moreover, the sooner the drug is introduced to dissolve the blood clot, the better the result will be. The maximum effect is achieved within the first hour from the onset of myocardial infarction. Then, drugs are prescribed that reduce the volume of circulating blood, and also slow down the heart rate and thereby reduce the need for oxygen in the heart muscle and prolong the life of starving cells in the infarct zone.
It is also equally important to prevent the appearance of new blood clots, for which drugs are used that reduce the ability of blood to clot. If necessary, surgical intervention is also possible, treatment for the surgical restoration of the permeability of the coronary arteries.
Thus, the treatment of infarction is carried out by specialist doctors and includes pain relief treatment, blood clotting prevention treatment, heart failure maintenance treatment, arrhythmia treatment, and so on.
With extensive myocardial infarction, death can occur, even despite the treatment taken.

Rehabilitation of patients with myocardial infarction
After an acute period, it is necessary to carry out treatment for the rehabilitation of patients with myocardial infarction. As a rule, in rehabilitation treatment include:
a) Fight against arterial hypertension
b) Weight loss (anti-obesity)
c) Eating a diet low in cholesterol and animal fats
d) Complete rejection of bad habits, especially smoking
e) Therapeutic exercise
f) Sanatorium and resort treatment.
A patient who has suffered a myocardial infarction must strictly follow all the instructions of doctors. Proper treatment and competent observance of all measures to prevent the disease will not only help to significantly prolong the life of the patient, but also improve the quality of his life.
In order to prevent the development of a heart attack, you must adhere to the following rules:
- Monitor nutrition, eat right - do not eat food with big amount cholesterol and animal fats
- Give up all bad habits such as smoking and alcohol
- If there is hypertension and obesity, then these problems need to be actively combated
- News healthy lifestyle life, because regular exercise will help form other ways of supplying the heart muscle necessary quantity blood, which will increase the endurance of the heart to a lack of oxygen, which will significantly increase the patient's chances of survival;
- Timely consult with a cardiologist.

Medicines for heart attack
With a heart attack, Nitroglycerin is primarily taken, as well as Validol. Besides, good medicine used for heart attack is Aspirin Cardio.

Alternative treatment of heart attack
It should be noted that all the following folk remedies for a heart attack are recommended to be used after a heart attack during the rehabilitation period.
1) To reduce pain in the heart after a heart attack, grind 1 kg of cranberries and 200 g of garlic in a meat grinder, then add 100 g of honey there, mix, leave for 3 days. Take 1 dessert spoon 2 times a day before meals.
2) Do you have heart pain after a heart attack? It is necessary to mix freshly squeezed onion juice with honey in equal proportions. Take 1 tablespoon 2-3 times a day after a heart attack.
3) Heart aches after a heart attack - in this case, the following recipe can help: pour 2-3 pre-chopped onions with 300 ml of warm boiled water, withstand 7-8 hours, then strain. Drink infusion of 0.5 cups before meals.
4) How to reduce heart pain after a heart attack? You can do the following: mix 1 kg chokeberry with 2 kg of honey. Take this mixture 1 tablespoon daily.
5) If the heart hurts after a heart attack, then to reduce heart pain, you need to eat 1 tablespoon of honey 3 times a day, you can dilute honey in 1 glass of warm water or eat it with fruits. Honey has a very beneficial effect on the heart muscle, dilates the vessels of the heart and improves its blood supply.
6) Relieve pain in the heart after a heart attack as follows: you need to crush 100 g of kernels walnuts and mix with 2 tablespoons of buckwheat honey. eat this remedy for 1 day in 3 doses.
7) When it hurts in the heart area after a heart attack, you can remove heart pain like this: you need to take 1 kg of honey, 10 lemons, 5 heads of garlic. Squeeze juice from lemons, add grated garlic and honey. All mix and insist 1 week. Take this remedy 1 teaspoon 1 time per day. It is especially recommended after a heart attack, with angina pectoris with severe shortness of breath.
8) You can get rid of pain in the heart after a heart attack if you take 20 g of ginseng root and 0.5 kg of bee honey. Then mix the root powder with honey, leave for 1 week, stirring frequently. Take after a heart attack 3 times a day, 0.25 teaspoon (especially taking this remedy is good for those who have low hemoglobin in the blood).
9) Worried about pain in the heart after a heart attack? You can do the following: pour 100 g of water grains of wheat and put in a warm place. When sprouts 1 mm long appear, rinse and pass through a meat grinder, then add vegetable oil, honey and other ingredients to taste (raisins, prunes). Eat this serving in the morning on an empty stomach.
10) How to treat the heart after a heart attack? It is necessary to dissolve 0.2 g of mummy in 1 glass of rosehip broth. Drink the resulting remedy in 2 doses - in the morning and in the evening. The course of treatment is 10 days.
11) If it hurts in the chest area, it aches in the heart area after a heart attack, then the heart can be cured with the help of a cardiovascular elixir.
To prepare it, you need to take: 0.5 kg of honey (better than May), 0.5 l of 70% medical alcohol, motherwort grass, cudweed grass, knotweed grass, chamomile flowers, rhizome with valerian roots, hawthorn fruits. Then mix honey and alcohol, heat over very low heat (stirring constantly) until foam forms. Next, take it off the heat and let it sit. Separately, in a thermos in 1 liter of boiling water, insist herbs: 1 tbsp. teaspoon each herb powder. Infuse for 2 hours, strain and mix with the first composition. The first week, take 1 teaspoon in the morning and evening, starting from the second week, switch to 1 tbsp. spoon. After the medicine runs out, take a break for 10 days, and then repeat the course.
12) To relieve heart pain from a heart attack, you need to do the following: take 20 g of crushed valerian roots, motherwort herbs, cumin fruits and 1 cup of boiling water.
Mix the ingredients. Then 1 tbsp. pour a spoonful of collection with boiling water, put on water bath for 15 minutes. Insist 30 minutes. Then strain, squeeze the raw material. Take 1 glass before bed.
13) How to get rid of heart pain after a heart attack? The following remedy can help: you need to take 20 g of hop cones, yarrow herb, valerian herb officinalis, lemon balm leaves, corn silk and 1 cup boiling water. Then 2 tbsp. spoon collection pour boiling water, close the lid, insist on a water bath. Then cool, strain, squeeze raw materials. Take 1/2 cup 1 time per day in the morning 30 minutes before meals.
14) Tortured heart pain after a heart attack, what to do? You can do the following: take 2 parts of hawthorn fruit, 6 parts of adonis grass, 3 parts of ground sunflower petals, 2 parts of tea kopek, 6 parts of wild strawberries and 1 glass of cold boiled water. Then
2 teaspoons of the collection should be poured with water, insisted for 2 hours, then poured with boiling water and put in a water bath for 5 minutes. Then strain, squeeze the raw material. Take 1 glass 2 times a day 10 minutes before meals.

One of the most dangerous complications diseases of the cardiovascular system is myocardial infarction. Myocardial infarction is the main cause of death not only in Russia, but throughout the world. What to do if myocardial infarction came to your house? The main thing we should not forget is that life does not end there, and by taking certain measures, you can live a fairly full life, rich in joys and happy impressions.

However, you need to know that people who have had a heart attack have a high probability of repeating this terrible disease, which can lead to coronary heart disease and even death. By adhering to certain rules, you can reduce the risk of a return of the disease. What is the chance of a second myocardial infarction? The first hour after myocardial infarction is very dangerous, the probability of death is very high and is about 50 percent.

juice is the percentage of people who do not live past the end of the first month. Therefore, it is very important to monitor your condition during this period of time. The probability of death remains during the first year after myocardial infarction (3-7% of patients). How not to fall into these deadly percentages? First, you need to properly treat your disease. Heart disease, especially if it occurs against the background of relative health, usually greatly undermines not only the physical, but also mental condition person.

After all, we all make plans for life, and many of us have a routine for every day. Collapses due to a heart attack familiar system life, as a result of which you have to restructure your life priorities. Depression, fear of imminent death, excessive worries may appear, which only aggravate the patient's condition and make it difficult for him to recover. Often undermines self-confidence cardio-pain syndrome, which manifests itself in the recovery period. There are pains in the chest area that radiate to left shoulder And lower jaw. These symptoms may be harbingers of a recurrent myocardial infarction. However, such symptoms are not always signals of cardiovascular pathology, they can be psycho-emotional in nature and occur with nervous strain. Therefore, it is very important to listen to your body. The Kardi.ru service can help in the correct diagnosis, the use of which allows you to find out the cause of the pain.

Features of rehabilitation after myocardial infarction

Rehabilitation of a patient who has had a myocardial infarction is aimed at restoring not only physical activity, but also mental health. After discharge from the hospital, it is very important to follow all the doctor's instructions. In addition, the relatives of the patient must also adhere to certain rules in relations with the patient. It is clear that relatives want to protect their loved one from overexertion and in every possible way try to protect him from physical exertion. However, we should not forget that during the recovery period, the survivor of myocardial infarction needs to move and perform a set of therapeutic exercises.

As you know, myocardial infarction every year affects more and more young people. Therefore, for patients, one of the important issues is the time of the return of sexual life. It is believed that with a non-extensive myocardial infarction, normal sexual life can start after two months, while healthy partner should choose more active postures. Contraindications to the beginning of sexual intercourse can serve as angina pectoris and high blood pressure. In these cases, you should definitely consult with your doctor. Changes in the work of the heart before and after sexual intercourse can be checked using the CardioVisor, which will help assess the effect of sex on the human body.

Physical activity after myocardial infarction

An important place in the rehabilitation of a patient who has had a myocardial infarction is the restoration of a person's physical abilities. A person is prescribed physiotherapy exercises, which are carried out under the supervision of a specialist. To date, the professional restoration of the physical health of "heart" patients is carried out by cardiological centers, which are very often located far from the place of residence of the patient. While ordinary clinics and hospitals cannot provide these services to patients. Therefore, most people after discharge have to do therapeutic gymnastics independently, following the instructions of the attending physician. It is known that patients who continued to perform exercises at home quickly rehabilitated and forgot about the disease in a short time. But the main thing in homework is not to overdo it. It is important to monitor your condition. It is required to measure the pulse, blood pressure. The service provided by the Kardi.ru service can come to the rescue. Using the Cardiovisor allows you to monitor the dynamics of changes in the work of the heart. At the slightest violation, the computer system will inform the subject about impending pathological conditions.

Features of nutrition after myocardial infarction

Diet also plays an important role. The human diet should contain foods that help recovery normal operation heart muscle. Therefore, it is necessary to eat bread, green vegetables and fruits. These products are rich in vitamins and substances that normalize metabolic processes in the body. In turn, it is necessary to reduce the amount of consumed products that lead to the formation of atherosclerotic plaques resulting from an increase in blood cholesterol levels. Therefore, a person who has had a myocardial infarction must give up animal fats. These foods include fatty meats, liver and kidneys. In addition, various smoked meats, sausages, sausages and sausages are rich in cholesterol. Refusal of fried food, which is recommended to be replaced with boiled or steamed food, can also have a beneficial effect on recovery. Dairy products should be abandoned - fatty cottage cheese, kefir, butter and sour cream. However, meat should not be completely abandoned. The diet should contain lean fish, poultry meat (should be eaten without skin). Cooking should only be done with oil. plant origin- It is believed that rapeseed oil is most useful, although sunflower oil is also suitable for cooking. An important feature post-infarction diet is to reduce the amount of salt consumed, which can provoke jumps blood pressure. With a properly selected diet, you will quickly recover, and the rehabilitation of the body will pass almost imperceptibly. The Kardi.ru project will help to control the work of the heart, thanks to which you can monitor the dynamics of recovery, as well as how your heart reacts to changes in the diet.

In addition, it is necessary to learn that people who have had a myocardial infarction should stop smoking forever. Cigarettes provoke attacks of pain in the region of the heart, and are most often the cause of a second heart attack.

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Myocardial infarction that came suddenly

A person lives for himself, as he knows how and is used to, one considers himself healthy, the other is slowly struggling with angina pectoris. And suddenly, one not quite perfect day, a sharp pain in the region of the heart stops the usual course of events. “People in white coats”, a siren, hospital walls… It’s too early to talk about the outcome at such a moment, each case is special, depending on the degree of damage to the heart muscle, on the complications and consequences that cardiologists, patients and their relatives are so afraid of.

Severe infarction with cardiogenic shock, arrhythmia, pulmonary edema and other complications require immediate hospitalization, resuscitation and a long period of rehabilitation with the prevention of all possible consequences heart attack:

1. Thromboembolism;
2. heart failure;
3. Aneurysm;
4. Pericarditis.

Some believe that there is a certain number of heart attacks that a person can endure. Of course, this is not the case, since the first heart attack can be so severe that it will be the last. Or small-focal heart attacks, not so formidable at the time of their development, but giving serious long-term effects. This indicator can be considered individual, but in most cases, the last is the third heart attack therefore, patients, even with past scars on the heart (accidentally recorded on the ECG), are not recommended to tempt fate.

It is also impossible to unequivocally answer how many people live after a heart attack, because the first one can be fatal. In other cases, a person can live up to 20 years after MI. full life without disability. All this depends on how the MI affected the hemodynamic system, what complications and consequences were or were not, and, of course, on what lifestyle the patient leads, how he fights the disease, what preventive measures he takes.

First steps after a heart attack: from bed to stairs

to the important aspects complex treatment myocardial infarction includes rehabilitation, which includes a number of medical and social measures aimed at restoring health and, if possible, working capacity. Early physiotherapy exercises help a person return to physical activity, however, exercise therapy can only be started with the permission of a doctor and depending on the patient's condition and the degree of myocardial damage:

• The average severity allows you to start exercising literally for 2-3 days, while in severe cases you need to wait a week. Thus, exercise therapy begins already at the hospital stage under the supervision of a physiotherapy instructor;
• From about 4-5 days, the patient can sit on the bed for some time, hanging his legs;
• From day 7, if everything goes well, without complications, you can take a few steps near your bed;
• After two weeks, you can walk around the ward, if allowed by the doctor;
• The patient is under constant control and can only go out into the corridor from the 3rd week of stay, and if the condition allows, the instructor will help him master several steps of the stairs;
• The distance traveled increases gradually and after a while the patient overcomes a distance of 500-1000 meters without being alone. A health worker or someone from the relatives is nearby to monitor the patient's condition, which is assessed by heart rate and blood pressure. In order for these indicators to be reliable, half an hour before the walk and half an hour after it, the patient's blood pressure is measured and an ECG is taken. In case of deviations indicating a deterioration in the patient's condition, physical exercise decrease.

If everything goes well for a person, he can be transferred for rehabilitation after a myocardial infarction to a suburban specialized cardiological sanatorium, where, under the supervision of specialists, he will engage in physical therapy, take measured walks (5-7 km daily), receive diet food and take medication. In addition, to strengthen faith in a successful outcome and good prospects for the future, a psychologist or psychotherapist will work with the patient.

This the classic version of the whole complex of treatment: heart attack - hospital - sanatorium - return to workudu or disability group. However, there are heart attacks detected during examination of a person, for example, in the case of a physical examination. Such people also need treatment and rehabilitation, and even more in prevention. Where do these heart attacks come from? To answer this question, it is necessary to digress somewhat from the topic and briefly describe the options for heart attacks that can pass by the hospital and by the cardiologist.

Few symptoms, poor prognosis

Asymptomatic and oligosymptomatic variants of MI, more characteristic of small-focal infarction, are a special and rather serious problem. The asymptomatic form is characterized complete absence pain and others, no matter what the symptoms, so MI is detected later and by chance (on the ECG - a scar on the heart).

Other variants of myocardial infarction with extremely poor nonspecific clinical picture are often the cause of delayed diagnosis. It is good if those few signs characteristic of many diseases alert the patient, and he should consult a doctor:

1. Moderate tachycardia;
2. Weakness with sweating, more than usual;
3. Decreased blood pressure;
4. A short-term increase in temperature to subfebrile.

In general, the patient can evaluate his condition as “something is wrong”, but do not go to the clinic.

Such forms of MI most often lead to the fact that the patient does not go anywhere, does not receive drug treatment, the limitations inherent in similar pathology does not apply to him. After the time has elapsed, the state of a person when taking an electrocardiogram will begin to qualify as a heart attack on the legs, which, however, does not pass without complications, albeit somewhat delayed. The consequences of such variants of IM are:

• A scar that will disrupt the normal structure of the heart muscle, which will aggravate the course pathological process in case of a repeated heart attack;
• Weakening contractile function myocardium and, as a result, low blood pressure;
• Chronic heart failure;
• Possibility of aneurysm formation;
• Thromboembolism, because the patient has not received special treatment to reduce the formation of blood clots;
• Pericarditis.

It should be said that the complications of heart attacks suffered on the legs are more pronounced than those treated in a hospital, since the person did not receive any preventive prescriptions, therefore, as soon as he becomes aware of past illness, visit to the doctor can not be postponed. The sooner preventive measures are taken, the less consequences heart attack will have a patient.

Atypical manifestations of MI make it difficult to diagnose

It is difficult to judge that a person has had or has a heart attack in the presence of an atypical course of the disease. For example, it can sometimes be confused with gastrointestinal disorders, which is called abdominal syndrome. Of course, it is not surprising to suspect the pathology of the gastrointestinal tract with the following clinical manifestations:

1. Intense pain in the epigastric region;
2. Nausea with vomiting;
3. Bloating and flatulence.

Even more confusing in such cases are certain painful sensations in the stomach during palpation and muscle tension. abdominal wall also accompanied by pain.

The cerebral form of myocardial infarction is so disguised as a stroke that even doctors find it difficult to quickly establish a diagnosis, especially since the ECG does not clarify the picture, since it is atypical and gives frequent "false positive" changes in dynamics. In general, how not to suspect a stroke if its signs are clearly visible:

• Headache;
• Dizziness;
• memory disorders;
• Motor and sensory disturbances.

Meanwhile, the combination of heart attack and stroke at the same time is not very common and, most likely, unlikely, but possible. With large-focal transmural MI, there is often a violation of the blood circulation of the brain, as a manifestation of thromboembolic syndrome. Naturally, such options must certainly be taken into account not only during the period of treatment, but also during rehabilitation.

Video: heart attack - how does it happen and is treated?

Diet - the first point of rehabilitation measures

The patient can get to the doctor in any postinfarction period. A detailed examination of people who have had a heart attack, it turns out that many of them have:

1. Some degree of obesity;
2. High cholesterol and disorder lipid spectrum;
3. arterial hypertension;
4. Bad habits.

If smoking, the use of alcoholic beverages can somehow be banned (or persuaded?) and thus eliminate the negative effect of these factors on the body, then the fight against overweight, hypercholesterolemia and arterial hypertension is not a matter of one day. However, it has long been noticed and scientifically proven that a diet can help in all cases at the same time. Some people force things so much that they try to reduce body weight in as soon as possible, which will not bring any benefit, and it will be difficult to keep the result. 3-5 kg ​​per month - the most best option, in which the body will slowly but surely enter the new body and get used to it.

There are a great many different diets, but they all have general principles construction, adopting which, it is already possible to achieve significant success:

• Reduce the calorie content of the food you eat;
• Avoid sticking bad mood carbohydrates (eating sweets, cakes, cakes - so sweet and tasty, it is very undesirable, so it’s better not to touch them at all);
• Limit the consumption of fatty foods of animal origin;
• Eliminate such favorite additions to main dishes as sauces, spicy appetizers, spices, which can well excite an already normal appetite;
• Bring the amount of table salt to 5 g per day and do not exceed this level, even if something turns out to be not so tasty without it;
• Drink no more than 1.5 liters of fluid per day;
• Organize multiple meals so that the feeling of hunger does not haunt, and the stomach is full and does not remind you of hunger.

In people who are overweight, the diet after myocardial infarction should be aimed at weight reduction, which will reduce the load on the heart muscle. Here is an approximate one-day diet:

1. First breakfast: cottage cheese - 100 g, coffee (weak) without sugar, but with milk - a glass of 200 ml;
2. Second breakfast: 170 g of fresh cabbage salad dressed with sour cream, preferably without salt or with the minimum amount of it;
3. Lunch consists of 200 ml of vegetarian cabbage soup, 90 g of boiled lean meat, 50 g of green peas and 100 g of apples;
4. As an afternoon snack, you can eat 100 g of cottage cheese and drink it with 180 ml of rosehip broth;
5. Evening meals should be limited. boiled fish(100 g) with vegetable stew (125 g);
6. At night, you are allowed to drink 180 g of kefir and eat 150 g of rye bread.

This diet contains 1800 kcal. Of course it is sample menu one day, so nutrition after a heart attack is not limited to listed products, and for patients with normal weight, the diet is greatly expanded. The diet after myocardial infarction, although it limits the intake of fats (animals) and carbohydrates (unrefined and refined), excludes them only under certain circumstances in order to give a person the opportunity to lose weight.

With patients without excess weight, everything is easier, they are given a diet with a daily calorie content of 2500-3000 kcal. The use of fats (animals) and carbohydrates (unrefined and refined) is limited. Daily ration divided into 4-5 receptions. In addition, the patient is recommended to spend fasting days. For example, one day, eat 1.5 kg of apples and nothing else. Or 2 kg of fresh cucumbers. If someone cannot live a day without meat, then 600 g of lean meat with a vegetable side dish (fresh cabbage, green peas) will also come down on a fasting day.

The expansion of the diet should also not be taken literally: if you can eat vegetables and fruits, lean meat and dairy products after a heart attack, in general, without restrictions, then it is not at all recommended to eat sweet confectionery, fatty sausages, smoked meats, fried and spicy dishes.

Alcohol, be it Armenian cognac or French wine, is not recommended for patients who have had a heart attack. We must not forget that any alcoholic drink causes an increase in heart rate (hence, tachycardia), and, besides this, it increases appetite, which the convalescent does not need at all, because it additional load, albeit a food one.

After discharge - to the sanatorium

The complex of rehabilitation measures depends on which functional class (1, 2, 3, 4) the patient belongs to, so the approach and methods will be different.

After discharge from the hospital, the patient assigned to 1 or 2 functional class, the next day calls a cardiologist at home, who draws up a plan for further rehabilitation measures. As a rule, the patient is assigned a 4-week observation of the medical staff in a cardiological sanatorium, where the patient himself does not need to worry about anything, he will only have to follow an approved program that provides, in addition to diet therapy:

• Dosed physical activity;
• Psychotherapeutic help;
• Medical treatment.

Physical rehabilitation programs are based on a classification that includes the following categories:

1. The severity of the patient's condition;
2. The severity of coronary insufficiency;
3. The presence of complications, consequences and concomitant syndromes and diseases;
4. The nature of the transferred infarction (transmural or non-transmural).

After determining individual tolerance to stress ( bicycle ergometric test), the patient receives optimal doses of physical training aimed at increasing the functionality of the myocardium and improving the nutrition of the heart muscle through stimulation metabolic processes in her cells.

Contraindications to the appointment of training are:

• aneurysm of the heart;
• Severe heart failure;
• Types of arrhythmias that respond to physical activity by aggravating rhythm disturbance.

Physical training is carried out under the supervision of a specialist, they are aimed at preventing a recurrent heart attack, increasing life expectancy, but at the same time, they cannot prevent the onset sudden death in the distant future.

In addition to dosed loads, physical rehabilitation after a heart attack, it also includes such methods as physiotherapy exercises (gymnastics), massage, health path (metered walking).

However, speaking about the training of the patient, it should be noted that they do not always go smoothly. In the recovery period, the doctor and the patient may encounter certain symptom complexes characteristic of convalescents:

1. Cardio-pain syndrome, to which are added cardialgia caused by osteochondrosis of the thoracic spine;
2. Signs of heart failure, manifested by tachycardia, an increase in the size of the heart, shortness of breath, moist rales, hepatomegaly;
3. The syndrome of general detraining of the patient's body (weakness, pain in lower limbs when walking, decreased muscle strength, dizziness);
4. Neurotic disorders, since patients, asking the question “How to live after a myocardial infarction?”, tend to fall into anxiety-depressive states, begin to fear for their family, and take any pain for a second heart attack. Of course, such patients need the help of a psychotherapist.

In addition, convalescents receive anticoagulant therapy to prevent blood clots, statins to normalize the lipid spectrum, antiarrhythmic drugs and other symptomatic treatment.

Rehabilitation in the clinic at the place of residence

Such rehabilitation is indicated only for patients with grades 1 and 2 after a 4-week stay in a sanatorium. The patient is carefully examined, what is recorded in his outpatient card, his progress in physical training, level of performance (physical), response to drug treatment. In accordance with these indicators, the convalescent is prescribed an individual program to increase physical activity, psychological rehabilitation And drug treatment which includes:

• Therapeutic exercises under the control of the pulse and electrocardiogram, carried out in the exercise therapy room 3 times a week in 4 modes (gentle, gentle training, training, intensive training);
• Individually selected drug therapy;
• Classes with a psychotherapist;
• The fight against bad habits and other risk factors (obesity, arterial hypertension and etc.).

The patient does not leave daily workouts at home (hiking, preferably with a pedometer, gymnastics), but does not forget about self-control and alternates stress with rest.

Video: exercise therapy after a heart attack

Group of increased medical control

As for patients assigned to the 3rd and 4th functional class, their rehabilitation takes place according to a different program, the purpose of which is to provide such a level of physical activity that the patient can independently serve himself and perform a small amount of homework However, with qualifications, the patient is not limited to intellectual work at home.

Such patients are at home, but under the supervision of a general practitioner and a cardiologist, all rehabilitation measures are also carried out at home, since the patient's condition does not allow high physical activity. The patient performs affordable work in everyday life, walks around the apartment from the second week after discharge, and from the third week begins to slowly engage in exercise therapy and walk for 1 hour in the yard. The doctor allows him to climb the stairs at a very slow pace and only within one march.

If before illness morning exercises was a common thing for the patient, then he is allowed to it only from the fourth week and only 10 minutes (less is possible, more is impossible). In addition, the patient is allowed to climb to the 1st floor, but very slowly.

This group of patients requires both self-control and special medical supervision, since at any time at the slightest load there is a risk of an attack of angina pectoris, an increase in blood pressure, the appearance of shortness of breath, severe tachycardia or a strong feeling of fatigue, which is the basis for reducing physical activity.

Patients of the 3rd and 4th functional class also receive a complex of medicines, psychological support, massage and exercise therapy at home.

The psyche also needs to be rehabilitated.

A person, having experienced such a shock, cannot forget it for a long time, every now and then he puts before himself and other people the question of how to live after a myocardial infarction, believes that now everything is impossible for him, therefore he is prone to depressive moods. The patient's fears are completely natural and understandable, so a person needs psychological support and readaptation, although here everything is individual: some cope with the problem very quickly, adapt to new conditions, others sometimes even half a year is not enough to accept the changed situation. The task of psychotherapy is to prevent pathological changes in personality and the development of neurosis. Relatives may suspect neurotic maladjustment for the following signs:

1. Irritability;
2. Instability of mood (it seems to have calmed down, but after a short time again plunged into gloomy thoughts);
3. Inadequate sleep;
4. Phobias of various kinds (the patient listens to his heart, is afraid to be alone, does not go for a walk unaccompanied).

Hypochondriacal behavior is characterized by "flight into illness". The patient is sure that life after a heart attack is not life at all, the disease is incurable, that doctors do not notice everything, so he himself, with or without reason, calls an ambulance and requires additional examination and treatment.

A special group of patients are not yet old men who are sexually active before the disease. They are worried and trying to find out if sex is possible after a heart attack and if the disease has affected sexual functions, because they notice some disorders in themselves (a decrease in sexual desire, spontaneous erections, sexual weakness). Of course, constant reflection on this issue and worries about your intimate life further exacerbate the situation and contribute to the development of the hypochondriacal syndrome.

Meanwhile, sex after a heart attack is not only possible, but also necessary, because it gives positive emotions therefore, if there are problems in this regard, the patient is prescribed additional treatment (psychotherapy, autogenic training, psychopharmacological correction).

To prevent the development of mental disorders and prevent other consequences of a heart attack, for patients and their relatives, special schools who teach how to behave after an illness, how to adapt to a new position and quickly return to labor activity. The statement that labor counts the most important factor there is no doubt about successful mental rehabilitation, therefore, the sooner the patient plunges into work, the sooner he will return to his usual track.

Employment or disability group

Patients of grades 3 and 4 will receive a disability group with a complete exclusion of physical activity, while patients of grades 1 and 2 are recognized as able-bodied, but with some restrictions (if necessary, they must be transferred to light work). There is a list of professions that are contraindicated after myocardial infarction. Of course, this primarily concerns hard physical labor, night shifts, daily and 12-hour shifts, work associated with psycho-emotional stress or requiring increased attention.

A special medical commission assists in finding employment and resolves all issues, which gets acquainted with the working conditions, studies the presence of residual effects and complications, as well as the likelihood of a risk of a second heart attack. Naturally, if there are contraindications to a particular work, the patient is employed in accordance with his capabilities or a disability group is assigned (depending on the condition).

After a heart attack, the patient is observed in the clinic at the place of residence with a diagnosis of post-infarction cardiosclerosis. Get Spa treatment(not to be confused with the sanatorium that is appointed after discharge!) it can be in a year. And it is better if these are resorts with a climate familiar to the patient, since the sun, humidity and Atmosphere pressure also affect cardiac activity, but not always positively.

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Stages of recovery of patients who have had the disease

Rehabilitation after a heart attack includes a number of measures, the task of which is to prevent recurrent attacks, eliminate complications and return the patient to normal life.

The main directions of the recovery process are:

• normalization of physical activity;
• drug therapy;
• diet;
• psychological help.

The choice of rehabilitation tactics is based on the individual condition of the patient, as well as his age and the reasons that led to the development heart attack.

At serious condition patient when he has complications such as arrhythmia or heart failure, rehabilitation should be carried out at first in a specialized medical institution, with further transfer to home recovery of the body and compliance nursing process with myocardial infarction.

Therapeutic exercise is milestone restoration of physical activity of a person who has had a heart attack. The start time of exercise therapy is prescribed by the doctor, depending on the degree of myocardial damage and the patient's condition.

With moderate severity of pathology start gymnastics already for 2-3 days, in severe cases, it is usually required to wait a week. The basic principles for restoring the patient's physical activity boil down to the following steps:

• the first few days require strict bed rest;
• on day 4-5, the patient is allowed to take a sitting position with legs hanging from the bed;
• on the 7th day, in a favorable situation, the patient can begin to move close to the bed;
• after 2 weeks it will be possible to take short walks around the ward;
• from 3 weeks after the attack, it is usually allowed to go out into the corridor, as well as go down the stairs under the supervision of an instructor.

After increasing the load, the doctor measures the patient's blood pressure and pulse. If the indicators differ from the norm, the load will need to be reduced. If the recovery is favorable, the patient may be referred to the cardiology department. rehabilitation center(sanatorium), where he will continue his recovery under the supervision of professionals.

Nutrition rules

In the process of rehabilitation great importance is given to proper nutrition of the patient. Diets can be different, but they all have common principles:

• reduction in caloric content of food;
• restriction of fatty, flour and sweet foods;
• refusal of spicy and spicy dishes;
• minimum salt intake - no more than 5 g per day;
• the amount of fluid consumed should be about 1.5 liters daily;
• meals should be frequent, but in small portions.

What should be the food after a heart attack? Must be in the diet include foods containing fiber, vitamins C and P, polyunsaturated fatty acids, potassium. The following foods are allowed:

• low-fat meat;
• fruits and vegetables, except spinach, mushrooms, legumes, sorrel, radish;
• vegetable oils;
• vegetable soups;
• compotes and juices without sugar, weakly brewed tea;
• bran and Rye bread, porridge;
• lean fish;
• dairy products without fat;
• omelette.

You will need to refrain from:

• fatty meat;
• natural coffee;
• fresh bread, any muffin;
• fried or boiled eggs;
• marinades, pickles, canned food;
• cakes, chocolates, pastries and other sweets.

What other foods should be discarded when dieting after myocardial infarction, see the video:

In the first week rehabilitation, it is advisable to eat only grated food 6 times a day.

From 2 weeks the frequency of meals is reduced, while the food should be crushed.

A month later It will be possible to take regular food, strictly controlling its calorie content. Daily rate should not exceed 2300 kcal. At overweight calories will need to be reduced slightly.

Physical activity and sex life

Return to physical activity begins in the hospital. After stabilization of the condition, the patient is allowed to perform small physical exercises, first passive (just sitting in bed), then more active.

Restoration of basic motor skills must occur during the first few weeks after an attack.

From 6 weeks patients are usually prescribed exercise therapy, exercise on a stationary bike, walking, climbing stairs, light jogging, swimming. The load must be increased very carefully.

Therapeutic exercise is very important in rehabilitation after a heart attack. Thanks to special exercises, Can improve blood circulation and restore heart function.

Useful video with the complex exercise therapy exercises for gymnastics of patients after myocardial infarction at home:

People who have had a heart attack you can do household chores depending on the functional class of the disease. Patients of the third class are allowed to wash dishes, wipe the dust, the second class - to perform minor household chores, while it is forbidden to saw, work with a drill, and wash clothes by hand. For first-class patients, the possibilities are almost unlimited. It is only necessary to avoid working in an uncomfortable position of the body.

Patients can begin sexual life in a month and a half after an attack. The possibility of sexual contact will be evidenced by the preservation normal pulse and pressure even when climbing to the 2nd floor.

Basic recommendations for sexual intercourse:

• nitroglycerin tablets should always be prepared nearby;
• it is recommended to have sex only with a trusted partner;
• the temperature in the room should not be too high;
• postures should be chosen such that they will not cause excessive physical exertion - for example, postures in an upright position are not recommended;
• do not drink alcohol, fatty foods and energy drinks before sexual intercourse, do not take hot baths.

Potency-enhancing drugs should be used with extreme caution.. Many of them negatively affect the work of the heart.

Learn more about sex after a heart attack from the video:

habits

People who smoke are more susceptible to tea various diseases hearts. Smoking causes spasms of the vessels of the heart, as well as oxygen starvation of the heart muscle. During rehabilitation after a heart attack you need to quit smoking completely, and for the prevention of relapse, you will need to make every effort to quit this addiction forever.

With the issue of alcohol consumption, everything is not so drastic, but moderation is still required. During the rehabilitation period, alcohol must be completely abandoned, and in the future, adhere to a strict dosage. Maximum allowed dose pure alcohol per day is: men - 30 ml, women - 20 ml.

Medical and medical control

Medication plays a key role in prevention possible relapses. In the postinfarction period, the following drugs are prescribed:

• Means to reduce blood viscosity: Plavix, Aspirin, Ticlid.
• Means for the treatment of arrhythmia, angina pectoris, hypertension (depending on which disease led to the development of a heart attack): beta-blockers, nitrates, calcium antagonists, angiotensin converting enzyme inhibitors.
• Means for the prevention of atherosclerosis: fibrates, statins, sequesters of bile acids, nicotinic acid.
• Preparations for improving metabolic processes in tissues: Solcoseryl, Actovegin, Mildronate, Piracetam.
• Antioxidants: Riboxin, vitamin E.

In addition, they may be assigned annual monthly courses multivitamin complexes which will help strengthen the body and prevent pernicious influence external factors on the state of the cardiovascular system.

Psychological help for this problem

survivor of a heart attack often prone to depression. His fears are well founded - after all, an attack can happen again. Therefore, in the postinfarction period of psychological rehabilitation, a special place is given.

To eliminate the fears of the patient is carried out training in relaxation techniques, motivation to work.

The psychologist usually works with the patient's relatives as well.. Often, after a heart attack, they begin to consider the patient a disabled person, surround him with excessive care and try to limit his physical activity - this attitude has a bad effect on psychological state the patient and makes it difficult for him to return to a full life.

Is disability required or can return to work

The patient's ability to work is determined by several parameters:

• electrocardiography indicators;
• clinical examination results;
• laboratory test data;
• data of a bicycle ergometric study.

Rehabilitation depends on individual features the course of the disease. The decision on the possibility to carry out this or that activity is made by a special commission.

After a heart attack forbidden to practice the following types professional activity : driving Vehicle, heavy physical work, daily and night shifts, as well as work requiring increased attention and associated with psycho-emotional stress.

To prevent recurrence of myocardial infarction, the patient must avoid nervous and physical stress. The first days he must observe bed rest. If shortness of breath is observed in the supine position, it is better to be in an elevated state.

Physical therapy is prohibited with severe arrhythmia, high temperature body, low blood pressure and heart failure.

If the patient has kidney failure or severe heart failure intracranial hematomas and increased bleeding some drugs may be contraindicated for him such as Mannitol. A number of diagnostic examinations can adversely affect the patient's condition. For example, coronary angiography is performed only before surgical treatment.

Measures to prevent relapse

Prevention of repeated attacks of a heart attack involves a set of measures that help strengthen the body and reduce the negative impact of pathologies that led to the development of the disease. Compliance following recommendations Helps prevent relapses

• to give up smoking;
• moderate physical activity;
• reduce the amount of junk and fatty foods and sweets in the diet;
• drink less strong coffee;
• avoid stress.

The program on the rehabilitation of patients in hospitals and at home and life after myocardial infarction in two parts:

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Rehabilitation after a heart attack

Most people can return to work after suffering a myocardial infarction, but the recovery time depends on the individual, the condition of the heart, and the nature of the work you do. Some take as little as two weeks to get back to work. Other people will need several months to recover. It is very important not to force rehabilitation, but to restore strength gradually.

During your rehabilitation, you will be assisted by a variety of medical professionals, including:

• nurses;
• physiotherapists;
• nutritionists;
• pharmacologists;
• physiotherapy physicians.

These specialists will provide you with medical and psychological support to ensure the proper organization and safety of the recovery process. Rehabilitation begins already in the hospital, where your condition will be closely monitored and they will be able to assess what you will need in the future. After discharge, you can continue the recovery process at home. There are two important goals of the rehabilitation process:

• Reducing the risk of a new myocardial infarction - through a combination of lifestyle changes, such as switching to a healthy diet, and taking medications, such as statins (lowering blood cholesterol levels).
• Gradual recovery of your fitness so you can resume normal life(cardiac rehabilitation).

Cardiac rehabilitation

The cardiac rehabilitation program begins in the hospital. Your rehabilitation doctor will tell you in detail about:

• health status and your capabilities after a heart attack;
• received treatment;
• medications you will need to take after you are discharged;
• possible causes of your heart attack;
• necessary lifestyle changes to avoid the risk of a second attack.

When returning home, it is usually recommended to rest and do only light exercise, such as going up and down stairs two to three times a day or taking a short walk. Over the course of several weeks, day in and day out, gradually increase your exercise level. How quickly you can increase your exercise level will depend on your heart condition and your overall health. Your doctor can give you an explanation of the proposed program to increase your activity level.

The attending physician at the clinic may prescribe a course of physiotherapy exercises for you. This is a set of special physical exercises that are regularly performed under the supervision of a physiotherapist. Therapeutic exercise is an important part of rehabilitation and helps to restore the work of the heart.

The types of exercise may vary depending on the specific program, but they should be primarily aerobic. Aerobic exercise is designed to strengthen the heart muscles, improve circulation, and lower blood pressure. Examples of aerobic exercise are exercise bikes, walking on a treadmill, and swimming.

Return to work

Most people can return to work after a heart attack, but how quickly will depend on your health and your heart, as well as the nature of the work you do. If the job is not heavy-duty, such as office work, you may be able to return to work in as little as two weeks.

However, if your job requires physical strength or your heart has been significantly damaged, it may be several months before you return to work. A more specific labor forecast will be given to you by your doctor.

Sex after a heart attack

According to foreign studies, having sex will not pose a threat to your health as soon as you can climb the stairs to the second floor without pain and shortness of breath. Usually this state can be reached approximately 4 weeks after myocardial infarction. Then having sex will not increase the risk of a new heart attack. Read more about sex after myocardial infarction.

Approximately one in three men who have had a myocardial infarction has an erectile dysfunction that can make it difficult to have sex. Most often, this is the result of feelings of anxiety and emotional stress associated with a previous myocardial infarction. Less commonly, erectile dysfunction occurs as a side effect of taking beta-blockers.

If you are experiencing a potency disorder, see a doctor who will recommend you suitable treatment. For example, you may be prescribed a drug that stimulates blood flow to the penis and makes it easier to get an erection.

Driving after a heart attack

It is highly recommended to refrain from driving for at least 4 weeks after a myocardial infarction. After that, you can drive, unless you have other diseases or complications that make driving a car contraindicated.

depression after a heart attack

A heart attack is a frightening and traumatic event that is often followed by feelings of anxiety. Many people have suffered emotional stress causes depression and despondency in the first weeks after discharge. If the depression persists, contact your doctor, you may need additional treatment to get rid of nervous tension. Depression impairs the recovery process after a heart attack.

Reducing the risk of recurrent myocardial infarction

Reducing the risk of recurrent myocardial infarction includes lifestyle changes and long-term treatment with various drugs.

• herring;
• sardines;
• mackerel;
• salmon;
• trout;
• tuna.

Instead of fish, your doctor may recommend nutritional supplements or medicines containing omega-3 acids. Never take nutritional supplements without consulting your healthcare professional. Some supplements, such as beta-carotene, can be potentially harmful to your body.

You are also advised to follow mediterranean diet: eat more bread, fruits, vegetables, fish, and less meat. Replace butter and cheese for products containing vegetable oil as their basis, such as olive oil.

If you drink alcohol, do not exceed the recommended daily norms consumption. Men are advised not to consume more than 2-4 drinks per day on a regular basis, and women - more than 2-3. By regular use is meant every day or most of the days of the week. 1 serving of alcohol roughly corresponds to a glass of vodka, half a glass of wine or half a beer.

Regularly exceeding the recommended levels of alcohol consumption will lead to an increase in your blood pressure and cholesterol levels, and therefore the risk of a second myocardial infarction. Avoid heavy drinking (consumption of more than three drinks in one to two hours). This causes a sharp and significant increase in blood pressure, which can be dangerous.

Studies have shown that people who abuse alcohol after a heart attack are 2 times more likely to die from a second heart attack or stroke. If a person who has had a heart attack stops drinking, the risk of death is reduced.

Once you have fully recovered from a heart attack (see above under cardiac rehabilitation for how long this usually takes), you will need regular exercise. Adults should do at least 150 minutes (2.5 hours) of moderate-intensity aerobic activity (such as cycling or brisk walking) each week.

The load level should be such that you are slightly out of breath. If you're having trouble getting up to 150 minutes a week, start at a level that's comfortable for you (for example, 5-10 minutes of light exercise a day). As your fitness improves, you will be able to increase the intensity of your workouts to the proper level.

Drug prevention of myocardial infarction

Currently, four types of drugs are widely used to reduce the risk of myocardial infarction:

• angiotensin-converting enzyme inhibitors (ACE inhibitors);
• antiplatelet agents;
• beta blockers;
• statins.

ACE inhibitors often used to lower blood pressure. ACE inhibitors reduce the activity of a hormone that affects blood pressure. As a result, vasodilation occurs, the amount of fluid in the body decreases and pressure decreases.

ACE inhibitors are contraindicated in people with certain kidney conditions, so your doctor may order blood and urine tests to make sure there are no contraindications. With long-term use of ACE inhibitors, blood and urine tests should be repeated annually. Possible side effects of ACE inhibitors:

• dizziness;
• weakness or fatigue;
• headache;
• persistent, dry cough.

The most persistent effect is cough, the rest adverse reactions usually go away in a matter of days. Unpredictable side effects may occur when ACE inhibitors are taken with other drugs, including over-the-counter drugs.

Therefore, do not take any drugs in combination with prescribed ICE inhibitors without consulting your doctor. It is usually recommended to start taking ACE inhibitors immediately after a heart attack and, in most cases, continue taking these drugs for life. In case of individual intolerance to ACE inhibitors, an alternative type of drug may be prescribed - angiotensin receptor blockers.

Antiplatelet agents and anticoagulants- a group of drugs designed to prevent thrombosis. They act by reducing the "stickiness" of platelets and destroying the base of the thrombus from fibrin filaments (blood protein). Platelets are very small cell formations in the blood that contribute to the formation of blood clots in it.

Most often, people who have had a heart attack are prescribed aspirin (which is often used as a painkiller for other diseases) to thin the blood. You may also be prescribed additional antiplatelet drugs such as clopidogrel or ticagrelor. These drugs are also used for allergies to aspirin.

Possible side effects:

• diarrhea;
• bruising or bleeding;
• dyspnea;
• abdominal pain;
• indigestion;
• heartburn.

Similar to ACE inhibitors, treatment with antiplatelet agents begins immediately after myocardial infarction. The time period for which antiplatelet drugs are prescribed varies from 4 weeks to 12 months, and depends on the type of myocardial infarction you have had and the rest of the treatment you are receiving.

It is generally recommended to use aspirin for life. If you are experiencing troublesome side effects of aspirin, check with your doctor, but do not stop taking aspirin, as stopping the drug abruptly increases the risk of a second myocardial infarction.

Sometimes you may also be prescribed warfarin. It is usually prescribed for an irregular heart rhythm ( atrial fibrillation) or severe heart damage.

Major bleeding is the most dangerous side effect of taking warfarin. Call your doctor right away and get a blood test done right away if you experience any of the following side effects:

• the appearance of blood in the urine or feces;
• black feces;
• severe bruising;
• prolonged nosebleeds (longer than 10 minutes);
• the presence of blood in your vomit;
• the appearance of blood when coughing;
• unusual headaches;
• in women, severe or heavy menstruation or any other vaginal bleeding.

If you are taking anti-clotting drugs, call ambulance, If:

• there was a serious injury (accident);
• you have experienced a severe blow to the head;
• unable to stop the bleeding.

Beta blockers is a type of drug used to protect the heart from further damage after a myocardial infarction. They help relax the heart muscles, causing the heart to beat more slowly and lowering blood pressure, which reduces the workload on the heart.

• fatigue;
• decrease in temperature of the hands and feet;
• slow heartbeat;
• diarrhea;
• nausea.

Less common side effects include:

• sleep disturbance;
• nightmares;
• inability to achieve or maintain an erection (impotence or "impotence").

Beta blockers can also interact with other medications, causing negative side effects. Therefore, check with your doctor or pharmacists before taking other drugs, including over-the-counter drugs, at the same time as beta-blockers.

Statins is a group of drugs that lower blood cholesterol levels. Statins are prescribed to prevent clogged arteries. cholesterol plaques and reduce the risk of recurrent heart attacks.

Statins block the action of an enzyme in the liver called HMG-CoA reductase, which is involved in cholesterol production. Statins sometimes have minor side effects, including:

• constipation;
• diarrhea;
• headache;
• abdominal pain.

Sometimes statins can cause muscle pain, weakness, and tenderness. Contact your doctor if you experience these symptoms, you may need to adjust the dose of the drugs. As a rule, statins are recommended to be taken indefinitely.

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To prevent a heart attack, you need to be able to listen to the “signals of our heart”, to know what and how it reacts, to learn how to control its reactions. People over 50 should be especially attentive to their well-being. Vessels and heart grow old together with us. Over the years, the elasticity of the vessels decreases, their channel narrows. Gradually, the heart loses its strength. If a person does not have atherosclerosis and other serious illnesses, then he can live 80 years or more without any heart problems.

What is a heart attack, and what harm is done to the body?

The risk of heart attack increases after the age of 50, although it can also occur in younger people. At any age, chest pain should alert you. When a complete blockade of a coronary artery by a thrombus (blood clot) occurs, a heart attack occurs. Any part of the heart muscle is bled, and the heart does not receive the right amount of nutrients and oxygen. As a result, part of the heart muscle is damaged or completely dies.

heart attack- a common disease, but few people know its symptoms. Many people think that heart pain should be sharp and appear on the left side of the chest. Usually, pain in a heart attack is localized behind the sternum (less often in the region of the heart) and is of a pressing nature. The main symptom of a heart attack is a prolonged attack of unbearable tearing pain in the chest. Sometimes the attack lasts for hours, and sometimes even days.

Signs of a heart attack

Pain that radiates left shoulder blade, in the left hand, right or left shoulder, in the little finger or in ring finger left hand, on inner surface left hand, jaw.

Cold sweat.

dizziness or severe weakness.

Increased heartbeat, interruptions in the region of the heart, shortness of breath.

Cough.

General malaise, vomiting, nausea, sensation of a lump in the throat, sweating.

A sense of impending disaster.

During an attack, a person may have a fear of death, anxiety, he begins to nervously walk around the room. The picture of a heart attack is different for everyone, it varies from the location of damage in the heart and the depth of damage, as well as from individual tolerance pain. A heart attack may develop atypical form. pain attack it may not be, the heart rhythm will be disturbed, shortness of breath may suddenly appear, pain in the upper abdomen may occur, which are accompanied by nausea, vomiting and stool disturbance. The person may even lose consciousness. Sometimes a person simply does not notice a heart attack. But small-focal heart attacks accumulate, and the consequences can be severe.

How do you know if it's a heart attack?

Not all chest pain is a sign of an impending attack. To understand whether the symptoms are really a signal of a violation of the heart, answer the questions:

Does the pain appear in the center of the back, chest, or on the left? (heart)

Does the pain occur after eating or exercising? (heart)

Does the pain last for seconds? (not heart)

More than 10 minutes? (heart)

Does the person begin to cough or become short of breath? (lungs or heart)

Increased sweating? (spasm of the esophagus or heart)

Does the pain worsen with inhalation or movement? (neuralgia)

Feeling pain in your chest? ( pectoral muscles)

Pain in the entire chest? (lungs or heart)

acute, burning pain? (problem with the gastrointestinal tract)

Pressing pain? (heart)

Belching? (problem with the heart or gastrointestinal tract)

Has your heart rate increased? (gastrointestinal tract or heart)

Does it feel like something serious is going on? (heart)

Do not miss the beginning of a heart attack, be attentive to yourself, sometimes the symptoms overlap. Myocardial infarction can develop against the background of coronary heart disease. It can begin with severe psycho-emotional or physical stress. A heart attack can occur for no apparent reason. Prolonged pain behind the sternum during an attack of angina pectoris, which does not decrease after taking nitroglycerin, is a serious signal. It is believed that choleric or sanguine people, who are distinguished by a sharply developed sense of responsibility, or people who achieve goals by any means, are more likely to have a heart attack. The reason may be the activity of "wear and tear" with the maximum tension of physical and spiritual forces. Such people often do not know how to relax. The risk group also includes very sociable people who overestimate their capabilities, are unstable and emotionally not restrained.

However, the danger of a heart attack lies in wait for phlegmatic and melancholic people. It happens when habitual image life changes to a very active lifestyle. When categorical, nervousness, extreme perseverance in achieving the goal is manifested. In older people, a heart attack can occur with a sharp change in climatic zones. Bad effect on the heart strong sounds or industrial noises, they increase blood pressure. The heart also reacts to air humidity, especially below 50% and above 90%. If you have the listed risk factors, then this does not mean at all that a heart attack is inevitable. You can change the situation yourself without waiting for trouble.

Video

Heart attack - acute manifestation ischemia of the heart, which most often affects women. If the blood supply to a certain area of ​​the heart muscle is cut off as a result of the destruction of an atherosclerotic plaque, it begins to die due to a lack of oxygen. This process is myocardial infarction.

Usually the plaque is located in the lumen of the vessel, however, with a certain load on it, it can collapse. Then a thrombus grows in this place, which can completely close the lumen of the vessel.

This can occur intermittently and manifest as pain in the heart. With a rapid blockage, we are already talking about an acute heart attack, which requires urgent hospitalization.

Eat different reasons heart attack, but most often a heart attack affects the elderly and those who lead a sedentary lifestyle, suffer from excess weight and move little. Wherein constant stress And nervous conditions lead to the development of the disease.

Although there are cases when a heart attack is diagnosed in physically strong people even at a young age. Most often, the disease overtakes young people in good physical shape as a result of the abuse of bad habits and constant stressful situations. It should be understood that any stressful situation and nervousness leads to cell death.

The main causes of a heart attack are:

• Constant overeating. You need to eat 3-5 times a day in small portions up to 300 grams.
• High pressure.
• Passive lifestyle. Every day you need to walk 2 or more km to train the muscles and actively contract them.
• Non-absorption of fats of animal origin in the body.
• Bad habits: cigarettes, alcohol, drugs and toxic substances.
• Elevated cholesterol, which leads to an increase in plaques.
• Diabetes mellitus, due to which oxygen through the bloodstream is supplied worse than usual.

In people who walk a lot and go in for sports, a heart attack is practically not diagnosed, and if it occurs, it is as a result of a stressful shock. All these causes lead to the formation of blood clots and blockage of blood vessels. As a result, oxygenated blood cannot reach the heart. The heart muscle can do without oxygen for no more than 10 seconds, after which the gradual death of the muscle begins.

After complete blockage, the heart muscle remains viable for about half an hour, after which irreversible processes begin. With angina pectoris and heart attack, pain occurs in the same place, but there are still basic differences between these diseases. A heart attack is characterized by a sharp prolonged pain that the patient can feel for up to half an hour, which does not subside even after taking nitroglycerin.

Myocardial infarction: symptoms and diagnosis

Myocardial infarction has symptoms that are manifested by acute pain in the region of the heart. However, these symptoms usually appear in men, but in women the situation is different.

Symptoms of a heart attack are different, it all depends on the complexity of the case, clinical manifestations, affected area and other factors. In women and men, the symptoms of the disease are slightly different.

With a sharp pain in the chest, it is not always clear that it is the heart that hurts, since most often the pain manifests itself in the area below the heart muscle during new physical exertion, as well as strong stressful situations and experiences.

Symptoms of myocardial infarction include:

• Sharp pains in the chest, shifted to the left. The pain can last up to half an hour and sometimes it is so strong that it is simply not possible to endure it. In this case, you need to urgently call an ambulance.
• When taking Nitroglycerin, the pain subsides, but does not go away completely.
• Sensation of burning, squeezing in the region of the heart.
• The pain gets worse over time and spreads to left forearm, neck and even jaw.

One of the terrible forms of ischemia is an extensive heart attack that affects all the muscle tissue of the heart. This causes cell death and damage to the walls of the myocardium.

An extensive heart attack manifests itself:

• Sudden pressure in the chest.
• Difficulty breathing and lack of oxygen.
• Numbness of the left side of the body or acute pain radiating to the arm.
• Blueness or blanching of the skin.
• The appearance of cold sweat on the forehead.
• Nausea, vomiting and abdominal pain.
• Arrhythmia and terrible panic.
• Severe pain and fainting.

The reasons for the occurrence massive heart attack comorbidities such as atherosclerosis, angina pectoris and hypertension can become. The main risk group includes people with diabetes And high cholesterol in the blood, obese and leading wrong image life, age category after 60 years.

Prolonged pain with a burning sensation, which are observed from 30 minutes to 1 hour, should definitely alert the patient, most likely it is a myocardial infarction. These signs indicate complications caused by coronary heart disease, which provoke the onset of a massive myocardial infarction.

In order to accurately determine the degree of damage and predict the outcome of the disease, specialized clinics carry out complete diagnostics patient:

1. Electrocardiography. Visualized using electrodes placed on the chest unnatural appearance T and Q waves, which indicate small and large-focal myocardial damage.
2. Blood analysis. Indicators: increase in the level of leukocytes, erythrocyte sedimentation rate, a large number of enzyme lactate dehydrogenase.
3. Echocardiography, ultrasound echocardiography. It reflects the parameters of the heart, the state of the walls and blood vessels, valves, determines the presence of blood clots and the quality of blood flow.
4. X-ray contrast coronography. Internal introduction through the femoral artery of a catheter that fills the venous vessels with a substance that allows you to determine the localization of the narrowing of the lumen and their degree.

Based on the data obtained empirically, cardiologists prescribe to the patient either subsequent intensive drug treatment, or a method of surgical intervention with an operation: coronary artery bypass grafting. This method involves the creation of artificial blood flow without affecting the coronary vessel already filled with blood clots and plaques. If the attack caught the patient at home, immediately call an ambulance.

It is unrealistic to normalize the condition at home with cardiovascular diseases, you can only alleviate and slightly reduce the pain syndrome before the arrival of specialists:

• Put the patient in a horizontal position. Be sure to raise your head. If there is shortness of breath, it is better to put in comfortable position, lower your legs down.
• Preparations: Nitroglycerin - 1 tablet under the tongue, dissolve, Aspirin - from 0.5 to 1 tablet to chew.
• Induce cough. In some cases, improves coronary blood flow.
• Loosen clothing and provide fresh air.
• Warm hands and palms with a hot compress.
• Try to calm the patient or give him a drink of Valocordin.
• In case of loss of consciousness or cardiac arrest, independently perform a chest massage and perform artificial respiration.

Emergency doctors are doing initial inspection patient with subsequent hospitalization for further examination and improvement of the condition.

Acute myocardial infarction and other forms and stages of myocardial infarction

Acute infarction myocardial infarction does not occur suddenly. A heart attack develops gradually, passes through characteristic stages.

So what are the stages of myocardial infarction:

1. Pre-infarction - the duration of the first manifestations can range from 2 days to several weeks. The symptoms are similar to angina pectoris.
2. Acute - state pain syndrome in the chest area and shortness of breath is observed 5 hours before the onset of a heart attack. It is characterized depending on the lesion. If insufficient circulation occurs in back wall myocardium, manifested vomiting, nausea, less often - loss of consciousness. Acute - worsening of the condition can last about 10 days. During these periods of myocardial infarction, body temperature and blood pressure may increase.
3. Subacute - increasing in strength and frequency attacks of diseases of the cardiovascular system are observed within 4 weeks. After this period, there is a temporary improvement in the condition.
4. Postinfarction - the period after myocardial infarction is accompanied by chest pain, arrhythmia, angina pectoris, shortness of breath.

To prevent the onset critical condition, at the first symptoms of coronary disease, you should immediately call an ambulance medical care. It is possible to determine that the patient does not have an intramural myocardial infarction, but an acute myocardial infarction, even before the doctors arrive. The disease has two distinctive forms.

The first is painful, typical. Signs are sharp sharp pains in the left side of the body, in the region of the scapula. Duration from 30 minutes to a day. The drug Nitroglycerin in this case is useless. Associated symptoms: fear, vomiting, sweating, shortness of breath, tachycardia.

The second is atypical. Has several varieties. It is completely asymptomatic or manifests itself in the upper abdomen. Possible violations observed from the side of the central nervous system: dizziness, loss of consciousness. Sometimes it resembles the onset of an asthmatic attack, which is accompanied by blue skin, lack of inhaled air.

In any case, without the help of specialists, it is impossible to leave a patient with such complications. It is possible to alleviate intramural myocardial infarction on your own only for a while.

At any stage of myocardial infarction, adequate treatment is required, the main goal of which is to restore blood circulation to the affected area of ​​the heart and maintain it at the proper level. Aspirin is used to treat a heart attack, which prevents the formation of blood clots. Plavix and Ticlopidin have the same effect but are considered more potent than acetylsalicylic acid. Heparin promotes blood thinning and destroys the factors that provoke the formation of blood clots. Entresto is also often prescribed - an innovative development for the treatment of CCC pathologies.

Thrombolytics easily dissolve the thrombus that is already in the vessels. All these drugs are prescribed by a doctor for complex treatment.

Coronary artery angioplasty is also often used for treatment. But if agioplasty cannot be done in the first hour of a heart attack, then it would be preferable to use drug treatment to dissolve blood clots and improve blood flow.

If the above methods do not give a result, then surgical treatment is performed - coronary artery bypass grafting, which will restore blood circulation and save a person's life.

In addition to restoring blood circulation, infarction treatment is carried out for:

• Reducing the size of the infarction and the load on the myocardium. For this, B-blockers are used.
• Pain relief with nitroglycerin and narcoanalgesics.
• Normalization of arrhythmia. For an accelerated rhythm, Lidocaine and Amiodarone are used, and for weak rhythm- Atropine or temporary pacing.
• Maintaining normal pressure, breathing, pulse, kidney function.

Outcomes of myocardial infarction and its consequences

Outcomes of myocardial infarction are not always joyful. Most often, with extensive and deep damage to the heart muscle, a heart attack gives complications. It is known that a heart attack is the necrosis of some area of ​​the myocardium, as a result of which the muscle tissue becomes connective and loses all its functional abilities. This leads to a narrowing of the wall thickness of the heart and an increase in the cavity of the left ventricle, followed by a deterioration in contractile function.

After a heart attack, a person may develop an arrhythmia. It is considered the worst ventricular tachycardia and ventricular fibrillation. In any case, arrhythmia must be treated so as not to start the disease.

Heart failure is also on the list of complications and is very often diagnosed with a heart attack. Increased pressure increases the area of ​​infarction due to oxygen starvation heart and tension in the left ventricle.

Within a week after a heart attack, mechanical damage to the cardiovascular system may develop, which will require surgical intervention to save a person's life.

A third of patients who have had a heart attack periodically pain syndrome.

Dressler's syndrome is manifested by inflammatory processes in the heart and lungs. All these outcomes of myocardial infarction can lead to the death of the patient.

Immediately after a heart attack, the patient is prescribed bed rest to strengthen the scar, after which small physical activity is prescribed. After a heart attack, a person must constantly take pills to expand blood vessels and blood thinning, as well as not overwork, rest more and get enough sleep.

To prevent a heart attack, you need to get rid of all bad habits, lose extra pounds, improve proper nutrition, move more and not be nervous over trifles, also in order to prevent a heart attack, the doctor may prescribe Sortis tablets.

Patients characterize pain in myocardial infarction as acute and even dagger-like, burning. Such pain is observed in people with ischemic necrosis, that is, the necrosis of the muscle tissue of the left ventricle of the heart. This necrosis is most often caused by a blood clot in the coronary artery, which supplies the area with blood.

What is the nature of pain in myocardial infarction?

The pain is pronounced, strong, its intensity directly depends on how much the heart muscle is affected. Pain in a heart attack is much more pronounced than in angina pectoris, and lasts longer. If with angina pectoris the pain lasts for 15 minutes, then with a heart attack after this period it only intensifies and can last for several hours. In addition, with a heart attack, you can’t help yourself with nitroglycerin, but with angina pectoris, you can.

The nature of the pain in a heart attack is not passing, in the form of waves, these pains can subside after the doctor injects an anesthetic. But then the pain can come back again.

By localization, pain during a heart attack can disturb in the area behind the sternum, as well as in the left side of the chest. The pain can give (radiate) to the left arm - its inner surface of the muscles. A tingling sensation may be felt in the fingers and wrist, as well as in the hands. Pain during a heart attack can also radiate to the shoulders, neck, space between the shoulder blades, jaw.