Acute heart attack. Acute myocardial infarction and its treatment

Acute infarction myocardium- a pathology characterized by necrosis of a section of the heart muscle, due to problems with blood flow in the coronary vessels.

Such disorders are the result of a discrepancy between the amount of oxygen necessary to maintain the normal functioning of the heart, and what is “delivered” in a real situation. In this article, I propose scrupulously to consider this formidable disease, which is considered a complication of coronary heart disease.

We will find out in more detail the causes of the manifestation of the disease, types of diagnosis, forms of treatment in order to reduce the risks of being in cardioreanimation.

I note that the information below, in no case, should create illusions, be perceived as a self-treatment manual. Such actions are categorically unacceptable. I consider naive the opinion of those who, after reading articles on the topic of their disease, imply that they are able to discuss and communicate with a cardiologist on an equal footing.

Making a diagnosis, developing a treatment strategy, prescribing drugs is the exclusive prerogative of a specialized attending physician.

However, one psychological aspect should not be discounted. To prevent the disease, we will arm ourselves with at least a minimum amount of information. Far from superfluous, it will be to learn about all the possible factors provoking the onset of the disease.

With regard to myocardial infarction, such a statement is relevant, since the percentage of death after the first heart attack is significant. Of the three patients diagnosed with acute myocardial infarction, only two survive. I am sure this is a convincing argument to consider how serious the danger to hearts represents this pathological condition.

Causes of a heart attack

Atherosclerosis is a fundamental risk factor that creates the prerequisites for the formation of cholesterol accumulations on the walls of arteries. Similar lipid formations are called atherosclerotic plaques that can appear in various forms: convex, flat, thick, thin, strong.

These criteria have a high degree of significance, since the probability of plaque rupture is based on them.

Vessels that have fallen under the onslaught of atherosclerosis lose their key property - elasticity, becoming dense. With a cholesterol plaque, the capacity of the artery is reduced. The “requirement of the heart” to increase blood flow through it turns out to be impossible.

However, the insidiousness of the problem is that "" is silent, for many years, monotonously performs black duties.

For a long time, vascular damage, does not declare itself. There comes a moment when a person is overtaken by oppressive pain in the middle of the chest. This heart is “signaling” you for help.

Similar manifestations of coronary artery disease are called angina pectoris.

The heart is unable to cope with the increased workload, as the coronary arteries, so far only partially blocked by atherosclerotic accumulations.

If you care about your heart health, then consult a cardiologist in a timely manner. By adhering to medical prescriptions, you can stop attacks, pain will occur less often, problems will temporarily recede.

If you do not take any steps, neglect the recommendations of doctors, ignore the basics healthy lifestyle life, there will come a time when the situation can dramatically worsen.

At the next time, taking nitroglycerin, no relief came.

Only by taking one more, or several tablets, will the long-awaited relief come. This serious signal, literally a heart alarm, saying that the integrity of the plaque has been violated. Reasons abound:

• stressful situation
• hypertensive crisis
• physical strain
• plaque inflammation

The resulting crack, the body will seek to “patch” a blood clot. Blood clotting at the site of damage increases, and the logical result is the formation of a blood clot.

Since there are no reasons preventing growth, the arterial lumen will be closed thrombus extremely fast. The passage of blood through the artery is stopped. Cells, tissues, experiencing a colossal lack of oxygen, die. Thus, acute myocardial infarction develops.

The degree of myocardial damage is directly dependent on the size of the artery that the thrombus blocked. The larger it is, the more cells fall under the influence of necrosis (die). Divided accordingly:

• large focal, when the entire thickness of the heart muscle is under the damaging effect
• small focal

A heart scar (scar) remains for life. He will not be able to dissolve, leaving his imprint forever.

Key Symptoms

In typical situations, the symptoms characteristic of acute are as follows.

The primary sign is the presence of pain behind the sternum. The intensity of the burning sensation is great, with the probable localization of pain in different places: shoulder, neck, jaw, arm, back. The nature of the flow is undulating. At the time of the attack, the patient's face is strongly distorted, turns pale skin covering. Extremities wet, cold, shortness of breath.

If with angina pectoris, such signs manifest themselves during exercise, then preinfarction state, characterized by the presence of pain when a person is at rest. The accepted nitroglycerin, does not help or assist.

An ambulance should be called immediately.

However, the list of signs is not limited to pain syndrome. The patient has strong fluctuations blood pressure. Immediately at the time of the onset of pain, pressure indicators can increase sharply, and then a steep “peak” occurs, to unusually low values ​​​​for the patient.

As for the pulse, it does not differ in its constancy. Basically, a frequent one is detected, although sometimes there is an exception (rare).

In addition to tachycardia, a whole bunch of various disorders from the autonomic nervous system:

• muscle weakness
• cold sweat
• dyspnea
• frequent urination
• heightened anxiety
• anxiety
• likely psychiatric disorders

The last three signs arise due to a sharp increase in exciting hormones (adrenaline) entering the blood.

At the end of the first day, after pain attack, a tangible is stated, which is due to the ingestion of “dead” cells of the affected myocardium into the blood.

Penetrating into the blood, they rapidly spread throughout the body, causing its poisoning.

An increase in temperature, after the chest pains have receded a little, is an alarming bell about an approaching heart attack. Usually, it stays in the range of 38-39 gr.

I note that an attack of angina pectoris does not cause an increase in temperature.

The clinical picture of the course of a heart attack is striking in its diversity. Some carry it on their feet, while others have a typical disease. In the third, against the background of a heart attack, a number of serious complications develop. In addition, there are situations when, as a result of complications, death.

Secondary signs

1. Pain that occurs in digestive tract, cannot be characterized as acute. The area where they are felt is not sensitive to touch. Causes problems in the patient, accompanied by a burning sensation. Slightly reduce the unpleasant feeling, taking antacids will help.
2. Sore arm, shoulder, usually left. However, the feeling of heaviness can also embrace right side. The nature of the pain is monotonous, aching, extending down to the fingers.
3. Shortness of breath is one of the “popular” symptoms of a likely approaching heart attack. You should be alarmed when a normal load makes you suddenly puff, choke. Any movement becomes difficult. These breathing problems are referred to as "air starvation", which disappears with rest. However, do not delude yourself, because by continuing walking, shortness of breath returns again.
4. Often, an accompanying symptom of shortness of breath is chronic fatigue covering the entire body.

Diagnosis of a heart attack

The statistics are relentless, the percentage of people hospitalized with this diagnosis is small. To identify the problem in a timely manner, not everyone will turn out in time.

Half an hour, a maximum of forty minutes - this is the optimal time period for the successful treatment of a heart attack.

The effectiveness of therapy against an attack of chest pain is directly dependent on the timeliness of seeking medical help. Successful fight with a thrombus that barricaded the cardiac artery, possibly in the first 3 hours after the onset of a heart attack.

An electrocardiogram made (in typical situations) will be enough for emergency doctors to state the seriousness of the situation (extensiveness, depth, through, lying in the thickness of the myocardium). How seriously affected, an ultrasound of the heart will help to find out, of course, provided that the patient was promptly taken to the hospital.

What to do before the doctors arrive

Feeling pain in the chest, you must:

1. Stop everything active actions, sit down.
2. Take advantage of nitroglycerin, putting it under the tongue.
3. If it does not help, then after at least five minutes, take another pill. It is permissible, in the absence of positive changes, to take 4-5 tablets within an hour. It should be borne in mind that taking nitroglycerin lowers blood pressure, headaches are likely.

Treatment of heart attacks

The primary task is to stop the attack of pain, by introducing intramuscularly, intravenously, analgesics, in various combinations. With a similar diagnosis, emergency transportation of the patient to the hospital is mandatory.

The idealized option for hospitalization would be an intensive care unit, with the possibility of constant monitoring of the work of the heart. If necessary, emergency help appears immediately. List of measures, depending on the indications:

• cardiac defibrillation
• lung ventilation (artificial)
• pacing

If the moment is not missed, less than six hours have passed since the beginning of the attack, in the absence of contraindications, the main task is to dissolve the thrombus that has made a blockage in the coronary arteries. Apply drugs such as fibrinolysin, streptase. To exclude the progression of thrombosis allows the introduction of heparin.

To slow down the death of myocardial cells and tissues, drugs are administered intravenously that reduce the heart's need for oxygen.

Complications of a heart attack

1. Rupture of the wall of the ventricle, accompanying cardiac tamponade - the most critical complication, leads to death in just five minutes.
2. A cardiac aneurysm is a formation that has a convex shape, with contractions, as if falling out. Thrombi form inside the cavity. The bloodstream carries them apart, causing a disease called thromboembolism.
3. Cardiogenic shock is the most dangerous complication characterized by a sudden decrease in blood pressure. The symptomatic picture is as follows:

• skin turns pale
• veins become barely visible on visual inspection
• limbs cold
• muffled heart sounds
• pulse is thready
• weak urination
• possible loss of consciousness
• blockade - problems with the conduction of the heart impulse
• sometimes arrhythmias may occur

How are complications treated?

In cardiogenic shock, focusing on the values systolic pressure inject dopamine.

Pulmonary edema - analgesics are administered intravenously. The procedure for removing foamy sputum from the bronchi is carried out by means of specialized suction devices (vacuum devices), and inhalation of oxygen enriched with vapor ethyl alcohol, promotes the removal of sputum from the small bronchi.

To accurately determine the artery responsible for the occurrence of a heart attack, a procedure called coronary angiography will help. If necessary, balloon angioplasty and stenting of the affected artery are performed, which helps to clear the blockages and restore normal blood flow.

An idealized option, the implementation of cardiologists who arrived on call (which is rare, therapists usually come), right at home, systemic thrombolysis. The essence of the method - a drug is injected that dissolves the thrombus that blocked the lumen of the coronary vessel.

Coronary artery bypass surgery for acute infarction is rarely performed because of the high risk of death. Exceptions, rupture of the interventricular septum - the life of the patient is in danger.

It is necessary to provide daily thorough care. It will be indispensable to help with washing, eating. You will need to systematically turn in bed, wipe the skin, monitor the stool.

Salt-free laxatives will help with constipation ( Vaseline oil, buckthorn).

The doctor adjusts the regime, a lot depends on how badly the myocardium was affected.

In case of small focal infarction, bed rest kept for two or three days. Then, in the case of positive dynamics, movements are allowed within the ward. A week later, movements are allowed within the department, with a gradual increase in motor activity.

At discharge, the distance that the patient is able to overcome, with complete absence discomfort in the chest, should approach 700-900 meters. An independent ascent to one floor should not cause any difficulties.

The recovery period after a heart attack is unthinkable without physiotherapy exercises. Its implementation begins during your stay in the hospital, and in the future, you should regularly visit the exercise therapy room.

Acute myocardial infarction does not pass without a trace, the functionality of the heart muscle is partially impaired. The risk factor (atherosclerosis of the coronary vessels) is still present, it is unfortunately impossible to become completely healthy after a heart attack.

So that a heart catastrophe does not thunder a second time, you should take care of your own health yourself. No one will lead you by the hand to the cardiologist's office. Try to follow medical advice. They are talked about a lot, but rarely performed.

The course of your psychological mood should be aimed only at a healthy lifestyle, although this is far from being the case for everyone. Take it seriously preventive measures because heart health is at stake.

Description:

This is one of clinical forms, proceeding with the development of an ischemic area of ​​the myocardium, due to the absolute or relative insufficiency of its blood supply.
Myocardial infarction is one of the most common diseases in Western countries. In acute myocardial infarction, approximately 35% of patients die, and slightly more than half of them before they get to the hospital. Another 15-20% of patients who have had an acute stage of myocardial infarction die within the first year. The risk of increased mortality among people who have had myocardial infarction, even after 10 years, is 3.5 times higher than in people of the same age, but without a history of myocardial infarction.

Symptoms:

Most often, patients with acute myocardial infarction complain of pain. In some patients it is so severe that they describe it as the most severe pain they have ever experienced. Severe, squeezing, tearing pain usually occurs in the depths of the chest and resembles ordinary attacks in nature, but more intense and prolonged. In typical cases, pain is felt in the central part of the chest and / or in the epigastric region. In about 30% of patients, it radiates to upper limbs, less often in the abdomen, back, capturing the lower jaw and neck. The pain may radiate even to the back of the head, but never radiates below the navel. Cases where pain is localized below the xiphoid process, or when patients themselves deny the connection of pain with a heart attack, are the reasons for making an incorrect diagnosis.
Often the pain is accompanied by weakness, sweating, nausea, vomiting, dizziness, agitation. Unpleasant sensations usually appear at rest, more often in the morning. If the pain begins during physical activity, then, unlike, it usually does not disappear after it stops.

However, pain is not always present. Approximately 15-20%, and apparently even a larger percentage of patients with acute myocardial infarction is painless, and such patients may not seek medical help at all. More often, painless myocardial infarction is recorded in patients with diabetes mellitus, as well as in individuals old age. In elderly patients, myocardial infarction is manifested by sudden onset of shortness of breath, which can turn into. In other cases, myocardial infarction, both painful and painless, is characterized by sudden loss consciousness, a feeling of severe weakness, the occurrence of arrhythmias, or simply an inexplicable sharp decrease in blood pressure.

In many cases, the reaction to chest pain dominates in patients. They are restless, agitated, trying to relieve pain by moving in bed, writhing and stretching, trying to cause shortness of breath or even vomiting. Otherwise, patients behave during an attack of angina pectoris. They tend to take a stationary position for fear of the resumption of pain. Pallor, sweating, and cold extremities are often observed. Retrosternal pain lasting more than 30 minutes, and the observed sweating indicate a high probability of acute myocardial infarction. Despite the fact that in many patients the pulse and blood pressure remain within the normal range, approximately 25% of patients with anterior myocardial infarction have manifestations of hyperreactivity of the sympathetic nervous system (tachycardia and / or hypertension), and almost 50% of patients with inferior myocardial infarction have signs increased tone sympathetic nervous system (bradycardia and / or hypotension).

Causes of occurrence:

Myocardial infarction develops as a result of obstruction of the lumen of the vessel supplying the myocardium (coronary artery). The reasons can be (by frequency of occurrence):

The death of a part of the heart muscle, leading to the formation of thrombosis of the coronary artery, is called myocardial infarction. This process leads to the fact that the blood circulation of this area is disturbed. Myocardial infarction is predominantly fatal, as the main heart artery is clogged. If, at the first sign, appropriate measures are not taken to hospitalize the patient, then a lethal outcome is guaranteed in 99.9%.

In a medical institution, they begin to immediately dissolve the clot in order to restore normal blood circulation in this area. Due to the fact that this disease occurs quite often and both the elderly and young people suffer from it, it is worth paying attention and considering all the nuances of the course of the disease. Let's start with an in-depth consideration of the question of what is a heart attack.

Description of the disease

Myocardial infarction is an acute manifestation. Mostly the disease often affects women, in rare cases it also occurs in men. If during a certain period of time there is no blood supply to the area of ​​the heart muscle, then the process of death of this part of the heart begins. The area that actually begins to die as a result of the lack of oxygen is called a myocardial infarction. Violation of blood flow to the muscle section occurs due to the destruction of an atherosclerotic plaque in the artery. This plaque in normal condition is located in the lumen of one of the vessels, but when any load is applied to it, its destruction occurs. In its place, a blood clot begins to grow, which can gradually clog the vessel, as a result of which a person is characterized by a periodic sensation acute pain in the region of the heart, and quickly. Rapid blockage causes acute myocardial infarction, which requires hospitalization of the patient.

The statistics of mortality from myocardial infarction is quite large. Most patients die without waiting for an ambulance. Another half die on the road if urgent resuscitation measures are not taken. Even those people who have undergone therapeutic resuscitation also die due to the development of complications. As you can see, the disease is so serious that it is almost impossible to survive after its manifestation. Only in 1-2% of cases it is possible to save people from death, but after that a recurrence of a relapse is not ruled out.

Every year, the dynamics of the rapid growth of the disease among young people is traced. Moreover, these are people aged 25-30 years and older. In women under the age of 40–50 years, this disease is less common, but with the onset of menopause, a heart attack is much more common. The reasons for this dynamics are estrogens. The bottom line is that the female reproductive organs produce a hormone called estrogen. It is estrogen in women that performs protective function, not allowing the atherosclerotic plaque to come off. In men, the disease is less common than in women, but every year the number of people affected by myocardial infarction is growing.

Classification of myocardial infarctions

A dangerous and fatal disease is classified according to the size, depth and localization of the focus. Consider what classes of myocardial infarction are distinguished:

1. macrofocal. Has characteristic features acute violation coronary blood flow. The reason for its formation is considered to be arteries resulting from spasm or the development of necrosis. The name suggests that the resulting thrombus is predominantly of considerable size. Large-focal is also called extensive myocardial infarction, since there is a violation of blood flow in general. As a result, a scar develops, based on cell death.
2. Small focal. The reasons for its formation are minor ischemic damage to the heart muscle. It is characterized by a small-sized thrombus formation and a mild form of the course of the disease. In rare cases, a small focal infarction can lead to heart rupture or aneurysm.
3. Atypical forms of myocardial infarction. The main feature of this species is the asymptomatic course of the disease. Mostly, a sign of the disease is detected in a hospital on a cardiogram. An ECG in this form of myocardial infarction is the only way to establish a diagnosis and determine the disease. In 1-10% of cases, this form of the disease occurs.
4. Anterior infarction. The anterior wall of the left ventricle is predominantly affected.
5. Posterior infarction. Caused by the formation of a thrombus in the coronary aorta. As a result, the posterior wall of the left ventricle is affected.
6. Inferior or basal. It is characterized by damage to the lower wall of the artery of the left ventricle.
7. Transmural myocardial infarction has a predominantly acute form of the disease. It belongs to the most dangerous species, and is characterized by an effect on the entire wall of the ventricle. The epicardium and endocardium are affected. Predominantly transmural myocardial infarction always has a large-focal form of manifestation. Under the influence are often men from 30 years older. Among women this species is extremely rare. The end of this form is the scarring of the focus and subsequent tissue death. Transmural myocardial infarction is practically untreatable and fatal.
8. Abdominal. It is formed as a result of the development of pathologies on the posterior wall of the left ventricle.
9. intramural. It is formed on the basis of muscle damage throughout the entire thickness.
10. recurrent. Occurs on the basis of the formation of blood clots in coronary sclerosis. Characterized by the presence of periodic repetitions.

Each form is dangerous and fatal, but it is worth highlighting the transmural extensive myocardial infarction, which occurs abruptly and does not last long. The end result is fatal in most cases.

Stages of a heart attack

What is a heart attack, and what types of it are known, now it is worth paying attention to the stages of development of a dangerous deadly disease. Stages are formed on the basis of the duration of the course of the disease and the danger to the patient. So, the stages of a heart attack are as follows:

1. Acute stage. Its duration is approximately 5-6 hours. This stage is treatable, but often death from a heart attack occurs much earlier than the patient is taken to a medical facility. On the background acute stage arrhythmias and severe complications occur.
2. Acute. Oddly enough, but this stage is the most dangerous. Occurs unexpectedly and may be accompanied by acute pain for 14 days. The stage is characterized by the formation of a scar.
3. Subacute stage. The duration of the formation takes about a month. During this period, a scar gradually forms, and signs of necrotic syndrome disappear. ECG for myocardial infarction subacute stage displays signs of normalization of the metabolism of the disease.
4. Postinfarction stage. It is mainly formed from the second month of the disease and depends on the lesion. The stage is characterized by the adaptation of the heart to new conditions.
5. scarring stage. The final stage, which is characterized by the formation of a scar.

What contributes to the formation of a dangerous disease or what are the reasons and prerequisites for this. Let us consider in more detail what are the causes of myocardial infarction.

Causes

The causes of myocardial infarction are very different, but first of all, it is worth highlighting that most often the disease is diagnosed in the elderly or little active people who are obese or immobile. If we add to this frequent psycho-emotional overload, mood swings, stress, etc., then the result will be 100% myocardial infarction syndrome.

Sometimes myocardial infarction also affects people with good physical fitness, both young and old. The cause of the disease in people with a developed system of muscle groups are mainly bad habits and frequent psychoemotional disorders. Any disorder leads to cell death. Among the main reasons for the formation of myocardial infarction, it is also worth highlighting the following factors:

• Frequent overeating. A person should eat 3-4 times a day, but more is allowed if food is consumed in small quantities. It is better to eat more often, but in small portions, than once / twice a day, but overeat at the same time.
• Hypertensive diseases.
• Low physical activity . A person must walk at least two kilometers daily so that the muscles have the opportunity to contract.
• Absence of animal fats in food.
• Bad habits. These include not only smoking and excessive alcohol consumption, but also the use of narcotic and toxic drugs.
• high cholesterol. Cholesterol is the main component that leads to the formation of plaque on the walls of arteries.
• . An increased composition of sugar in the blood leads to a deterioration in the transport of oxygen by the bloodstream.

Based on research, it was nevertheless revealed that the syndrome mainly occurs in sedentary and inactive people. These are mainly women aged 40–50 years and men over 30. Relapses are especially common in men who consume extremely much alcoholic beverages. In physically active people, a heart attack is extremely rare and often caused by severe emotional stress.

Against the background of all of the above reasons, there is a blockage of the vessels of the heart by a thrombus, which is a plug in the artery. Accordingly, blood with a fresh supply of oxygen does not enter the heart. The heart muscle can do without oxygen for 10 seconds, if after this time the process of oxygen supply is not restored, then the muscle gradually dies. About 30 minutes after complete blockage, the heart muscle is viable, and after that irreversible processes are already developing.

Thus, in order to exclude such a disease, it is necessary to switch your body and mind to a healthy lifestyle and not succumb to stressful situations. How does a heart attack manifest in humans?

Symptoms

Symptoms of the disease are mainly manifested in the form of acute pain in the chest. But such symptoms are inherent mainly in males. In women, the symptoms appear in a different form.

Symptoms of myocardial infarction depend on the degree of complexity of the disease, clinical manifestations, myocardial damage and other contributing factors. It was found that in women and men the symptoms of the disease are somewhat different. Consider the main types of symptoms of the disease and atypical signs.

The main symptoms of a heart attack

Against the background of the above reasons, a person develops a pain symptom, which is an attack of pain in the chest area. Sometimes it is quite difficult to say that it is the heart that hurts, since the area below the heart is a characteristic place of pain localization. The pain is formed mainly during the performance of physical activity, which previously could not be performed, with strong and prolonged emotional disorders.

Symptoms of a heart attack also have the following characteristic features:

1. Sudden onset of acute pain in the chest area, predominantly on the left side of the body. The duration of pain takes up to 15-30 minutes. The pain is sometimes so severe that a person wants to scream. In case of signs of acute malaise in the heart area, emergency care should be called.
2. Even if a person resorts to taking nitroglycerin, the pain does not disappear, but may slightly decrease.
3. Acute pain is characterized by compressive, squeezing and burning symptoms.
4. Signs of myocardial infarction often have an intense form of manifestation, but in rare cases it can be undulating.
5. Over time, the symptoms of pain increase and are given to the neck, left arm and even jaw.

According to the first signs, we can say that a person begins a heart attack, which is caused by the activation of the nervous system. Also, the symptoms of myocardial infarction are manifested in the form of increased sweating, general weakness and malaise of the body. A person often, being in this state, cannot continue further movement or perform any actions, blanching of the skin occurs, the patient becomes white. Sweat is characterized by stickiness and coldness. With acute pain, the patient begins to feel dizzy and at the same time he falls to the floor, holding his heart.

Nausea and vomiting are also signs of myocardial infarction. Vomiting occurs due to a decrease in pressure. In rare cases, symptoms of the development of cardiogenic shock are observed, which are characteristic mainly for the acute stage of the disease. Cardiogenic shock is characterized by blanching of the human body, the appearance of cyanosis on the lips, the limbs become white with a blue tint, and the pulse is not felt.

Important! First aid for myocardial infarction is mandatory, even if you find a person who is holding his chest and cannot speak, you must immediately call an ambulance and start providing first aid.

If " ambulance” arrived on time, and managed to save the patient, then the next day there is a second period of malaise, which is characterized, first of all, by an increase in temperature to 38 degrees. An increase in temperature is the body's reaction to the cessation of myocardial activity and its further death. If there is cardiogenic shock, then defeat is not excluded internal organs, that is, their death or decrease in vital activity. Often, the first organ to fail is the kidneys. In this case, there is an accumulation of urine in the kidneys, which is practically not excreted. The accumulation of unnecessary products in the body begins, which lead to intoxication.

The rehabilitation period also has its own characteristics, which are inherent in:

1. The appearance of swelling on the upper and lower extremities.
2. Frequent shortness of breath even with slight exertion.
3. There is an increase in the liver and its soreness.

Often, at the stage of rehabilitation, such a phenomenon develops as caused by the cause of depletion of the heart muscle. Symptoms of myocardial infarction are the first messengers of the need to urgently call an ambulance in order to save a person. The disease is one of the most dangerous diseases that are known. Basic or typical symptoms are clearly manifested in men, and women are characterized by atypical signs of the disease, which are worth talking about.

Atypical symptoms

Atypical symptoms of myocardial infarction, which are inherent in women, have several types of clinical forms.

1. Asthmatic form. It is characterized by the appearance of a feeling of insufficiency of air and shortness of breath. Often, against the background of shortness of breath, panic begins, which aggravates the situation. Attempts to inhale full chest end unsuccessfully. accumulates in the alveoli excess fluid, which makes itself felt in the form of the appearance of gurgling during inhalation. Further development of the disease leads to the formation of pulmonary edema and the development of pneumonia. Asphyxiation in myocardial infarction often occurs during sleep, while a sharp awakening resembles an attack.
2. gastralgic form. A rare event, which is characterized by the appearance of pain in the abdomen, mainly in the upper sections. By the first signs, it is very difficult to determine the real diagnosis, since the symptoms are more like acute or poisoning. But in fact, under the symptoms in the form of vomiting, hiccups and belching, a dangerous heart attack is hiding. It is determined only by diagnosing in a medical center.
3. Cerebrovascular form. The first signs of the disease appear in the form of a deep fainting. This form of the disease is more common in men and less common in women. Against the background of the disease, paralysis and paresis occur, and brain failure And pathological abnormalities.
4. Arrhythmic form. Symptoms of arrhythmic myocardial infarction are manifested in the form of arrhythmias. The most dangerous in arrhythmic form is the formation of atrioventricular blockades. Based on these blockades, a decrease in the heart rate occurs. With such signs, immediate hospitalization of the patient is required for assistance.

The symptoms of myocardial infarction are quite diverse, therefore, at the first ailments in people with ischemic abnormalities, an ambulance should be urgently called and first aid should be started for the patient. How to do this, we will consider a little later, but first we will analyze how the disease is diagnosed in medical centers.

Diagnostics

Diagnosis of myocardial infarction is carried out according to three main factors:

1. clinical picture.
2. Laboratory studies and troponin test.

The clinical picture of the disease is determined mainly by close people who observe the aggravation of the situation. Based on the following symptoms: sharp acute pain in the sternum, inability to breathe, nausea, vomiting, weakening of the body, cold sweat and difficulty in speech, it is necessary to call an ambulance and tell all the signs to the doctor who arrived. Based clinical picture an experienced doctor and without tests will determine accurate diagnosis. But a mandatory procedure is also an ECG in a hospital or in an ambulance. In cases of myocardial infarction, not a minute can be lost, so all diagnostic procedures are carried out very quickly.

The study of cardiac abnormalities by means of an electrocardiogram confirms the diagnosis previously made by an experienced doctor. On the ECG, myocardial infarction manifests itself as the formation of Q waves and the rise of the ST segment in the leads. The doctor, according to the data obtained, observes the picture of damage certain parts heart compartments, which is a sign of a heart attack.

The content of the article

myocardial infarction is an acute clinical manifestation of ischemic disease. The atherosclerotic plaque located in the heart vessel is destroyed under increasing blood pressure. In its place, a clot or thrombus forms, which completely stops or partially limits the normal movement of blood in the entire muscle. As a result of limited blood supply, insufficient to supply the heart tissues with the necessary elements (including oxygen), necrosis develops in them, that is, the death of the affected area that does not receive enough blood within 10-15 minutes. Subsequently, the work of the entire cardiovascular system is disrupted, a threat to the health and life of the patient is created.

Acute myocardial infarction is a common diagnosis with high level mortality. Statistics paint the following picture: about 35 percent of cases end in death, while half of the patients die before they come under the care of a doctor. In another 15-20 percent of cases, death occurs within a year after diagnosis and treatment. Often, death occurs directly in the hospital due to the development of complications that are incompatible with life. The threat to life and health remains even after successful treatment, however, timely diagnosis and treatment still increase the chances and improve prognosis.

Symptoms of myocardial infarction

The main symptom of a typical painful form infarction - pain localized in thoracic region. Echoes of pain can be felt in the left arm, the area between the shoulder blades and mandible. The pain is sharp, accompanied by burning. Angina pectoris also provokes similar manifestations, however, in the case of a heart attack, the pain persists for half an hour or more, and is not neutralized by taking nitroglycerin.

Atypical manifestation of myocardial infarction is more difficult to diagnose, because. has a latent or "masked" form of symptoms. So, with the gastritis variant, the pain is localized in the epigastric region and falsely indicates an exacerbation of gastritis. This form of manifestation is characteristic of necrosis of the lower part of the left ventricle of the heart adjacent to the diaphragm.

Repeated myocardial infarction, accompanied by severe cardiosclerosis, may manifest itself in an asthmatic variant. In this case, the patient feels suffocation, cough (dry or with sputum), wheezing is present, the heart rhythm is disturbed, and blood pressure is reduced. Pain syndrome is not observed.

The arrhythmic variant is characterized by arrhythmias of various kinds or atrioventricular blockade.

At cerebral infarction the patient feels dizziness, pain in the head, nausea, weakness of the limbs, consciousness is disturbed, circulatory disorders in the brain are detected.

The erased form of a heart attack does not manifest itself in any way: there is discomfort in the sternum, sweating increases. Common in diabetic patients.

Periods of myocardial infarction

The considered acute manifestation of the disease is preceded by a prodromal period, during which the patient feels an increase and a gradual increase in angina pectoris. so-called. the preinfarction period can last from several hours to several weeks. It is followed by an acute period, the duration of which is limited to 20-120 minutes. It is she who gives the described picture. After that, the necrotic tissues begin to straighten, which corresponds to the acute period (2-14 days). Then the symptoms subside, a scar forms on the affected area. This process lasts from 4 to 8 weeks and corresponds to the subacute period. The last, post-infarction period is the time of adaptation of the myocardium to the conditions created by the disease.

Causes of myocardial infarction

The cause of acute myocardial infarction observed in the vast majority of cases is atherosclerosis of the coronary arteries. In turn, its cause is a violation of lipid metabolism, as a result of which atherosclerotic plaques form on the walls of blood vessels, which can disrupt the integrity of the walls and reduce the patency of blood vessels. Less commonly, the cause of a heart attack is spasm of the vessels of the heart muscle. The course of the process of blockage of blood vessels is aggravated by thrombosis - blood clots can form at sites of plaque destruction due to the presence of high viscosity blood or other predisposition of the body to the formation of blood clots (for example, coronary artery disease).

As a result, the vessel is partially or completely blocked, the blood carrying oxygen to the heart stops flowing into the muscle tissue, which provokes necrosis of that part of the heart muscle that depends on the failed vessel.

Often, an acute form of myocardial infarction is preceded by a strong nervous or physical stress, however, the presence of this factor is not necessary - the disease can manifest itself in a state of complete rest, which is provoked by "background" diseases and conditions of the body.

Risk of myocardial infarction

The risk of developing myocardial infarction increases with age. The disease often affects patients who have reached the age of 45-50. At the same time, women are subject to a heart attack by 1.5-2 times. more men especially during menopause.

Already once transferred myocardial infarction increases the chances of a relapse.

Risk cardiovascular disorders large if the patient has arterial hypertension. This is due to increased oxygen consumption by the myocardium.

At risk are also people who are obese, inactive, addicted to alcohol or smoking. All these factors lead to metabolic disorders and subsequent narrowing of the coronary arteries.

Elevated blood glucose (observed in diabetes mellitus) reduces transport function hemoglobin (namely, it delivers oxygen) and damages the walls of blood vessels.

Diagnosis of myocardial infarction

Discomfort and / or chest pain that persists for half an hour or longer is the reason for calling an ambulance team and subsequent diagnosis of acute myocardial infarction. To diagnose the disease, specialists make big picture symptoms based on patient complaints and conduct studies using electrocardiography, echocardiography, angiography and analysis of creatine phosphokinase or CPK activity. In addition, the diagnosis is general state patient to determine and further stop the causes of the disease.

Electrocardiography

At the initial stage of a heart attack, one of the few signs that a patient has a disease may be an increase in peaked T waves. The study is repeated at a frequency of up to half an hour. The ST segment is assessed, the rise of which by 1 or more millimeters in two or more adjacent leads (for example, II, III, aVF) allows us to conclude an affirmative diagnosis of a heart attack. At the same time, experts take into account the likelihood of a pseudo-infarction curve that manifests itself in other diseases. If the interpretation of the ECG is difficult. Use the posterior chest leads.

Enzymes in myocardial infarction

After 8-10 hours from the moment of the first manifestation of a heart attack, an increase in the activity of the CPK MB-fraction is manifested in the body. But after 2 days, this indicator returns to normal. For complete diagnosis the study of enzyme activity is carried out every 6-8 hours. In order to exclude this diagnosis, specialists must obtain at least 3 negative results. The most informative is the picture of troponin (Tp) activity. On days 3-5, the activity of LDH (lactate dehydrogenase) increases. Treatment of a heart attack is started until confirmation is received from an enzyme analysis.

Echocardiography (Echo-KG)

In case of fixation of a protracted pain syndrome, but the absence positive result ECG, for the diagnosis of a heart attack and the formation of a picture of the disease, an Echo-KG is performed. About ischemia, acute or already myocardial infarction will indicate a violation of local contractility. If the wall of the left ventricle of the heart is thinned, we can talk about past illness. In the event that Echo-KG gives full visibility of the endocard, the contractility of the left ventricle with an indicator within the normal range can, with a high degree of probability, indicate a negative result.

Emergency coronary angiography

In the event that the ECG and analysis of enzyme activity did not give results or their interpretation is difficult (in the presence of concomitant diseases that “blur” the picture), emergency coronary angiography is performed. The indication for it is ST-segment depression or / and T-wave inversion. Acute myocardial infarction can be confirmed by results indicating a violation of local contractility in the left ventricle of the heart, as well as occlusion of the coronary artery with the presence of a thrombus.

Complications of myocardial infarction

The disease itself has a mediocre effect on the state of the body (subject to timely removal acute form), but under its influence (often as defensive reaction organism) other symptoms and diseases begin to develop. Thus, the main danger to the health and, first of all, the life of the patient is created precisely by the complications of myocardial infarction, which often manifest themselves in the first hours. So, most often a heart attack is accompanied by arrhythmias of various types. The most dangerous is ventricular fibrillation, which is characterized by a transition to fibrillation.

In case of insufficiency in the left ventricle, the disease is accompanied by wheezing and cardiac asthma, pulmonary edema. The most dangerous complication is cardiogenic shock, which in most cases is fatal. Signs of this are a drop in systolic pressure, impaired consciousness, tachycardia.

Necrosis of muscle tissue can lead to rupture of the latter with subsequent hemorrhage - cardiac tamponade. Subsequent failure of the scar tissue leads to the development of an aneurysm.

Very rarely (in 2-3 percent of cases) the disease is complicated by pulmonary embolism.

Forms of myocardial infarction

The classification of myocardial infarction is made depending on several factors: the size or depth of tissue damage by necrosis, according to changes in ECG results, based on the location of the affected tissues, the presence of pain syndrome and the frequency of occurrence of the disease. In addition, the period and dynamics of the course of the disease are taken into account. The course of treatment and subsequent prognosis and prevention may depend on the form of myocardial infarction.

Large focal myocardial infarction

Large-focal myocardial infarction is characterized by a larger area of ​​tissue damage by necrosis. In this case, rupture of dead tissue may occur, followed by hemorrhage. This form of the disease is complicated by aneurysm or heart failure, thromboembolism. This form of heart attack accounts for up to 80 percent of all cases.

Small focal myocardial infarction

Small-focal myocardial infarction occurs in 20 percent of cases, but often subsequently becomes complicated to a large-focal form (in 30 percent of all recorded cases). Initially characterized by a small area of ​​affected tissues. In this case, there is no rupture of the heart or an aneurysm; a complication of thromboembolism, fibrillation, or heart failure is extremely rarely recorded.

transmural

This form of the disease is characterized by damage to the entire thickness of the muscle tissue. Most often, transmural myocardial infarction is large-focal and in most cases is accompanied by complications. For a complete diagnosis of such cases, several methods are used, since it is not possible to unambiguously determine the depth of tissue damage on the ECG, as well as the prevalence.

intramural

In this case, necrosis is located directly in the thickness of the heart muscle, without "touching" the epicardium or endocardium. In case of untimely relief of the development of a heart attack, given form may develop into subendocardial, transmural or subepicardial infarction, accompanied by complications. In the case of a large-focal lesion, it can lead to rupture of the heart. It is diagnosed by a complex of methods.

Subendocardial

This form of infarction is characterized by the proximity of the affected area of ​​tissue to the endocardium. It is diagnosed on the basis of the ECG, in the results of which in this case there is ST-segment depression and T-segment inversion, noted in direct leads. Due to the development of reactive inflammation around the affected tissue, this form is accompanied by thrombotic overlays.

Subepicardial

It is characterized by the location of the focus under the epicardium or in the area adjacent to it. In this case, necrosis may be accompanied by fibrous overlays provoked by reactive tissue inflammation. Diagnosis of this form of the disease is carried out on the basis of the ECG, however, in the case of a "blurred" picture, it may require additional studies.

Q-infarction

Q-myocardial infarction is diagnosed by determining the formation of the pathology of the Q wave, may also be accompanied by a QS complex in the direct leads of the cardiogram. A coronary T wave may also be noted. Most often, this is a large focal lesion of a transmural nature. This form of myocardial infarction most often provokes a whole range of complications, always characterized by thrombotic occlusion. Diagnosis of Q-infarction frequent occurrence(about 80 percent of cases).

Not a Q heart attack

Myocardial infarction, not accompanied by Q waves on the cardiogram, as a rule, occurs in the case of spontaneous restoration of perfusion, as well as with a good degree of development of collaterals. With this form of infarction, tissue damage is minimal, and the complications caused by them are not great. Mortality in this case is practically absent. However, such a heart attack (called incomplete, that is, one due to which the myocardium continues to receive nutrition from the affected coronary artery) often has a "continuation", that is, the patient presents with a repeated or recurrent heart attack. To prevent relapse, doctors prefer active diagnostic and therapeutic tactics.

First aid for myocardial infarction

With the manifestation of the above symptoms of the disease. You should immediately call an ambulance team, indicating suspicions of a heart attack. It is this action that is the basic rule of first aid in this case. You should not strive to "endure" the pain on your own for more than 5 minutes. It should be remembered that if an ambulance cannot arrive or it is not possible to call one, an attempt should be made to get to qualified medical care on your own.

After the doctor has been called, that is, while waiting for help, you can pre-chew an aspirin tablet. However, this action is taken only if the doctor has not voiced a ban on taking it, and it is known for sure that the patient is not allergic to the drug. If there is a doctor's recommendation for taking nitroglycerin, you can drink it, guided by the prescribed doses.

In case of loss of consciousness, cardiopulmonary resuscitation should be performed. Correctly direct the resuscitation can be an ambulance officer or a doctor using the phone, in case no one present nearby has the skills or experience

Treatment of myocardial infarction

At the first reasonable suspicion of myocardial infarction, the patient is prescribed hospitalization. Further treatment takes place on the basis of a medical institution, or rather cardiological resuscitation. During the period of acute infarction, the patient is provided with a bed regimen and complete mental and physical rest, fractional nutrition, limited in calorie content. At the subacute stage, the patient can be transferred to the department (cardiology), where the mode of his nutrition and movement is gradually expanding.

The pain syndrome that accompanies the disease is stopped by fentanyl and droperidol, as well as by the introduction of nitroglycerin intravenously.

To prevent the development of complications, enhanced therapy is carried out using appropriate medicines(antiarrhythmic, thrombolytic and others).

If the patient is admitted to cardiology within the first 24 hours of disease manifestation, perfusion may be restored with thrombolysis. It is used for the same purpose and balloon coronary angioplasty.

Consequences of myocardial infarction

Once myocardial infarction has an extremely negative impact on overall health. The extent of the consequences always depends on the degree of damage by myocardial necrosis, the presence of complications, the rate of scar formation and the quality of scar tissue. Often there is a subsequent violation of the heart rhythm, and due to the necrosis of the area of ​​\u200b\u200bmuscle tissue and the formation of a scar, the contractile function. Subsequently, the development of heart failure may occur.

In the case of a massive infarction, an aneurysm of the heart may form, which requires surgical intervention to prevent rupture.

Prognosis of myocardial infarction

Up to 20 percent of patients with a heart attack do not survive to hospitalization, another 15% end in deaths in the hospital, most in the first 48 hours after admission, because it is during this period that the most intensive therapy occurs. Studies have shown that the restoration of perfusion in the first 120 minutes significantly improves the prognosis, and in 240-360 minutes it reduces the degree of damage.

The threat to the life of a patient who once had this disease persists after 10 years - the probability premature death of such people is 20% higher than in people who have never suffered a heart attack.

After myocardial infarction

The period of rehabilitation after myocardial infarction is different and strictly individual, but always lasts at least several months. The intensity of the loads should increase gradually, so people who were previously engaged in physical labor are forced to change their activities or temporarily (or permanently) give up work. Under the supervision of a doctor, a person remains for at least a year, periodically undergoing stress tests to control the process of restoring body functions.

After discharge from the hospital, the patient continues to take medication and will continue to do so constantly and throughout his life, if necessary, on the recommendation of a doctor, reducing or increasing the dose.

Prevention of myocardial infarction

Prevention of a heart attack is divided into primary (that is, aimed at reducing the likelihood of a primary occurrence) and secondary (prevention of recurrence or relapse). In both cases, it is recommended to control body weight due to the load on the heart muscle, optimize metabolism proper nutrition and regular physical activity (this reduces the risk by 30%).

People at risk should control the amount of cholesterol and glucose in the blood. Half the risk of disease in case of refusal bad habits.

Aspirin-containing preparations also have a preventive effect.

A heart that has suffered from severe ischemia at least once will never be the same. If you have a history of at least one coronary attack, you need to carefully monitor your condition. Adhering to simple recommendations, you can significantly reduce the risk of serious complications.

Myocardial infarction: acute period and development of pathological changes

The international classification of diseases identifies various forms ischemia, the names of the disease may differ depending on the severity of the lesion, starting stable angina and ending with an attack of necrosis of the heart muscle. The definition of pathology by ECG depends on the stage of development of ischemia. The necrotic process of the heart muscle can be much more difficult to determine than the defeat of the anterior wall, since it is not always visualized on the electrocardiogram.

Acute myocardial infarction is manifested by cardiac disorders and other characteristic symptoms, accompanied by numerous complications and is a threat to life.

The following stages of the formation of necrosis of the heart muscle are distinguished:

• Damage to muscle fibers. In connection with the violation of the normal blood flow through the coronary arteries, persistent ischemia occurs. The lack of oxygen negatively affects the state of cardiomyocytes, in the affected area they begin to collapse. Still living fibers react to ischemia, pain occurs. The stage lasts from several hours to 2-3 days.
• Period acute manifestation clinical signs. Depending on the severity of ischemia, necrosis or slight damage fabrics.

Attention! Experienced doctor able to diagnose characteristics such as: burning and pressing pain behind the sternum, fear of death, dizziness.

Within two weeks, the focus of inflammation continues to form. Deciphering the ECG helps to detect a pathological Q wave. An ischemic zone is formed on the periphery of the necrotic area.

Acute myocardial infarction is the undisputed leader in the structure of mortality worldwide

• AMI in the subacute stage. There is a final stabilization of muscle tissue. The area of ​​necrosis becomes clearer, and the damaged areas are restored. It is difficult to say exactly how long this stage lasts. Usually its duration is up to 3 months, in severe cases - up to 1 year.
• Scar stage. Signs of the most acute period finally disappear, the person practically ceases to be disturbed by pressing pains behind the sternum, dizziness and weakness. Adaptive mechanisms imply education fibrous tissue at the site of the lesion. Healthy areas hypertrophy, trying to compensate for the decrease in the functioning area of ​​the heart.

If a conclusion was provided that describes an ischemic attack, one should be on the alert.

Important! Mild manifestations of coronary artery disease in the absence of appropriate treatment can eventually turn into its more severe forms.

A dangerous complication is left ventricular failure followed by cardiogenic shock.

Myocardial infarction: causes and diagnosis

Spontaneous occurrence of a heart attack is quite common. A person can engage in habitual activities until a burning retrosternal pain takes him by surprise. Doctors attribute this disease to polyetiological diseases and argue that AMI is formed only if there are predisposing factors.

The most common cause of acute myocardial infarction is atherosclerosis.

The cause of ischemia is the blockage of the coronary vessels:

• blood clot in coronary thrombosis;
• atherosclerotic plaque.

The etiology of IHD can be associated with the following conditions:

• high blood cholesterol (linked to atherosclerosis);
• endocrine pathologies;
• blood pathologies (hypercoagulation, thrombosis);
• arterial hypertension;
• bad habits;
• advanced age and the presence of concomitant diseases of the circulatory system.

Diagnosis of AMI necessarily includes an electrocardiogram, which will help identify pathological abnormalities. A blood test is done to detect neutrophilic leukocytosis. Additional diagnostics myocardial infarction, its acute form, is produced by detecting biochemical markers of necrosis in the blood (CPK-MB, tropinin, myoglobin).

How does necrosis of the heart muscle appear on the ECG

The manifestations of the disease on the electrocardiogram may vary depending on the location of the lesion, its size and the severity of the necrotic process. In turn, there are common signs for most forms of the disease.

"Q-infarction" - with the formation of a pathological Q wave, sometimes a ventricular QS complex (more often large-focal transmural myocardial infarction)

ECG with necrotic heart disease has a number of features:

• under damage: rise segment S-T above the isoline, the R wave has a reduced amplitude, the presence of a pathological Q wave depends on the formation of necrosis, at this stage it may be absent;
• the most acute stage is characterized by: a slight decrease in the S-T segment, the appearance of a pathological Q wave, a negative T wave;
• the third stage of the development of the disease is divided into two parts: first, a negative T wave with a large amplitude is present on the ECG, as it recovers, it decreases and rises to the isoline;
• recovery occurs in the scarring stage normal view electrocardiogram, the Q wave may disappear, the S-T segment returns to the isoline, the T wave becomes positive.

Restoration of normal heart function after AMI is individual. In some people, the signs of the disease disappear very quickly and its presence in the anamnesis is almost impossible to establish on the ECG, in others the pathological Q wave may persist for a long time.

What are the characteristics of a non-Q heart attack?

The small-focal lesion is more easily tolerated than the large-focal form of the disease. Clinical signs characteristic of the non-Q form of the disease are less pronounced. There may be a slight retrosternal pain that resembles an angina attack.

“not Q-infarction” - not accompanied by the appearance of a Q wave, manifested by negative T-teeth (more often small-focal myocardial infarction)

Important! With this type of disease, an electrocardiogram is observed without a pathological Q wave.

Some people who have experienced a small-focal form of myocardial necrosis become aware of the presence of pathological changes only during a routine examination, for example, a medical examination. It is necessary to pay attention to the T wave, which in this form of the disease changes greatly, it becomes two-humped or serrated.

Acute coronary infarction

Since the symptoms of ischemia can vary greatly, there are cases when necrosis of the heart muscle was mistaken for angina pectoris.

Before proceeding with the treatment of coronary syndrome, it is recommended to make an electrocardiogram, which helps to establish the type of disease:

• Spicy . Blockage occurs blood vessel thrombus or atherosclerotic plaque, which causes ischemia transmural damage to the heart muscle.
• AMI without ST segment elevation. This type of ECG is seen in initial stages necrotic process. When fixing small focal changes, the ST segment is at the usual level, and the pathological Q wave is most often absent. The difference from angina pectoris is the presence of markers of necrosis.

Typical cases of myocardial infarction are characterized by an extremely intense pain syndrome with localization of pain in the chest and irradiation to left shoulder, neck, teeth, ear, collarbone, lower jaw

Important! Upon admission to the hospital, the patient is usually given a general diagnosis of " coronary syndrome”, which can be with or without S-T segment elevation on the electrocardiogram.

After examination by a cardiologist and collection of complaints, additional examination, promoting differentiation unstable angina and necrosis of the heart muscle.

Myocardial infarction: how to provide emergency care

Call an ambulance if you suspect a heart attack medical care. Self-medication can lead to irreversible severe consequences.

Important! “If you have already had sharp pains behind the sternum before, this is fraught with an increase in the focus of necrosis. The further success of the treatment of the disease depends on how correctly first aid is provided.

Bye medical workers go to the patient, the algorithm of actions is as follows:

• the patient must completely relax, for this it is desirable to take a horizontal position, relax tight clothes, open the window, create a calm environment in the room;
• you can try to stop the attack, it is able to slightly reduce the spasm of the coronary vessels;
• first aid does not include special preparations(thrombolytics, anticoagulants), their intake should be carried out in a hospital under the supervision of a doctor, it is very risky to give such medicines to the patient on your own;

To slow down the further development of atherosclerosis, it is important to prevent the formation of fatty plaques in the vessels. For this, drugs from the group of statins are prescribed.

• if cardiac arrest is suspected, the patient should immediately start doing indirect massage, which is presented as 30 chest compressions, mechanical ventilation may sometimes be required.

An attack of AMI is completely stopped only by narcotic analgesics. To prevent recurrence of the disease in a hospital setting, it can be prescribed specific therapy, which involves a set of drugs that reduce the load on the heart and protect muscle tissue from the manifestations of ischemia.

Complications of acute myocardial infarction

Even if no signs of necrosis remain on the electrocardiogram and you feel satisfactory, you should be examined periodically to rule out dangerous complications.

AMI can cause such serious consequences:

• heart failure;
• the nearest complication is cardiogenic shock;
• (as a consequence of heart failure);
• Dressler's syndrome (autoimmune damage to the heart muscle);
• change in rhythm and conduction (arrhythmias, blockade).

Often, complications occur already in the first hours and days of myocardial infarction, making it worse

Medicine of the twenty-first century does not stand still, it carefully studies the problems of each cardiac patient. To eliminate the severe consequences of the disease, there are a number of drugs that will help reduce the load on the heart, restore vascular tone and protect tissues from the development of ischemia. Proper first aid provided during the initial period of the disease, and careful adherence to the recommendations of doctors will help reduce the risk of complications.

Signs of acute myocardial infarction

People who first suffered from necrosis of the heart muscle remember its manifestations for a long time. In some cases, the symptoms may be somewhat blurred, depending on the presence comorbidities or with a small-focal form of the disease.

Attention! If you suffer from diabetes, it can be difficult to understand what is really happening with the heart. The sensitivity of tissues decreases, and therefore some people calmly tolerate the disease “on their feet”.

You have in fact been overtaken by an attack of this serious illness if:

• A sign of the most acute stage is pain behind the sternum of a burning and pressing nature, which radiates to left hand, shoulder blade, neck, jaw. May be accompanied by indigestion, abdominal cramps, numbness of the limbs.

Complaints of the patient with myocardial infarction depend on the form (typical or atypical) of the disease and the extent of damage to the heart muscle

• Characteristic signs of ischemia: dizziness, malaise, shortness of breath, rapid fatigue. Cold sweat appears, a person during an attack is completely unable to engage in habitual views activities.
• Jumps (it can fall or rise to critical values), the pulse becomes more frequent, there is a strong excitement for one's condition and life. Sometimes the body temperature rises, there are signs of intoxication of the body with particles of dead tissue.

Has the meaning clinical variant ailment (abdominal, asthmatic, collaptoid, arrhythmic, etc.). Depending on the form of the disease, nausea or coughing may occur, which bring additional difficulties in diagnosing the disease.

Attention! Cases have been recorded when a patient was admitted to a hospital with suspected pathology of the gastrointestinal tract or lungs, but only with careful examination signs of necrosis of the heart muscle were revealed.

If the diagnosis is not established in time, severe syndromes may occur that carry a risk to the patient's life.

Treatment of acute myocardial infarction

The complex of symptoms characteristic of coronary disease does not apply to conditions that "will pass by themselves." disappearance pressing pain behind the sternum does not carry full recovery. Even a small focus of necrosis can seriously affect the functioning of the heart.

Therapy for myocardial infarction is aimed at preventing and eliminating arrhythmias, heart failure, cardiogenic shock.

In the initial period of the disease there is a very strong pain, which requires the use of intensive care:

• nitroglycerin at a standard dose of 0.4 mg (to increase the speed of action, it is recommended to put under the tongue, up to 3 tablets can be used);
• beta-blockers that fight ischemia and help protect parts of the heart from necrosis (standard drugs are Metoprolol and Atenolol);
• in severe cases, when there is a significant necrotic process, narcotic analgesics, such as morphine, are administered intravenously.

Myocardial infarction is dangerous, first of all, for its complications. In order to restore damaged tissue and reduce the burden on diseased heart, a special therapy is selected by a cardiologist.

Drugs for severe myocardial infarction are taken constantly, and not only in acute period, for the prevention of relapse are prescribed:

• Thrombolytics (streptokinase, urokinase). The pathogenesis of the disease most often consists in a violation of blood flow through the coronary vessels, which are blocked by a thrombus.
• Beta blockers. Reduce the need for oxygen, reduce the load on the heart muscle. They are often used in drug therapy arterial hypertension. These drugs can lower blood pressure.

Relief of pain syndrome is carried out by a combination of narcotic analgesics

• Anticoagulants and antiaggregants. Treatment standards include drugs that can thin the blood. The most popular today is acetylsalicylic acid. It is contraindicated in gastritis and bronchial asthma.
• Nitrates. It is appropriate to use nitroglycerin in the first minutes of an attack, its beneficial effect on the protection of cardiomyocytes from ischemia has been proven. With its use, the risk of complications, including cardiogenic shock, is reduced.

If you do everything clinical guidelines many dangerous complications can be avoided. A history of AMI makes a person more vulnerable. Even minor physical activity can lead to a relapse. To make life easier, specialists in the field of cardiology provided an algorithm of actions to improve the patient's condition.

In order for your life after suffering a heart attack to become the same, you need to radically change your lifestyle. Correctly selected drug therapy with AMI - that's not all. harmful products power, heavy physical work, chronic stress and the presence of concomitant diseases can adversely affect the rate of recovery of the body. Doctors around the world have developed clinical guidelines aimed at improving the patient's condition.

The necessary conditions for the prevention of myocardial infarction are maintaining a healthy and active lifestyle, avoiding alcohol and smoking, and a balanced diet.

Acute myocardial infarction implies only proper nutrition:

• products with low content cholesterol;
• fresh fruits, vegetables, berries, which a large number vitamins contribute to the regeneration of cardiac fibers;
• required special diet, implying the exclusion from the diet of fast food, chips, crackers, etc .;
• refusal to drink alcohol and coffee.

If a person often clutches his heart, he has shortness of breath after minor physical exertion, limbs go numb or blood pressure jumps - this can become alarm bell in the progression of the disease.

Prevention of acute myocardial infarction requires you to carefully monitor your own health, which includes:

• getting rid of bad habits (nicotine negatively affects blood vessels and the heart, coffee increases the need for oxygen);
• moderate physical activity (walking in the fresh air would be an excellent choice);
• lack of stress, training in relaxation methods;
• maintaining weight within the norm;
• periodic measurement of blood pressure and pulse.

AMI is easier to avoid than to treat it all your life later. Among people who are accustomed to regular physical activity, are eating proper food and try to look at life positively, coronary heart disease is much less common.

Acute myocardial infarction, how is rehabilitation

The development of the disease and the rehabilitation of patients in each individual case can take place in different ways. Some people endure ischemia, which is very dangerous, and at the same time quietly carry out their usual activities. Other patients after the illness are forced to avoid unnecessary stress, some of them even begin to apply for disability. Properly selected sports will help you recover faster.

Exercise therapy after acute myocardial infarction implies:

• moderate dynamic loads (running, skating or rollerblading, cycling, swimming);
• breathing exercises (for example, Strelnikova's set of exercises);
• Indian yoga.

But static exercises with a heavy load on the cores are categorically contraindicated.

Attention! Lifting heavy weights can contribute to the recurrence of an attack. It should also be remembered that it is necessary to start gymnastics no earlier than at the stage of scar formation.