Myocardial infarction

Myocardial infarction

is a disease that is a form of ischemic heart disease. With this disease, the development of ischemic necrosis of the site of the heart muscle. The death of a portion of the myocardium is associated with an acute insufficiency of its blood supply.

Myocardial infarction

The main cause of myocardial infarction is a blockage of the coronary arteries, as a result of which the supply of blood to the heart is disturbed. With myocardial infarction, the part of the heart muscle wilts away, and the muscle tissue is subsequently replaced by a scar tissue.

The main symptom of myocardial infarction is chest pain, but pain can be observed in other parts of the body, and may be absent altogether.

One of the most modern methods of treating myocardial infarction is the dissolution of a thrombus formed in the coronary artery. After treatment in the hospital (mandatory), there should be a long rehabilitation period, which should include an increase in the physical activity of a person who has undergone myocardial infarction. The level of possible physical activity is determined by a specialist doctor.

Prevention of the development of myocardial infarction, which includes a certain diet, the rejection of fatty foods (and foods rich in carbohydrates), smoking cessation and much more is important. Myocardial infarction requires immediate hospitalization, otherwise the risk of developing dangerous complications is greatly increased.

Myocardial infarction can be classified according to several signs.

The first of them is based on the stages of the development of the disease. In this case, the pre-infarction period, acute period, acute period, subacute period, as well as the period of scarring are distinguished. The duration of the pre-infarction period can vary from a few minutes to a year and a half; this period is characterized by an increase in the intensity and frequency of attacks of unstable angina. It is important to know that if you immediately consult a doctor and start receiving treatment, then the development of myocardial infarction can be completely avoided. The most acute period, as a rule, occurs suddenly – it is impossible to predict its beginning. The duration of the acute period is approximately equal to ten days, during which the place of necrosis is clearly indicated and the scar begins to form – the muscle tissue is replaced by a scar tissue. In an acute period, patients sometimes experience an increase in body temperature. Subacute period lasts about eight weeks, during which the scar is formed finally – there are processes of its compaction. The duration of the last – postinfarction period – is a period of time up to six months. During this period the patient undergoes rehabilitation, his condition stabilizes. However, during this period it is necessary to monitor your health very carefully, since it is at this time that there is a chance of a second development of myocardial infarction. The second variant of the classification is related to the extent of the lesion: in this case, a large-focal myocardial infarction and a small-focal myocardial infarction are distinguished. There are other options for classification.

Closure of the lumen of the coronary artery leads to the development of myocardial infarction.

The coronary artery is an artery whose function is to supply blood to the heart muscle. Closure of the lumen of any hollow organ is called obturation.

The cause of myocardial infarction is coronary artery atherosclerosis.

In most cases this is the case. In 93-98%, it is the clogging of vessels supplying the heart muscle, thrombus or plaque that causes the patient to develop a myocardial infarction. However, surgical obturation (for example, in connection with the ligation of the artery) or embolization of the coronary artery may also lead to a heart attack, although in a much smaller number of cases. Separately considered infarction, developing with the presence of heart defects. To such vices can, for example, include a significant separation of the coronary arteries from the pulmonary trunk.

Ischemia is a predictor of a heart attack.

Coronary heart disease can lead to this disease, and may not lead. In addition, coronary artery disease can last as long as desired – for whole years and decades. At some point, damage can occur (this period lasts from four to seven hours), as a result of which the functionality of the heart muscle is disturbed. However, the changes that occurred during this period are reversible. The necrosis arising after damage is an irreversible process. After one or two weeks, the area with the dead tissue begins to scar, and this process lasts for one or two months. When scarring, the normal tissue of the myocardium is replaced by a scar tissue.

Pain behind the breastbone is the main symptom of myocardial infarction.

This is, in fact, the main clinical sign of this disease. Pain, as a rule, differs by a rather high degree of intensity, but can also be of a variable nature, that is, the patient can feel discomfort in the chest cavity, pain in the shoulder blade, arm. Belly. Sometimes myocardial infarction develops without concomitant pain. Approximately one-third of cases of development of large-heart attack of myocardial infarction in patients have symptoms of heart failure: patients complain of unproductive cough, shortness of breath, often in patients with arrhythmias.

Diagnosis of myocardial infarction can be difficult.

These are cases when the symptoms of this disease are of an atypical nature, according to this, the following atypical forms of myocardial infarction – abdominal, asthmatic, painless, cerebral forms, are distinguished.
The abdominal form of myocardial infarction is associated with a situation where the symptoms of this disease are pain in the upper abdomen and its swelling, nausea and vomiting, and hiccups. In the case of abdominal form, the symptoms of myocardial infarction are similar to the main symptoms of such a disease as acute pancreatitis.
The asthmatic form of myocardial infarction is a situation where the symptoms of the disease are more associated with the appearance of dyspnea, which tends to increase. Therefore, in this case, we can talk about some similarity to the clinical picture of an attack of bronchial asthma.
Painless form of myocardial infarction is rare, mainly in the development of this disease in patients with diabetes mellitus. Pains such patients do not feel because one of the manifestations of diabetes is just loss of sensitivity.
In cerebral form of myocardial infarction, the symptoms of this disease are, as a rule, mental disorders and dizziness. Patients may also experience neurologic symptoms. The cerebral variant of the disease is also called cerebral, as a rule, in this case there are no pains in the heart. But there may be headaches. The reason for their occurrence is a decrease in blood supply to the brain.

Myocardial infarction requires hospital treatment.

The patient is treated in the intensive care unit of the hospital, the earlier the patient gets there with a diagnosis of myocardial infarction, the more effective the results of treatment will be. However, the treatment itself must begin immediately after the onset of an attack – with the provision of first aid to the patient. Before the arrival of an ambulance, you need to put the patient and try to cope with the pain. First, immediately it is necessary to give the patient a tablet of nitroglycerin. If nitroglycerin did not have a positive effect, then the ambulance that arrived will introduce narcotic analgesics intravenously. Thus, the very first and very important step in the case of myocardial infarction is getting rid of the pain, otherwise it can lead to the development of cardiogenic shock. It is very difficult to get the patient out of this state. Subsequently, drugs of different groups are used.

There are several ways to improve the condition of a patient with myocardial infarction.

There are three.
First – dissolve the blood clot formed in the coronary artery. This method of treatment was called thrombolysis. At this point in time, this is the best method of treating the disease. The result directly depends on the time of administration of the drug, which is able to dissolve the thrombus – the faster, the more effective (the best result can be during the first hour – “golden” – after the onset of the infarction). If the thrombus dissolves only six hours after the onset of a heart attack, then it is possible to save only about 5% of the affected cardiac muscle.
The second is to reduce the load that the heart receives. To this end, the patient is prescribed to take medications that help reduce blood pressure, reduce heart rate, and help reduce the volume of circulating blood.
The third is to improve metabolism in the heart muscle. To this end, the patient is discharged preductal, vitamin E.

For a myocardial infarction, there is a long period of rehabilitation.

It lasts up to six months. This means that myocardial infarction is treated not only in inpatient settings, but an obligatory stage is treatment after the hospital. During the rehabilitation period, a person gradually increases physical activity. A person who has undergone a myocardial infarction should know that throughout the rest of his life he will have to take certain medications and control his blood pressure. In addition, such a person will have to get rid of bad habits, if any. However, do not think that after a heart attack, life will become inadequate. This is not so – especially if you follow all the recommendations of doctors clearly.

If there is a threat of a heart attack, the patient must begin to cough badly.

These kinds of statements can now be found on the Internet. Presentation of this content is sent by e-mail. Do not believe this. It’s a delusion. The argument, which says that by means of a strong cough can improve blood circulation, is not proven and is unlikely to be proved. On the contrary, a patient with a threat of a heart attack should, as soon as possible, provide peace and call for emergency medical care.

Physical activity is contraindicated after myocardial infarction.

This is another misconception that is common among the population. On the contrary, the rehabilitation period is significantly facilitated in the case of early activation of a patient who underwent a myocardial infarction in conjunction with therapeutic physical training. All this significantly reduces the risk of complications. Conversely, the lack of physical activity greatly increases the risk of recurrence of myocardial infarction. The specialist himself will pick up the possible level of physical exertion for the patient.

Prognosis in the treatment of myocardial infarction is unfavorable.

To be more precise, it is conditionally unfavorable, since after the development of this disease in the heart muscle, ischemic changes occur which are irreversible. These changes can lead to the development of various complications.

The dietary regime is the main measure for the prevention of myocardial infarction.

In this case we are talking about individuals who suffer from multiple sclerosis of the coronary vessels of the heart. It is important to know that overeating carries a great harm to everyone’s health, but in particular this applies to the aforementioned group of individuals.
If a person is inclined to develop obesity, then he should choose in his diet those foods that are not characterized by high caloric content. In this regard, the preference should be given to those products that contain a small amount of carbohydrates and fats. But the consumption of proteins in any case can not be below the norm – 100-150 grams. It is desirable to eat fruits and vegetables. Scientifically proven that vitamin C helps prevent the development of atherosclerosis, so in addition to vegetables and fruits you can use infusions of black currant and dogrose, which are rich in this vitamin.
However, in addition to the need to maintain a certain diet regime, important moments in the prevention of myocardial infarction are the passage from time to time of treatment with iodine, rational rest (really rest on weekends and on holidays – then they are given), rejection of bad habits (smoking, drinking alcohol etc.), exercise therapy, as well as effects on the nervous system. The latter implies the provision of normal sleep (at least seven hours at night, preferably one or two hours in the afternoon), the correct change of activities – rest and work.

Myocardial infarction can lead to serious complications.

They can be divided into early (develop in the early days of the disease) and later (develop two to three weeks after the onset of the disease). The first group of complications include cardiogenic shock, acute heart failure, rhythm and conduction disorders, and others. For example, chronic circulatory failure may be attributed to the second group of complications. Some of the complications can be both early and late – these are, for example, thromboembolism, heart aneurysm, etc. Violations of the rhythm and conduction of the heart are most common, especially if it is a large focal disease form, so if monitoring special monitors heart of the patient in the first day after the onset of a heart attack, it turns out that almost all patients have these complications.

Cardiogenic shock is a serious complication of myocardial infarction.

Manifestations of this complication are pronounced arterial hypotension, impaired consciousness, decreased contractility of the heart muscle. It is not the easiest task to get the patient out of cardiogenic shock. There are three degrees of cardiogenic shock. This is an easy, moderate and severe degree. E.I. Chazov proposes the following scheme for the classification of cardiogenic shock forms. In connection with this classification, cardiogenic shock is divided into the following forms.
The first is a reflex cardiogenic shock. In this case, the shock develops against the background of the existing pain. However, if the myocardial infarction is characterized by a painless form, then the pain may be absent.
The second is an arrhythmic cardiogenic shock. In this case, the shock can develop against the background of tachyarrhythmias, tachycardia, and also on the background of atrioventricular blockades.
The third is true cardiogenic shock – this is the most severe form of shock among all known. In this case, he has units. This is a cardiogenic shock of medium severity (or grade I – the changes are not very severe), severe (or grade II) and reactive (or grade III – as a rule, such cardiogenic shock is irreversible).

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