Myocardial infarction( MI) - what is it and what are the consequences? This is one of the forms of IHD, in which necrosis of the muscle tissue of the heart is acute because of a lack of blood supply.
Today, this disease is one of the main causes of death. Fatal cases with myocardial infarction about 40%.Age 70% of people who had a heart attack, 55-65 years.
The infarction disrupts the entire cardiovascular system and is a threat to human life. Depending on how much the myocardium is affected, it can be small-focal and large-focal.
Causes, risk factors, etiology and pathogenesis
Infarction occursdue to obstruction of blood supply in the coronary artery.
The main cause of myocardial infarction is the atherosclerosis of vessels, which caused thromboembolism( 95% of cases).Vessels form plaques that narrow their lumen, disrupting the blood flow.In other cases, in the absence of atherosclerosis, a prolonged spasm of the unchanged coronary artery occurs. In rare cases, it occurs against the background of other pathologies( endocarditis, arteritis, etc.).
The risk of an infarction increases significantly if there are such factors:
- Age after 45-50 years.
- Hypertensive disease, in which the myocardium more in need of oxygen.
- Previously infarcted.
- Obesity - atherosclerosis develops more intensively in violation of the metabolism of fats. A person runs the risk of developing diabetes, hypertension.
- Hypodinamy. Due to low mobility, metabolism is disrupted, which is one of the factors of accumulation of excess weight.
- Smoking. When exposed to nicotine, the coronary arteries narrow, resulting in a lack of oxygen in the heart muscle.
- Diabetes mellitus. With an increase in blood glucose, the vascular walls and the quality of hemoglobin suffer. Its transport function is deteriorating.
Danger and complications
Myocardial muscles, when experiencing oxygen starvation, begin to die( necrosis).This causes an acute process - a heart attack. It has irreversible consequences. The affected place is scarred. The heart can no longer function in full, as before .
The disease is dangerous because of its unpredictability. Its complications are affected by several factors :
- area affected by the myocardium;
- location of the source of damage;
- period of cardiovascular restoration in the myocardium.
Early :
- cardiac rhythm disorder;
- pericarditis and aneurysm;
- acute heart failure;
- cardiogenic pulmonary edema;
- hypertension;
- heart rupture.
Late :
- post-infarction syndrome or cardiosclerosis;
- neurotrophic disorders;
- thromboendocarditis.
Complications are reflected in the work of the whole body .An extensive heart attack leads to the formation of a large scar and the development of an aneurysm of the aorta of the heart. This state is dangerous for life.
Symptoms of acute attack
To be able to provide emergency care in case of MI, it is necessary to know the peculiarities of its symptoms.
When myocardial infarction occurs:
- Reinforced chest pains, which are characterized by changes in sensations. At first it can be pressing pains, which are replaced by cutting and burning. Painful attacks are given to other parts of the body( arm, neck, shoulder).Pain lasts at least 20 minutes. Taking nitroglycerin does not give an anesthetic effect.
- When the posterior wall of the myocardium is damaged, there are pains in the abdominal cavity.
- Tachycardia - heartbeat can then become more frequent, then the pulse may be absent altogether. When the pulse is lost, the patient loses consciousness.
- Shortness of breath - when there is a shortage of oxygen, a person suffocates.
In atypical forms of MI, other symptoms may occur:
- nausea;
- vomiting;
- cough;
- swelling.
Diagnosis
In addition to recognizing MI on clinical manifestations, there are other methods of diagnosing the disease. To confirm the diagnosis, ECG and laboratory tests are performed. Atypical forms can be detected only by such methods.
The electrocardiogram shows the presence of scarring Q, which indicates the necrosis of muscle tissue. The size of the tooth R decreases, and the segments ST rise from the isoline.
Changes in blood:
- leukocytosis;
- increased ESR;
- appearance of C-reactive protein;
- increase in the level of fibrinogen, sialic acids.
IM must be differentiated from diseases characterized by retrosternal pain( acute pericarditis, angina, pleurisy, intercostal neuralgia, etc.).
First aid before the arrival of the doctor
First of all, is necessary to give the patient nitroglycerin .The person should be put on a flat surface, throwing his head up. If nitroglycerin does not work, you can inject an analgin or promedol.
More information about pre-medical care for myocardial infarction is told on the video:
Tactics of treatment
How to treat myocardial infarction, what drugs and medications are included in therapy in this complication of ischemic heart disease? The provision of medical care should be phased.
- Pre-hospital stage - emergency care and transportation to the hospital.
- Hospital - the maintenance of the body with medicines in a hospital. It includes restoration of the heart rhythm, prevention and elimination of thrombi, etc.
- Rehabilitation.
- Dispensary observation and outpatient treatment.
In case of an acute attack of , the patient is necessarily placed in the hospital. In order to resume blood supply to the lesion in case of myocardial infarction, thrombolytic therapy is prescribed.
For these purposes, appoint:
- Heparin;
- Aspirin;
- Plavix;
- Prasugrel;
- Fraxyparin;
- Alteplase;
- Streptokinase.
Anesthetics are prescribed for:
- Promedol;
- Morphine;
- Fentanyl with droperidol.
To normalize the heart rhythm, is administered intravenously with a 4.4% magnesium solution .Help improve blood flow to the heart muscle calcium antagonists, nitrates, beta-adrenoblockers. With a pronounced sense of fear and strong excitement, tranquilizers are prescribed. More about the nursing process during this period is told here.
In case of ineffectiveness or inadmissibility of taking medications, urgent aortic-coronary bypass surgery is performed. In some cases, this is the only method to save the patient's life and restore the blood supply to the myocardium.
Part of the complex treatment is strict compliance with bed rest for the first 2 weeks after the attack of .Physical stress should be minimal. We must begin to walk with great care. The patient should stay in the hospital for about 3 weeks. Such a regimen should also be observed by those who have transferred the MI on their feet.
Forecast
With respect to forecasts, they directly depend on the amount of damage to the heart muscle, as well as on the timeliness and quality of emergency care. Even if there are no serious complications after an acute infarction, can not guarantee the absolute recovery of .If the area affected by the myocardium is large, it will not be able to fully recover.
In the future, a person will suffer from cardiovascular problems. This requires continuous monitoring from the cardiologist .According to statistics, a year after the attack, relapse occurs in 20-40% of cases. To avoid this, you must carefully follow all the established recommendations of a specialist.
Rehabilitation after illness
Restorative procedures begin from the first days after the infarction. Their goal - to prevent the development of complications, restore the emotional state of a person, mobilize the compensatory mechanisms of the body .
Rehabilitation should be comprehensive( cardiac and physical).Cardiological rehabilitation is aimed at minimizing complications. It helps the patient recover and reduce the risk of repetition of MI.
Recovery continues for a long time .A person may remain incapacitated for up to 3 years, and sometimes does not return to work. Find out when after a heart attack give a group of disabilities and on the basis of what.
For the rest of his life a person should take a complex of medicines:
- Aspirin( in case of individual intolerance - ticlopidine);
- Beta-blockers;
- Lipid-lowering drugs;Angiotensin inhibitors.
Under the supervision of the specialist , you should gradually begin to load the body with physical loads of .Over time, the intensity and duration of training should increase. Thanks to physical exercises, the oxygen level in the blood increases, the heart muscle trains.
Recovery after MI is impossible without adherence to proper nutrition .In the diet of the patient should not be fried, fatty, spicy dishes. It is necessary to limit the use of salt. Exclude alcoholic beverages, coffee, strong tea.
Prevention
Preventive measures can be primary and secondary. The goal of primary prevention is to prevent myocardial infarction, secondary - to prevent a re-attack of the disease.
Prevention is needed not only by people with diseases of the cardiovascular system, but also healthy. Especially in the risk zone are people with overweight , suffering from diabetes, smokers, and also those over 50.
How to prevent myocardial infarction:
- Monitor body weight.
- Regularly do physical exertion to improve metabolism.
- Refuse from addictions.
- Control the cholesterol level in the blood.
- Regularly measure blood pressure. If persistent hypertension is observed, correction with drugs should be performed.
- Monitor the level of sugar in order to timely detect diabetes.
- Adhere to a healthy diet. Limit the use of foods that contain cholesterol. There are more vegetables, fruits, fiber.
- If you are addicted to cardiovascular disease, take drugs with aspirin( Cardiomagnolo, Aspicor, etc.).Dosage should be selected by a doctor.
The best defense against disease is prevention. Therefore, you need to lead a healthy lifestyle, eat right, exercise, and regularly monitor your health.
