Atypical forms of myocardial infarction: a short digression into the basics of self-diagnosis

Species of atypical forms of infarction	Characteristic symptoms of	Pain sensations and their localization	Diagnosis measures
Peripheral with atypical pain localization	weakness sweating at rest pressure drop heart rhythm disturbances blue fingernails and lips	Pain concentrates in the left armlimb or only in the fingers), the left scapula( tunic), the lower jaw on the left( noeth), in the neck( in the upper part of the spine a sharp pain), in the throat and esophagus. At the same time, classical pain in the heart is much weaker or absent.	ECG in dynamics, constant observation
Abdominal or gastralgic	nausea vomiting flatulence and diarrhea hiccup arrhythmia pressure drop	The pain is sharp and strong in the stomach and liver regions - at the top of the abdomen, under the ribs on the right. It reminds an attack of pancreatitis.	Symptoms of abdominal( gastralgic) form of myocardial infarction: the anterior wall of the abdomen is strong, the heart rhythm is changed. Requires an ECG in the dynamics. Consultation of the gastroenterologist. It often happens in people with atherosclerosis and digestive problems. instagram viewer
Asthmatic	dyspnea at rest asthma attack foamy cough with abundant phlegm pressure drop strong heartbeat fear of death	Heart does not hurt or does not hurt much	Occurs in patients with cardiosclerosis or severe hypertension. More often in pre-retirement women and older men. An ECG is needed.
Collapse of	Collapse of Dizziness Dizziness Dramatic sweat before the eyes darkens Pale and cold skin Loss of consciousness State of prostration become invisible veins on the extremities	No pain	At risk, elderly diabetics. It flows very hard. Emergency assistance is required. It is diagnosed by ECG.
Edema	shortness of breath weakness edema of limbs sharply enlarges the liver and ascites - accumulates fluid in the abdomen	Pain is missing	It flows very hard. Emergency assistance is required. It is diagnosed by ECG.
Arrhythmic	attack of abnormal heartbeat( rapid increase or decrease of heart rate) syncope arrhythmic shock( pressure drop, palpable pulse)	With arrhythmic form of myocardial infarction, pain in the heart area is weak or none at all	More common in patients with already existing problemsheart rate. An emergency ECG is needed.
Cerebral	sudden pressure drop sudden fainting confusion and loss of consciousness( pseudo-stroke) - from mild inhibition to coma may be nausea and vomiting speech disorders muscle paresis	Heart pain no	Most common in elderly people with cerebrovascular disorders. Consultation of a neuropathologist, ECG and EEG is necessary.
Malosymptomnaya	unmotivated weakness sweating insomnia discomfort behind the breast bone	Severe pain in the heart none	Often found in diabetics or alcoholics
Combined	combines various symptoms of atypical forms of heart attack	Pain in the heart is negligible and the patient does not pay attention to it	Carefulmultifaceted diagnostics in dynamics with the invitation of doctors of other specializations

Myocardial infarction is almost the most common cause of death in middle and older age groups.

The high lethality of this disease is due to the fact that it arises most often all at once, and its irreversible consequences develop at lightning speed.

In addition, the clinical picture does not always correspond to the "classical scenario": there are a large number of variations in atypical forms of myocardial infarction.

Content of

1

Contents
3
3 statistics Variation: their symptoms and differences, diagnostic measures
4 Treatment
5 Prognosis, rehabilitation and prevention

What is different from typical

Comparison criterion	Typical infarction	Atypical infarction
Patient category	Can be diagnosed inof any age	More commonly diagnosed in humans: of elderly with recurrent infarction suffering from severe cardiovascular diseases( giisthemia) with diabetes
Clinical manifestations at various stages of the disease	In the initial stages( in the pre-infarction, acute and acute periods) heart pain, considerable deterioration of state of health, sweating, shortness of breath, fear of death, blue skin and mucous membranes	the initial stages( in the first few hours or days after the onset of myocardial infarction) there are no characteristic classical symptoms. Pain in the heart is insignificant or may be absent altogether. Clinical manifestations are unconventional and correspond to one or another form of atypical heart attack. Later( in acute, subacute and postinfarction periods), the clinic of the disease becomes the same as with a typical infarction.
Diagnosis and prognosis	The correct diagnosis is made by an experienced physician without any difficulties	It is difficult to make a correct diagnosis. The prognosis is worse than with a typical heart attack.

Statistics

0.5% of men and 0.1% of women suffer a heart attack each year. Of these, one in five is in atypical form.
Every second patient dies before the first aid is given to him - at the pre-hospital stage. Among patients with atypical form of the disease, this figure is much higher.
Approximately 3% of all deaths per year in Russia died as a result of an acute heart attack.
Most often the ailment develops in the morning hours( between 4 and 8 am), in the fall or in the spring( in November or March) .About 25% of all registered heart attacks occur at this time.
Women suffer from a heart attack less often, but the lethal outcome as a result of them happens more often - 53% of women with this disease die. In men this figure is lower by 10%.

Sinus bradycardia of the heart - what it is and how this condition affects the body, you can read in our material.

The main features of paroxysmal supraventricular tachycardia, symptoms and ECG signs of the disease are described in detail in this article.

What is dangerous sinus tachycardia of the heart and how to treat it? You can read the exhaustive information here.

Varieties: their symptoms and differences, diagnostic measures

The main symptoms, causes and methods of treatment of such a disease as paroxysmal ventricular tachycardia are discussed in detail on our website.

On the tactics of treating sinus arrhythmia of the heart, as well as its causes and symptoms, find out from this publication.

What does the diagnosis of "tahisystolic form of atrial fibrillation" mean, what is dangerous and how to treat it? All the details are here.

Treatment of

Algorithm of care for any form of atypical heart attack is the same :

Urgent hospitalization is needed.
Bed rest and complete rest in the first day .In the future, moderate motor activity is necessary.
Diet with restriction of salt and animal fats.
It is necessary to eliminate the pain in its presence, because as a result of pain discomfort, cells and tissues receive less oxygen, hence the focus of the lesion of the heart muscle increases in size. Prior to the arrival of doctors, the patient every 5 minutes is given Nitroglycerin sublingually .Morphine and beta-blockers intravenously are used in the hospital.
The use of an oxygen mask or oxygen therapy is necessary for all infarctions in the first few hours after exacerbation of the disease.
Stabilization of the heart rhythm with Amiodarone or Atropine.
Antiaggregant therapy or the use of blood thinning drugs. In the absence of contraindications before the arrival of emergency physicians, the patient can be given acetylsalicylic acid - 1 tablet chew and swallow, squeezed with water. Plavix, Ticlopidine, Heparin, Bivalirudin have an even more powerful antithrombotic effect. In a hospital, such patients with a view to dissolving the thrombus that has already been formed undergo thrombolytic therapy with the use of Streptokinase, Urokinase, Alteplase.
Surgical treatment of is performed strictly according to indications by the methods of coronary bypass, endovascular angioplasty. Studies show that angioplasty is most effective if it was performed in the first few hours after a heart attack.

If time is lost - preferably conservative medical treatment with thrombolytics. If this does not help, the only thing that can save the heart muscle is aorto-coronary bypass.

Prognosis, rehabilitation and preventive measures

Mortality in atypical infarction is higher than mortality in the usual form of the disease precisely because the nonclassical infarction is difficult to immediately diagnose and recognize .About half of all patients die before calling a doctor or before the arrival of an ambulance. Decisive are the first day - if the patient survives the first 24 hours, that is 70-80% of the likelihood that he will survive in the future.

Post-infarction rehabilitation includes a set of measures for medical and physiotherapeutic treatment of .Such patients are recommended to sanatorium-and-spa rehabilitation.

In order to prevent recurrence and prevent complications, it is necessary to take therapeutic doses of antiplatelet agents( aspirin) and beta adrenoblockers, to follow a diet and reasonable motor activity.

At the slightest suspicion of a heart attack a person should immediately be hospitalized with - this is the only way to prevent a fatal outcome. Self-treatment or ignoring the symptoms of the disease in this case are unacceptable. Particular attention must be paid to those who fall into the "infarct" risk group: the elderly, diabetics, patients with cardiovascular and endocrine diseases.

Atypical forms of myocardial infarction: a short digression into the basics of self-diagnosis

What is different from typical

Statistics

Varieties: their symptoms and differences, diagnostic measures

Treatment of

Prognosis, rehabilitation and preventive measures

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