What to do with the first signs of myocardial infarction in women and men

Infarction - necrosis, which develops due to circulatory disorders. In clinical practice, most often occurs myocardial infarction( heart), less often the kidneys, lungs, brain, intestines and spleen. Disease is one of the main causes of death among men and women. However, a heart attack can be prevented, it is enough to know only the first signs of an approaching attack.

• Causes Symptoms Signs
• Classification
• Stage
• microinfarction
• Complications
• First Aid
• Diagnosis Treatment Drug therapy
• Surgery Diet
• Rehabilitation
• Prevention

reasons

infarction in men is mainly developed in the age range 35-60years, in women after 50 years. However, there are a number of provocative factors that can accelerate the likelihood of a heart attack:

• Excess cholesterol, arteriosclerosis of blood vessels.
• Diabetes mellitus.
• Hypertension. Excess weight.
• Metabolic disorders.
• Smoking.
• Incorrect power.
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• ischemic heart disease( ischemic heart disease).
• Alcohol abuse.
• Chronic kidney disease.
• Hereditary predisposition.
  

  
  

• Diseases of the nervous system.
• A sedentary lifestyle.
• Heart attacks in the past.
• Menopause( in women).
• Gout( in men).
• Syndrome of paroxysmal apnea( respiratory arrest) in a dream.
• Frequent stress and psychological stress.

The immediate causes of heart attack in women and men are:

• Spasm of the heart arteries on the background of angina pectoris.
• Blockage of vessels after surgical procedures( artery ligation, angioplasty).
• Coronary thrombosis in the area of ​​atherosclerotic plaque finding( 95% of all infarctions).

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Symptoms

Infarction can manifest itself in different ways, as have asymptomatic cases( they are more common in diabetics and women).Explicit symptoms of the disease in men and women are:

• Strong pain sensations behind the chest. This is a sudden and pain-blocking movement. With the slightest movement, it intensifies and becomes intolerable. Patients describe it as acute, pressing and squeezing.
• Pain sensations are given under the scapula, in the shoulder and neck area.
• Changing the behavior of the victim: he becomes restless, puts his hand to the chest, rubs his forearm. There is shortness of breath, dizziness, profuse sweating, numbness of hands, sometimes loss of consciousness.

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Signs of

In addition to the main symptoms, there are additional signs of impending myocardial infarction in men and women that, at first glance, do not pose a serious threat to human health and life, but in reality require special attention:

• Snoring and sleep apnea provoke malfunctions in the supply of cardiac muscle with oxygen and the development of constant myocardial ischemia.
• Frequent headaches, accompanied by severe hypertension, indicate the beginning of disturbances in the activity of the cardiovascular system.
• Shortness of breath and fatigue, as well as heaviness in the chest, is a sign of heart failure.
• Swelling of the feet in the morning and increased sweating.
• Short-term cyanosis( cyanosis) of the nasolabial triangle, accompanied by a violation of breathing, indicates the development of a heart attack or a microinfarction.
• Frequent urination at night can be a sign of heart failure.
• Arrhythmia indicates the presence of heart failure. In addition, the cause of its occurrence is often a violation of the function of the coronary artery, which feeds the myocardium.
• Acute pain in the left shoulder is a sign of angina pectoris, which exerts an additional strain on the heart.

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Classification of

The following types of infarction are distinguished according to the depth of organic changes in myocardial tissue:

• Intramural - necrosis develops in the inner layer of the heart muscle.
• Transmural - necrotic changes span the entire thickness of the myocardium.
• Subepicardial - necrosis of the heart muscle in the area of ​​adherence to the outer shell of the myocardium.
• Subendocardial - necrosis of the myocardium in the zone of adherence to the inner shell of the myocardium.
• If the area of ​​necrotic changes is located along the entire circumference, then the infarction is called circular.
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Depending on the clinical symptoms of the disease, isolated:

• A typical( anginal or painful) form.
• Atypical( asthmatic, cerebral, abdominal and arrhythmic) form.

Localization of the process distinguishes infarction of the posterior, lateral and anterior walls of the myocardium, as well as a variety of their combinations.

In size, the infarct is divided into small-focal and large-focal species. If new foci of necrosis appear in the acute stage, then this condition is called a recurrent or recurrent infarction.

According to macroscopic signs, three types of infarction are distinguished: white( ischemic), white with hemorrhagic whisk, red( hemorrhagic).

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Stages of

Depending on the sequence of development of necrotic changes in the heart, the following stages of the disease are distinguished:

• The pre-infarction state( prodromal period) lasts from 2 hours to several weeks, and in some cases completely absent. During this period, the smallest foci of necrotic changes are formed, in the place of which the heart attack then develops.
• The acute period lasts from 30 minutes to 2 hours and corresponds to the increasing ischemia of the heart muscle until its transition to necrosis.
• The acute period( acute infarction) lasts 2-10 days and is accompanied by the formation of necrosis and partial resorption of the affected muscle tissue.
• Subacute period has a duration of 2-6 weeks, during this time part of the necrosis is replaced by a granulation tissue.
• The postinfarction period lasts 6 months and is accompanied by the formation and consolidation of the scar.
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Microinfarction

The small focal damage of the heart muscle, which is formed against the background of circulatory disturbance and is accompanied by the death of small sections of myocardial tissue, is called a microinfarction. This is one of the most common pathologies of the cardiovascular system, which is considered a harbinger of a more serious heart disease - a heart attack.

Symptoms of the disease can be confused with the development of the common cold:

• Lethargy and weakness in the whole body.
• Short-term and slight increase in temperature( appears in response to necrosis of a small portion of the myocardium).
• Shortness of breath and pain behind the sternum.
• Dizziness( rarely loss of consciousness).

Sometimes the course of the disease can be asymptomatic. At the time of an attack a person feels short-term pain behind the chest, which then gives way to anxiety and discomfort. Because of the low threshold of pain sensitivity, elderly people and people with diabetes almost do not feel the symptoms of the microinfarction, the complications of which may vary from beginning to arrhythmia to myocardial rupture.

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Complications of

Often the consequences appear in the first days or even hours of a heart attack, thereby weighting its course. The main complications are:

• Arrhythmias( sinus tachycardia, extrasystole, atrial fibrillation, complete intraventricular blockade).The most dangerous is the fibrillation of the ventricles, which can go into fibrillation and lead to the death of a person.
• Left ventricular heart failure develops in the acute period of a heart attack and is characterized by congestive cardiac asthma, wheezing, pulmonary edema.
• Cardiogenic shock occurs in the event of extensive damage to the left ventricular heart muscle and is characterized by a severe course, often fatal.
• The rupture of muscle fibers in the necrosis area can trigger the appearance of myocardial tamponade( haemorrhage in the pericardial cavity).
• Thrombosis of the arteries of the internal organs and the pulmonary artery can lead to the development of pneumonia, stroke and bowel necrosis. A thrombosis of a large circle of blood circulation can cause the necrosis of a part of the lung and a fatal outcome.
• Patients with extensive transmural infarction in the first 10 days may die from rupture of the ventricle due to cessation of circulation. Also, with a large heart attack, scar tissue can fail, and it may break with the development of an acute aneurysm of the heart muscle.
• In the late period there is a possibility of postinfarction disorders, which are manifested by eosinophilia, pleurisy, pericarditis, arthralgia.

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First aid

Calling an ambulance is the first thing to do. The faster the doctors start their work, the more likely the patient will survive and remain a full-fledged person. Prior to the arrival of medical personnel, the victim should be given emergency care:

• Place on a flat surface, slightly lifting the upper part of the trunk, and create conditions for stabilizing the breathing - open the window, unfasten the waist belt, collar, etc. The injured person should not be in a standing or sitting position,because the heart can not properly expel blood from the chambers.
• One tablet of Aspirin and Nitroglycerin should be given. After 30 minutes, if the ambulance did not arrive, you need to repeat Nitroglycerin.
• To stop a panic attack, something is given from sedatives: tincture of valerian, Corvalol, Valocordin.
• To eliminate pain, you can give an analgin tablet.

All the time before the arrival of a doctor you need to stay close to the victim and closely monitor his breathing, heart function and pressure. In case of myocardial arrest, it is necessary to carry out resuscitation measures:

• Indirect massage of the heart muscle.
• A short and powerful punch in the center of the sternum will only help in the first seconds of stopping the heartbeat.
• Ventilation of the lungs of the mouth in the nose or mouth to mouth.

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Diagnosis

To recognize infarction in a typical course it is possible according to the clinical picture of the disease. For an accurate diagnosis, laboratory diagnostics and electrocardiography( ECG) are used. Atypical infarction in most cases can be determined only by additional methods of investigation. Important diagnostic signs of the disease are the following:

• Characteristic changes on the ECG( electrocardiogram).
• Prolonged pain( more than 30 minutes).
• Changes in the general blood test: increase in leukocytes, ESR.
• Deviation from the norm of biochemical parameters( occurrence of C-reactive protein, increase in the level of sialic acids, fibrinogen, troponins).

In addition to the atypical form, it is difficult to correctly diagnose and with abdominal infarction. Often this form is taken for acute cholecystitis, peptic ulcer, pancreatitis, or food poisoning. When the cerebral form, when the first symptoms and complaints appear, indicating acute violations of the cerebral circulation, the doctor should be able to distinguish the stroke from a heart attack.

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Treatment of

Modern medicine uses medications and surgical intervention to treat heart attack.

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Medical therapy

In the first hours of the attack, the following medicines are shown to the injured:

• Thrombolytics( Metaleze, Actylise, Streptokinase) for dissolving thrombi and restoring normal blood flow to the artery.
• Narcotic painkillers( Morphine and others) reduce pain syndrome.
• Sedatives have a sedative effect.
• Nitroglycerin intravenously helps to expand the coronary arteries and improve the nutrition of the heart muscle.
• Heparin is administered intravenously to reduce the risk of recurrent thrombosis.

The following groups are prescribed for the treatment of infarction:

• Disaggregants( Plavix, Aspirin) reduce the risk of atherosclerotic plaques on the affected surface of the vessels.
• Beta-blockers( Concor, Egilok, etc.) reduce the load on the heart muscle, reduce heart rate and blood pressure.
• Inhibitors APF( Monopril, Enalapril) lower the pressure, slow the restructuring of the myocardial muscle layer.
• Diuretics are diuretics that remove excess fluid from the body.
• Statins to reduce cholesterol and reduce the risk of blood clots.

In addition to the main groups, there are other medicines( antioxidants, metabolites), the purpose of which is optional, but sometimes their application is sufficiently effective.

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surgery This method of treatment is divided into open surgery( shunting) and a mini-invasive procedure( stenting, angioplasty, coronary angiography).

Aortocoronary bypass surgery is performed under general anesthesia with the use of an artificial circulatory system( AIC).At the same time the patient's heart stops temporarily, which makes it possible to carry out all manipulations.

During the operation, part of the seized own artery or vein( shunt) of the patient is sewed with one end to the aorta, and the other to the vessels that supply the heart muscle with blood. Due to this, a bypass path for the blood flow is formed and the nutrition of the heart is greatly improved. In addition, if necessary, perform an aneurysm resection or suturing a defect in muscle tissue. After this, the AIC is switched off and the myocardium is triggered by the discharge of electricity.

Shunting is a traumatic operation that is not always well tolerated, therefore it is performed according to strict indications:

• Treatment of complications of a heart attack, including an aneurysm and rupture of the muscular septum.
• Vascular damage.
• Impossibility to perform a mini-invasive procedure.

Stenting( the installation of a tube that will prevent re-contraction of the vessels) and balloon angioplasty( inflation of a special balloon at the site of arterial narrowing) refer to the gold standards of surgical intervention in infarction. At the same time, all required manipulations are carried out through a small puncture in the radial or femoral artery using an X-ray contrast medium, which is introduced into the coronary vessels.

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Diet

After a heart attack, women and men need to adhere to the following dietary rules for a speedy recovery:

• Observe a low calorie diet.
• Replace animal proteins with plant.
• Eliminate foods that contain large amounts of cholesterol. These include: fatty milk food and animal fats, as well as semi-finished products, smoked products, sweets, butter, liver, etc.
• Reduce salt intake.
• More to eat fruits and green vegetables. Also in the diet should include olive and vegetable oil, fiber, flax seeds, legumes and other products that help lower blood cholesterol.

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Rehabilitation

The main tasks of the rehabilitation period include:

• Decrease in blood cholesterol levels.
• Restoration of the cardiovascular system: normalization of blood pressure and heart rate, improvement of contractile function.
• Restoration of work capacity.
• Increased endurance during exercise.
• Increased stress resistance.

For the maximum and speedy recovery during rehabilitation after a heart attack the following measures are shown:

• Medication.
• Therapeutic gymnastics( LFK).
• Special food.
• Motor activity.
• Refusal from smoking and alcohol.
• If necessary, help the psychologist.

In the first days after a heart attack, a person who has experienced a heart attack must comply with strict bed rest until the scar is tightened, then small physical exertion is allowed. Life after an attack is associated with a constant intake of medications diluting the blood and dilating the blood vessels.

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Prevention

The best method of preventing myocardial infarction is its prevention. The main preventive measures are an annual medical examination( with blood sugar analysis and general) and ECG.In case of detection of changes on the cardiogram, a blood test for cardioblots is assigned and ultrasound of the cardiac muscle is performed.

The second mandatory prevention point is the rejection of bad habits. Very dangerous is nicotine, which has a vasoconstrictive effect. Also, much attention should be paid to proper nutrition and control over your own weight.

The most effective method of preventing infarction with drugs is Acetylsalicylic acid( Aspirin), because of its influence on the formation of blood clots. The medicine is taken in small doses after consultation with the doctor.