What is myocardial infarction? Blood enters the heart through the coronary arteries. Cholesterol can be deposited on their walls, narrowing the vessels and forming the so-called plaques. This process is called atherosclerosis and can last for decades. If the plaque is destroyed, a blood clot begins to form in its place, which further reduces the blood supply to the heart. If a blood clot blocks the coronary artery completely or almost completely, a heart attack occurs. Heart cells do not receive blood, and with it oxygen, and begin to die. The more time passes from the moment of blood flow disturbance to the start of treatment, the more extensive the damage becomes.
Know the symptoms
The signs of myocardial infarction are different in different people, the intensity of the manifestations can also vary. Some suffer a heart attack, as they say, "on their feet", while completely without experiencing pain. But in most cases, the first sign of a heart attack is severe pain behind the sternum. Many describe this pain as a constricting, oppressive, feeling of fullness in the chest. Pain can be given to the back, left arm, neck, jaw, upper abdomen, and sometimes to the right arm. It can be permanent, or go through in a few minutes, and then resume.
Here is a list of the main symptoms:
- sudden compressive pain or a feeling of pressure in the middle of the chest, lasting several minutes or more,
- pain can spread to the left shoulder blade, left arm, neck or jaw,
- heartburn or constant pain in the stomach area is possible,
- shortness of breath, shortness of breath,
- dizziness or fainting,
- weakness or feeling tired
- profuse sweating,
- numbness of the arm or jaw,
- agitation, anxiety, insomnia, fear of death,
- blue lips and ears, fingertips.
Many of those who had a heart attack felt chest pain, shortness of breath and weakness several days before the attack. In some, a heart attack was preceded by arrhythmia (a disturbance in heart rhythm). Unlike an attack of angina pectoris, nitroglycerin does not reduce the pain of a heart attack. The pain attack itself is usually longer and stronger than with angina pectoris. It is extremely rare that a heart attack can be asymptomatic and can be detected by chance on an electrocardiogram taken for another reason.
Some ignore the symptoms or attribute them to another disease, such as indigestion or intestinal infection. But given that most deaths occur within an hour from the onset of the first symptoms, it is imperative to recognize a heart attack on time and act quickly. The earlier treatment is started, the fewer heart cells will die and the better the long-term prognosis.
Special warning for women
Different people have a heart attack in different ways, but the variability of symptoms in women is on average higher. In addition, women have a higher pain threshold (they tolerate pain more easily). The main signs they may become nausea and dizziness, weakness, sweating, blue lips and nails, anxiety.
What to do
If you suspect a heart attack, call a doctor. Even if there is no certainty that it is he, it is better to play it safe than to delay treatment. Life depends on how quickly assistance is provided.
- sit down at the first symptoms, or rather lie down,
- if the symptoms last more than three minutes, call an ambulance, tell the dispatcher that you have a heart attack,
- if you have nitroglycerin tablets, take it three times, one at an interval of 5 minutes (you don’t need to do this if your face turns pale, your eyes fly “dizzy”: this may be a sign of low pressure, which nitroglycerin will “drop” even more) ,
- if you don’t have nitroglycerin, take aspirin: it reduces thrombosis,
- hide in something warm if you are chilling,
- Do not try to drive to the hospital on your own, especially to drive.
How to recognize a heart attack
Myocardial infarction is called necrosis (death of cells and tissues) of the heart muscle caused by acute circulatory disorders. This is an acute process that arises and develops rapidly. The first symptoms of a heart attack appear suddenly, these include:
- acute burning sternal pain that radiates to the left shoulder blade, shoulder, arm, jaw, sometimes to the abdomen or perineum. Having arisen, the pain does not subside and is not relieved by conventional painkillers (in the hospital they are eliminated with narcotic analgesics). The patient clings to the heart, can instantly weaken, fall,
- interruptions in cardiac activity - arrhythmias and fibrillation. The patient complains of a feeling of irregular heartbeat, uneven heartbeat. A common symptom is a feeling of cardiac arrest, which is accompanied by intense fear,
- pallor of the skin, sticky cold sweat,
- heart failure - usually develops several hours after the onset of an attack, and sometimes faster, manifested by shortness of breath, cyanosis of the skin.
Non-specific symptoms are also possible, for example, increased blood pressure, weakness, loss of consciousness, intermittent breathing. These same signs can be harbingers of the impending myocardial damage.
With a myocardial infarction, the patient complains of sudden pain in the region of the heart and behind the sternum, noticeable disturbances in the work of the heart.
It should be borne in mind that patients with diabetes mellitus have a dangerous, painless form of the disease. In this case, the patient does not experience pain, but discomfort in the heart.
How to distinguish a heart attack from a stroke
Sometimes people, describing their problem during an ambulance call, find it difficult to differentiate myocardial infarction from stroke. Sometimes they are misled by what ischemic stroke is called cerebral infarction. Pathological processes are important to distinguish from each other at the initial stage, because the treatment and first aid for them are completely different. A stroke is a violation of the blood circulation of the brain, while there is a headache, weakness in the limbs, their paralysis, numbness of the face and paralysis of the facial muscles, difficulties with speech. With a myocardial infarction, the patient complains of sudden pain in the region of the heart and behind the sternum, noticeable disturbances in the work of the heart. He does not show complaints of pain in the head, numbness and other signs of a stroke.
How to determine a heart attack in women and men
Depending on gender, the manifestations of a heart attack may vary slightly. The fact is that women and men have different pain thresholds, hormonal levels and the body's natural resistance, so the speed and completeness of the reaction to the pathology also vary. The differences are also associated with the characteristics of the work of men and women, as well as with the greater prevalence of bad habits among men.
Statistically, men get sick more often than women. The age of the manifestation of the disease is also different - for men, the critical mark is 40 years. For women, this figure is 50 years. The highest risk of heart attack among the population is fixed in men older than 60 years.
In men, the first signs of a heart attack appear faster, and in the future the symptoms manifest themselves more strongly. As a rule, they have a classic clinical picture of the disease.
The main complication of a heart attack is the appearance of heart failure in a patient, and as a result - shortness of breath, pulmonary edema, extremity edema, unproductive cough, cardiac conduction disturbances.
A heart attack in women often proceeds more secretively, manifested by stitching pain in the abdomen, weakness, temporary arrhythmias, but this does not become less dangerous. Due to late seeking medical help, women have a higher risk of developing complications.
Diagnosis of a heart attack and its complications
The final diagnosis of myocardial infarction is made not by the early symptoms, but by the results of a medical examination. Diagnosis begins already in the ambulance - an ECG is performed. According to the data obtained, it is possible to determine the degree of myocardial damage by diagnosing one of four stages, each of which has its own manifestations on the cardiogram. Treatment and prognosis depend on this.
The hospital conducts two more informative studies - echocardiography and a biochemical blood test. Echocardiography shows in detail the focus of necrosis, its size, the depth of damage to the heart muscle, the location of the supply vessels, their condition, and the condition of the surrounding tissues. A biochemical blood test is necessary to detect special fractions of proteins that are released during the breakdown of myocardial cells - cardiotropic proteins (MV-KFK, LDH1, LDH5, troponin). This is a quick method of confirming the diagnosis - the result can be obtained in an hour. Also, the activity of inflammatory processes is judged by the content of proteins of the active phase of inflammation (C-reactive protein).
If the sudden manifestations of the disease are eliminated, the patient is in a hospital under the supervision of doctors, this does not mean that he is already healthy. A heart attack is dangerous with its late complications.
Due to the death of muscle tissue and the appearance of a connective tissue scar on the heart, the affected area will never return to its functions. The main complication of a heart attack is the appearance of heart failure in a patient, and as a result - shortness of breath, pulmonary edema, extremity edema, unproductive cough, cardiac conduction disturbances.
In men, the first signs of a heart attack appear faster, and in the future the symptoms manifest themselves more strongly. As a rule, they have a classic clinical picture of the disease.
The inflammatory process can spread to other membranes of the heart. With a large size of the scar, the heart wall becomes thinner, after which it can rupture under certain loads.
Often, thromboembolic complications occur due to poor circulation and stagnation of blood. A common problem is cardiogenic shock, which can also develop in the initial stage of the disease. In the later stages, reperfusion syndrome occurs, associated with the ingress of oxygenated blood to necrotic tissues. The latest, but one of the most dangerous complications, is Dressler’s syndrome, the body’s autoimmune response to its own defective proteins.
First aid for myocardial infarction
When the first signs of a heart attack appear, you should immediately proceed to first aid to the patient. From the verified actions depends on its survival. The algorithm is as follows:
- Call an ambulance. No matter how skilled the patient is provided on the spot, it requires immediate hospitalization, a complete diagnosis of the heart, the introduction of a narcotic analgesic to reduce pain and prevent shock. At home, without a doctor and special equipment, all this will not work.
- The patient is seated, reassured. They take off excess clothing, unfasten close ones so that a person can breathe more freely. All windows open in the room. The main goal is to increase the amount of oxygen that goes to the starving cells of the heart.
- If the patient takes drugs for angina pectoris, then you need to give him a tablet of Nitroglycerin under the tongue. They expand the coronary vessels - arteries that feed the heart. You need to find out if a person is allergic to aspirin. In its absence, you can give up to 300 mg of this drug. Any sedative (sedative) drugs of natural origin can be used to relieve stress.
- Prior to the arrival of an ambulance, you must be close to the patient. If for some reason the ambulance cannot arrive quickly, you can take the person to the hospital on your own, by car.
A heart attack in women often proceeds more secretively, manifested by stitching pain in the abdomen, weakness, temporary arrhythmias, but this does not become less dangerous.
If cardiac arrest occurs, it is urgent to start cardiopulmonary resuscitation and conduct it until the arrival of an ambulance or until the resumption of cardiac activity.
We offer you to watch a video on the topic of the article.
Cardiopulmonary resuscitation includes mechanical ventilation and indirect heart massage. Since this can cause serious injury, you do not need to remember what you saw in the movie and try to put it into practice. Before starting cardiopulmonary resuscitation, you need to call an ambulance and do not stop the procedure until it arrives.
Relatives of patients with angina pectoris should preferably receive training in this technique. There are training courses supported by the Red Cross in many cities; you can find out if they are in your city on the website of this organization. Many commercial companies offer similar training. As for distance learning, its effectiveness is doubtful, since it is impossible to work out the necessary actions in practice.
An implantable defibrillator may be useful for people with uncontrolled ventricular tachycardia or flickering paroxysms. When such conditions occur, it produces an electric discharge that restores the normal rhythm of the heart. It also stimulates the work of the heart when it suddenly stops.
Despite the fact that the device is actively used in Western countries, there is no exact methodology for selecting patients who have indications for implantation. In our country, such operations are performed, more specific information can be obtained from a cardiologist. Since such a procedure cannot be prescribed for yourself, a cardiologist will be required in any case.
A portable portable defibrillator can only be effective in the hands of a person who knows how to handle it. It is not difficult to purchase it, including via the Internet, but with training everything is much more complicated. In order to understand how this is happening in our country, it’s enough to mention that state clinics are not equipped with these devices. However, in an emergency, a defibrillator can save lives, and many of them come with simple and clear instructions.
Where does my heart attack come from?
Myocardial infarction is a necrosis (necrosis) of heart tissue. It appears when a muscle lacks oxygen due to the narrowing of its arteries.
In order for a coronary disease to transform into a heart attack, sometimes you do not need any provoking factors: it is enough to wake up and get out of bed. With stress or unusual physical activity, the risk increases.
How to understand that this is a heart attack
The main symptom is severe pain behind the sternum, which sometimes spreads to the left arm, under the left shoulder blade. The pain can be different: presses behind the sternum, burns, bursts. Fear comes along with pain, a person worries, clutches at his heart.
There are other symptoms that differ depending on the type of heart attack:
- A person does not have enough air, as in an asthma attack, but from drugs that facilitate breathing, it does not get better.
- The man is weak, pale, with cold arms and legs.
- Arrhythmia develops.
- Stomach ache, vomiting begins.
- A person loses balance, weakens, signs of a stroke appear.
Doctors must accurately determine if a heart attack has occurred or not with an ECG.
How to protect against a heart attack
A heart attack often affects people after 50 years. At risk are also younger men and those who already had a heart attack in the family.
And even smoking, a love of alcohol, high blood pressure, excess weight, poor nutrition and a sedentary lifestyle lead to serious heart problems: if you move a little, any physical activity will become excessive.
You can’t argue with genetics, age and gender, and we choose our lifestyle. This is a very boring prevention recipe, but others do not work.
How to recognize the symptoms of myocardial infarction
Symptoms of myocardial infarction develop due to a sudden interruption in the blood supply to the heart muscle, as a result of which necrosis develops in it. Myocardial infarction refers to a form of coronary heart disease.
The most important factors in the development of a heart attack are blockage of the cardiac coronary vessels by a thrombus, leading to the formation of large foci of muscle necrosis (necrosis), as well as the narrowing of the heart vessels due to the formation of atherosclerotic plaques.
If the narrowing of the lumen of the coronary arteries is widespread (two or more arteries are involved in the process), with myocardiosclerosis already existing, microinfarction develops. Symptoms of it are less pronounced than a common lesion. Although this is a microinfarction, it can lead to the same complications and consequences that develop with large focal necrosis.
Symptoms of myocardial infarction
At the onset of the disease, patients complain of severe and prolonged pain behind the sternum. This is a classic version of the localization of pain. The pain persists for several hours and does not go away after taking nitrates. There are other options for the localization of pain, for example, it can appear in the stomach (gastralgic or abdominal variant), in the epigastric region with concomitant shortness of breath (asthmatic version). Pain can be given in the back, neck, arm. Нередко острая боль настолько сильна, что возникает кардиогенный шок, с левожелудочковой недостаточностью и отёком лёгких. Часто нарушается привычный ритм сердца, сердцебиение учащается, а артериальное давление наоборот падает.If ventricular fibrillation occurs, clinical death may occur.
If in the first hours after the seizure, ectopic ventricular arrhythmias are recorded on the cardiogram, this may indicate a restoration of patency of the coronary artery of the heart.
In addition to pain in the heart, the initial symptoms of a heart attack are high blood pressure, which, as a rule, disappears with the relief of pain, rapid heartbeat, a rise in body temperature to subfebrile condition. The temperature remains elevated to three to four days. In the blood, the number of leukocytes increases, ESR and the level of nitrogenous toxins increase (do not take this symptom for a uric acid infarction). All these are signs of an inflammatory reaction. In the first hours, there is an increase in enzymes: creatine kinase, ALT, AST, LDH.
On the cardiogram, a picture of a heart attack is characterized by an increase in the ST segment, a wide Q wave, the appearance of the ventricular complex QS in those leads where myocardial necrosis occurred. For a more accurate diagnosis, especially with repeated heart attacks, it is necessary to take a series of cardiograms.
If a microinfarction occurs, the symptoms are often not so pronounced and the pain may not be so intense. A person can transfer it “on its feet” or take it for an attack of angina pectoris, then it is accidentally detected on an ECG. Symptoms of a heart attack with a small focal lesion are usually observed in people with a long history of angina pectoris or cardiosclerosis. In those cases when it occurs in the initial stages of coronary heart disease, a microinfarction is a precursor of a vast transmural lesion.
In the early days, the patient may be excessively euphoric, possibly a repeated resumption of pain in the heart, the appearance of arrhythmia and extrasystole.
As a complication, aneurysm of the heart wall or aorta, heart failure and pulmonary edema, embolism of blood vessels of organs and limbs can develop.
Therapy of a heart attack is necessarily carried out in stationary conditions. Severe cases are treated under intensive care conditions. Nitrates are prescribed in the form of intravenous infusion, heparin in large doses, analgesics. Apply polarizing mixtures containing potassium, betta blockers, oxygen inhalation. The patient should observe bed rest and be as much as possible protected from stress and overstrain.
How to recognize myocardial infarction
How to recognize myocardial infarction
Pain in the heart often can have nothing to do with the heart itself. For example, they can be caused by osteochondrosis or intercostal neuralgia. A heart attack is most often just a consequence of atherosclerotic vascular damage, which can develop for more than a dozen years. At the onset of the disease, the atherosclerotic plaque has the form of a thin film on the inner surface of the vessel and does not interfere with the movement of blood to the heart muscle. Subsequently, the size of the plaque increases, and the lumen of the vessel becomes smaller and smaller. Only when an atherosclerotic plaque occupies 3/4 of the inner diameter of the vessel, symptoms of angina pectoris appear.
A person begins to experience a feeling of discomfort, heaviness, pain behind the sternum, especially with fast walking or physical effort. It is characteristic that when the load is reduced, for example, if you go slower or stop completely, the pain decreases and disappears within a few minutes. Often pain is felt not in the chest, but in the arm, back, or even the lower jaw. It may seem that she is absolutely not connected with the heart. Let this not deceive you. If you notice that chest pain intensifies during exertion and forces you to stop working, this is most likely a serious signal. In the very near future you need to see a cardiologist, since angina pectoris often precedes a heart attack.
The main sign of myocardial infarction is pain, similar to pain with angina pectoris, but more severe and protracted. With a heart attack, it appears suddenly, is not necessarily associated with physical activity and does not pass at rest. An attack can last more than 10 minutes, and taking a nitroglycerin tablet does not always alleviate the condition. In addition to pain, a person may feel nausea, suffocation, dizziness. It is even possible loss of consciousness. In no case should you try to "endure" such symptoms. Delay in such a situation is dangerous. It is necessary to call an ambulance as soon as possible.
Until the doctors arrived
Having felt pain behind the sternum, you need to stop all active actions, sit down, leaning on the back of a chair or chair. If the pain persists within 4–5 minutes, a nitroglycerin tablet should be placed under the tongue and wait for it to completely dissolve. Nitroglycerin quickly penetrates through the oral mucosa and enters the bloodstream almost instantly. Remember that taking nitroglycerin, especially for the first time, may be accompanied by a sharp decrease in blood pressure and a headache. If the first pill does not bring relief and the pain does not completely disappear, you can take another pill, but not earlier than after 5-6 minutes. It is undesirable to take more than 5 tablets per hour. If you have high blood pressure, do not try to lower it yourself. Even if you usually take drugs to reduce blood pressure, now it’s better to refrain from using them: perhaps nitroglycerin will be enough. In addition, you can chew half a tablet of ordinary aspirin.
Often the development of myocardial infarction is accompanied by a feeling of fear, anxiety, and even panic. A man starts nervously rushing about the room, scurrying around. Doing this is highly undesirable. In this case, the most correct action is to calm down, take nitroglycerin and call a doctor. If the nerves still pass, drink 30–40 drops of valocordin and sit quietly until the doctor arrives. But delay in calling the ambulance is impossible. Indeed, according to statistics, about half of patients who die from a heart attack die before the doctor sees them, and this is due to the features of this disease. The ideal time for medical care is the first 40 minutes.
Myocardial infarction may occur out of the blue
Often the first symptom of atherosclerosis developing in the vessels for a long time is precisely myocardial infarction. The man felt fine, nothing hurt - and suddenly a heart attack. Sometimes even a medical examination is not able to recognize an impending disaster. Therefore, it is especially important to consider the so-called risk factors for myocardial infarction. We can influence some of them, some not. For example, a person’s gender, age, and heredity cannot be changed. It is known that women are less susceptible to the development of cardiovascular diseases, but only until menopause occurs. With the onset of menopause, the risk of developing cardiovascular disease increases dramatically, especially in combination with other risk factors.
The development of myocardial infarction is promoted by such diseases as hypertension, diabetes mellitus, high cholesterol in the blood, excess body weight. Risk factors that we can affect include smoking, a sedentary lifestyle, excessive emotional stress, and, of course, malnutrition.
Prevention of myocardial infarction, in the first place, is to eliminate these factors. It is useful to control blood cholesterol and follow the recommendations of a cardiologist. For example, replacing animal fats with vegetable fats in the diet leads to a marked reduction in the risk of heart attack. In general, if you lead a healthy lifestyle, many problems can be avoided.
Myocardial infarction risk group and first-aid kit
Especially attentive to the condition of your heart you need to be those who suffer from hypertension, obesity, diabetes. All people over 60 years old, those who have had early myocardial infarction in the family, and everyone who has high blood cholesterol. If you belong to at least one of these population groups, nitroglycerin and valocordin must be in your home medicine cabinet. It does not hurt to have a tonometer at home. In addition, there is now the opportunity to purchase a portable electrocardiograph transmitter. This extremely easy-to-maintain device the size of a pack of cigarettes makes it possible to register your ECG at the time of the attack. The recorded ECG using any telephone is transmitted to a specialized medical center, whose doctors will understand the situation in real-time mode and give appropriate recommendations. Due to this, the time between malaise and its qualified assessment is reduced from several hours to 2-3 minutes.
From a conversation with cand. honey. Sciences, cardiologist, chief physician of the medical center "Cardio-Scan" in Moscow Nina Andreevna Sysoeva.
Myocardial infarction how to suspect and what to do
Myocardial infarction(THEM) Is a condition in which the tissue of the heart muscle begins to die slowly - necrotic. He is the most common cause of death not only in our country, but also in many other countries of the world.
Last time I wrote about a condition such as angina pectoris. which occurs due to incompatibility of the request and the delivery of oxygen to the heart, which as a result causes pain.
A heart attack is a complete cessation of oxygen delivery to some part of the heart, which is associated with a complete blockage of the lumen of the artery that feeds the heart muscle - myocardium. Most often this happens due to the rupture of the same atherosclerotic plaque. which leads to the rapid formation of a blood clot and the blockage of blood flow to the myocardial site.