As shown by the statistical study, myocardial infarction usually develops in men aged 40 to 60 years. In women the disease occurs in about half to two times less.
Myocardial infarction in patients with coronary heart disease (CHD), atherosclerosis, hypertension. Risk factors for myocardial infarction include Smoking (as it causes constriction of the coronary arteries and reduces the supply the heart muscle with blood), obesity, lack of physical activity.
At the same time myocardial infarction may be the first manifestation of coronary artery disease.
Unfortunately, the myocardial infarction is now one of the main causes of disability in adulthood, and the mortality rate among all patients is 10-12%.
Oxygen and nutrients to the cells of the heart muscle delivers a special extensive network of blood vessels called coronary. In myocardial infarction there is a blockage of one of these vessels by a blood clot (in 95% of cases the clot in the coronary artery is formed in the region of an atherosclerotic plaque). Oxygen supply to cardiac muscle cells, which harbored a blocked artery, will last for 10 seconds. About 30 minutes cardiac muscle remains viable. Then begins the process of irreversible changes in cells and the third and sixth hour from the beginning of occlusion, the heart muscle in this area is killed. Depending on the size of the lost area is isolated large and small coronary. If necrosis captures the entire thickness of the myocardium, it is called transmural.
The clinical picture of myocardial infarction is diverse, which complicates the correct diagnosis as soon as possible.The diagnosis is established on the basis of three criteria:
- typical pain
- ECG changes
- changes of indicators of biochemical analysis of blood, suggesting damage to the cells of the heart muscle.
In doubtful cases, doctors use additional studies, such as radionuclide methods for detection of necrosis of the myocardium.
Typically in myocardial infarction identified the following characteristics:
- long-term intensive simeuse-pressive pain behind the sternum in the heart region, may radiate to arm, neck, back or shoulder blades;
- the pain does not go after taking nitroglycerin;
- pale skin, cold sweat;
Not always the disease manifests such a classic pattern. A person can feel only discomfort in the breast or disruption of the heart. In some cases pain is absent. In addition, there are atypical cases of myocardial infarction, when the disease is manifested by difficulty in breathing with shortness of breath or abdominal pain. Such cases are particularly difficult to diagnose.
In the absence of timely treatment of myocardial infarction can cause acute heart failure, cardiogenic shock, cardiac arrest, cardiac arrhythmias and other dangerous conditions.
Complications associated with myocardial infarction, they require urgent medical care.
If you notice or close the symptoms described earlier, you need to urgently call an ambulance. Before the arrival of the doctor should first aid is to give the guests a comfortable sitting or lying position, give nitroglycerin (its resolves under the tongue) and aluminum (30-40 drops inside).
In order to avoid mistakes at the slightest suspicion on a heart attack patient as soon as possible delivered to the hospital. Treatment of myocardial infarction is necessarily performed in the intensive care unit of a hospital.
Treatment includes painkillers, drugs that promote dissolution of the formed clot, medication, reducing blood pressure, reducing blood volume, reducing heart rate. The effectiveness of the treatment depends on the time elapsed since the onset of the disease before reaching the hospital.
After the hospital begins a very important period of rehabilitation, which lasts up to 6 months. The doctor will prescribe you the necessary treatment. Some medications have to take the rest of my life. However, when performing assignments, quitting Smoking and dieting people after myocardial infarction for years to live a full healthy life.
Prevention of myocardial infarction is an annual medical check-UPS and timely adequate treatment of chronic diseases such as coronary heart disease, hypertension, atherosclerosis etc.
The diagnosis of coronary heart disease is the basis for the evaluation of coronary arteries using coronary angiography (coronary angiography). In a special way made x-rays allow us to determine the exact location of atherosclerotic plaques and the degree of narrowing of the coronary arteries. If indications are found the narrowing can be extended from the inside of the vessel – this procedure is called coronary angioplasty. In addition, the coronary artery may be implanted stent – a metal frame that will support the expanded state of the vessel. In some cases, carry out a complicated operation coronary artery bypass, when you insert additional vessels between aorta and the coronary arteries, bypassing the area of narrowing of the coronary vessel and creating the opportunity to divert the blood flow to the heart muscle.