The heart is an extremely important organ for life, the failure of which leads to immediate death. It is for this reason that heart disease ranks first among all causes of death among people. And the most terrible heart disease is myocardial infarction. Meanwhile, the symptoms of this disease in most cases can be recognized in advance. But do we always carefully listen to your body?
- Description of the disease
- Age and Sexual Features
- Factors contributing to the appearance of a heart attack
- Symptoms of a heart attack
- Atypical forms of a heart attack
- Signs of a heart attack in a woman
- What should I do when symptoms appear?
- Diagnosis of Infarction
- Complications of a heart attack
Description of the disease
A heart attack is a necrosis (dying off) of a specific part of the heart muscle. In most cases, the cause of death of the heart fibers is the lack of their blood supply. And the blood supply of the heart, in turn, is disturbed by the fact that its vessels (the so-called coronary vessels) cannot deliver oxygen and nutrients to the tissues.
In most cases, atherosclerosis is the cause of impaired functioning of the coronary vessels, much less often embolism or spasm. Regardless of the cause, the lumen of the vessel narrows so much that blood stops circulating in it. Muscle feels a lack of oxygen. But the heart needs much more oxygen than any other muscle, because it is always in work. If this condition lasts long enough (15-20 minutes), then a part of the muscle tissue may die.
Muscle tissue necrosis in any other part of the body is also quite unpleasant. However, in most cases it does not threaten life, although it leads to severe pain, inflammation and reduction of motor functions of the body. It is quite another thing if such a thing happens in the heart. His work is immediately disturbed. And, as a result, the blood supply of the whole organism is disturbed. That can lead to oxygen starvation and suffocation, brain damage. With a severe heart attack, even heart failure can occur.
If the heart copes with the trouble and continues to work, then its functionality will no longer be the same as before. Thus, changes in the heart caused by a heart attack are irreversible. The affected surface of the heart muscle is covered with connective scar tissue, which does not carry a functional load, and the contractility of the heart decreases. The electrical impulses that stimulate the contraction of the heart are no longer so good. This means that the quality of human life is deteriorating.
The main temporary stages of heart attack:
- Hottest – less than 2 hours from the start;
- Acute – up to 10 days from the start;
- Subacute – 10–45 days from the start;
- Scarring stage – 1, 5-6 months from the beginning.
Also, a heart attack can affect both parts of the heart muscle, and also cover its significant areas (transmural or Q-infarction). Subendocardial infarction affects the inner lining of the heart, subepicardial – external. If a heart attack is not extensive, then it most often affects the left ventricle of the heart. Also, the area of necrosis can be localized in different parts of the ventricle – the side, front and rear walls, as well as in the interventricular septum.
If a heart attack happened to a person once, then the probability of a heart attack will increase significantly. Recurrent heart attack is called heart attack, which developed within 2 months after the first. A heart attack that occurred 2 months after the first is called reoccurrence.
Age and Sexual Features
Heart attack is considered to be a disease of older men. However, this is not the case. Although heart attack occurs predominantly in people over 50 years old, however, younger people are not immune from it. Recently there has been a significant decrease in the lower age threshold of the disease. In general, 60% of people over 65 face a heart attack at least once in their life.
It should also be noted that men do suffer from a heart attack more often than women (3-5 times). This is due to the fact that the female sex hormones have a more intense protective effect on the heart vessels than the male ones. Therefore, atherosclerosis of the coronary vessels in women develops on average 10 years later than in men, and a heart attack in women before menopause is a relative rarity. However, after 45 years, the number of sex hormones in women begins to decline sharply, which leads to an increased risk of heart attack. In general, women aged 55-60 years are more likely to have a heart attack than men.
Unfortunately, some women are not ready to meet with a new scourge. It must be confessed that many representatives of the stronger sex suffer from heightened suspiciousness and, as soon as something pricks their heart, they immediately run to the doctor. This behavior is less typical for women, and the pain threshold for women who have given birth is usually very high. Many women engaged in household chores and family for a long time do not notice the dangerous symptoms or attribute them to vascular dystonia, fatigue, etc.
Factors contributing to the appearance of a heart attack
Our life in most cases does not contribute to the health of the cardiovascular system. The reason for this are the constant stress, and unhealthy diet, and sedentary lifestyle. But the greatest influence on the development of coronary heart disease and an increased risk of heart attack have bad habits: smoking and excessive drinking.
What else contributes to a heart attack:
- increased cholesterol in the blood
- hormonal disorders (in particular, lack of thyroid hormones),
- extra weight,
- staphylococcal and streptococcal infections
- passive smoking,
- rheumatism of the heart,
- excessive exercise,
- stress, depression and neurosis.
What signs may indicate heart failure that can lead to a heart attack:
- snoring, apnea;
- swelling of the legs, feet and hands;
- bleeding gums, periodontal disease;
- pain in the left shoulder;
- shortness of breath, especially after exercise;
- frequent headaches;
- frequent night urination.
All these signs may be evidence of preinfarction state of the body.
Symptoms of a heart attack
So, how do you recognize the disease on time? Fortunately, cardiovascular catastrophes rarely occur just like that, against the background of flourishing health. Almost always, such a formidable disease as a heart attack is accompanied by rather obvious signs that you need to be able to recognize.
The main risk factor in which the likelihood of a heart attack is very high is coronary heart disease (CHD). It occurs predominantly in old age and is expressed in the clogging of coronary vessels by atherosclerotic plaques formed from low density lipoproteins. It is for this reason that it is important to monitor the level of “bad” cholesterol in the blood.
The narrowing of the lumen of the coronary vessels, in turn, leads to an increase in the load on the heart, which further depletes its resources. At a certain point, for example, with an increased heartbeat, the plaque can rupture, and this usually results in arterial thrombosis. And all the tissues to which this artery delivers blood, begin to die.
Until a heart attack occurred, coronary disease manifests itself as periodic pain in the sternum, primarily after intense physical exertion. In most cases, the use of vasodilators, such as nitroglycerin, helps relieve bouts of CHD. However, in the event that it fails, then this may indicate that an active death of myocardial cells occurs.
The characteristic symptoms of a heart attack include:
- acute pain in the left side of the chest;
- shortness of breath;
- weakness, dizziness, sticky sweat;
- fear, panic attacks;
- cardiac arrhythmias (extrasystoles, atrial fibrillation).
Sometimes a patient may also experience:
- nausea and vomiting;
- drop in blood pressure;
- paleness of the skin, especially on the face;
- speech and coordination problems, vision.
A few words should be said about pain. The pain during a heart attack has a burning, stabbing or contracting character. She has extremely high intensity. Many people who have suffered a heart attack claim that this pain is the strongest of all that they have experienced in their lives. The pain during a heart attack is not stopped not only with nitroglycerin, but sometimes with the help of analgesics. In addition, pain is usually observed for a long time, for several tens of minutes. The pain may have a recurrent nature, then retreat, then reappear.
In some cases, the pain may go down to the shoulder, to the stomach. You may also experience symptoms resembling gastric colic, an attack of peptic ulcer, especially if the posterior wall of the myocardium is affected.
A heart attack most often appears in the morning, closer to dawn. This is due to the fact that at night the heart does not work in such an intensive mode as during the day, and the morning rise is associated with the release of hormones into the bloodstream, stimulating its activity. Therefore, in the morning hours are most likely such phenomena as increased blood pressure, heart palpitations, arrhythmias, and as a result, atherosclerotic plaques ruptures. But this does not mean that a heart attack cannot overtake a person at a different time of day.
The degree of manifestation of symptoms of a heart attack is usually directly proportional to the extent of the damage to the muscles of the heart. The intensity of the symptoms is also affected by comorbidities. With small lesions (the so-called microinfarcts), the patient may not feel any serious discomfort or attribute unpleasant symptoms to colds, fatigue. In this case, they say that the patient suffered a heart attack “on his feet.” Often microinfarcts can be detected on an ECG , done on another occasion.
Atypical forms of a heart attack
These forms are difficult to recognize because they may coincide with the symptoms of other diseases.
Symptoms and first signs observed during an atypical infarction can be grouped into several types. Depending on which group of symptoms prevails, the heart attack can be divided into several types:
With an abdominal type of heart attack, the symptoms resemble the symptoms of disorders of the gastrointestinal tract in many ways – nausea, bloating, stomach overcrowding, vomiting. With arrhythmic type, cardiac arrhythmias come to the fore. With cerebral disorders of the nervous system are most noticeable – dizziness, headache, speech and consciousness disorders, fainting. When an asthmatic patient, first of all, suffers from shortness of breath and lack of air. With the collaptoid variant, the patient has a strong drop in pressure, darkening of the eyes, dizziness, and loss of consciousness is possible. When edematous type is characterized by shortness of breath, weakness, the appearance of edema in the limbs, the liver increases.
A painless variant of heart attack is rare, but it is still not excluded. Most often, this type of disease is susceptible to diabetics. The fact is that diabetes affects not only the blood vessels of the heart, but also the nerves. Therefore, during a heart attack, patients with diabetes can feel only short and slight chest pain, which does not seem dangerous to them.
Signs of a heart attack in a woman
In women and men, most signs of heart attack are the same. But there are some differences. In particular, different symptoms can occur with different frequency in different sexes. Symptoms of heart attack in women are more atypical in nature, that is, women may not experience intense pain in the heart area. Instead, pain may appear in the left arm, under the scapula, pain in the left shoulder joint, upper chest, even in the throat and lower jaw.
What should I do when symptoms appear?
If the patient has experienced the symptoms described above, then he should immediately call for emergency help! The sooner assistance is given for a heart attack, the greater the likelihood that the outcome of the disease will not be fatal, and that the heart attack will have fewer consequences.
You must immediately assume a recumbent or reclining position. It is unacceptable to go or do some business with a heart attack. Not only does this put a heavy strain on the heart, it also increases the likelihood that a person will fall down and cause injury if he loses consciousness. You must also take three tablets of nitroglycerin 0.5 mg (even if it does not help relieve pain) with an interval of 15 minutes. However, before this should measure the pressure. If the systolic (upper) pressure is too low, below 100 mm, then nitroglycerin should not be taken.
It is also recommended to take sedatives – validol or Corvalol. An aspirin pill should also be taken (unless the patient has a severe peptic ulcer). Aspirin must be chewed, but nitroglycerin and validol cannot be swallowed – they should be kept under the tongue until completely absorbed.
If the patient is not alone, then the other person should help him in everything – give medicine, calm down, put on the bed if necessary, open the window to ensure fresh air in the room. And remember that it is necessary to wait for the arrival of the doctor, even if the patient suddenly felt better. It should be remembered that his life and further recovery depend on how faithful and quick the first-aid care provided to the patient depends.
Diagnosis of Infarction
No doctor can diagnose “heart attack” only on the basis of the patient’s story about his symptoms and sensations. Therefore, to determine the disease using various diagnostic methods, the main of which is the cardiogram. On the ECG, in most cases, pathological phenomena occurring in the heart muscle are reflected, reflected in the form of changes in the teeth and intervals. Often, for the diagnosis of heart attack, ultrasound (ultrasound), coronary angiography, scintigraphy are used. Also of great importance are changes in the composition of enzymes in the blood serum – an increase in the amount of myoglobin, creatine phosphokinase, trolonin.
Treatment of heart attack is carried out only in the hospital. After the end of treatment, the patient is rehabilitated in order to prevent the occurrence of recurrent heart attacks and stabilize his condition.
Complications of a heart attack
A heart attack is dangerous, above all, by cardiac arrest and clinical death. Of course, if this happens not in the walls of a medical institution, but at home, then the person has almost no chance of survival. There are other complications that a heart attack can cause. This is:
- pulmonary edema,
- persistent heart rhythm disorder
- brain damage,
- gastric and duodenal ulcer,
- heart aneurysm,
- cardiogenic shock,
- mental abnormalities.
On average, every tenth patient dies of heart attack. But here it should be borne in mind that most of the dead did not receive adequate medical care. In general, 80% of people who have had a heart attack return to normal. This shows how important it is to be able to recognize the symptoms and signs of this disease in time.
In more than half of cases, a heart attack is the culmination of a progressively progressing coronary heart disease. This means that treating ischemic disease can significantly reduce the likelihood of a heart attack.
In the prevention of heart attacks and other serious diseases of the cardiovascular system, great attention should be paid to nutrition. The diet should contain a large amount of vitamins and plant fiber. At the same time, the consumption of fatty meat, trans fat, should be minimized. Also, the diet should contain fish dishes containing a large amount of omega-3 fats.
The most important methods to help avoid heart attack include:
- weight loss;
- physical exertion to fight hypodynamia;
- control cholesterol and blood sugar levels
- control blood pressure.