Methods for the prevention of heart attack and the prevention of seizures. Possible consequences of pathology. What examinations for the purpose of early diagnosis should be done

Heart disease is “getting younger” every year, and if earlier a heart attack could only happen in an elderly person or a patient with congenital disease, then today an unexpected attack is increasingly pursuing young people. To provide timely assistance, you need to know how to determine a heart attack and what are its first signs.

Signs of a heart attack

Some are familiar with a disease such as a heart attack - symptoms, the first signs of it cannot be confused with other diseases. With this disease, the heart muscle is affected, often this is caused by a violation of its blood supply due to blockage of atherosclerotic plaques in one of the heart arteries. The affected muscle dies, necrosis develops. Cells begin to die 20 minutes after the blood supply stops. The first signs of a heart attack:

• severe chest pain radiating to left shoulder, half of the neck, arm, on the space between the shoulder blades;
• feeling of fear;
• drawing pains in the limbs;
• nitroglycerin does not provide relief;
• an attack can last from 10 minutes to several hours;
• arrhythmic form is accompanied by rapid pulse;
• blood pressure drops sharply;
• with an asthmatic form, suffocation occurs, the skin suddenly turns pale;
• cerebral infarction is accompanied by loss of consciousness, the symptoms of this form resemble a stroke: the patient's speech becomes incomprehensible, coordination of movements is disturbed.

If you have symptoms, you should urgently call an ambulance, before her arrival, you can take nitroglycerin tablets (0.5 mg) at intervals of 15 minutes, but not more than three times, so that there is no sharp drop in pressure. At risk are mainly the elderly, active smokers. Diabetes mellitus, alcoholism, obesity can become the cause of an attack.

Signs of a heart attack in a woman

The fairer sex is also at risk of undermining their health with a heart attack. This is due to the production of estrogens, which affect the expansion of blood vessels and the favorable functioning of the heart muscle. But with a hormonal failure (ovulation, pregnancy, menopause), estrogen production is reduced. And this leads to malfunctions in the work of the cardiovascular system. How to recognize a heart attack in women? An attack can begin a few hours before the peak of exacerbation, it is important to understand this in time and seek help. The first symptoms of a heart attack in women:

• burning in the upper abdomen;
• severe pain that radiates to the left arm and part of the chest;
• increased sweating;
• pain in the upper abdomen;
• heaviness in the chest;
• stabbing heart pain;
• numbness of the limbs;
• aching toothache;
• discomfort in the jaw;
• pain in the back of the head;
• vomiting reflex;
• dyspnea;
• a sharp decline blood pressure;
• dizziness;
• nausea;
• bronchospasm;
• panic attacks;
• swelling of the legs and feet;
• anxiety;
• slurred speech;
• feeling of fear;
• pulmonary edema.

The death of heart cells due to blockage by a thrombus of one of the coronary vessels causes a heart attack, more often than others it occurs in the stronger sex. Treatment of such diseases, including stroke and angina pectoris, cannot be carried out at home, you should definitely seek help from specialists, otherwise there will be unpleasant consequences. The attack can be spontaneous (primary) or repeated at regular intervals. The first symptoms of a heart attack in a man:

• dyspnea;
• pressing sharp pains in the left arm, chest area, shoulder blade;
• conditions of oxygen deficiency;
• toothache;
• chest numbness;
• a state of nausea;
• lowering blood pressure;
• general sluggish state of the body;
• arrhythmia;
• heavy sweating;
• sleep disturbance;
• dental problems (periodontal disease, bleeding gums);
• arrhythmia (cause - dysfunction coronary artery).

Myocardial infarction - symptoms

An acute heart attack is accompanied by severe chest pains that can even cause shock. Sometimes the symptoms of a heart attack are vague, especially for women. In this case, the attack is easy to mistake for fatigue or flu, this is especially dangerous, because the patient may not understand the seriousness of the disease. If you do not seek help, the risk of death increases several times. To prevent the disease, you need to know the main symptoms of myocardial infarction:

• pain and discomfort in the chest;
• nausea, vomiting;
• pain in the upper body, radiating to the back, arms, neck, teeth;
• labored breathing;
• anxiety;
• panic attack;
• dizziness;
• profuse sweating;
• fainting is possible.

pressure in a heart attack

Certain conditions help to recognize the signs of an attack in time. As a rule, the precursors of a heart attack (sleep disturbance, fatigue) often occur a few days before the moment when the blood flow is blocked and necrosis begins. The pressure rises during a heart attack. But this is only on the first day, then it falls. Low blood pressure can lead to the development of anemia of the brain, which is accompanied by fainting and clouding of consciousness. Normalization of pressure is considered a positive phenomenon.

Pulse in a heart attack

If a person's pulse begins to quicken, then this is a signal for the development of the disease. As a rule, the pulse during a heart attack is 50-60 beats per minute. The skin, when felt in severe cases, is often cold, while the pulse is weakly palpable, interruptions are noted. The more extensive the attack, the more pronounced the tachycardia (rapid heartbeat) and the faster the pulse.

Pain in a heart attack

A heart attack is accompanied by severe chest pains that radiate to the left arm. In this case, a person feels tingling fingers. In certain cases, pain from the arm can turn into numbness, reflected in the neck, shoulders, jaw. Abdominal pains are possible, unpleasant sensations are noted in the stomach, the navel zone. The duration of pain in a heart attack is approximately 20 minutes. With angina pectoris and stroke, discomfort can be the same, so a specialist can accurately diagnose. Exist atypical forms pain masquerading as other ailments:

• The asthmatic form of the disease resembles an asthma attack. A person has a cough, a feeling of chest congestion. The facial expression is exhausted, the lips are blue, the breathing is noisy.
• Abdominal ailment is characterized by pain in the upper abdomen. The disease is accompanied by vomiting, nausea, bloating, hiccups, and diarrhea.
• The cerebral form is characterized by nausea, loss of consciousness, abdominal pain.

Heart attack on the legs - symptoms

Some people with a high threshold of sensitivity, hypoxia and hypertension of the heart muscle may not feel obvious symptoms of a heart attack, so they endure it on their feet. In many cases, we are talking about microinfarcts, when only a small area of ​​the heart muscle is affected. At the same time, prolonged and sharp pain is absent, from obvious signs pressure surges, malaise, nausea are felt. Women are less susceptible to such attacks than men, due to their greater resistance to pain and body characteristics. Signs of a heart attack in men on the legs:

• pallor of the skin;
• pulmonary edema;
• a sharp drop in blood pressure;
• violation of the heart rhythm (arrhythmia);
• weakening of the pulse;
• panic attack.

Kidney infarction - symptoms

A rare variant ischemic disease kidney is a heart attack. Its appearance provokes a complete and sudden cessation of blood flow through the large arterial renal vessel. Infrequently, a kidney infarction occurs - its symptoms depend on the extent of the lesion. With a small attack, signs of the disease may be completely absent. A major malaise is manifested by an admixture of blood in the urine and a sharp pain in the back. More can be developed:

• arterial hypertension;
• renal chronic insufficiency;
• decrease in diuresis;
• body temperature rises;
• severe nausea;
• vomit;
• a huge content of urates, if we consider the analysis of urine.

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Causal factors

The main causes of the pathology in question in men, according to doctors, are the gradual development of such a disease as atherosclerosis. When the blood contains an excess amount of cholesterol, other lipids, there is a gradual deposition of their plaques on the walls of the vascular bed.

Often, atherosclerotic plaques can rupture, forming blood clots or blood clots, which, in turn, can cause stenosis (narrowing of the lumen) of the coronary arteries.

It must be understood that the larger the artery will be affected by atherosclerosis (narrowed or completely blocked), the more myocardial cells will lose nutrition and viability, the more extensive myocardial infarction will be.

But among the risk factors for the development of atherosclerosis in men, doctors call the following:

The causes of the development of coronary heart disease and, as a result, myocardial infarction can arise in each of the above factors, which is why doctors insist on the need for regular examinations of all men over 45 years of age and correction of their lifestyle and nutrition.

Signs of the development of pathology in the stronger sex

Most of us are familiar with the term pre-infarction condition. This is an emergency condition that precedes necrosis of the muscle tissue of the heart. Usually, given state characterized by well-defined recognizable symptoms.

In addition to the development of cardiac (ischemic) pain at this time, patients may experience panic attacks, a feeling of anxiety, a sudden, extremely severe weakness throughout the body, and some kind of depression.

Unfortunately, today myocardial infarction can increasingly develop non-standardly, bypassing the previous state, starting from the most acute period, in such situations, the consequences of a heart attack in men turn out to be the saddest, since help for such patients is simply late. But what to do, how to determine the development of this pathology and is it possible at all?

It's important to understand! In most cases, ischemia still develops after the appearance of its precursors. And this means that, noticing certain manifestations of the problem, promptly seeking help from doctors, the patient has every chance of surviving!

So, the manifestations of heart problems that should make the patient see a doctor are as follows:

• in the sudden appearance of acute, pressing or squeezing pain behind the sternum;
• ischemic pain can be characterized by irradiation - to the shoulder, shoulder blade, lower jaw on the left;
• the patient may feel a lack of oxygen, severe unreasonable shortness of breath;
• in development panic attacks characterized by the appearance of an unreasonable feeling of fear of death.

If the patient observes the symptoms described above, it is strictly forbidden to stay on his feet (continue to do daily activities), it is important to urgently call an ambulance and just lie down, putting a nitroglycerin tablet under the tongue.

Cases on your own myocardial infarction incredibly rare, they are described in some fairly rare medical sources as a negligible rare exception to the rule. As a rule, this emergency condition makes a person turn to doctors as quickly as possible.

How to independently understand whether it is a heart attack or not?

It is not possible to accurately determine the presence of a necrotic area on the myocardium on its own. Nevertheless, there are a number of symptoms that make it possible to suspect the development of pathology.

These are symptoms such as:

Before providing first aid to a patient, it is extremely important to call an ambulance team, since this emergency requires medical intervention as early as possible.

In the future, first aid to such patients may be to help the patient take a horizontal position, unbutton tight clothes, and give air flow.

You can also put a nitroglycerin tablet under the patient's tongue. Further assistance to patients with suspected development of a heart attack should be provided only by qualified physicians!

Problem Diagnosis

Diagnosis of heart attacks is based on the initial collection of anamnesis (understanding when and how the attack began, how long it lasted, etc.). Secondary examination of the patient, analysis of his condition. Often the condition of such patients may require urgent resuscitation activities.

If the patient's condition allows, for diagnostic purposes, he is carried out:

In addition, such patients quite often for diagnostic purposes may require consultations of other narrow specialists - a neurologist, gastroenterologist, endocrinologist or others.

Clinics where to go

It is important to understand that if symptoms are detected similar to the manifestations of the pathology described, the appeal to doctors should be as soon as possible. That is why, in addition to the name, reputation and qualifications medical institution, it is important to pay attention to its territorial location.

How is life changing?

There are certain pathologies, after the discovery of which, the lifestyle of a particular patient changes dramatically. Myocardial infarction is just such a disease. This emergency condition can often overtake unexpectedly, forcing you to abandon some plans for the future.

The consequences of this pathology most often turn out to be very serious literally for all parts of our body.

The acute stage of the disease is characterized by a violation of the coronary blood flow, necrosis of the heart tissue and can be fatal. If the patient survives, an incredibly long rehabilitation awaits him and, unfortunately, disability.

I must say that the complications of this pathology are often incredibly serious:

But in some rarer cases, after a heart attack, the patient manages to recover almost completely, and then most patients think about measures. secondary prevention to avoid a recurrence of the emergency.

Prevention

Measures of primary (prevention of primary pathology) and secondary (after a previous heart attack) prevention are basically identical. The only difference is that for secondary prevention of the problem, patients may be advised to take certain medications regularly.

General prevention of the development of this emergency condition is:

In conclusion, I would like to say that myocardial infarction is an extremely dangerous pathology, which does not allow joking with it, self-medicating. Finding the first symptoms of pathology, it is important to deliver the patient to the doctor as soon as possible.

But it is best to think about primary prevention problems from the age of forty!

That's right, you can get every chance to never face such a formidable disease!

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Not only a dangerous, but also a very insidious violation in the work of the cardiovascular system is the death of myocardial cells, which causes seizures, and most often the stronger sex becomes the victims of necrosis. The fact that the signs of a heart attack in men appear much more often than in women indicates that they are less careful about their health and have much more bad habits.

When one of the arteries ceases to participate in the process of blood supply due to blockage, an irreversible process of cell death begins, which ultimately leads to the failure of the entire organ. It would seem that such a serious pathology cannot go unnoticed, but in practice, the first signs of a heart attack in men can be so veiled that it is possible to make a diagnosis only after a thorough examination. On the other hand, representatives strong half humanity, the disease still proceeds more clearly than in women, so that if you have basic knowledge of the clinical picture with necrosis, you can understand when you should urgently go to the hospital or call the doctor.

Attention! The final death of tissues occurs extremely quickly - within 20-40 minutes after the blood supply stops, although the symptoms of a heart attack in a man can appear only at the very the last moment when it is no longer possible to save the affected artery.

To belong to stronger sex in itself is not a risk factor for the development of myocardial pathology, but the presence of an abundance of bad habits increases the chances of becoming a "core" several times. No less important are such causes of heart attack in men as:

• bad heredity;
• chronic vascular problems;
• atherosclerosis;
• constant eating of foods high in cholesterol - it accumulates on the walls of the arteries and prevents the passage of blood;
• elevated blood pressure;
• high blood sugar - diabetics are much more likely to suffer from necrotic damage to one or more areas of the heart than other categories. It must be said that the diet after a heart attack for a man with diabetes is much tougher than for people without metabolic disorders;
• obesity at any stage - the presence of excess body weight extremely adversely affects general well-being and on the functionality of the heart muscle, forced to work in the most intensive mode in order to provide organs and systems with oxygen;
• frequent stress and psychological stress.

Interesting! As scientists have recently established, signs of a heart attack often occur in men with a tough and despotic character.

What does it say about the onset of an attack?

Pain of various localization

Due to the fact that your life and well-being directly depend on the timeliness of diagnosing a heart attack, everyone needs to know about the course of the disease at an early stage. And of course, you should not ignore the discomfort, because the symptoms of a heart attack in a man on his legs, if they are not stopped, can move to a more serious stage, which will be evidence of irreversible damage to a significant part of the myocardium. It will be possible to avoid death and significantly increase the chances of full rehabilitation only if you immediately contact the doctors.

So, the first "harbinger" of the necrosis of a part of myocardial cells is pain, which can be of the most diverse nature and localization, although mostly unpleasant spasms are felt in the central or left side of the chest. At the same time, there is a feeling of constriction and burning, which are deployed in one place and gradually move to the shoulders, neck and arms. The appearance of sticky cold sweat and dizziness are no less common signs of a heart attack in men. First aid for the appearance of such a complex of symptoms should be provided without delay, as well as in case of shortness of breath or loss of consciousness.

Important! Ailments sometimes develop long before the transition of the pathology to a critical stage, for example, a few hours before the attack, the patient may experience an incomprehensible fear or pain in the jaw, which is serious reason for worry.

First aid

In order to really help, and not harm your health when an attack occurs, it is advisable not to self-medicate, but at the first symptoms of necrotic damage to the heart muscle, call an ambulance or go to the hospital yourself. Naturally, you can’t drive in this state, but taking a taxi to the nearest medical facility can be much faster than waiting for the doctors at home.

Emergency medical care

A universal remedy for stopping an attack is nitroglycerin (dosage 0.5 milligrams) - it should be taken at intervals of 15 minutes and no more than three times for the arrival of doctors. In addition, it is advisable to chew one aspirin tablet with a dosage of 150-250 milligrams.

Diagnostic specifics

The absence of the same signs of a heart attack in all men is by no means the only obstacle to making an accurate diagnosis. The fact is that the symptoms are very often similar to other diseases, so it is extremely difficult for a non-professional to understand what is happening with his body. The greatest similarity in manifestations is observed with such diseases as:

1. syndrome of "acute abdomen" - very similar to the gastric form and is accompanied by bloating, general weakness, pain in the stomach, increased heart rate;
2. stroke - it is very similar to the cerebral variant, in which confusion of speech and consciousness develops;
3. angina pectoris - approximately ten percent of people with this diagnosis actually have necrosis of the heart tissue.

Pain is forbidden

The general rule, both for the representatives of the stronger sex and for women, is the need to urgently consult a doctor in the presence of retrosternal pain. Even if the discomfort seems insignificant, you should not rely "on chance", because your life is at stake. It is wiser to spend several hours of your time on examination than to suffer the severe consequences of a heart attack, such as pulmonary edema, arrhythmias and pericarditis. It will also be useful to reconsider your lifestyle, getting rid of bad habits and doing regular exercise.

Subject to a prompt response to symptoms, rehabilitation will last much less time, although you will have to get used to the new “rules”, in particular, nutrition after a heart attack for men is prescribed by a doctor and involves the use minimum quantity animal fats and an abundance of vegetables and fruits.

In men, the risk of heart attack increases after the age of forty, but now men in their thirties are also in clinics. According to statistics, in males under the age of 65, the risk of developing this disease is three times higher than in women. Therefore, many people want to know what are the signs of a heart attack in men and what needs to be done first.

The main signs of the disease

Symptoms of a heart attack in men are quite specific and therefore a heart attack can be confused with other diseases. Sometimes there are no signs at all, but if they are, they appear as follows:

— very severe chest pain. It seems to a person that a dagger is thrust into his heart, this is the most important symptom of this disease. The pains are lingering and severe, they can radiate to the shoulder blade and arm, the attacks last ten or fifteen minutes;

— appears cold sweat;

— the skin becomes pale gray;

— weakness is felt and shortness of breath and dizziness appear;

— heart rate becomes faster. You can’t endure pain, you don’t need to rush around the room or try to get to the hospital yourself. It is better to drink nitroglycerin, sit down and lean on the back of a chair, and let your relatives call an ambulance as soon as possible. If the pain does not go away, then you can give the patient more nitroglycerin with an interval of six minutes after the first dose of the medicine, and validol will not help here;

— pressure may rise. The pressure itself can not be reduced during a heart attack in any case, you can chew half an aspirin tablet.

How can a heart attack be masked

In the cinema, we often saw a scene: a person heard bad news, he got worse, he clutched his heart and had a heart attack. But this is only a classic, very often the harbingers of a heart attack in men are completely different:

— toothache starts. The pain may also be in the area of ​​the left jaw. A person believes that he has a toothache and goes to the dentist, and not to the cardiologist, while precious time is lost;

— there is pain in the neck, left arm, elbow and even in the left leg. Attacks go on for ten minutes, or even longer, then everything lets go;

— an attack that looks like asthma. Shortness of breath appears, the person does not have enough air, everything is bubbling in the chest. It may be an "asthmatic" type of heart attack;

— temperature rises for no reason. It can reach up to 38.5 degrees. The patient becomes pale, weakness and sticky sweat appear;

— there is a condition similar to food poisoning . A man begins to have a severe stomach ache, often heartburn, nausea and even vomiting.

If any of the above signs are present, call an ambulance immediately. Doctors will do an ECG and clarify the diagnosis.

You need to know!

The acute period of a heart attack can last one day, or maybe several weeks. At this time, the main signs are weakness, shortness of breath, fever, and the attack itself can happen again. Blood pressure first rises, and then may fall. It also happens that a heart attack passes without symptoms at all. This happens in people with diabetes, they sometimes have anxiety and depression, fainting. Only an ECG will show that there is a problem with the heart. Therefore, doctors insist on an annual preventive examination people from risk groups: smokers, with problematic diseases such as diabetes, overweight and at an age dangerous for a heart attack, that is, after forty years. Men who have survived a myocardial infarction should remember that the risk of a secondary attack is very high and therefore restoring health and a proper lifestyle is very important.

What are the signs of a heart attack?

One of the most difficult human conditions when emergency care is required is myocardial infarction. To prevent the occurrence of irreversible consequences, it is advisable to recognize in advance all the symptoms of this terrible disease. Signs of myocardial infarction are quite specific, but very often they are confused with other diseases that are completely different from it. It also sometimes happens that there are no symptoms of a heart attack at all. Let's look at the most common signs of myocardial infarction, which we very often do not pay attention to.

What is a heart attack

First of all, this is an acute condition, characterized by the necrosis of one of the sections inside the tissues of the heart muscle. It can easily lead to rupture or cardiac arrest. That is why it is necessary to look closely at even the slightest ailment. This disease ranks among the most common causes of death in our country. To really save the patient's life, it is necessary to recognize a heart attack in a timely manner and begin its treatment. Its symptoms directly depend on the degree of localization of the infarct-prone zone itself, which is located inside the heart muscle. Consider the signs of a heart attack, which are most characteristic of the elderly.

The main signs of a heart attack

If a macrofocal infarction occurs, then the necrosis of the myocardial zone, that is, the heart muscle, begins. With the development of this form of myocardium, several stages can be distinguished, characterized by a special set of features. To correctly recognize a heart attack, it is necessary to consider the manifestations of the disease at each stage of its development.

The first signs of a heart attack appear long before a person begins to feel unwell. First, the pressure rises, angina attacks become more and more acute and long. Medications stop helping when such attacks occur. Also, in the period before a heart attack, the patient may feel very restless or, on the contrary, depressed. If angina begins to worsen, then the person should immediately go to the doctor's office. Only timely assistance can prevent the occurrence of a heart attack.

Very often, there is no preinfarction period as such. The disease itself approaches imperceptibly and begins with an acute period. Immediately after the pre-infarction state, an acute period appears, which is fraught with the most deplorable consequences. Signs of a heart attack in women in this period are as follows:

• the appearance of acute pain, which can last up to half an hour. This fact suggests that the infarction begins to absorb more and more extensive areas of the heart muscle that were not previously affected. The pain is more severe and burning than during the pre-infarction state. Also, pain points gradually begin to focus in the area of ​​\u200b\u200bthe chest and pectoral muscles. It also sometimes spreads to the left shoulder, between the shoulder blades and to the thigh. It is in such cases that it can be very difficult to distinguish a heart attack from simple lower back pain. In the case when a person is sick with diabetes, pain in the heart is hardly feasible. Sometimes there is even no pain at all. Thus, recognizing the attacks of the disease becomes even more difficult;
• after an attack, the patient begins to feel restless, weak, shortness of breath does not allow him to relax and feel safe. As for the skin, it becomes paler and covered with a rather cold sweat. The pressure either rises or falls, so very often a person faints or feels severe dizziness.

Signs of a heart attack in men are no different from female signs this disease. However, atypical signs of myocardial infarction also occur very often. Sometimes the focus of pain does not occur in the chest cavity. In this case, it becomes very difficult to detect the disease at an early stage.

For example, there is an abdominal type of heart attack, when the pain is concentrated only in the upper abdomen. Sometimes this process is accompanied by nausea, hiccups and vomiting. It is also very rare that pain occurs in the neck, jaw and throat.

As for the acute period, it lasts at least several of them, and during this time period the infarction zone is disconnected from the rest of healthy tissues. The main symptoms in this case are the appearance of heart failure and fever. Also, after a while, a heart attack may recur.

When under acute period myocardial infarction, the final formation of the infarct zone occurs, as well as the replacement of dead tissues with scars made up of connective tissue. This period lasts a month or more. Signs of heart failure remain, and the temperature drops sharply and returns to normal. Over a certain period of time, there is an increase in blood pressure. If the angina attacks have stopped, then this is a favorable sign. Thus, the patient may not be afraid of the recurrence of a heart attack.

After the subacute period stops, the post-infarction stage appears, which can last up to six months. During given period the scar is fully formed, and the part of the heart muscle that remained intact begins to work more efficiently. Blood pressure and pulse begin to work more efficiently, and the symptoms of heart failure disappear completely.

These are the main symptoms of a macrofocal heart attack. To find out in advance whether you are susceptible to this disease, we advise you to do an ECG regularly. Signs of myocardial infarction can appear at any time, so you should always meet them fully armed.

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Causes of a heart attack

The causes of myocardial infarction are different. main reason the occurrence of heart disease is atherosclerosis and the violation of blood circulation in the coronary vessels that occurs on its basis. The plaques that fill the vessels contribute to the deformation of their walls, which can collapse and cause vasospasm and thrombosis.

Some parts of the heart muscle die as a result of lack of oxygen. It is believed that heart attacks are more common in men. This is probably due to the fact that they have more reasons for the appearance of this disease.

More often, a heart attack occurs in men who have poor heredity, abuse alcohol, and smoke.

People who don't move much are overweight, putting extra stress on the heart muscle, which works hard to supply oxygen to the organs. Elderly men fall into the risk group, although in recent years young people from thirty years of age have been treated to the hospital with a diagnosis of myocardial infarction.

One of the causes of the disease is unbalanced diet, the use of fatty, spicy, fried and smoked foods, which leads to an increase in cholesterol levels, and it, in turn, is deposited on the walls of blood vessels, narrowing them and making it difficult for blood to pass.

Men with diabetes and high blood pressure are much more likely to have a heart attack. Important causes of heart attack in men are stressful conditions and psychological stress, because men are predisposed to rivalry, confrontation, disputes and pay less attention to the prevention and treatment of diseases that become chronic.

Symptoms of a heart attack in men

Sometimes myocardial infarction in men does not have pronounced signs, so seeking help from a doctor is belated. Attentive attitude to your health, the ability to recognize the first signs of a heart attack in men, to know all the symptoms that precede the disease, to start treatment on time will help to avoid many complications, and maybe even death.

Strong sharp or pressing pains incipient heart attack, behind the chest on the left, radiating to the arm, shoulder blade, neck, and even to the lower jaw during physical exertion. The pain goes away after a short period of time.

Later, they may again make themselves felt. Shortness of breath may appear, it is difficult for a person to breathe, there is not enough oxygen, he cannot breathe deeply. These are manifestations of an asthmatic heart attack.

Some patients are characterized by an increase in temperature to 39 degrees and above, then a drop in temperature, the appearance of intense sweating, weakness, dizziness. Mistakenly, these symptoms are mistaken for the development of colds.

People at risk should immediately contact a cardiologist for examination. If you ignore the first symptoms that appear, developmental attacks may begin. acute infarction.

In addition to the severe burning pains described above, the person sweats heavily, a feeling of a foreign object appears in the chest and gurgling is heard, nausea begins, the head is very dizzy, there may be fainting, a feeling of fear for one's life comes, an understanding that something serious is happening in the body.

The pains disappear after forty minutes, and then, after fifteen or twenty minutes, they resume again. Similar signs A heart attack in men should not only be alarming, it is necessary to urgently call an ambulance, explaining that the patient has a heart attack so that a team with cardiological services can leave.

Before the arrival of emergency care, the patient needs rest. It must be carefully laid, unbuttoning the gate, open a window or window leaf, so that Fresh air put nitroglycerin under the tongue. With an increase in pressure, the patient can be given half an aspirin tablet. After 5 minutes, if there is no ambulance yet, another nitroglycerin tablet should be given.

Symptoms of myocardial infarction in men may be atypical, which are more like disorders digestive tract. There may be nausea, sometimes accompanied by vomiting, heartburn, severe pain in the abdomen. Such symptoms of myocardial infarction mislead not only patients and their loved ones, but also doctors. Therefore, a comprehensive examination is necessary to make an accurate diagnosis and prescribe the correct treatment.

Signs of myocardial infarction in men are not the same, and if you do not pay attention to them, self-medicate, then this can cause death from a formidable illness.

With a heart attack, an increase in pressure is initially observed even in those who have never had high rates. Then it returns to normal, and after a while it rises again. During a heart attack, you can’t knock it down on your own, the doctor strictly monitors this so that there is no deterioration.

With a fuzzy manifestation of signs of a heart attack, a person can suffer the disease on his legs. This can lead to pulmonary edema and re-infarction. Having found a deterioration in well-being, a sharp drop in blood pressure, noticing blanching of the skin, feeling arrhythmic disorders, it is urgent to visit a cardiologist who, having established the correct diagnosis, will prescribe competent treatment.

Diagnosis of myocardial infarction

To establish the correct diagnosis, the patient undergoes some procedures:

1. Electrocardiography, which determines the location of the lesions, their size and the amount of time the disease progresses. ECG is carried out every half an hour to establish a more detailed monitoring of the development of the disease.
2. Be sure to do a biochemical blood test, which shows the presence of special markers that are a sign of a heart attack.
3. Additionally, echocardiography is performed, with the help of which some details of the disease and the presence of angina pectoris and coronary heart disease are clarified.
4. If the disease is complicated, then it can lead to stagnation in the lungs. It is recognized on X-ray.

Treatment and prevention of myocardial infarction

After establishing correct diagnosis the doctor prescribes medication. Eliminate heart pain, improve blood circulation, have a dilating effect on blood vessels and reduce the load on the heart nitroglycerin, isosorbitol, mononitrate.

Painkillers are suitable for the localization of pain. To achieve a quick result, narcotic analgesics are used. All patients are prescribed thrombolytic drugs, which activate blood flow to the heart and break down blood clots.

In order for blood clots to dissolve and the blood to become thinner, in order to avoid stress on the heart and to normalize biochemical processes, beta-blockers are prescribed: toprol, inderal, which begin to be taken with minimum dose gradually increasing to normal. These are acetylsalicylic acid, heparin, warfarin. Reduce cholesterol statins, niacins, fibrates.

After the postponed massive heart attack men may experience both acute and long-term effects. acute pain include:

• Heart failure, when the left side of the heart is damaged by a heart attack. It is poorly reduced due to the presence of a scar. As a result, the blood stagnates, its release decreases, and the internal organs are poorly supplied with blood.
• Pulmonary edema. Then the patient suffocates, coughs, he does not have enough air, shortness of breath appears.
• Arrhythmia that occurs in the left ventricle of the heart.
• Thrombosis. Blood clots travel through the blood vessels throughout the body to the brain.
• Rupture of the heart occurs as a result of a large tension of blood on the heart muscle damaged by a heart attack.

Long-term effects have a lesser effect on the patient's body, these are:

• cardiosclerosis, which appears due to poor circulation;
• left ventricular failure, which is manifested by cardiac asthma and circulatory disorders;
• arrhythmia atrioventricular or sinoatrial blockade;
• pericarditis - inflammation of the serous membrane of the heart;
• heart aneurysm;
• postinfarction syndrome;
• thromboendocarditis;
• neurotrophic changes in the myocardium.

All these consequences do not pass without a trace, and over time, the process of resumption of blood clots may begin, the work of the heart worsens and the risk of heart rupture increases. Effects past illness can negatively affect the nervous system. Men have cases of aggressive behavior, they often become depressed.

In such cases, it is necessary to visit a psychologist so that they can look to the future with optimism. The recovery period can last several months, or it can last several years.

A heart attack can be prevented. Patients who have had this disease need to change their attitude to life, forget about bad habits, give up smoking and alcohol forever. Protect the nervous system from stress, depression.

It will not be superfluous to do feasible sports, guided by the recommendations of a cardiologist. You can not overload yourself with physical work, it is imperative to alternate it with rest. Shown sanatorium rest and treatment. Proper nutrition also plays an important role in the prevention of disease and helps in a speedy recovery.

You need to give up fats, except plant origin. It is allowed to use steam or boiled white poultry meat, sea ​​fish. Salt should be used limited quantity. Fresh vegetables and fruits are very useful and rich in vitamins. It is forbidden to use salty, spicy, smoked, fried foods. Do not consume alcohol, coffee and products containing caffeine.

Men who have experienced an acute myocardial infarction should not forget that a second attack may occur, which will further worsen health and can lead to lethal outcome Therefore, you need to take care of restoring your health and lead a proper lifestyle.

Myocardial infarction occurs due to the fact that insufficient blood is supplied to the heart, as a result, heart muscle cells die due to oxygen starvation. The connective tissue formed in their place is not able to contract, as a result, the heart does not work properly, and the state of human health worsens. Symptoms of a heart attack in women begin to appear a few months before its onset. Properly carried out preventive work to improve overall health can fundamentally change the picture of predicted events and prevent complications.

Signs of a heart attack

According to WHO statistics, myocardial infarction in women under 30 years of age occurs several times less than in men. But every year the statistics change, and women over 50 with the onset of menopause become the main risk group. Signs of a heart attack in women can be distant and approximate.

Long-term symptoms appear as follows.

1. Sudden onset of chronic, for no apparent reason, fatigue. Even a long rest cannot bring relief. This is caused by poor blood supply to the heart.
2. Sleep disorders that manifest as insomnia.
3. A few months before the onset of a heart attack, a woman begins to have non-falling edema. At the same time, the legs swell especially strongly, since weak cardiac activity does not allow the organs to function normally.
4. Constant shortness of breath and shortness of breath are signs of an approaching heart attack in a woman. Pain in the region of the heart during any physical work. Difficulty breathing when walking. When visiting a doctor, angina pectoris is diagnosed.
5. Feeling of discomfort and inexplicable anxiety, bouts of fear, ending in the release of cold and clammy sweat. This is caused by an uneven rhythm of the heart, a cardiologist in such situations diagnoses an arrhythmia caused by a malfunction of the coronary artery.
6. Loss of appetite, constant heartburn, feeling of fullness in the stomach.

Particular attention should be paid to pain in the chest and heart, which spread to the arm, shoulder and upper back. These symptoms can appear 1-1.5 months before the onset of a heart attack.

Approximate character

With the transition of the disease from the chronic stage to the acute form pain amplify, and a number of new ones are added to them. The time to call an ambulance remains minimal - no more than 20 minutes. Knowing what are the signs of a heart attack in a woman will provide first aid during an attack.

1. A sharp decrease in pressure, even in people with hypertension:

• gait becomes unsteady;
• darkens in the eyes;
• weakness appears.

1. A feeling of heaviness and constriction arises in the chest, which cannot be removed even by taking special means.
2. Attacks of shortness of breath pass to the stage of suffocation. The woman catches her breath and loses consciousness. These are the first signs of acute heart attack in women.
3. Upper limbs suddenly lose sensation. It becomes impossible to take the object in hand.
4. With the rapid progression of the disease, a woman sharply loses speech and coordination of movements.
5. In the end, the brain does not receive the necessary amount of oxygen, and the patient experiences constant feeling fear and panic.
6. Body temperature drops to the maximum allowable, and the woman is covered with sticky sweat.

In diagnosing a heart attack, ordinary people can easily make a mistake, since it is easy to confuse it with large quantity a variety of diseases such as asthma, pancreatitis or with ophthalmic changes.

Types of heart attack

If a young or elderly woman develops any of these symptoms, both distant and approximate, it is urgent to undergo a medical examination. Only under these conditions, the doctor will be able to accurately diagnose and distinguish the first signs of a heart attack, even if they manifested themselves outside the box.

1. The most common asthmatic form of a heart attack:

• attacks begin in the same way as with bronchial asthma;
• occur at night during sleep;
• in the chest area there is a gurgling similar to a beginning cough;
• pulmonary edema may develop.

1. If during a heart attack there is pain in the abdomen, accompanied by hiccups, heartburn, and even nausea with vomiting, then the attack is gastralgic in nature:

• the picture of the approaching attacks of a heart attack is similar to food poisoning;
• often causes late detection of heart disease.

1. If the signs of the disease approach from the side nervous system, then the cerebrovascular form of the development of the disease manifests itself:

• dizziness;
• loss of consciousness;
• possible paralysis.

1. The arrhythmic form is characterized by cardiac arrhythmias.

But the most dangerous is the painless form, which manifests itself too late and therefore threatens the life of the patient. A similar manifestation occurs in women with diabetes.

Risk group

There are a number of reasons why girls and women are at risk of getting a heart attack:

• genetic predisposition of a woman;
• sedentary lifestyle, office work;
• kidney disease congenital or acquired in childhood;
• alcohol abuse and smoking;
• obesity of a high degree;
• hypertension and rheumatic diseases;
• vascular atherosclerosis or diabetes mellitus;
• regular stress and nervous tension, overload, emotional breakdowns.

The causes of myocardial infarction may be associated with other circumstances:

• pathological spasm of the artery of the heart after an attack of angina pectoris;
• a complication that appeared as a result of an incorrectly performed operation on the vessels;

If a woman knows that she is at risk, then she should be regularly examined by highly specialized specialists.

The main manifestations of an attack

Attentive attitude to one's own feelings and knowledge of what are the harbingers of a heart attack will make it possible to notice its approach by the first symptoms and avoid an attack.

1. Pressing pain behind the sternum, extending into left side chest and extending to the shoulder.
2. Heaviness in the left arm and tingling along its entire length from the shoulder to the hand, occasionally turning into a burning sensation.
3. Pain sensations occur with a certain frequency and are not drowned out by drugs - these are signs of an approaching heart attack.
4. Difficulty breathing even at rest.
5. Increased perspiration during chill. The skin is cold, and the sweat is sticky.
6. Numbness of the hands, beginning in the fingers.

Others may notice that a woman at home behaves as if drunk. She begins to lose coordination, slurred speech appears. This is the most dangerous moment, as it indicates a complete lack of oxygen access to the heart muscle. A person in this condition should be urgently hospitalized.

What to do if called Ambulance long time not coming? Before her arrival, one should try to provide all possible assistance to the patient.

1. Vigilantly monitor the woman's pulse and blood pressure.
2. In case of cardiac arrest, make a strong sharp blow to the chest with a fist.
3. Then carry out artificial respiration with simultaneous heart massage:

• inhalation of air into the mouth of the victim with a pinched nose;
• 4 shocks in the region of the heart.

1. Ventilation and massage should be carried out without stopping until the patient begins to breathe on his own, or until the arrival of specialized assistance.

Consequences of a heart attack

Heart - main body human body, and the consequences of myocardial infarction are largely irreversible.

1. Violation of the blood supply to the heart causes necrosis of its sections.
2. The scar formed instead of damaged fibers causes arrhythmia.
3. The consequence of a heart attack can be a subsequent rupture of the heart. A condition characterized by a violation of the integrity of the walls of the body and the instant death of the patient.

The characteristic signs of myocardial infarction in women who have had it remain for a long time, but with adequate treatment, many of the consequences can be smoothed out:

• Regular attacks of suffocation and frequent breathing.
• Typical for people with heart disease, pale skin and cyanotic color of the mucous membranes, indicating a lack of oxygen.
• The woman constantly complains of nausea, pain and disruption in the rhythm of the heart, high blood pressure.
• Neuroses may be observed.
• On the part of the internal organs, there is an increase in the liver.
• A couple of weeks after a heart attack, an aneurysm of the heart appears, inflammatory processes in the blood, and a slight increase in temperature.
• After the disease, a post-infarction syndrome may develop, which is dangerous by aggravating the severity of the disease with the imposition of polyarthritis, pneumonia, pleurisy, leukocytosis and fever and joint pain.

Recovery

To reduce the risk of subsequent complications after a disease, it is necessary to undergo a rehabilitation course, the program of which is compiled for each woman individually based on the analyzes and observations of a doctor.

1. A maintenance course of taking pharmacological preparations is mandatory. This treatment contributes to the stabilization of blood pressure and normalization of the heart rhythm.
2. To maintain the normal functioning of the heart muscle, a large amount of vitamins is required. To do this, you need to reduce the consumption of fatty foods and increase the amount of vegetables and fruits. To normalize blood pressure and heart function, you should avoid drinking coffee, strong tea, alcohol and smoking.
3. Continuous implementation of special exercise guarantees normal access of oxygen to the heart, even after an illness.

What can be confused with a heart attack?

Women suffering from chronic forms of diseases of the internal organs or diseases associated with disorders of the endocrine system may not pay attention when a heart attack begins, due to the similarity of symptoms.

1. Respiratory spasms and sensations of lack of air are similar to an attack of bronchial asthma. However, this condition is removed by taking a special medicinal product or breathing exercises, and the pre-infarction state does not go away from this.
2. Strong pain syndrome in the abdomen, vomiting, nausea accompany an attack of appendicitis and pancreatitis. All these symptoms in women require immediate hospitalization, so the diagnosis will be made by specialists in a medical institution.
3. Dizziness, pain in the sternum, in the region of the heart and in the shoulder, pain under the shoulder blade are well known to people suffering from neuralgia and osteochondrosis. The condition differs in that during an attack of a heart attack, the pain does not spread to the shoulders and ribs, as with neuralgia.

It makes no sense to try to relieve pain during a heart attack and treat it yourself, since it does not stop. This disease is treated only in a hospital. To prevent serious health problems, it is imperative to take measures that involve preventing the development of a heart attack in a woman.

You can learn more about heart attack in women from the video:

All about myocardial infarction

Everyone understands that myocardial infarction is the most severe heart disease leading to disability or death of the patient. But not everyone has an idea about the causes of acute myocardial infarction, its exact symptoms and the order of development. It is worth considering these issues in more detail in order to prevent such serious problems with heart.

Myocardial infarction - what kind of disease?

In a science such as cardiology, myocardial infarction is recognized emergency associated with acute failure of blood flow in the vessels of the heart. The disease is one of the forms of coronary artery disease - coronary heart disease, and half of men and a third of older women have such a diagnosis. If angina pectoris pain in coronary artery disease is a sign familiar to many, which can be dealt with with the help of pills, then in case of a heart attack without emergency hospitalization, the case can be fatal.

So what is a myocardial infarction, when can it happen? The disease occurs when there is a violation of the blood supply to the heart muscle, in the area of ​​\u200b\u200bwhich oxygen ceases to flow. Such a failure is reversible only in the first 10-15 minutes, then myocardial cells die off - a heart attack itself occurs. The risk of death of the patient is highest during the first two hours, when myocardial necrosis (death) progresses. If a person enters the intensive care unit for treatment on time, intensive monitoring and timely administration of drugs, physiotherapy, the risk of death is rapidly reduced.

How common is myocardial infarction?

The urgency of the problem, based on the data on IHD statistics, is very high. In recent years, acute myocardial infarction (AMI) occurs even in the fourth decade of life, mainly in men. The reason is this: in the stronger sex, atherosclerosis occurs more often, and at a younger age (hormones protect women from pathology before menopause). By the age of 60, the incidence of heart attacks becomes the same regardless of gender (approximately 3-6 cases per 1,000 population).

With an extensive area of ​​necrosis, most patients die, half before arriving at the hospital. 1/3 of the surviving patients die from repeated heart attacks that occur in the period from several days to a year, as well as from complications of the disease. Average mortality is about 30-35%, of which 15% is sudden cardiac death. Only living in some countries (Japan, Mediterranean countries), due to the peculiarities of nutrition, guarantees less sad statistics.

Causes of myocardial infarction

The etiology of myocardial infarction is 97% due to the presence of atherosclerosis of the arteries. Blockage of blood vessels causes progressive insufficiency of blood supply - over time, a person develops coronary artery disease. The acute form of coronary artery disease, when the myocardium affects a heart attack, occurs when there is a sharp violation of blood flow along one of the branches of the cardiac (coronary) arteries. This occurs when an atherosclerotic plaque breaks off and then moves to the heart.

Much less often, the etiology and pathogenesis of a heart attack are associated with other cardiac pathologies. They cause a prolonged vasospasm with the development of a site of necrosis. Such reasons may be:

• Endocarditis
• Arteritis
• Heart disease
• Organ injury

How does this disease develop?

The pathogenesis of myocardial infarction is directly related to advanced forms of atherosclerosis. With this pathology, plaques from cholesterol and other lipids appear on the walls of large vessels. When calcium is deposited on the plaque, it seems to be fixed, and the risk of its detachment is reduced. Fatty plaques that are not firmly attached to the walls can come off at any moment and turn into a “traveling” embolus.

plaque inside coronary vessel may not come off, but be damaged, causing inflammatory process and trauma to the arterial wall. The place of damage to the vessel is immediately sealed blood clot- a thrombus occurs. Thus, both a thrombus (closing the lumen of a coronary vessel) and an embolus, an atherosclerotic plaque that has come off from any other part of the body, can clog a vessel during myocardial infarction.

In the future, with a heart attack, the following occurs:

• A blood clot or fatty plaque closes the vessel
• In the artery, blood flow is completely stopped or partially disturbed
• Myocardial oxygen supply drops sharply
• Myocardial cell death begins

Often, the pathology is called "ischemic heart attack in the heart", because ischemia is oxygen starvation of tissues. The larger the non-functioning branch of the artery, the larger the zone of myocardial infarction.

Risk factors for developing the disease

Everything about possible heart attack everyone needs to know, but some people have a higher risk of developing pathology. So, the integrity of atherosclerotic plaques is more often violated in those who suffer from hypertension and arrhythmia. A disease such as myocardial infarction can occur against the background of severe stress, protracted nervous shocks, emotional experiences and depression (in the presence of atherosclerosis).

It is believed that a heart attack is more likely to occur in the morning, when rest is replaced by activity. Excessive physical activity is also recognized as a risk factor for the development of pathology. The risk of a heart attack increases many times over in the presence of the following factors, especially two or more:

• Smoking
• Elevated blood cholesterol
• Passive lifestyle
• Diabetes
• Ischemic disease
• Unfavorable heredity (heart attacks in relatives)
• Ineffective treatment of heart disease, refusal of pills
• Previous heart attack
• Unstable angina
• Alcohol abuse
• Hormonal fluctuations

In medicine, a kind of "standard" of a patient entering treatment with a myocardial infarction has developed - a man over 55 years old, smoking, overweight, hypertension and a number of chronic diseases of the heart and blood vessels. But this definition is, of course, not exhaustive. By the way, the risk of a heart attack persists for 3 years after quitting smoking, and the most dangerous hypertension is the one that causes an increase in pressure in excess of 150/90 mm Hg.

Forms of the disease

There are several classifications for myocardial infarction. Conducting a detailed diagnosis and making an accurate diagnosis is very important for selecting a treatment regimen (surgery, physiotherapy, drugs) and determining the prognosis. According to the size of the affected area of ​​the myocardium, all heart attacks are divided into:

1. Large focal. Cell necrosis extends to the entire thickness of the myocardium.
2. Small focal. Necrosis does not cover the entire layer of the heart muscle.

In a third of patients, the occurring small-focal infarction is transformed into a large-focal one, the treatment of which is more complicated, and the risk of heart rupture, acute heart failure is much higher. There is another classification of infarcts according to the depth of myocardial necrosis:

1. Transmural - covers the myocardium to the full depth.
2. Intramural - striking inner part muscles.
3. Subepicardial - develops in that layer of the myocardium that is adjacent to the outer one.
4. Subendocardial - extends to the inner shell of the organ.

According to the time of occurrence, the disease is primary, recurrent (within 2 months after the primary), repeated (2 months later from the primary). A heart attack can be uncomplicated or complicated. The complex of symptoms, or syndromes of myocardial infarction, can also be different, so the classification includes such forms:

• Typical (with pain syndrome of usual localization)
• Atypical (pulmonary, cerebral, abdominal, associated with arrhythmia, painless, obliterated)

By finding the area of ​​necrosis in a heart attack, it is differentiated into left ventricular, right ventricular, combined.

Periods of a heart attack

The standard of treatment for myocardial infarction varies not only from the type and severity of the disease, but also from the period in which the patient was admitted to the hospital department. There are 5 periods according to which pathology develops:

1. Prodromal, or preinfarction state. It lasts from an hour to a week or more, in some patients it is absent. Small foci of ischemia are formed, which later transform into zones of necrosis.
2. Acute (20 minutes - 2 hours). Oxygen starvation increases, foci of necrosis appear.
3. Acute (2-10 days). The zone of necrosis partially resolves, but new areas of myocardial damage may join.
4. Subacute (4-8 weeks). At the site of necrosis, a scar appears - a granulation area.
5. Postinfarction (up to six months). The heart "learns" to work in new conditions, the scar thickens.

Symptoms of myocardial infarction

Only in 40% of patients the pathology develops rapidly, without preliminary manifestations and warning signs. In other patients, a suspicion of a heart attack occurs earlier - pain in angina pectoris intensifies and becomes more frequent, they are poorly stopped by taking Nitroglycerin. On the this stage it is important that the son, a relative deliver the patient to a cardiological hospital. Conducted medication or physiotherapy will help prevent an approaching heart attack.

What are the symptoms of myocardial infarction in the acute period? A typical course of pathology includes the following symptom complex:

• Severe pain in the chest - piercing, cutting, stitching, bursting, burning
• Irradiation of pain in the neck, left shoulder, arm, collarbone, ear, jaw, between the shoulder blades
• Fear of death, panic
• Shortness of breath, chest tightness
• Weakness, sometimes loss of consciousness
• Paleness, cold sweat
• Blue nasolabial triangle
• Pressure rise, then fall
• Arrhythmia, tachycardia

The attack of pain from a heart attack is stronger, the larger the affected area. The duration of the pain syndrome is different, sometimes up to several days. The main standard for distinguishing heart attack pain from angina pain is the lack of effect from taking nitrates. All of these symptoms are characteristic of the acute period. In the acute period, the pain subsides (sometimes it persists - if complications develop), but fever, blood pressure failures, signs of heart failure join. In the substroke period, all symptoms subside, heart murmurs do not appear, the condition stabilizes.

Atypical heart attack - symptoms

An urgent problem in recent years is atypically developing forms of pathology, which are difficult to diagnose and prescribe treatment in time. They can disguise themselves as a variety of diseases, while they are more typical for women, diabetics and for people over 75 with advanced forms of atherosclerosis. Often, pain from a heart attack is localized in the epigastrium, resembling an exacerbation of gastritis. At the same time, the abdomen swells, painful when palpated, the muscles of the peritoneum are tense.

In some people, a heart attack begins with a dry cough, chest congestion, shortness of breath, which is more typical for chronic lung pathologies. Sometimes pain in the defeat of the heart does not appear in the chest, but in the cervical spine, in the fingers of the left hand. A heart attack can manifest itself as edema, arrhythmia, dizziness in the absence of typical pain in the heart. A painless heart attack may involve only mild chest discomfort and sweating and is sometimes detected incidentally on an ECG.

Possible consequences of pathology

What awaits a person if he has a myocardial infarction - what is it, and what are the consequences? The likelihood of complications is high if first aid, drug treatment, physiotherapy, surgery or other methods were not timely. The danger of the disease lies in its unpredictability, so it is difficult to give an accurate forecast for survival. Most often, complications develop with:

• Large area and depth of damage to the heart muscle
• Locations on the anterior wall of the ventricles
• Too much late recovery coronary blood flow

After a heart attack, part of the myocardium is converted into connective tissue, so the contractility of the organ decreases, and heart failure occurs. As a result, arrhythmias can develop, some of which are deadly and cause cardiac arrest. Due to the increase in the need for oxygen, taking into account the poor functioning of the heart, arterial hypertension appears.

In some patients, after a heart attack, an inflammatory process occurs in the heart sac. Patients with complications such as an aneurysm of the heart, a rupture of the septum between the ventricles have practically no chance of survival without urgent surgery. A person can also die from thromboembolism pulmonary artery- it happens in 2% of situations after a heart attack. The earliest severe complication cardiogenic shock, it is diagnosed when more than 50% of the myocardium is affected. Myocardial infarction without complications has a favorable prognosis, patients, for the most part, recover.

Myocardial infarction: causes, first signs, help, therapy, rehabilitation

Myocardial infarction is one of the forms of coronary heart disease, which is necrosis of the heart muscle, caused by a sharp cessation of coronary blood flow due to damage to the coronary arteries.

Heart and vascular diseases continue to occupy the leading position in terms of the number of deaths worldwide. Every year, millions of people are faced with one or another manifestation of coronary heart disease - the most common form of myocardial damage, which has many types, invariably leading to disruption of the usual way of life, disability and taking life a large number sick. One of the most common manifestations of IHD is myocardial infarction (MI), at the same time, it is the most common cause of death in such patients, and developed countries are no exception.

According to statistics, about a million new cases of myocardial infarction are registered per year in the United States alone, about a third of patients die, and about half of the deaths occur within the first hour after the development of necrosis in the myocardium. Increasingly, among the sick there are able-bodied people of young and mature age, and there are several times more men than women, although by the age of 70 this difference disappears. With age, the number of patients is steadily increasing, among them more and more women appear.

However, one cannot fail to note the positive trends associated with a gradual decrease in mortality due to the emergence of new diagnostic methods, modern methods of treatment, as well as increased attention to those risk factors for the development of the disease that we ourselves are able to prevent. Thus, the fight against smoking at the state level, the promotion of the basics of healthy behavior and lifestyle, the development of sports, the formation of public responsibility for their health significantly contribute to the prevention of acute forms of coronary artery disease, including myocardial infarction.

Causes and risk factors for myocardial infarction

Myocardial infarction is a necrosis (necrosis) of a section of the heart muscle due to complete cessation blood flow through the coronary arteries. The reasons for its development are well known and described. The result of various studies of the problem of coronary heart disease has been the identification of many risk factors, some of which do not depend on us, while others can be excluded from our lives.

As you know, hereditary predisposition plays an important role in the development of many diseases. Ischemic heart disease is no exception. Thus, the presence among blood relatives of patients with IHD or other manifestations of atherosclerosis significantly increases the risk of myocardial infarction. Arterial hypertension, various metabolic disorders, such as diabetes mellitus, hypercholesterolemia, are also a very unfavorable background.

There are also so-called modifiable factors that contribute to acute coronary heart disease. In other words, these are the conditions that can either be completely eliminated or significantly reduce their influence. At present, thanks to a deep understanding of the mechanisms of the development of the disease, the emergence of modern ways early diagnosis, as well as the development of new drugs, it became possible to deal with disorders of fat metabolism, maintain normal blood pressure and blood sugar levels.

Do not forget that the exclusion of smoking, alcohol abuse, stress, as well as good physical shape and maintaining adequate body weight significantly reduce the risk of cardiovascular pathology generally.

The causes of heart attack are conventionally divided into two groups:

1. Significant atherosclerotic changes in the coronary arteries;
2. Non-atherosclerotic changes in the coronary arteries of the heart.

The problem of atherosclerosis today is becoming rampant and is not only medical, but also social in nature. This is due to the variety of its forms, the manifestations of which can significantly complicate the life of such patients, and are also potentially fatal. Thus, coronary atherosclerosis causes the appearance of coronary heart disease, one of the most severe variants of which will be myocardial infarction. Most often, patients have simultaneous damage to two or three arteries supplying blood to the heart muscle, while the magnitude of their stenosis reaches 75% or more. In such cases, the development of an extensive heart attack of the heart, affecting several of its walls at once, is very likely.

Much more rarely, no more than 5-7% of cases, non-atherosclerotic changes in the vessels supplying it can act as the cause of myocardial infarction. For example, inflammation of the arterial wall (vasculitis), spasm, embolism, congenital anomalies vascular development, a tendency to hypercoagulability (increased blood clotting) can also lead to impaired blood flow in the coronary arteries. The use of cocaine, unfortunately, quite common, including among young people, can lead not only to severe tachycardia, but also to significant spasm of the arteries of the heart, which is inevitably accompanied by malnutrition of its muscle with the appearance of foci of necrosis in it.

It should be noted that only a heart attack resulting from atherosclerosis is an independent disease (nosology) and one of the forms of coronary artery disease. In other cases, when there is a non-atherosclerotic lesion, myocardial necrosis will be only a syndrome complicating other diseases (syphilis, rheumatoid arthritis, mediastinal injuries, etc.).

There are certain differences in the occurrence of myocardial infarction depending on gender. According to various data, in men aged 45-50 years, a heart attack occurs 4-5 times more often than among the female population. This is due to the later occurrence of atherosclerosis in women due to the presence of estrogen hormones that have a protective effect. By the age of 65-70, this difference disappears, and about half of the patients are women.

Pathogenetic mechanisms of myocardial infarction development

In order to understand the essence of this insidious disease, it is necessary to recall the main features of the structure of the heart. Since school, each of us knows that it is a muscular organ, the main function of which is to pump blood into the systemic and pulmonary circulation. The human heart is four-chambered - it has two atria and two ventricles. Its wall consists of three layers:

• Endocardium - the inner layer, similar to that in vessels;
• Myocardium - the muscle layer on which the main load falls;
• Epicardium - covers the outside of the heart.

Around the heart is the cavity of the pericardium (cardiac shirt) - a limited space containing a small amount of fluid necessary for its movement during contractions.

In myocardial infarction, the middle, muscular layer is necessarily affected, and the endocardium and pericardium, although not always, are often also involved in the pathological process.

The blood supply to the heart is carried out by the right and left coronary arteries, which branch directly from the aorta. The closure of their lumen, and especially when collateral (bypass) paths of blood flow are poorly developed, is accompanied by the appearance of foci (foci) of ischemia and necrosis in the heart.

It is known that the basis of the pathogenesis, or mechanism of development, of acute myocardial infarction is atherosclerotic damage. vascular wall and the resulting thrombosis and arterial spasm. The sequence of development of pathological changes is expressed by the triad:

1. Rupture of lipid plaque;
2. Thrombosis;
3. Reflex vasospasm.

Against the background of atherosclerosis, in the walls of the arteries supplying blood to the heart, there is a deposition of fat-protein masses, which eventually grow into connective tissue with the formation of a fibrous plaque that protrudes into the lumen of the vessel and significantly narrows it. In acute forms of coronary artery disease, the degree of narrowing reaches two-thirds of the diameter of the vessel and even more.

An increase in blood pressure, smoking, intense physical activity can provoke plaque rupture with damage to the integrity of the inner lining of the artery and the release of atheromatous masses into its lumen. A natural reaction to damage to the vascular wall in such a situation is thrombosis, which, on the one hand, defense mechanism designed to eliminate the defect, and on the other - playing leading role in the cessation of blood flow through the vessel. Initially, a thrombus forms inside the damaged plaque, then spreads to the entire lumen of the vessel. Often, such thrombi reach 1 cm in length and completely close the affected artery with the cessation of blood flow in it.

When a thrombus is formed, substances are released that cause vasospasm, which can be limited or cover the entire coronary artery. At the stage of spasm development, an irreversible and complete closure of the lumen of the vessel and the cessation of blood flow occur - occlusive obstruction, which leads to inevitable necrosis (necrosis) of the area of ​​the heart muscle.

The last one is especially pronounced. pathogenic mechanism the appearance of necrosis in the heart with cocaine addiction, when even in the absence of atherosclerotic lesions and thrombosis, a pronounced spasm can cause complete closure of the lumen of the artery. The likely role of cocaine should be kept in mind when a heart attack develops in young and previously healthy people who had no signs of atherosclerosis before.

In addition to the described main mechanisms for the development of myocardial infarction, various immunological changes, an increase in blood coagulation activity, and an insufficient number of bypass (collateral) blood flow paths can have an adverse effect.

Video: myocardial infarction, medical animation

Structural changes in the focus of myocardial necrosis

The most common location of myocardial infarction is the wall of the left ventricle, which has the greatest thickness (0.8–1 cm). This is due to a significant functional load, since blood is pushed out from here under high pressure into the aorta. In the event of trouble - atherosclerotic damage to the wall of the coronary artery, a significant amount of the heart muscle remains without blood supply and undergoes necrosis. Most often, necrosis occurs in the anterior wall of the left ventricle, in the posterior, at the apex, and also in the interventricular septum. Heart attacks of the right side of the heart are extremely rare.

The zone of myocardial necrosis becomes visible to the naked eye after 24 hours from the onset of its development: a reddish, and sometimes gray-yellow area appears, surrounded by a dark red stripe. With a microscopic examination of the affected heart, a heart attack can be recognized by detecting destroyed muscle cells (cardiomyocytes) surrounded by an inflammatory "shaft", hemorrhages and edema. Over time, the focus of damage is replaced by connective tissue, which thickens and turns into a scar. In general, the formation of such a scar takes about 6-8 weeks.

They speak of transmural myocardial infarction when the entire thickness of the heart muscle undergoes necrosis, at the same time it is very likely that the endocardium and pericardium are involved in the pathological process with the appearance of secondary (reactive) inflammation in them - endocarditis and pericarditis.

Damage and inflammation of the endocardium is fraught with the occurrence of blood clots and thromboembolic syndrome, and pericarditis over time will lead to the growth of connective tissue in the cavity of the heart shirt. At the same time, the pericardial cavity overgrows and the so-called "shell heart" is formed, and this process underlies the formation of chronic heart failure in the future due to the restriction of its normal mobility.

With timely and adequate medical care, most of the patients who survived acute myocardial infarction remain alive, and a dense scar develops in their heart. However, no one is immune from repeated episodes of circulatory arrest in the arteries, even those patients in whom the patency of the heart vessels was restored surgically (stenting). In those cases when, with an already formed scar, a new focus of necrosis occurs, they speak of a repeated myocardial infarction.

As a rule, the second heart attack becomes fatal, but the exact number that the patient is able to endure has not been determined. In rare cases, there are three transferred episodes of necrosis in the heart.

Sometimes you can meet the so-called recurrent heart attack, which occurs in the period of time when scar tissue forms in the heart at the site of the acute one. Since, as mentioned above, it takes an average of 6-8 weeks for the “maturation” of the scar, it is during such periods that a relapse is possible. This type of heart attack is very unfavorable and dangerous for the development of various fatal complications.

Sometimes a cerebral infarction occurs, the causes of which will be thromboembolic syndrome with extensive transmural necrosis with involvement of the endocardium in the process. That is, blood clots formed in the cavity of the left ventricle when the inner lining of the heart is damaged, enter the aorta and its branches that carry blood to the brain. When the light is blocked cerebral vessels and there is necrosis (heart attack) of the brain. In such cases, these necrosis is not called a stroke, since they are a complication and consequence of myocardial infarction.

Varieties of myocardial infarction

To date, there is no single generally accepted classification of cardiac infarction. In the clinic, based on the amount of necessary assistance, the prognosis of the disease and the characteristics of the course, the following varieties are distinguished:

• Large-focal myocardial infarction - it can be transmural and not transmural;
• Small focal - intramural (in the thickness of the myocardium), subendocardial (under the endocardium), subepicardial (in the area of ​​the heart muscle under the epicardium);
• Myocardial infarction of the left ventricle (anterior, apical, lateral, septal, etc.);
• right ventricular infarction;
• Atrial myocardial infarction;
• Complicated and uncomplicated;
• Typical and atypical;
• Protracted, recurrent, repeated heart attack.

In addition, the periods of the course of myocardial infarction are distinguished:

1. Pre-infarction;
2. Sharpest;
3. Spicy;
4. Subacute;
5. Postinfarction.

Symptoms of a heart attack

The symptoms of myocardial infarction are quite characteristic and, as a rule, make it possible to suspect it with a high degree of probability even in the pre-infarction period of the development of the disease. So, patients experience more prolonged and intense retrosternal pain, which is less amenable to treatment with nitroglycerin, and sometimes does not go away at all. Perhaps the appearance of shortness of breath, sweating, a variety of arrhythmias and even nausea. At the same time, patients are increasingly difficult to tolerate even minor physical exertion.

At the same time, characteristic electrocardiographic signs of circulatory disorders in the myocardium appear, and constant observation for a day or more (Holter monitoring) is especially effective for their detection.

The most characteristic signs of a heart attack appear in the most acute period, when a zone of necrosis appears and expands in the heart. This period lasts from half an hour to two hours, and sometimes longer. There are factors that provoke the development of an acute period in predisposed individuals with atherosclerotic lesions of the coronary arteries:

• Excessive physical activity;
• Strong stress;
• Operations, injuries;
• Hypothermia or overheating.

The main clinical manifestation of necrosis in the heart is pain, which is very intense. Patients can characterize it as burning, squeezing, pressing, "dagger". Soreness has retrosternal localization, can be felt to the right and left of the sternum, and sometimes covers the front of the chest. Characteristic is the spread (irradiation) of pain in the left arm, shoulder blade, neck, lower jaw.

In most patients, the pain syndrome is very pronounced, which also causes certain emotional manifestations: a feeling of fear of dying, marked anxiety or apathy, and sometimes excitement is accompanied by hallucinations.

Unlike other types of IBS, pain attack with a heart attack lasts at least 20-30 minutes, and the analgesic effect of nitroglycerin is absent.

Under favorable circumstances, at the site of the focus of necrosis, the so-called granulation tissue begins to form, rich in blood vessels and fibroblast cells that form collagen fibers. This period of the course of a heart attack is called subacute, and it lasts up to 8 weeks. As a rule, it proceeds safely, the condition begins to stabilize, the pain weakens and disappears, and the patient gradually gets used to the fact that he suffered such a dangerous phenomenon.

In the future, a dense connective tissue scar is formed in the heart muscle at the site of necrosis, the heart adapts to new working conditions, and postinfarction cardiosclerosis marks the onset of the next period of the course of the disease, which continues for the rest of life after a heart attack. Those who have had a heart attack feel satisfactory, but there is a resumption of pain in the heart and angina attacks.

As long as the heart is able to compensate for its activity due to hypertrophy (increase) of the remaining healthy cardiomyocytes, there are no signs of its insufficiency. Over time, the adaptive capacity of the myocardium is depleted and heart failure develops.

It happens that the diagnosis of myocardial infarction is significantly complicated by its unusual course. This characterizes its atypical forms:

1. Abdominal (gastralgic) - characterized by pain in the epigastrium and even throughout the abdomen, nausea, vomiting. May occasionally be accompanied by developmental gastrointestinal bleeding acute erosions and ulcers. This form of infarction must be distinguished from peptic ulcer of the stomach and duodenum, cholecystitis, pancreatitis;
2. Asthmatic form - occurs with asthma attacks, cough, cold sweat;
3. Edematous form - characteristic of massive necrosis with total heart failure, accompanied by edematous syndrome, shortness of breath;
4. Arrhythmic form, in which rhythm disturbances become the main clinical manifestation of MI;
5. Cerebral form - accompanied by the phenomena of cerebral ischemia and is typical for patients with severe atherosclerosis of blood vessels supplying the brain;
6. Erased and asymptomatic forms;
7. Peripheral form with atypical localization of pain (mandibular, left-handed, etc.).

Video: non-standard signs of a heart attack

Diagnosis of myocardial infarction

Usually the diagnosis of a heart attack does not cause significant difficulties. First of all, it is necessary to carefully clarify the patient's complaints, ask him about the nature of pain, clarify the circumstances of the attack and the effect of nitroglycerin.

When examining a patient, pallor of the skin, signs of sweating are noticeable, cyanosis (cyanosis) is possible.

A lot of information will be given by such methods of objective research as palpation (feeling) and auscultation (listening). So, with palpation, you can identify:

• Pulsation in the region of the cardiac apex, precordial zone;
• Increased heart rate up to 90 - 100 beats per minute;

On auscultation of the heart, the following will be characteristic:

1. Muting the first tone;
2. Quiet systolic murmur at the apex of the heart;
3. A gallop rhythm is possible (the appearance of a third tone due to left ventricular dysfunction);
4. Sometimes IV tone is heard, which is associated with stretching of the muscle of the affected ventricle or with a violation of the impulse from the atria;
5. Perhaps systolic "cat's purr" due to the return of blood from the left ventricle to the atrium with pathology of the papillary muscles or stretching of the ventricular cavity.

In the vast majority of patients suffering from a macrofocal form of myocardial infarction, there is a tendency to lower blood pressure, which, when favorable conditions may return to normal in the next 2-3 weeks.

A characteristic symptom of necrosis in the heart is also an increase in body temperature. As a rule, its values ​​do not exceed 38 ºС, and the fever lasts for about a week. It is noteworthy that in younger patients and in patients with extensive myocardial infarction, the increase in body temperature is longer and more significant than in small foci of infarction and in elderly patients.

In addition to physical, laboratory methods for diagnosing MI are of no small importance. So, in the blood test, the following changes are possible:

• An increase in the level of leukocytes (leukocytosis) is associated with the appearance of reactive inflammation in the focus of myocardial necrosis, persists for about a week;
• An increase in the erythrocyte sedimentation rate (ESR) is associated with an increase in the concentration in the blood of proteins such as fibrinogen, immunoglobulins, etc .; the maximum falls on the 8-12th day from the onset of the disease, and the ESR numbers return to normal after 3-4 weeks;
• The appearance of the so-called "biochemical signs of inflammation" - an increase in the concentration of fibrinogen, C-reactive protein, seromucoid, etc.;
• The appearance of biochemical markers of necrosis (death) of cardiomyocytes - cellular components that enter the bloodstream when they are destroyed (AST, ALT, LDH, myoglobin protein, troponins, and others).

It is difficult to overestimate the importance of electrocardiography (ECG) in the diagnosis of myocardial infarction. Perhaps this method remains one of the most important. An ECG is available, easy to perform, can be recorded even at home, and at the same time it provides a large amount of information: it indicates the location, depth, prevalence of a heart attack, the presence of complications (for example, arrhythmias). With the development of ischemia, it is advisable to record the ECG repeatedly with comparison and dynamic observation.

ECG signs of an acute phase of necrosis in the heart:

1. the presence of a pathological Q wave, which is the main sign of necrosis of muscle tissue;
2. a decrease in the size of the R wave due to a decrease in the contractile function of the ventricles and the conduction of impulses along the nerve fibers;
3. dome-shaped displacement of the ST interval upwards from the isoline due to the spread of the infarction focus from the subendocardial zone to the subepicardial zone (transmural lesion);
4. T wave formation.

By typical changes cardiograms, it is possible to establish the stage of development of necrosis in the heart and accurately determine its localization. Of course, it is unlikely that you will be able to decipher cardiogram data on your own without having a medical education, but doctors of ambulance teams, cardiologists and therapists can easily establish not only the presence of a heart attack, but also other disorders of the heart muscle and conduction.

In addition to these methods, echocardiography is used to diagnose myocardial infarction (allows you to determine local contractility heart muscle), radioisotope scintigraphy, magnetic resonance and CT scan(helps to assess the size of the heart, its cavities, to identify intracardiac blood clots).

Video: lecture on the diagnosis and classification of heart attacks

Complications of myocardial infarction

Myocardial infarction in itself poses a threat to life, and through its complications. The majority of those who have undergone it have certain disturbances in the activity of the heart, associated primarily with changes in conduction and rhythm. So, in the first day after the onset of the disease, up to 95% of patients face arrhythmias. Severe arrhythmias in massive heart attacks can quickly lead to heart failure. The possibility of rupture of the heart muscle, thromboembolic syndrome also cause many problems for both doctors and their patients. Timely assistance in these situations will help the patient to prevent them.

The most common and dangerous complications of myocardial infarction:

• Heart rhythm disorders (extrasystole, ventricular fibrillation, atrioventricular blockade, tachycardia, etc.);
• Acute heart failure (with massive heart attacks, atrioventricular blockades) - it is possible to develop acute left ventricular failure with symptoms of cardiac asthma and alveolar pulmonary edema, threatening the life of the patient;
• Cardiogenic shock is an extreme degree of heart failure with sharp drop blood pressure and impaired blood supply to all organs and tissues, including vital ones;
• Rupture of the heart is the most severe and fatal complication, accompanied by the release of blood into the pericardial cavity and a sharp cessation of cardiac activity and hemodynamics;
• Aneurysm of the heart (protrusion of a portion of the myocardium in the focus of necrosis);
• Pericarditis - inflammation of the outer layer of the heart wall in transmural, subepicardial infarcts, accompanied by constant pain in the region of the heart;
• Thromboembolic syndrome - in the presence of a thrombus in the infarction zone, in the aneurysm of the left ventricle, with prolonged bed rest, thrombophlebitis of the veins of the lower extremities.

Most deadly complications occur in the early post-infarction period, so careful and constant monitoring of the patient in a hospital setting is very important. The consequences of extensive heart infarction are macrofocal post-infarction cardiosclerosis (a massive scar that replaced the site of dead myocardium) and various arrhythmias.

Over time, when the ability of the heart to maintain adequate blood flow in organs and tissues is depleted, congestive (chronic) heart failure appears. Such patients will suffer from edema, complain of weakness, shortness of breath, pain and interruptions in the work of the heart. Increasing chronic circulatory failure is accompanied by irreversible dysfunction of internal organs, accumulation of fluid in the abdominal, pleural and pericardial cavities. Such decompensation of cardiac activity will eventually lead to the death of patients.

Principles of treatment of myocardial infarction

Emergency care for patients with myocardial infarction should be provided as soon as possible from the moment of its development, since delay can lead to the development of irreversible changes in hemodynamics and sudden death. It is important that there is someone nearby who can at least call an ambulance. If you are lucky and there is a doctor nearby, his qualified participation can help to avoid serious complications.

The principles of helping patients with a heart attack are reduced to the phased provision of therapeutic measures:

1. Pre-hospital stage - provides for the transportation of the patient and the provision of necessary measures by the ambulance team;
2. At the hospital stage, maintenance of the basic functions of the body, prevention and control of thrombosis, heart rhythm disturbances and other complications in the conditions of the departments continue. intensive care hospital;
3. The stage of rehabilitation measures - in specialized sanatoriums for cardiological patients;
4. The stage of dispensary observation and outpatient treatment is carried out in polyclinics and cardio centers.

First aid can be provided under time pressure and outside the hospital. It is good if it is possible to call a specialized ambulance cardio team, which is equipped with the necessary for such patients - medicines, defibrillators, a pacemaker, equipment for resuscitation. Otherwise, it is necessary to call a linear ambulance brigade. Now almost all of them have portable ECG devices, which make it possible to make a fairly accurate diagnosis and start treatment in a short time.

The main principles of care before coming to the hospital are adequate pain relief and prevention of thrombosis. In this case, apply:

• Nitroglycerin under the tongue;
• The introduction of analgesics (promedol, morphine);
• aspirin or heparin;
• Antiarrhythmic drugs as needed.

Video: first aid for myocardial infarction

At the stage of inpatient treatment, the initiated measures to maintain the function of the cardiovascular system continue. Eliminating pain is the most important of them. Narcotic analgesics (morphine, promedol, omnopon) are used as analgesics; if necessary (pronounced excitement, fear), tranquilizers (relanium) are also prescribed.

Thrombolytic therapy is of great importance. With its help, lysis (dissolution) of a thrombus in the coronary and small arteries of the myocardium is carried out with the restoration of blood flow. This also limits the size of the focus of necrosis, which improves the subsequent prognosis and reduces mortality. Of the drugs with thrombolytic activity, fibrinolysin, streptokinase, alteplase, etc. are most commonly used. An additional antithrombotic agent is heparin, which prevents subsequent thrombosis and prevents thromboembolic complications.

It is important that thrombolytic therapy be started as early as possible, preferably within the first 6 hours after the development of a heart attack, this significantly increases the likelihood of a favorable outcome due to the restoration of coronary blood flow.

With the development of arrhythmias, antiarrhythmic drugs are prescribed, to limit the zone of necrosis, unload the heart, and also for cardioprotective purposes, β-blockers (propranolol, atenolol), nitrates (nitroglycerin intravenously drip), vitamins (vitamin E, xanthinol nicotinate) are prescribed.

Supportive care after a heart attack can continue for the rest of your life, its directions:

1. Maintaining a normal level of blood pressure;
2. Fight against arrhythmias;
3. Prevention of thrombosis.

It is important to remember that only timely and adequate drug treatment can save the patient's life, and therefore herbal treatment will by no means replace the possibilities of modern pharmacotherapy. At the stage of rehabilitation in combination with supportive treatment, it is quite possible to accept and various decoctions from herbs as a supplement. So, in the post-infarction period, it is possible to use motherwort, hawthorn, aloe, calendula, which have a tonic and calming effect.

Diet and rehabilitation

An important role is given to the nutrition of patients with myocardial infarction. So, in the intensive care unit in the acute period of the course of the disease, it is necessary to provide such food that will not be burdensome for the heart and blood vessels. Easily digestible, non-rough food is allowed, taken 5-6 times a day in small portions. Various cereals, kefir, juices, dried fruits are recommended. As the patient's condition improves, the diet can be expanded, but it is worth remembering that fatty, fried and high-calorie foods that contribute to the disruption of fat and carbohydrate metabolism with the development of atherosclerosis are contraindicated.

In the diet after a heart attack, it is necessary to include products that promote bowel movement (prunes, dried apricots, beets).

Rehabilitation includes a gradual expansion of the patient's activity, and, in accordance with modern concepts, the sooner it comes, the more favorable the further prognosis. Early activity is the prevention of congestion in the lungs, muscle atrophy, osteoporosis and other complications. Physical rehabilitation after a heart attack is also important, which involves physical therapy, walking.

With a satisfactory condition of the patient and the absence of contraindications, further recovery is possible in cardiological sanatoriums.

The terms of disability after a heart attack are determined individually, depending on the severity of the course and the presence of complications. Disability reaches significant numbers, and it is all the more sad that more and more young and able-bodied population suffers. Patients will be able to work if their work is not associated with strong physical or psycho-emotional stress, but general state satisfactory.

Video: heart attack - from prevention to rehabilitation

Summing up, it is important to remember that a heart attack can be avoided if healthy lifestyle life, good physical activity, the absence of bad habits and proper nutrition. Taking care of your health is within the power of each of us. However, if such a misfortune nevertheless befell, you should not wait and waste precious time, you should immediately consult a doctor. Patients who have received adequate treatment and good rehabilitation live more than one year after suffering a heart attack.

Prevention of myocardial infarction is a complex measure aimed at preventing the occurrence and development of myocardial infarction. Prevention of myocardial infarction includes physical training, regular consumption of pure water, rational nutrition, giving up bad habits (smoking, excessive consumption of alcoholic beverages), a positive emotional attitude and periodic preventive visits to a cardiologist.

physical training

According to progressive doctors, all problems of the cardiovascular system, including myocardial infarction, occur due to insufficient workload of the heart muscle. And this is quite natural, because the heart is the same muscle as all the others, which are integral components of the human body. And, therefore, she, like all other muscles, needs constant training and loads. However, heart muscle training cannot be spontaneous. After all, if a person is not physically developed and prepared, and has never (or for a long time) been engaged in sports exercises, then it is not reasonable, and in some cases dangerous, it will be under the influence of a spontaneously made decision to load the body with loads that are not typical for it.

Sports should be progressive (from simple to complex), and people with certain diseases or health problems need advice and recommendations from a specialist. Vessels, as it may seem strange, are also equipped with muscle tissue. Consequently, the cardiovascular system of the human body is in vital need of constant training and exercise, incl. and elevated. Training of blood vessels consists in stimulating their contractions - wiping or dousing with cold water, a contrast shower, visiting baths, saunas, etc. (which also needs advice an experienced specialist). And it is the training of the heart muscle and blood vessels that is paramount in the list of preventive measures against myocardial infarction.

Physical exercise, in addition to training vital organs (heart muscle and blood vessels), they also contribute to weight loss. Excess weight leads to an imbalance in breathing (shortness of breath), which, in turn, leads not only to problems with the lungs, but also to cardiovascular insufficiency. Excess weight also entails the occurrence and development of atherosclerosis. Physical activity, of course, contributes to the overall hardening of the body. After all, it is known that an intolerant organism is more susceptible to diseases of a viral and bacterial nature (tonsillitis, influenza, etc.), which, in turn, give complications to the myocardium. Physical activity also contributes to emotional unloading.

Balanced diet

Proper rational nutrition is not at all strict food restrictions or a hunger strike. Rational nutrition implies a good nutrition, in which the calories consumed and burned by the body are balanced. This method does not leave the body the opportunity to accumulate unnecessary body fat. Rational nutrition also implies the consumption of a significant amount of plant products, especially in fresh. A healthy diet also includes the transition from animal fats to vegetable fats, the transition from fatty meats to lean, poultry, fish and seafood. A balanced diet must include all essential vitamins and trace elements, without which the human body cannot do. This is especially true of foods rich in potassium and magnesium, which are essential for the health of the heart muscle.

Rejection of bad habits

People with nicotine addiction are more likely to suffer from abnormalities in the cardiovascular system. Nicotine most negatively affects the heart muscle and blood vessels. Smokers (including passive smokers) doom their body to oxygen deficiency, an antispasmodic reaction to nicotine from the vessels and the heart, to the risk of atherosclerotic plaques and metabolic disorders in the body. Any reasonable person needs to give up nicotine addiction, which, moreover, harms the people around him. With the consumption of alcoholic beverages, the issue is not so drastic (complete refusal), but moderation is still necessary. Permissible alcohol consumption (translated into pure alcohol) for women is 15-20 gr. and for men - 25 - 30 gr.

Positive emotions

In today's world, filled to the brim with negative factors, stress, it is very important to learn to be balanced, calm, friendly to others. Often problems with cardiovascular system are observed in people who cannot adequately cope with problems, overloads, with neuropsychic stress in the environment (at work, in in public places, at home). It is in nervously excitable and impressionable people that the risk of myocardial infarction is 25% higher than in people who are reasonable and calm. It is very important to set yourself up in a positive way, engage in self-hypnosis, try to create a benevolent aura around yourself, learn to relax and unwind. In some cases, it will be useful to consult a psychologist. many to deal with stressful situations allow new hobbies, taking care of pets, chatting with friends, active life, good rest. Speaking of rest, do not forget about a full sleep. Night rest should be at least 8 hours a day.

Cardiologist visits

To emphasize the need for regular visits to a cardiologist, it is enough to cite the following statistics. Mortality from myocardial infarction is 30 - 35%. Approximately 20% of patients diagnosed with myocardial infarction die before reaching the hospital. Another 15% of patients with a heart attack die already within the walls of a hospital. In order not to fall into the sad statistics, in order to avoid long-term treatment, recovery, as well as complications after a myocardial infarction, it is advisable to take all preventive measures, and if any abnormalities associated with the heart muscle are noted, you should definitely visit a cardiologist. For people approaching the age of 40, even without complaints about the heart muscle, it is advisable to visit a cardiologist once a year (preventive ECG).

Prevention of myocardial infarction

Primary prevention

Primary prevention of myocardial infarction includes effective treatment of chronic coronary heart disease. elimination of those factors that can lead to the occurrence of coronary thrombosis, acute and subacute disorders coronary circulation, often turning into myocardial infarction, correction of metabolic (coronary and non-coronary) disorders, on the basis of which small-focal necrosis may occur, followed by the formation of large-focal myocardial infarction, identification of patients in the pre-infarction period and their successful treatment, timely hospitalization, intensive and effective treatment of patients with intermediate forms of ischemic heart disease.

Primary prevention of myocardial infarction is closely related to the prevention of coronary heart disease.

Prevention of complications of myocardial infarction

Prevention of complications consists in the earliest hospitalization of the patient in the department (block, ward) of intensive observation, treatment and resuscitation, where the whole complex of the previously described measures is carried out, which is aimed not only at treating myocardial infarction, but also at preventing its main complications. To prevent complications, it is necessary to normalize high blood pressure (in the presence of hypertension), intensive treatment diabetes(if any), other concomitant diseases.

Secondary prevention

Secondary prevention is aimed at preventing recurrent myocardial infarctions and practically includes the same measures that are used in primary prevention. There is evidence of a more favorable course of coronary heart disease after myocardial infarction in cases long-term use antianginal drugs and anticoagulants. So, when carbocromene (intensain) is used for 6 months, a positive effect is observed 2 times more often, and deterioration is 2 times less common than in the control group (T. Ya. Sidelnikova, 3. V. Krukovskaya, 1971).

Long-term (within a year) anticoagulant therapy with an adequate therapeutic level of the prothrombin index leads to a decrease in mortality and the frequency of recurrent myocardial infarction (by an average of 3 times), to some increase in working capacity.

Secondary prevention is aimed at preventing RCS, recurrent MI, the development of CHF and other syndromes. When conducting it, it is necessary to take into account the data of echocardioscopy, ECG, VEM, other stress tests, radioventriculography, and monitoring. If possible, it is desirable to obtain such data when the patient is discharged from the hospital. There are the following types of medical rehabilitation therapy (rehabilitation):

• a) medication
• b) physical
• c) psychological
• d) sexual.

For secondary prevention after acute myocardial infarction, the following groups of drugs are used: a) antiplatelet agents or anticoagulants of indirect action, b) beta-blockers, c) calcium antagonists, d) ACE inhibitors.

In recent years, antiplatelet agents (aspirin, ticlid, etc.) have been widely used to prevent thrombosis and thromboembolism. Long-term use of aspirin reduces mortality by 15-30%, and the frequency of non-fatal recurrent MI by 31%. The average therapeutic dose is from 100 to 325 mg / day, but preference is given to small doses - 100 mg / day in one dose. Aspirin is more effective for unstable angina and MI without Q. Duration of treatment - up to a year or more. Such therapy does not require laboratory control, and complications are quite rare. The therapeutic efficacy of indirect anticoagulants is questionable. hard to pick up optimal dose anticoagulant in outpatient settings, while it is enough high percent heavy bleeding (3-8% during the year).

As shown by multicenter studies, after myocardial infarction, long-term use of beta-blockers reduced overall mortality by 22%, the incidence of RCS by 32%, and the frequency of non-fatal recurrent MI by 27%. It is advisable to use them primarily for anterolateral MI with Q in combination with ventricular arrhythmia and moderate heart failure. These patients are in the high-risk group. A positive effect is caused by beta-blockers without internal sympathomimetic activity. Maintenance doses at the outpatient stage are as follows:

1) propranolol (anaprilin) ​​60-120 mg / day,

2) metoprolol 100-200 mg/day,

3) atenolol 50-100 mg/day.

The duration of treatment is 12-18 months or more. At the same time, there are no reliable data on the positive effect of beta-blockers in patients with myocardial infarction without Q. It is not always advisable to prescribe them for uncomplicated MI with Q. So, beta-blockers remain the drugs of choice for MI with Q and complications.

Of the calcium antagonists, only the diltiazem group (cardyl, tildium, etc.) is used. At a dose of 120-180 mg/day, diltiazem reduces the risk of recurrent MI during the first 6 months in patients with previous myocardial infarction without Q and heart failure.

The main role in the thanatogenesis of sudden coronary death in patients with prior myocardial infarction, it belongs to fatal ventricular arrhythmia. To prevent it, beta-blockers or cordarone are used. In patients with a high risk of sudden death, cordarone is effective, but causes a lot of adverse reactions. It is advisable to prescribe it to patients with fatal ventricular arrhythmia, for whom beta-blockers are contraindicated or ineffective. First of all, these are people with severe heart failure or successfully resuscitated after ventricular fibrillation and previously treated with beta-blockers.

The method of treatment with amiodarone (cordarone) is as follows: the first 7-10 days - 800-600 mg / day, the next 7-10 days - 600-400 mg each with a gradual transition to a daily intake of 200 mg (one tablet). With a favorable course of arrhythmia, a break in treatment is made for 1-2 days a week.

In the first days and weeks of acute MI with Q, remodulation of the heart occurs with a decrease in the contractile function of the left ventricle, which ultimately leads to congestive CHF. There is an intensive search for drugs that can prevent or slow down the progression of postinfarction LV dilatation with its systolic dysfunction. Studies have shown that when using the ACE inhibitor captopril (Capoten) from the 3rd day of MI with Q, the progression of postinfarction LV dilatation slows down with an improvement in coronary blood flow. It is advisable to prescribe captopril to patients if there is a heart attack with heart failure with vF<40-45%, по гипокинетическому и застойному типам кровообращения. Начальная доза составляет 6,25 или 12,5 мг 2 раза в сутки с постепенным повышением дозы до 50-75 мг / сут под контролем давления.

The duration of treatment is at least 3 months, and even better results with treatment for 2-3-5 years. As shown by international multicenter studies (SAVE. SOLVD. CONSENSUS II, AIRE), long-term therapy with captopril reduced cardiovascular mortality by 21%, the risk of developing heart failure by 37%, and the frequency of recurrent MI by 25%. On the use of ACE inhibitors of the enalapril group (renitec, vasotec, etc.) in acute myocardial infarction with heart failure, this issue is subject to further study. So, short-acting ACE inhibitors (captopril, capoten, Lopril, tensiomin, etc.) from the 3rd day of acute MI with Q and heart failure prevent the progression of heart weakness, improve the quality of life of patients.

Physical rehabilitation

After discharge from the department of late rehabilitation (sanatorium stage) to restore cardiovascular activity and return to professional work, the patient is engaged in physical exercises (physical rehabilitation). It is advisable to perform a load test after 6-8 weeks from the onset of MI, more often it is a VEM, with the achievement of a submaximal load. Contraindications for dosed physical activity are: severe cardiac decompensation, myocarditis, dissecting aortic aneurysm, thromboembolism, dangerous rhythm and conduction disturbances, cardiac aneurysm, sick sinus syndrome, etc. It is dosed physical activity that makes it possible to judge the patient's tolerance to physical activity and to determine the level of intense physical training on a VEM or treadmill under the supervision of a doctor.

Most often, walking on flat terrain in the first half of the day is used as a physical training. Choose a distance of 2.5-3 km at a speed of 3-4 km / h (or 80-100 steps per minute) with a gradual increase in speed under the control of well-being, AT. Heart rate and ECG. It is advisable to take part in group physical exercises (LFK). Then you need to independently maintain the level of physical and mental well-being.

Nutrition and diet after a heart attack

Rehabilitation after MI includes the fight against the main risk factors. In patients with hypercholesterolemia, it is necessary to achieve a decrease in the level of total cholesterol to 5.2 mmol / l. For most of them, it is enough to follow a hypocholesterol diet with a restriction of saturated fats in food to 10% of total calories. The content of cholesterol in food does not exceed 300 mg/day, and table salt - 6 g/day. It is necessary to increase the consumption of vegetables, complex carbohydrates, fruits, polyunsaturated and monounsaturated fatty acids, to achieve normalization of body weight. If hypercholesterolemia is > 6.5 mmol/l, then the most effective hypocholesterolemic agent is simvastatin at a dose of 20 mg/day in one dose at night. Since tobacco smoking is a major risk factor and contributes to the progression of atherosclerosis, it must be abandoned.

AH with diastolic pressure > 100 mm Hg remains an important risk factor for the development of MI. In the presence of such hypertension, the risk of sudden death and recurrent myocardial infarction increases several times. It is necessary to control the level of AG with antihypertensive drugs, which simultaneously improve coronary blood flow, cause regression of hypertrophied myocardium and do not increase the level of atherogenic lipoproteins in the blood. These drugs include cardioselective beta-blockers (metoprolol, atenolol), nifedipine, prazosin, ACE inhibitors. Dose selection is individual. At the same time, diastolic AT should not be reduced.<85 мм рт.ст. поскольку при более низком AT ухудшается перфузия миокарда.

Sex life after myocardial infarction

Patients with MI can return to sexual life after 5-6 weeks from the onset of the disease. If it rises to the second floor without stopping, if during the stress test the heart rate reaches 120 beats, and the systolic pressure is 165 mm Hg. This indicates the possibility of resuming sexual activity. Sexual intercourse should be restored with a familiar partner at a comfortable temperature. The position for intercourse should be comfortable for both partners. Safe postures are:

a) lying on your side

b) lying on his back, when the patient is below.

In some cases, it is advisable to take nitrates 30-50 minutes before sexual intercourse to prevent angina pectoris. Sexual intercourse with an unfamiliar partner should be avoided.

In conclusion, the following should be noted. With early hospitalization of patients with myocardial infarction, a staged principle of treatment with timely and justified use of thrombolytics, anticoagulants, antiplatelet agents, beta-blockers, nitrates, and, if necessary, balloon angioplasty, mortality reaches 5-10%. Such treatment should be considered effective. When carrying out a full-fledged rehabilitation, 70-80% of patients of working age return to work, restore their working capacity. Secondary prevention after acute myocardial infarction using cardioselective beta-blockers, cordarone, ACE inhibitors, antiplatelet agents, coronary artery bypass grafting and balloon angioplasty leads to a decrease in mortality within a year to 2-5% of all cases.

Prevention of myocardial infarction

Description:

Primary prevention is aimed at preventing the disease. It includes standard precautions, the main of which are: increasing physical activity, controlling body weight and giving up bad habits. In addition, the normalization of blood pressure and blood lipid spectrum. For primary prevention of myocardial infarction in patients with angina pectoris and high blood pressure, it is imperative to use acetylsalicylic acid (ASA) - the "gold standard" of drug prevention of myocardial infarction. All these measures are also valid for secondary prevention (prevention of re-infarction).

1. Control of body weight.

In every extra kilogram of adipose tissue there are many blood vessels, which dramatically increases the load on the heart. In addition, excess weight contributes to high blood pressure, the development of type 2 diabetes, and therefore significantly increases the risk. To control weight, a special indicator is used - body mass index. To determine it, weight (in kilograms) must be divided by height (in meters) squared. The normal indicator is 20-25 kg / m2, the numbers 35-29.9 kg / m2 indicate overweight, and above 30 - obesity. The control of body mass index, of course, occupies an important place in the treatment and prevention of myocardial infarction.

The diet provides for the presence of a large number of green vegetables, root crops, fruits, fish, wholemeal bread. Red meat is replaced with poultry meat. In addition, it is necessary to limit the amount of salt consumed. All this is included in the concept of the Mediterranean diet.

3. Physical activity.

Physical activity helps to reduce body weight, improve lipid metabolism, lower blood sugar levels. The complex and the level of possible loads must be discussed with the doctor. Regular exercise reduces the risk of a second heart attack by about 30%.

4. Refusal of bad habits.

Smoking significantly aggravates the picture of coronary heart disease. Nicotine has a vasoconstrictive effect, which is extremely dangerous. The risk of recurrent myocardial infarction in smokers is doubled.

Alcohol abuse is unacceptable. It worsens the course of coronary heart disease and associated diseases. Perhaps one-time consumption of a small amount of alcohol with food. In any case, you should discuss this with your doctor.

5. The level of cholesterol in the blood.

It is determined within the blood lipid spectrum (a set of indicators on which the progression of atherosclerosis depends, the main cause of coronary heart disease) and is the main one. With an increased level of cholesterol, a course of treatment with special drugs is prescribed.

6.Blood pressure control

High blood pressure significantly increases the workload on the heart. Especially, it worsens the prognosis after myocardial infarction. Also, hypertension contributes to the progression of atherosclerosis. The level of systolic (upper) blood pressure below 140 mm Hg is considered optimal. and diastolic (lower) - no higher than 90 mm Hg. Higher numbers are dangerous and require correction of the regimen for taking drugs that lower blood pressure.

7. Blood sugar level.

The presence of decompensated (not regulated) diabetes mellitus adversely affects the course of coronary heart disease. This is due to the detrimental effect on the vessels of hyperglycemia (elevated blood sugar). It is necessary to monitor this indicator constantly, and with increased sugar, it is imperative to consult an endocrinologist to correct the treatment regimen.

Proven "gold standard" in drug prevention of coronary heart disease. myocardial infarction is acetylsalicylic acid.

A heart attack is a severe cardiac disease in which the death of myocardial tissue is observed. This process occurs against the background of oxygen starvation in the cells, caused by a lack of blood circulation. Even despite the development of modern cardiology, mortality from a heart attack remains very high. According to this indicator, this pathology is the leader among all diseases of the cardiovascular system. Therefore, people at risk need to know how to prevent a heart attack. To do this, you need to follow certain medical recommendations.

There are several factors that provoke necrosis of the heart muscle:

• Atherosclerosis. The disease is characterized by the deposition of cholesterol on the vascular walls, which subsequently forms plaques that can worsen the functioning of the circulatory system or completely block the lumen of the vessel.
• Age changes. The features of the human body are such that with its aging, the walls of blood vessels become thinner, which causes plaques to form on their inner surface.
• Floor. Men, according to statistics, are more susceptible to the disease than women.
• Arterial hypertension, due to which there is a thinning of the walls of blood vessels.
• Obesity.
• Diabetes.

Prevention of myocardial infarction is designed to minimize the negative impact of the above factors on the human body. Prevention of relapse is especially important for patients who have experienced a heart attack. In addition to drug treatment, they need to follow a number of medical recommendations regarding dietary changes, increased physical activity and lifestyle adjustments in general.

Features of prevention of myocardial infarction

The whole complex of such events can be divided into two groups:

1. primary prevention. This group includes those people who have problems with the cardiovascular system, but have not had a heart attack before.
2. Secondary prevention of myocardial infarction. Adhering to these medical recommendations is required for those patients who have previously encountered acute pathology or experienced it “on their feet”. In this case, the whole complex of preventive measures is reduced to restoring the body and preventing the recurrence of the disease.

Primary prevention

If the patient has a predisposition to the development of necrosis of the heart muscle, then he
certain precautionary recommendations should be followed:

Secondary prevention

This set of measures is necessary to prevent a relapse. In this case, the above recommendations apply, with some adjustments. They are explained by the fact that the prevention of a heart attack after a heart attack is carried out for the rest of the patient's life and is conditionally divided into two stages:

1. First two years. During this period, there is an improvement in the condition of the heart muscle, and the patient himself is recovering health in emotional and physical terms. It normalizes blood circulation and metabolic processes.
2. After a two-year period, the patient's body should fully recover. Therefore, further prevention is reduced to the prevention of recurrence of the disease.

Medicines to help

For patients who have had an attack, the following drugs are usually prescribed to maintain the normal functioning of the cardiovascular system and prevent myocardial infarction:

1. "Aspirin". The drug thins the blood, reducing the likelihood of death during an attack.
2. calcium antagonists. The drugs are prescribed to patients suffering from coronary artery disease and angina pectoris. They are also used in cases where the patient has contraindications to taking adrenoblockers.
3. ACE inhibitors. Prevent the development of heart failure by preventing malfunctions of the left ventricle.
4. Beta blockers. Contribute to the "unloading" of the left ventricle, which reduces the likelihood of a recurrent attack by 20%.

1. Regular exercise. Exercise therapy is one of the main methods used in the rehabilitation of patients with a heart attack. The intensity of physical activity is selected individually and is determined by the attending physician.
2. Psychological rehabilitation. A very important nuance in maintaining the health of the cardiovascular system is the exclusion of stress and negative emotions from the patient's daily life. This requires a consultation with a psychologist.

In the process of secondary prevention of a heart attack, the patient must notify the doctor about the occurrence of any symptoms of cardiac pathologies, even if they seem harmless to him. The main condition for recovery is to strictly follow the recommendations of a specialist, which will prevent the development of possible complications.

Upon the return of working capacity, the patient can get a job. But it is advisable to choose the type of activity that does not require serious physical exertion and emotional stress.

About physical activity

As mentioned above, the allowable load is determined by the doctor for each patient individually. But in both primary and secondary prevention, moderate exercise is essential. They allow you to maintain the cardiovascular system in good shape and avoid complications.

If we talk about secondary prevention, then she usually prescribes the following procedures:

1. In the subacute period, the patient is prescribed exercise therapy. Most often, exercises begin even during the patient's stay in a medical institution under the supervision of an experienced specialist. He must be told about all the unpleasant sensations that arise during the exercise.
2. A couple of months after the attack, the patient undergoes an ECG test. Most often, bicycle ergometry is used to determine the patient's state of health. It allows you to show how the heart is able to work without failures under stress.
3. Regarding the indications of the above procedure, the patient is determined by the course of physical therapy.

Contraindications to preventive sports activities are the following pathologies:

• the presence of inflammatory processes in the myocardium;
• aneurysm;
• acute stage of heart failure;
• weakness of the sinus node;
• severe stages of arrhythmias and failures in the conduction of impulses.

In the absence of these pathologies, the patient is recommended to start training with measured walking, involving up to 100 steps per minute. At first, he needs to walk no more than a kilometer, but the distance gradually increases. At the same time, strict control of pulse and pressure is necessary. If you feel worse, classes should be stopped.

The prevention of such a serious disease as myocardial infarction involves the use of an integrated approach. This is especially important for those people who have cardiac pathologies and people who have previously had seizures.

Representatives of both groups need to carefully monitor their health. This will eliminate the possibility of complications. If any alarming symptoms appear, you should immediately contact a specialist.