What medicines after a heart attack. Myocardial infarction: treatment, drugs and general recommendations. What vitamins are good for the heart and blood vessels

Finoptin

Synonyms. Verapamil; Isoptin.

Directory of drugs bradycardia Verapamil dizziness Isoptin myocardial infarction cardiogenic shock general weakness angina tachycardia extrasystole

Ticlid

medicinal forms. Ticlid- a synthetic drug. Produced in tablets in a package of 30 pieces.

myocardial infarction

Many human lives have been interrupted heart attack. This formidable disease can overtake a person at the moment of excitement, when, as they say, he was “brought to a heart attack”, or during physical overstrain. More often, a heart attack develops in the morning during the transition from nighttime rest to daytime activity, but it also happens that it affects the heart for no apparent reason, even in a dream.

With acute myocardial infarction, only about fifty percent of patients can be taken alive to the hospital. Although the quality of ambulance services is not the same in many countries, these sad statistics are practically unchanged everywhere. Of those patients who managed to be delivered to the hospital, due to severe complications, another third do not live to be discharged.

But what is a heart attack and why does it occur?

When the blood supply to the heart muscle deteriorates, the so-called coronary heart disease occurs. Every second man and every third woman suffers from it. When the blood supply to a section of the heart muscle is completely stopped for any reason, coronary heart disease becomes acute. In that area of ​​the myocardium where blood does not flow for more than fifteen to twenty minutes, heart cells undergo death (necrosis). This area of ​​dead cells is called myocardial infarction .

Acute myocardial infarction- an acute disease caused by the development of foci of necrosis in the heart muscle as a result of a violation of its blood supply, which occurs due to thrombosis of the coronary artery or its sharp narrowing with atherosclerotic and plaque.

In the event that necrosis captures a large area of ​​\u200b\u200bthe cardiac muscle along its surface and spreads in depth, the infarction is called large-focal, if the volume of necrosis is not very large - small-focal. Of course, large-focal heart attacks are the most dangerous, especially when localized on the anterior wall of the ventricles of the heart. When a heart attack heals, a scar remains in its place - a scar. Since the heart muscle does not recover from damage, a scar remains on the heart for the rest of its life.

Myocardial infarction causes

The main cause of coronary disease and heart attack is atherosclerosis. that is, the narrowing of the lumen of the vessels due to the fact that cholesterol and other lipids contained in the blood are deposited in them. In those places of the vascular wall where lipids form the largest accumulations, there are atherosclerotic plaques. growing into the vessel wall. Over time, calcium is deposited in the plaques, which makes them stiff. While the plaque has not yet hardened, it is very fragile and can easily crack. Damage to the plaque in the artery of the heart can be caused by various reasons, even the increase in blood pressure and palpitations that occur during exercise. When the plaque ruptures, the integrity of the vessel wall is broken in this place. The body always closes the damaged wall of the vessel with blood clots (thrombi). In case of damage to the heart vessel, the blood coagulation system also turns on, and a blood clot grows around the crack quickly, like a snowball rolling down a mountain. It can, growing, clog the artery. Then the blood flow in it stops, and the surrounding cardiac muscle cells die. As a result of their necrosis, myocardial infarction occurs. Its size depends on the size of the area fed by the artery, or, as they say, on the size of its basin.

Factors predisposing to the development of a heart attack

A heart attack affects men more often than women. True, this applies only to young women who have not yet experienced menopause, whose vessels protect estrogen and other sex hormones. Those women "who are over fifty" get a heart attack even more often than men. In recent years, there has been an alarming trend of "rejuvenation" of infarction, and often in cardiological departments one can meet heart attacks a little over thirty years old. There are various risk factors for a heart attack that you should be aware of.

Plays an important role in the predisposition to a heart attack heredity. If a heart attack, cerebral stroke, coronary heart disease have been registered by at least one of your direct relatives, and especially under the age of 55, then this is a reason for you to be wary. Since coronary heart disease is very common, as already mentioned, it is recommended for everyone to be on the alert.

If the blood level is increased cholesterol content- more than 5 mmol / l or more than 200 mg / dl, - the risk of atherosclerosis and atherosclerotic plaques increases.

Smoking is one of the main risk factors, as it has an extremely adverse effect on blood vessels.

Sedentary lifestyle and its frequent companion - excess weight has a bad effect on the activity of the heart muscle.

Arterial pressure more than 140/90 mm Hg. can cause atherosclerotic plaque rupture.

Diabetes severely damages blood vessels, including those of the heart, making the myocardium vulnerable to a heart attack.

It is believed that male pattern baldness also indicates the possibility of developing a heart attack, since it is caused by an increased level of male hormones - androgens, and hormonal instability provokes an increase in blood pressure and an increase in the concentration of cholesterol in the blood.

Doctors warn that the combination of several risk factors increase the likelihood of myocardial infarction exponentially. How does it start?

Symptoms and diagnosis of myocardial infarction

Signs of myocardial infarction There are different ones, but the first warning sign of a heart attack is severe, sometimes unbearable pain behind the sternum, which cannot be relieved by three nitroglycerin tablets placed under the tongue one after another with an interval of five minutes. It occurs at rest, in contrast to the pain of angina, which typically occurs during exertion. The pain may be pressing, burning, or squeezing and often radiates to the arm, back, shoulder, neck, or jaw. This kind of pain is unbearable. To get into the fifty percent group of survivors on the way to the hospital, immediately call an ambulance.

Signs of a heart attack may include loss of consciousness, vomiting, abdominal discomfort, difficulty breathing, or heart failure. But in some cases, the patient may not even feel that he has a heart attack. The painless form of a heart attack is most often found in patients with diabetes mellitus. No matter how a heart attack manifests itself, it can be reliably diagnosed by an electrocardiogram. The area of ​​damage and changes in the structure of the heart muscle are best determined using echocardiography, or ultrasound of the heart. Sometimes the doctor prescribes scintigraphy - a radioisotope study of the heart muscle, which allows you to accurately determine the localization of ischemia in the myocardium.

Treatment of myocardial infarction

When it comes to heart pain, time is of the essence. First aid for myocardial infarction should be provided as soon as possible. If the attack lasts no more than half an hour, the consequences will be minimal. It is necessary to put Nitroglycerin under the tongue until the tablet is completely resorbed. It relieves the pain attack within 3-5 minutes. If not, take a second tablet. In cases where nitroglycerin does not give an effect within 10 minutes, all hope is for an ambulance.

Ambulance for myocardial infarction. If a heart attack is suspected, the patient should be urgently taken to the hospital and placed in the intensive care unit as soon as possible. The first few hours after a heart attack is a precious time for treatment, when you can still dissolve the newly formed blood clot with special drugs and improve the blood supply to the heart. To reduce the risk of complications and prevent the formation of new blood clots, drugs are prescribed that slow down blood clotting. A tried and tested remedy is aspirin, also known as acetylsalicylic acid.

Often, the patient is prescribed beta-blockers of adrenergic receptors, which do not allow the "stress hormone" - adrenaline to increase the heart rate, which means that they protect it from overload, which is vital in a heart attack, and allow saving heart muscle cells from death.

Recently, non-drug methods of treating a heart attack are increasingly being used, the use of which can improve impaired blood supply. For example, coronary balloon angioplasty will help if medications are ineffective. A balloon is inserted through the femoral vein into the vessels of the heart. By inflating it, you can expand a dangerously narrowed vessel. In more complex cases, coronary artery bypass grafting is indicated.

In the first few days after a heart attack, strict bed rest is necessary to reduce the load on the damaged heart as much as possible. Nowadays, it is not necessary to lie in bed for several weeks, as was considered necessary before. The patient observes bed rest for at least three days, then gradually, as he is allowed to sit, get up and walk, he begins the path to recovery and literally takes the first steps in a new life after a heart attack.

Rehabilitation after myocardial infarction

Everyone who has suffered a heart attack is concerned about the question - will they be able to return to a full life after myocardial infarction. There is no single answer to this question, because all people have different ideas about a full life, and everyone has a heart attack in their own way. If a heavyweight weightlifter and a programmer suffer a heart attack of the same severity, but, most likely, the first is unlikely to return to the platform, and the second will be able to do what he loves.

Restoring the body after a heart attack is a long process that lasts for months. This is the most suitable period in order to comprehensively consider your previous lifestyle and make adjustments to it. Already in the hospital, in parallel with taking medications and physiotherapy, they also do physical exercises, but their intensity should increase gradually and very carefully, the struggle for records is inappropriate here! Physical activity begins with physical therapy, then you need to train in walking on a flat surface, then it's the turn of the most popular and very effective simulator - the usual stairs. With its help, you can determine whether the patient is ready for an active life. If he is able to climb to the fourth floor without shortness of breath and chest pain, rehabilitation is successful. There are also more accurate tests, for example, a dosed load test, which is carried out on special simulators - on a treadmill or a bicycle ergometer.

After a heart attack, the patient takes a lot of medication. How long do you need to continue taking? Undoubtedly, all my life. Only with their help can you ensure good heart function and good health.

Many are concerned about the question of whether sexual life is possible after a heart attack, but they do not always dare to ask the attending physician. Without false shame, ask him about it! Only he will be able to objectively assess your physical condition and decide whether this load is within your power. Once you're strong enough, be sure to take the precautions necessary to ensure that sexual intimacy brings you joy, not another heart attack. It is optimal if you are in a familiar environment with a familiar partner. The position should be such as to minimize the load - on the side or on the back.

Heart attack prevention

It is possible to prevent a heart attack by acting on risk factors. It is possible to minimize any of them, with the exception of sex and heredity.

It is necessary to normalize blood pressure and monitor it especially carefully under adverse conditions, for example, in heat and during geomagnetic disturbances.

To prevent diabetes, you need to maintain normal blood sugar levels.

Increase physical activity! Daily walks of at least 5-6 kilometers are required.

It is imperative to quit smoking, this risk factor can nullify all efforts.

It is also important to get rid of excess weight. How many extra pounds are in your kilograms? This can be calculated by determining the body mass index (BMI). Square your height in meters and divide your weight in kilograms by that. A normal BMI does not exceed 26.

In order not to gain excess weight and save blood vessels, you need to eat as few foods containing animal fats and cholesterol as possible, and as many vegetables and fruits as possible. Replace pork with white poultry, butter with sunflower or olive, lard with unsalted fish. Such a diet will have a beneficial effect not only on cholesterol levels, but also on your wallet.

heart attack treatment at home

The myocardium is the heart muscle. The arteries, called coronary arteries, carry blood to it. If any of these arteries clogs a blood clot - a thrombus, then the part of the heart that it feeds remains without blood supply, which means without oxygen. "On a starvation diet" myocardial cells can live only 20-30 minutes. Then they die - this is a heart attack, a site of necrosis in the tissue of the heart. A scar remains on the affected area.

Recently, myocardial infarction is rapidly “getting younger”. Now it is not uncommon when it strikes people who have barely stepped over the thirty-year threshold. True, in women under 50 years of age, a heart attack is a rarity. Until this point, their vessels are protected from atherosclerosis by estrogens and other sex hormones. But with the onset of menopause, women, on the contrary, get sick more often than men.

Treatment of myocardial infarction

In order not to risk, at the slightest suspicion of a heart attack, doctors send a person to the intensive care unit of the hospital. And the faster the better. After all, only during the first few hours, by introducing special preparations, it is possible to dissolve a “fresh” thrombus and restore blood flow in the coronary artery. Then the formation of new blood clots should be prevented. To do this, use drugs that slow down blood clotting. One of the most reliable means is acetylsalicylic acid, that is, ordinary aspirin. It reduces the number of complications and prolongs the life of people who have had a heart attack.

Often, beta-blockers are used in the treatment. These drugs reduce myocardial oxygen demand, which means they save heart muscle cells from death, reduce the size of necrosis. At the same time, they make the work of the heart more economical, which is very important during a heart attack. In recent years, not only medicines have been used to treat a heart attack. In particular, the so-called invasive methods include coronary balloon angioplasty. Angioplasty is indicated when drug therapy is ineffective. In another case, a cardiac surgeon may suggest coronary artery bypass surgery.

In the early days, strict bed rest is required. At this time, the damaged heart may not withstand even minimal stress. Previously, a person who had a heart attack did not get out of bed for several weeks. Today, the period of bed rest is significantly reduced. But still, at least three days after a heart attack, you need to lie in bed under the supervision of doctors. Then it is allowed to sit, get up later, walk ... Recovery begins, adaptation to a new, “post-infarction” life.

Patients who are recovering from a myocardial infarction should be aware that medications need to be taken for a long time, and possibly even for life.

It all depends on the degree of damage and localization of necrosis. Medicines are prescribed individually according to indications.

Therapy after the disease is aimed at preventing atherosclerosis, angina pectoris and the formation of blood clots in the vessels, and antiarrhythmic drugs are also required.

After a myocardial infarction, the main goal of doctors is to prescribe such therapy to the patient in order to reduce the risk of complications and re-infarction, as well as:

• to reduce the size of the lesion;
• to prevent thrombosis;
• establishing the process of systemic circulation.

An important aspect of treatment after myocardial infarction is to reduce the load on the heart, nitrates and beta-blockers do an excellent job with this.

These remedies prevent many complications. Also an important task in this state is the expansion of blood vessels.

Drug groups

Groups of drugs that are prescribed after a heart attack:

• statins;
• antiplatelet agents;
• antihypertensive drugs;
• antiarrhythmic drugs;
• beta-andrenoreceptor blockers and ACE inhibitors;
• nitropreparations.

These are drugs that help lower the level of cholesterol in the blood, that is, its breakdown and withdrawal. This is necessary so that atherosclerotic plaques do not form in the arteries, that is, fat deposits do not grow.

Thanks to statins, fats that enter the body through the digestive tract are not absorbed into the bloodstream. Another important task of these drugs is that they eliminate inflammation in the vessels. But the intake of these drugs should occur only in combination with a diet.

These are drugs that affect the composition of the blood, thereby making it less viscous, that is, they prevent blood from clotting. This means that thrombosis is prevented - the formation of blood clots.

These are medicines that are needed to normalize and maintain blood pressure.

ACE inhibitors and ARBs. These medicines reduce blood pressure and as a result there will be no changes in the structure of arteries and vessels. Also, these drugs can reduce the heart or increase it, depending on the damage to the myocardium.

For example, with angina pectoris, these drugs reduce the work of the heart and its oxygen consumption. Inhibitors are taken for a long time, they can be prescribed from the first days.

This group includes the well-known nitroglycerin. Such drugs have a quick effect, dilate blood vessels, relieve pain and lower blood pressure. If a myocardial infarction is suspected, doctors recommend taking a nitroglycerin tablet under the tongue before the doctors arrive.

Antiarrhythmic drugs. This is a group of drugs that are prescribed for palpitations, for example, for estrasystole, atrial fibrillation, etc.

It should be noted that all drugs are prescribed by doctors and in individual doses, since violations in each patient can be different and of varying degrees. Diuretics may also be prescribed. They help lower blood pressure and reduce swelling.

Beta-blockers are drugs that are prescribed for rapid heartbeat, that is, tachycardia, and can also lower blood pressure. Often people after a heart attack, these drugs are prescribed for a long time, as they prevent heart attacks. That is, such drugs help reduce the load on the body and saturate the blood with oxygen.

Due to the fact that beta-blockers reduce the work of the heart, the likelihood of an increase in blood pressure is reduced, since there is no load from a large cardiac output.

Beta-blockers are also prescribed for other problems, such as heart failure, left ventricular failure, etc. There are such types of drugs of the group of beta-adrenaline receptor blockers:

• cardioselective (Lokren, Metaprolol, etc.);
• non-selective (Sotalol, Nadolol, etc.).

There is no significant difference between these groups of blockers, their effectiveness is the same. Doctors select them for patients according to individual characteristics. Cardioselective have fewer adverse reactions and do not provoke bronchospasm. They are also prescribed for patients with impaired peripheral circulation.

There are also beta-blockers of the 1st generation (non-selective), 2nd generation (cardioselective), 3rd generation (these drugs have a vasodilatory effect, which means they relax blood vessels).

vitamins

Multivitamin therapy is very important for patients after myocardial infarction. The course of such therapy can last 1-2 months. For people with atherosclerosis, you need to carefully select vitamins, as there are substances that can reduce each other's activity.

Vitamin therapy normalizes metabolic processes in the myocardium and other organs and systems. Vitamins remain in the body for 2 to 4 weeks.

After completing the course, a break is made for about 2 months, and you need to repeat it again.

You should not prescribe vitamins on your own, this should be done by a doctor. The correct ratio of different vitamins is very important.

Medicines

Vasodilating drugs - ACE inhibitors

Postinfarction period

After the acute period after a heart attack has passed, the next one comes - the restoration of the body.

During this period, drug therapy continues due to the fact that there is already a scar on the myocardium and, accordingly, the organ does not perform its functions as efficiently as before.

All drugs prescribed by doctors are very important, since a heart attack complicated all the diseases that a person had before the defeat. Namely, coronary disease, hypertension, arrhythmia, atherosclerosis, etc. have become more complicated.

All therapy is aimed at eliminating these diseases or at least stabilizing their course. It is also important to prevent a repeated or recurrent heart attack and sudden death syndrome.

You can resort to various innovative methods, for example, the Zdorov medical pillow. It is recommended to use it in the post-infarction period.

As you can see, after a heart attack, a complex of drugs is prescribed to improve the functioning of the cardiovascular system.

The patient needs to take them according to all the prescriptions of the doctors and not to cancel on their own, or not to change the dose without consulting a specialist. This can lead to complications and serious consequences.

Also, all drugs have side effects. This must always be remembered. And if, when taking this or that medicine, unpleasant sensations arise or worse than worsening of the state of health, then you should immediately inform the doctor.

In contact with

Myocardial infarction is an acute and extremely dangerous disease of the cardiovascular system. The cause of this disease is insufficient blood supply to myocardial tissues.

Under certain conditions (for example, malnutrition, smoking, hereditary factors), atherosclerotic plaques or blood clots form on the walls of the arteries that feed the heart muscle. As a result, the lumen of the vessels is greatly narrowed, myocardial cells receive less nutrients and oxygen.

Our body begins to give alarming "bells", which are expressed in pain symptoms in the region of the heart. This is how IHD develops or. If timely measures are not taken and treatment is not started, foci of necrosis may occur in the tissues of the myocardium. This condition is commonly referred to as myocardial infarction.

Myocardial infarction requires urgent medical attention. Delay can lead to very disastrous consequences.

And after stopping the acute condition, the patient needs in further long-term and systematic treatment. Most likely, the patient will have to completely reconsider his lifestyle and take certain drugs for many years.

Drug treatment after myocardial infarction should be prescribed strictly by a cardiologist, usually a specialist prescribes drugs of several groups.

Statins

Statins fight the main cause of insufficient blood supply - cholesterol plaques. Medicines from this group break down cholesterol in the liver and remove it from the body, and also help maintain blood cholesterol levels at an acceptable level. In addition, statins relieve inflammation in the vessels.

Statins include the following drugs:

• Simvastatin(active ingredient - simvastatin), dosage 10, 20, 40 mg, cost in the range of 70-170 rubles
• Vasilip(simvastatin), packaging 10, 20, 40 mg, cost range 350-500 rubles
• Simgal(simvastatin), dosage 10, 20, 40 mg, the purchase will cost 300-600 rubles
• Simlo(simvastatin), packaging 10, 20, 40 mg, can be bought at a pharmacy for 250-350 rubles
• Cardiostatin(lovastatin), dosage 20, 40 mg, cost in the range of 240-360 rubles
• Lipostat(pravastatin), packaging 10, 20 mg, the purchase will cost only 140-200 rubles
• Lescol Forte(2nd generation drug, active ingredient - fluvastatin), dosage 80 mg, cost about 2500 rubles
• Tulip(3rd generation drug, active substance - atorvastatin), packaging 10, 20, 40 mg, price range 220-550 rubles
• Liptonorm(3rd generation, based on atorvastatin), dosage 20 mg, can be bought at a pharmacy for 290-400 rubles
• Torvacard(3rd generation, based on atorvastatin), packaging 10, 40 mg, cost in the range of 310-550 rubles
• Atoris(3rd generation, based on atorvastatin), dosage 10, 20, 30, 40 mg, cost range 310-550 rubles
• Crestor(4th generation drug, active ingredient - rosuvastatin), packaging 5, 10, 20, 40 mg, the purchase will cost 1150-1600 rubles
• Rosulip(4th generation, active substance - rosuvastatin), dosage 10, 20 mg, cost range 630-1000 rubles
• Tevastor(4th generation, based on rosuvastatin), packaging 5, 10, 20 mg, cost in the range of 380-700 rubles
• Livazo(4th generation, based on rosuvastatin), dosage 1, 2, 4 mg, cost about 2500 rubles

All of the listed medicines have the same principle of action, so there is usually no need to buy more expensive ones.

Before taking statins determine the level of cholesterol in the blood. With a high content of it, the doctor prescribes a mandatory diet aimed at limiting foods containing an increased amount of cholesterol.

Statins are usually taken once a day at bedtime. for a long time, often for life.

Contraindications to the appointment of statins are individual intolerance, pregnancy and liver disease in the active stage.

Side effects are rare. Among them: allergic reactions, dizziness, weakness, peripheral edema, nausea, stool disorders, tachycardia, increased or decreased blood pressure, pain in the joints and muscles, sweating.

In addition to pharmaceutical drugs, there are also natural statins - garlic, turmeric, fish oil. If there are no concomitant diseases of the digestive system, these products should be included in the diet.

Nitropreparations

To maintain the normal functioning of the cardiovascular system for the patient you will have to take certain medicines for a very long time, possibly for a lifetime. Specific drugs, dosage and course of treatment should be prescribed only by the attending physician, self-medication in this case is unacceptable.

For more useful information, see the video:

Myocardial infarction - damage to the heart muscle due to thrombosis of the coronary artery with the development of necrosis. Occurs against the background of coronary artery disease, more common in men. The disease requires immediate treatment in a hospital (medical and / or surgical). Then a long recovery period in sanatoriums and at home, constant medication, lifestyle changes.

Drugs for the treatment of myocardial infarction

Medications for relief of an attack in the prehospital period

Before arriving at the hospital, it is not always possible to determine whether a patient has a heart attack, so a "working diagnosis" is often made: acute coronary syndrome with or without ST segment elevation. The patient should be given a supine position with a slightly raised head, provide access to fresh air and calm the patient.

The list of drugs used to relieve an acute condition in myocardial infarction:

1. "Nitroglycerin" (antianginal, vasodilating effect) under the tongue in tablets of 0.5-1.0 mg or 1-2 doses in an aerosol. If necessary, repeat (if the pressure (BP) is not very low) after the expiration of the previous tablet (every 5-10 minutes). With a strong pain syndrome, 2.0 ml of a 1% solution of "Nitroglycerin" is diluted in 500 ml of 0.9% NaCl or 5% glucose. The combination is administered intravenously under the control of blood pressure and pulse. Stop infusion at systolic pressure< 90 мм рт. ст.
2. Acetylsalicylic acid, "Aspirin" (ASA) - chew a dose of 160-325 mg. You can apply "Clopidogrel" 300 mg to patients under 75 years of age. Patients after this age - 75 mg.
3. Oxygen is supplied 2-4 liters per minute.
4. β-blockers are prescribed to everyone in the absence of contraindications (bradycardia, arterial hypotension, congestive heart failure). Non-selective substances are used: "Propranolol" - 20-40 mg; "Metoprolol" - 25-50 mg orally or in / in a slow stream; "Esmolol" - 250-500 mg bolus (syringe into a vein) followed by infusion at the rate of 50-100 mcg per kilogram of body weight per minute.
5. Calcium channel blockers ("Verapamil", "Diltiazem") are given if there are contraindications to β-blockers.
6. In acute rhythm disturbances, antiarrhythmic drugs are used ("Cordaron" - 5 mg per kg of body weight intravenously, diluted with 250 ml of 5% glucose.

   After a heart attack, what kind of help, state support can you count on?

   Enter for 20-120 minutes.).

7. Narcotic analgesics (in order to avoid pain shock, anesthesia is necessary): "Morphine hydrochloride" - use 1.0 ml of 1% diluted substance in 20 ml of 0.9% NaCl (inject 4-10 ml, fractionally); "Promedol" - according to the same scheme; with respiratory depression - "Naloxone" (0.1-0.2 mg every 15 minutes).
8. Anticoagulants: unfractionated heparin - 60 IU per kilogram of the patient's weight should be diluted in 20 ml of 0.9% NaCl and administered intravenously; "Enoxaparin" - subcutaneously 0.1 ml per 10 kg of weight; "Fondaparinux" - subcutaneously 2.5 mg.
9. With emotional and psychomotor agitation, you can use the tranquilizer "Diazepam".

Medicines used in a hospital setting

In the hospital, patients undergo reperfusion (restoration of normal oxygen supply to the heart), using thrombolytic agents. The first 12 hours after the onset of the disease, the procedure can be free.

List of drugs, the use of which is relevant for thrombolysis:

1. "Streptokinase" - 1.5 million IU / in for 30-60 minutes. (contraindicated if not previously used).
2. "Alteplase" - 15 mg IV bolus (0.75 mg per kg of body weight is administered over 30 minutes, then 0.5 mg / kg over 60 minutes, the total dose is not more than 100 mg).
3. "Tenecteplase" - used in / in bolus: 30 mg with a patient weighing less than 60 kg; 35 mg per 60-69 kg; 40 mg - for 70-79 kg; 45 mg - 80-89 kg; 50 mg if weight > 90 kg.

A patient who is scheduled for thrombolysis needs antiplatelet agents: acetylsalicylic acid, Brilinta or Clopidogrel, as well as anticoagulants: Enoxaparin, unfractionated heparin.

In the first 12 hours after the onset of symptoms of a heart attack, the patient can undergo percutaneous coronary intervention (stenting). In this case, the installation of the stent will be free.

If necessary, continue to use drugs used for myocardial infarction at the prehospital stage: nitrates, antiarrhythmic drugs, beta-blockers. It is important to remember that the latter are able to reduce blood pressure and pulse, which is not always advisable for the patient. With prolonged use of these tablets, the potency in men decreases.

What to drink after a heart attack?

Medicines after myocardial infarction, used as long-term or permanent therapy:

1. Antiplatelet and/or anticoagulant therapy. Antiplatelet agents: "Aspirin" (ASA) - 75-100 mg / day - must be used constantly; "Clopidogrel" - 75 mg / day - 12 months.
2. If these drugs are contraindicated, anticoagulants are recommended: Warfarin (under the control of INR analysis), Rivaroxaban, Dabigatran. First of all, they are prescribed for atrial fibrillation, a thrombus in the left ventricle, the presence of artificial valves.
3. Sometimes combinations of anticoagulants and low doses of ASA, Clopidogrel are used.
4. β-blockers and ACE inhibitors ("Perindopril", "Ramipril") are prescribed regardless of the level of blood pressure and the state of the left ventricle.
5. Mandatory lipid-lowering therapy (lowering cholesterol fractions): Atorvastatin, Rosuvastatin.
6. In diabetes mellitus, it is recommended to achieve a glycosylated hemoglobin level of 6.5%.
7. Diuretics are used for heart failure: "Torasemide" in a daily dose of 10 mg.

Why is it important to take pills during recovery?

Drug treatment of myocardial infarction is mandatory during rehabilitation after it. This prevents ischemia from progressing, thereby increasing survival and reducing mortality. Medications prevent complications and recurrence of seizures, and drugs such as beta-blockers and ACE inhibitors even take part in left ventricular remodeling.

There are government programs to provide patients who have had a heart attack with free medicines (statins, antihypertensive pills). For more information about which medicines are eligible for reimbursement, contact your local or family doctor.

conclusions

Pharmacology is constantly moving forward. Methods of therapy and drugs for myocardial infarction are being improved, and the survival of patients is increasing. The government regularly introduces bills that provide benefits for the treatment of acute ischemia, since the risk of a second episode depends on the fact of continuous use of the pills. But it should be remembered that the best way to deal with pathology is its prevention, which includes giving up bad habits, proper nutrition, sports, good sleep and rest, and regular medical examinations.

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Myocardial infarction is a dangerous form of heart disease, which, unfortunately, is becoming more common in people of all ages.

After a heart attack, a person needs long-term treatment and rehabilitation, which can be fully provided only with the help of additional measures of social support.

What additional benefits can a person expect after a myocardial infarction?

1) Paid sick leave (if the patient works under an employment contract) for a long period - up to 10 months (with a periodic commission extension) or up to 12 months (if an operation was performed).

2) Receiving free medicines necessary for the treatment of the disease, in accordance with the doctor's prescription - during the first 6 months after a heart attack.

3) Referral for free post-treatment to a domestic sanatorium and resort institution (balneological or climatic type) for up to 24 days. Vouchers are issued by medical institutions where people who have had a heart attack are treated, they are paid at the expense of the FSS. A voucher to a sanatorium is issued on the condition that the patient has suffered an acute myocardial infarction, while he has no medical contraindications for sanatorium treatment, he is physically active enough, can independently move up to 1.5 km and climb the stairs for 1 – 2 spans without pain.

4) Restrictions in labor activity. Persons who have had a myocardial infarction are contraindicated in the following types of work:

- associated with an increased degree of danger (work as a driver, pilot, airport dispatcher, railway transport, etc.), maintenance of electrical devices,
- involving active movement (work as a courier, postman, seller, etc.),
- work outside the settlement, in the field, in the open air (work as a builder, geologist, etc.) or in an unfavorable climate (in the northern regions, for example),
– work at high altitude (installers, crane operators, etc.),

- conveyor work,
- harmful production (with the impact on the body of toxic substances),
- night or day work.

If a person who has had a heart attack is employed in one of these types of work, he is issued a medical certificate on the inadmissibility of performing certain types of work and the issue of disability registration is resolved.

What are the benefits after a heart attack?

The employer is obliged to temporarily transfer such a person to a job that corresponds to the state of his health (with his consent), or release him from the performance of labor duties without pay for a period until disability is established, but not more than 4 months. If after that the employer does not find jobs that meet the medical indications for the employee, he is fired.

5) Establishment of disability. Depending on the state of health of a person, his ability to self-care, the attending physician may decide to send him to a medical and social examination (MSE) to establish disability. ITU institutions conduct a survey of a citizen and, guided by the criteria of the Ministry of Health, determine whether he has signs of disability.

If a citizen has a moderate disorder of the functions of the circulatory system and there are difficulties in performing his usual work, he is assigned a 3rd disability group. At higher degrees of disorder of body functions, the ability to self-service, they can assign 2 or 1 group. With the establishment of disability, a citizen can use all the benefits provided for disabled people (pensions, single income, travel subsidies, utility bills, etc.).

Know your rights and enjoy the benefits! And most importantly - be healthy!

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Free medicine after a heart attack

Fedorov Leonid Grigorievich

An acute condition caused by a violation of the proper blood supply to the heart muscle is called. This is a very dangerous disease, since some patients do not survive it due to extensive damage to the myocardium. But even in the case when the patient remains alive, the treatment of myocardial infarction with drugs will continue for life. Medication, diet, walking and a positive attitude are all part of the therapy, which is designed to prevent development, as well as return a person to the most normal healthy life.

Tasks of therapy

The goal of therapy after the elimination of the main manifestations of the disease is to improve the patient's health, eliminate the threat of another heart attack, improve nutrition and oxygen supply to the heart muscle, eliminate thrombosis, thin the blood, lower blood pressure.

To normalize the condition, a complex effect is used, which includes not only mandatory drug therapy, but also changes in lifestyle, nutrition, and attitudes towards one's own health. This process is long and complicated, so the support and love of his relatives and friends is very important for a person. Depending on the severity of the condition, the patient may have to give up his previous job, especially if it was associated with significant psychological and physical stress, constant stress, moving, and so on.

Drugs used after a heart attack are aimed at restoring normal blood circulation in the myocardium, relieving acute pain, reducing arrhythmia and preventing necrosis of heart tissue, which can be fatal.

Rehabilitation after such a serious illness will certainly be long, we can say that the entire patient is focused on coping with the consequences of the disease and preventing the development of complications and side effects.

In addition to drug treatment, therapy necessarily includes a complete rejection of bad habits, weight loss and diet, light physical activity, mainly walking and swimming, physiotherapy exercises. It is very important to stop smoking, as this destructive passion leads to a constant deterioration in the condition of blood vessels, and any spasm of them can cause another heart attack, which can be fatal. The same danger is borne by alcoholic beverages of any type and degree of strength. Like smoking, alcohol has a negative effect on blood vessels, causing them to expand first, and then a sharp spasm. All this is extremely dangerous for a person with high blood pressure and problems with the functioning of the cardiovascular system.

Drugs for myocardial infarction are prescribed only by the attending physician and are selected depending on the patient's condition, the severity of myocardial damage, as well as the presence of other diseases, especially arterial hypertension and diabetes mellitus.

Drug treatment complements the use of intravascular methods to expand the lumen of the vessels and restore blood flow in the blocked artery, as well as the use of surgical methods of treatment. They include, stenting, balloon angioplasty.

Prescribed drugs

All drugs for myocardial infarction belong to different groups of drugs and perform the functions of improving blood circulation, thinning the blood, supplying the heart muscle with oxygen by various methods.

The most popular and commonly used drugs after myocardial infarction:

1. Statins. They are able to break down and remove bad cholesterol, which prevents the formation of plaques that lead to the development of atherosclerosis. The presence of plaques narrows the lumen of blood vessels, promotes an increase in blood pressure, the formation of blood clots and the development of heart attacks.
2. Beta blockers. This is one of the most important means of treating the consequences of the disease, since such drugs reduce the heart rate, reduce the need for oxygen in the heart muscle, and help normalize blood pressure. But these drugs have contraindications and side effects, so they are selected by a cardiologist individually for each patient. This group includes those that even out the heartbeat and improve the patient's condition.
3. Nitropreparations. Drugs such as Nitroglycerin are an emergency remedy that is used for an attack of pain in the heart, to dilate blood vessels, lower blood pressure, and improve well-being. Nitroglycerin is the first remedy that should be given to a patient with a suspected development of a heart attack.
4. Antiplatelet agents. This is a group of drugs that prevent sedimentation on the walls of blood vessels in the area of ​​​​atherosclerotic plaque aggregates - platelets. If such drugs are not taken, a thrombus may occur at the site of narrowing of the vessel with a plaque, which will lead to impaired blood circulation in the surrounding tissues, oxygen starvation and tissue death, that is, it will cause a heart attack. Most often, acetylsalicylic acid in various forms acts as an antiplatelet agent. But when using the drug, it is necessary to strictly follow the instructions and take precautions, since uncontrolled intake of Aspirin threatens to develop bleeding.
5. ACE inhibitors. This is a group of substances that resist vasoconstriction and an increase in blood pressure. Under the influence of these funds, vasodilation occurs, pressure decreases, blood supply to the myocardium and its oxygen supply improve. Preparations of this series have serious contraindications, therefore they cannot be used independently.
6. 
   ARBs (angiotensin receptor blockers). These drugs are considered the most modern way to treat the consequences of a heart attack. They are also called sartans. They work great with arterial hypertension, relieving vasospasm and reducing the load on the heart. The mechanism of their action is to block angiotensin receptors, which provokes vasospasm, circulatory disorders and an increase in pressure. The most advanced post-heart attack pills combine ARBs, renin secretion inhibitors, calcium blockers, and diuretics. These are effective, but expensive remedies that may have contraindications and side effects. The dose must be selected by an experienced doctor.
7. Analgesics. With myocardial infarction, a severe pain syndrome develops, therefore, the patient, along with nitroglycerin, is given strong painkillers that prevent the development of shock.
8. Thrombolytics. These are drugs that fight existing blood clots, that is, cope with the consequences of heart attacks. They have the ability to destroy blood clots and improve tissue nutrition by restoring normal blood circulation. This is a very important part of therapy, which is designed to prevent the breakage and movement of a blood clot, the development of repeated heart attacks.
9. Tranquilizers. During a heart attack, the patient experiences not only acute pain, but also a strong fear of death, so the patient needs sedatives. They reduce the excitement and feelings that negatively affect the patient's well-being. For a faster and more effective recovery, a person needs a calm environment, love and support from loved ones.
10. Anticoagulants. The purpose of such drugs is to thin the blood and prevent the formation of blood clots. Thick blood and its accelerated clotting leads to vascular thrombosis, and this, in turn, causes the death of tissues suffering from a lack of oxygen. If a blood clot forms in one of the heart vessels, it can cause a heart attack. The development of extensive necrosis with repeated attacks often leads to the death of the patient.