The early post-infarction angina - is the resumption of attacks of pain in the chest during the day by up to two weeks after acute myocardial infarction. This type of angina is a poor prognostic sign: these patients often develop recurrent myocardial infarction.

Postinfarction angina: types and causes of

Angina - is at the heart attacks of pain caused by oxygen starvation of cells of the heart muscle (myocardium). Most often, angina develops against the background of atherosclerosis and coronary heart disease (CHD) due to reduction of the lumen of the coronary vessels, which are deposited on the walls of atherosclerotic plaques. An extreme manifestation of coronary heart disease is myocardial infarction - necrosis of cardiac muscle tissue segment with prolonged oxygen deficiency.

After myocardial infarction, many patients when properly conducted timely treatment of angina is not renewed for a long time. Sometimes the attacks of angina after myocardial infarction does not happen at all. It is a good prognostic sign - in these patients rarely visit another heart attack.

At the same time, quite often there are cases of post-infarction angina, which is divided into early and late. The early post-infarction angina may occur one day after the relief of pain and in the next two weeks. As a rule, it is unstable, that is, attacks do not develop on the background of physical exertion and at rest. The development of angina attacks immediately after myocardial is a bad prognostic sign, because it can talk about increasing areas of necrosis, or the risk of its development.

The early post-infarction angina may develop on the background of a residual stenosis of the coronary artery after medical or spontaneous thrombolysis (dissolving blood clot closes the lumen of the artery), multiple lesions of coronary vessels with the development of spasm in an artery unrelated to the infarction, postinfarction enlargement of the left ventricle of the heart associated with impaired contractility of the infarction and so on.

Late post-infarction angina develops after myocardial infarction in the period from the third to fourth week inclusive. Symptoms of late postinfarction angina usually develop on the background of the outbreak of physical activity of the patient and are associated with physical exertion. Thus, late postinfarction angina is stable in nature and therefore less dangerous than earlier.

Nevertheless, postinfarction angina and later re-infarction can be complicated, particularly if its symptoms progress, i.e. increases the frequency, intensity and duration of pain episodes.

Symptoms

Symptoms of the disease are symptoms of angina at rest Angina rest - invisible enemy When heart attacks of pain not associated with physical activity and occur at rest. The pains usually occur in the upper or middle third of the sternum, and extend to the area of ​​the left shoulder and left breast. The pains are intense squeezing character and do not last more than 5 minutes. As a rule, they are well removed nitroglycerin.

After the period ends scarring of myocardial infarction, myocardial infarction is generated, and angina is no longer a post-infarction, it is determined by the kind of clinical signs.

Treatment

The main objective of the treatment of early post-infarction angina, unstable angina is a translation Unstable angina - alarm organism   stability. To do this, try to minimize the load on the myocardium: patients with high blood pressure prescribed antihypertensives in patients with heart rhythm disturbances - antiarrhythmics, in violation of cardiac contractility and heart failure events - diuretics and restores the water-salt metabolism.

To remove the angina attack started Angina - oxygen deficiency   prescribed nitroglycerin to prevent strokes - nitrosorbid, nifedipine. To suppress the activity of the sympathetic nervous system administered atenolol or metoprolol.

The early post-infarction angina - is a dangerous complication that requires an individual approach to the treatment of the patient.

Galina Romanenko

The thickening of the interventricular septum - is one of the most characteristic symptoms of the disease such as hypertrophic cardiomyopathy. This violation is observed hypertrophy, or thickening of the walls of the right and left ventricles of the heart; most often the disease affects the interventricular septum. The thickening of the interventricular septum is observed in approximately 70% of people with hypertrophic cardiomyopathy. At the same time the heart becomes harder to pump blood, which may eventually lead to various health problems.

Symptoms of a thickening of the interventricular septum

The vast number of people thickening of the interventricular septum, and hypertrophic cardiomyopathy remain undetected for a long time, as the disease can be for many years did not cause any symptoms. A man with such a violation can lead quite a normal life, but during intense physical exertion disease makes itself felt. This violation has repeatedly became the cause of death of young athletes, among them - Miklos Feher, Hungary striker in football. At 24, his heart stopped right at the time of the match, and attempts to resuscitate the athlete have failed - a few hours later he died in hospital. Only the autopsy he was found hypertrophic cardiomyopathy.

Apparently, up to a certain time heart with thickened interventricular septum can handle even severe loads and the person will feel normal. In some cases, however, the violation may cause the following symptoms:

• Shortness of breath, especially during exercise;
• Chest pain that occurs, as a rule, the same time training;
• Nausea and dizziness Dizziness - if the ground is slipping from under his feet ;
• Fatigue;
• Palpitations of the heart - a very strong and frequent palpitations, occurs from time to time;
• Heart murmur that the doctor can identify the survey.

The above symptoms may be caused by many disorders, but in any case can not be ignored. When you see any of these signs as soon as possible address to the doctor to be examined.

Immediately seek medical attention if for more than five minutes, you have the following symptoms persist:

• Fast or irregular heartbeat;
• Heavy breathing;
• Chest pain.

The causes and possible complications

The thickening of the interventricular septum is most often caused by gene mutations, due to which part of the heart muscle becomes abnormally thick. Unlike many other diseases of the heart, a violation is not related to bad habits or overweight. The probability that human children with this disease, too, will suffer from hypertrophic cardiomyopathy, is 50%. If a person was found a violation of his close relatives - parents, siblings, children - are also encouraged to walk through inspection at the cardiologist.

The consequences of a thickening of the interventricular septum is strongly differing from person to person. In some cases, a person may not realize the years of his illness. This becomes clear when people - especially the young and leading an active lifestyle - die from this disorder, but for obvious reasons, it is impossible to say how many people died in old age, and not knowing that they had hypertrophic cardiomyopathy. However, some people have a thickening of the interventricular septum can lead to the following consequences:

• Arrhythmia. Thick interventricular septum, as well as anomalies in the structure of the heart muscle cells, which are often observed in hypertrophic cardiomyopathy may lead to disturbances in the conduction system of the heart, which causes an irregular heartbeat, or arrhythmia. Atrial fibrillation, ventricular tachycardia Tachycardia - the body to the limit?   and ventricular fibrillation - a kind of arrhythmia, which can be caused by hypertrophic cardiomyopathy;
• Violation of the outflow of blood from the heart muscle. At the same time there may be symptoms such as dyspnea on exertion, chest pain Chest pain is one symptom - a lot of diseases , Dizziness, and sometimes fainting;
• Dilated cardiomyopathy. Over time, the seal wall of the heart muscle may become weak and will work less efficiently. Dilated cardiomyopathy - a disorder in which the cavities of the heart are stretched, there are problems with the conduction system of the heart, the heartbeat becomes irregular, reduced cardiac output;
• Problems with the mitral valve. Due to the thickening of the interventricular septum and other structures of the heart muscle in the heart is less space for blood flow, because of what she has to move through the heart valves faster, and with greater force. As a result, the mitral valve (located between the left atrium and left ventricle) can not normally be closed, and the blood can flow through it back. This disorder is called mitral regurgitation and its complications can be arrhythmia and heart failure;
• Heart failure. Thick interventricular septum and / or other parts of the heart muscle may become too hard to have a normal of the heart to fill with blood. If because of this, the cardiac output is reduced so that the circulatory system receives less blood than needed by the body, heart failure is diagnosed. The main symptoms of heart failure are shortness of breath, which may occur even at light load, extreme fatigue and swelling of the feet Swelling of the legs - do not leave without attention . Some patients have had and features such as persistent cough, lack of appetite, weight loss, increased heart rate;
• Sudden cardiac arrest. Hypertrophic cardiomyopathy is the most common diseases of the heart, causing death in people under the age of thirty years, and though such cases are very rare.