- Myocardial infarction - the most formidable diagnosis
Types of heart attacks
Myocardial infarction - a serious illness, which all fear. But absolutely healthy heart attacks do not happen, so we need to promptly identify and treat heart disease, especially if they are accompanied by pain in the heart. And as the pain in my heart are different, only a doctor can tell whether they threaten the patient's life. Myocardial infarction occurs in acute coronary violation (which supplies blood to the heart muscle) circulation. If a coronary artery spasm lasts a long time, then it dies of the heart muscle, which is suitable for this artery, so the more the artery, the greater part of the heart muscle it supplies oxygen and nutrients and the more extensive infarction is in violation of its terrain.
Myocardial infarction can be macrofocal and melkoochagovogo. Depending on the extent of necrosis (necrosis) in wall thickness are the following forms of myocardial infarction:
- transmural (necrosis extends through the entire thickness of the heart muscle and adjacent outer and inner lining of the heart);
- intramural (necrosis develops within the heart muscle);
- subepicardial (myocardial necrosis in the layer adjacent to the outer shell of the heart - pericardium);
- subendocardial (myocardial necrosis in the layer adjacent to the inner shell of the heart - the endocardium).
In most cases of myocardial infarction in men older than 50 years, but there are cases of development and 30 years of age and younger. In women under 60 years it occurs almost three times less than that of men, then the difference is reduced.
Macrofocal myocardial infarction
Typical for myocardial infarction involves five periods: prodromal, acute, acute, subacute, and after infarct.
Prodromal period or period of precursors (PIS) lasts from a few hours to a month. By precursors include appearing for the first time signs of angina
Symptoms of angina - chest discomfort
or acceleration, elongation, and increased severity of existing angina attacks.
Acute period - the time between the onset of severe ischemia infarction area and the appearance of signs of its necrosis. It occupies the period from half an hour to two hours and is characterized by episodes of severe pain, which is localized in the chest, at least - in other areas of the chest and in the stomach. Pain can give to his left arm, back, jaw, has a constricting, oppressive character. The pain is accompanied by sharply there is a sharp general weakness, often nausea, vomiting. In the first minutes or hours usually marked by high blood pressure, then it drops sharply.
Acute period during which the image portion myocardial necrosis, lasts 2 to 10 days, sometimes - longer. During this period, pain in the heart
Pain in the heart - always consult a doctor
It decreases or disappears altogether. During this period may appear cardiac arrhythmias, rise the temperature to 38˚ or higher.
Subacute period during which completes the initial processes of formation of scar necrosis at the site is completed by the end of 4-5 weeks from the onset of the disease (not counting the prodromal period). Heart pain is usually absent, gradually increased blood pressure, decreased cardiac arrhythmias.
Postinfarction period lasts 3-6 months after the formation of necrosis. At this time, the density of the scar, and the myocardium becomes accustomed to the new conditions of work. This results in a compensatory increase in mass of the heart muscle are not infarcted.
Small focal myocardial infarction
Frequency during melkoochagovogo myocardial infarction is less pronounced than in macrofocal. Heart pain in this form of less severe and prolonged. Prolonged pain could be due to the formation of additional foci of necrosis. Arrhythmias and sudden drop in blood pressure
Blood pressure - dangerous if his swing?
Atypical forms of myocardial infarction
In some cases, completely absent heart pain. The disease may begin with an acute heart failure
Heart failure - when the heart is unable to cope with the work
, For example, pulmonary edema: stagnation in the blood vessels of the lungs causing propotevanie fluid into the lungs and the person starts to choke.
Sometimes myocardial infarction begins with cardiac arrhythmias (such as atrial fibrillation, when the heart beats irregularly and often). Often the beginning of the disease in the form of general weakness and malaise, and in such cases, myocardial infarction, or its effects may be accidental finding on an electrocardiogram.
Diagnosis of myocardial infarction based on characteristic symptoms and ECG data, which are clearly visible characteristic changes from the beginning of myocardial infarction. Nevertheless, the clinical signs are basic, because there are ECG-negative form of the disease, when this study revealed signs of myocardial miokardane.
Additional methods of research - laboratory (blood revealed signs of inflammation and tissue decay).
Treatment of patients with myocardial infarction is made up of the earliest possible admission to the hospital, strict bed rest, pain relief in the heart, preventing the formation of clots in blood vessels, efforts to restore areas of the heart muscle adjacent to the necrotic zone, and treatment of complications of the disease. The recovery period is attached physiotherapy.
Remember, long sharp pain in my heart requires immediate medical attention!