Disorder in which damage occurs to the area of heart muscle because of its insufficient supply of oxygen.
Causes, incidence, and risk factors
Causes of the clot or a spasm of the arteries that supply the heart muscle with blood (coronary arteries). This and other similar states are blocking the flow of oxygen to the heart area, causing damage or death of cells in the area. This is usually in a coronary artery that is narrowed due to changes caused by atherosclerosis. Damaged tissue forever lose the ability of the contraction of heart muscle.
Risk factors are: smoking, hypertension, hypotension, diabetes mellitus, foods high in fat, high cholesterol levels (LDL), obesity, people over 65 years of age and hereditary factors. At the same time, the disease affects more men of the population. Increase the risk of personal or family preference coronary artery disease, cerebrovascular disease, peripheral vessel disease, angina (especially unstable angina) or renal failure requiring hemodialysis. "Trigger" for me sometimes, though rarely, it can be an unexpected high stress. In the elderly may be a risk factor in defecation straining.
Acute MI annually affects about two out of 1000 people and is the most common cause of sudden death in adults.
Symptoms
The main symptom of MI is chest pain. However, in many cases it is mild, even nonexistent, especially in elderly and diabetic patients. Other symptoms such as weakness, shortness of breath, nausea and vomiting can be dominant.
chest pain below the sternum
backache
abdominal pains
pain in the chest, arms and shoulders (see the pain in the shoulder)
pain in the neck, jaw and teeth (see: toothache, sore face)
backache
duration of pain is prolonged, typically over 20 minutes
angina-like pain that never ceases to bed rest or by taking nitroglycerin
longer any pain in the chest, back or abdomen
Pain is:
as for "indigestion"
intense, strong, weak, there is
has the character of shrinkage or weight, belt-tightening around the chest
like "an elephant sitting on chest"
shortness of breath
cough
dizziness
loss of consciousness
nausea
vomit
sweating profusely, which can be (diaphoresis)
dry mouth
sense of "near death"
restlessness
Other symptoms that may be associated with disease are:
cramps
exhaustion
temporary cessation of breathing
shortness of breath, the need for laying
blood pressure (low, high, normal)
behavior (and unusually agitated)
Note: Number of cases most likely to deny having a heart attack. Symptoms may be absent ("silent attack").
Signs and tests
Scanning is usually establishes a rapid pulse. Blood pressure may be normal, high or low. Stethoscope (auscultation) may detect crackles in the lungs, heart murmur and other abnormal sounds.
ECG, single or repeated over 2-3 days is often reveals MI.
MI size and cardiac damage can be diagnosed by the following tests:
coronary angiography
ventriculography (MUGA or Rnv)
echocardiography
ergometry
Byproducts of heart damage and factors that indicate the MI determined by laboratory tests (LDH, LDH isoenzymes, CPK, CPK isoenzymes, etc.).
Treatment
Acute MI requiring immediate medical intervention
Usually need hospital treatment lasting 1-14 days. It is necessary to immediately begin monitoring the ECG for arrhythmias during the first few hours after acute MI can be fatal. The goal of treatment is to reduce cardiac workload in order to prevent possible complications and eliminate the current. At first, limit physical activity, and then gradually increase. In emergency drugs and infusion solutions are given intravenous catheter.Depending on the general condition can be applied to invasive diagnostic methods. To directly monitor the status of body fluids enter the urinary catheter. It is usually given oxygen, even if its level in normal blood, which ensures fast supply of tissues and reduce the burden on the heart.
Limit feeding is not inevitable, but if the food is indicated not contain much salt, caffeine should be free and low fat content.
Medicines
Morfijje analgesic that is generally given for pain management.
Nitratikao example. nitroglycerin, are given pain relief and reduction of cardiac oxygen consumption.
Beta-blockers (atenolol) reduce cardiac workload.
Digitalis improves heart function as a pump.
Channel blockers kalcijasmanjuju oxygen consumption in heart muscle. They can prescribe diuretics and antiarrhythmics.
Therapy with thrombolytics (anticoagulants) typically begins within 6 hours after the first chest pain. Initial therapy consists of intravenous infusion of anticoagulant (streptokinase or tissue plasminogen activator) and immediately after intravenous infusion of heparin. Heparin is given over 48-72 hours. In addition to giving oral aspirin and warfarin to prevent thrombus formation. Thrombolytics therapy is contraindicated in cases of minor surgery, organ biopsy or major trauma experienced back 6 weeks, then a recent neurosurgical procedure, head trauma back a month, history of GI (gastrointestinal) bleeding, intracranial tumors, stroke back 6 months or pregnancy.
Bleeding and hemorrhage are potential complications of therapy with thrombolytics.
Surgical Procedure
Some patients need to make an emergency surgery.
Forecasts
The outcome depends on the size and location of damaged tissue. Damage to the electroconductive system (impulses that control heart rate) worse prognosis. In one third of cases the outcome is fatal. If the patient survives 2 hours after the attack, the greater the possibility of his survival, but complications were not excluded.If not, complete recovery is possible. MI does not cause disability, and sufferers can gradually return to normal life and normal activities, including sex.
Complications
Arrhythmias like. ventricular tachycardia, ventricular fibrillation, heart block, congestive heart failure, cardiogenic shock, an extension of the affected heart tissue, pericarditis, a complication of treatment (eg, use of thrombolytics during treatment increases the risk of bleeding).
Contact your doctor
If you feel lancinating chest pain or any symptoms of acute MI, go to the doctor on duty or call an ambulance (telephone 94).
Prevention
Whenever you are able to control your risk factors. Control your blood pressure and total cholesterol, reduce or stop smoking, change diet (increase the intake of high-density lipoprotein and reduce your intake of low-density lipoprotein), if you need a test for diabetes if you are obese remove excess weight. Engage in exercise to improve cardiovascular status. (Prior to this, consult your doctor). After MI is important to be under constant medical control to reduce the risk of new MI. Many recommended rehabilitation program that promotes a gradual return to normal life. Follow the exercise program, diet and / or prescribed medication.
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