What Is Myocardial Infarction?
Myocardial infarction (MI) is an acute form of coronary heart disease characterized by the development of ischemic necrosis of the area of the myocardium, which occurs as a result of absolute or relative insufficiency of blood supply to a separate area of the heart. The reason for acute MI in the vast majority of patients is stenosing atherosclerosis of the blood vessels, thrombosis and prolonged spasm with occlusion. Myocardial necrosis almost always occurs because of total occlusion of the coronary ("infarct-dependent") artery thrombus, which is formed on the destabilized atherosclerotic plaque, often due to the rupture of the plaque. In the case of young people, the cause of acute MI may also be congenital anomalies of coronary arteries, severe acute bleeding, aortic stenosis, or other clinical conditions, when there is a sharp discrepancy between the need for myocardium in oxygen and its insufficient blood supply. What are the symptoms of this disease?
The main clinical symptom of MI - intense pain in the sternum or in the area of the heart, compression, "dagger" or burning nature, lasting for more than 15-20 minutes, in common cases irradiates in the left arm, left shoulder, shoulder blade, not removed by the intake of nitrates. However, pain may be different. So, the patient is likely to complain about abdominal pain, throat, arms, shoulder blades. Quite frequently the pain is accompanied by a sense of fear of death, which soon comes into a sharp general weakness. Sometimes the disease has a pain-free nature, which is typical for patients with diabetes mellitus. Often pain is followed by profuse sweating. Patients may also notice sudden shortness of breath, unproductive cough, manifestations of arrhythmias in the heart (feeling heartbeat, interruptions in the work of the heart, etc.), severe weakness or dizziness.
However, in 20% of patients, the diagnosis of acute MI is contaminated due to the absence of a typical pain syndrome. Yes, there are often atypical cases of myocardial infarction when the disease appears only stomach pain with nausea / vomiting, sudden shortness of breath, acute attack or arrhythmia zneprytomninnyam.
Such a clinical picture contaminates the diagnosis of MI. The current treatment of MI is the prompt recovery of coronary blood flow in the early stages of the disease. Acute myocardial ischemic reperfusion can be made with a quick appointment intravenous or intracoronary thrombolytic therapy, urgent coronary balloon anґ ioplastyky, stenting of coronary arteries or coronary bypass surgery. It is early reperfusion and concomitant antiplatelet / anticoagulant therapy to prevent thrombosis and subsequent retrombozu / restenosis is the most powerful means for limiting infarct size and prevent complications of the disease. And these modern methods of treatment of MI allow to reduce the mortality rate caused by the MI.
Early pharmacological reperfusion (thrombolysis), as well as invasive, endovascular techniques for coronary circulation (balloon coronary angioplasty, stenting of the "infarct-dependent" artery after coronary angiography) are used in cases of patients with MI on the basis of the Khmelnytsky regional cardiologist. And for those patients who have a multicentric lesion of the coronary arteries, a lesion of the valve apparatus of the heart or arrhythmic complications, a wide range of cardiac surgery is performed such as aortic coronary or mammal coronary artery bypass grafting, prosthetics of the valves of the heart, implantation of pacemakers with violations of the cardiac rhythm and Conductivity and so on.
After the discharge from the hospital an extremely important period of rehabilitation has lasted up to 6 months. The patient is assigned to go through a combined medical therapy, which should be taken permanently during the life in order to maximize the patient's prognosis. There is also the so-called spa resort rehabilitation of patients with myocardial infarction, which lasts for an average of 2-4 weeks and involves a gradual phase-out expansion of their physical activity, physical training (walking distance of 2-3 km in one reception, a total of 7-10 km during the day ), Elimination of risk factors, psychological rehabilitation and correction of medical therapy depending on the functional state. The main purpose of rehabilitation at the sanatorium is to prepare the patients for returning to work. It should be noted that the in terms of the following recommendations and medical appointments, refusal of smoking, as well as compliance with the diet, after the transmitted MI patients can live a healthy and healthy life for a long time.
How to protect yourself from MI?
Specialists from the World Health Organization say that three-quarters of all deaths in the world can be prevented through appropriate lifestyle changes. So, first of all follow the principles of a healthy lifestyle, opt out of smoking, be active and regularly busy with exercise, get rid of excess weight, eat low-fat food, limit consumption of salt and alcohol, control your blood pressure and levels of cholesterol and glucose in the blood. This is the primary prevention of cardiovascular disease and MI, in particular.
If you have suffered from myocardial infarction, it is important to take measures to avoid the repeated diseases, prevent premature death, slow down the progression of atherosclerosis and heart failure (secondary prevention). To do this, it is necessary to clearly fulfill the appointment of a doctor to take medicine and modify the lifestyle in compliance with the recommendations. Remember that treatment should be permanent and any independent changes may adversely affect your health.
Klenets Andriy Ivanovich
Khmelnytsky Regional Cardiology Dispensary
The main freelance cardiac surgeon of the Department Health care of the Khmelnytsky Oblast
Honored Doctor of Ukraine
Candidate of Medical Sciences
Shchepina Natalia Vadimovna
Candidate of Medical Sciences
Khmelnitsky Regional Cardiology Center
Khmelnytsky city, Volodymyrska str., 85
Tel .: 0382764366