Infarction: what is it, the causes of the onset, the first signs, diagnosis and treatment. Types of heart attacks

Cardiovascular disease is almost the number one cause of mortality in many countries. One of the common pathologies is an infarction, what kind of disease is it, for what reason is it developing, is it possible to prevent the disease and how to help the patient? We will try to answer all these questions in detail.

An infarction - what is it?

Almost everyone knows about this dangerous condition, but the mechanism and causes of development are not always of interest, although it must be known to prevent such pathology. An infarct is developing as a result of a violation of the blood supply to the areas of the heart muscle.

This pathology is also called one of the forms of ischemic heart disease. If the blood supply is disrupted for more than 15-20 minutes, then necrosis of living tissues occurs, which is accompanied by severe pain and can result in death.

Cardiologists note that the male population has a heart attack much more often, because in the female body, estrogens control the level of cholesterol in the blood. Earlier, the average age of development of the infarction was 55-60 years, but now it is relatively younger. Diagnosis of cases of pathology, even in young people.

Not always a heart attack ends for a person deadly, but you need to know that after the accident there is always a scar on your heart, so many patients after the transfer of such a disease get a disability.

How is myocardial infarction developing?

The formation of a heart attack begins long before its manifestation. It all begins with the formation of atherosclerotic plaques, which begin to form in the vessels of bad cholesterol. The culprits of his appearance in the blood are errors in nutrition and a sedentary lifestyle. These plaques gradually narrow the lumen of blood vessels, disrupting normal blood circulation.

The process is gradually exacerbated, plaques become so large that any pathological effect on them leads to rupture. At this point, the blood coagulates, forming a thrombus, which clogs the vessel, preventing the blood from passing further. This is exactly what happens in the heart area during an infarction.

Causes of pathology development

If a heart attack develops, the causes may be different, but the main thing is to stop the blood flow to certain parts of the heart muscle. This is most often due to:

• Atherosclerosis of the coronary arteries, as a result of which the walls of the vessels lose their elasticity, the lumen narrows atherosclerotic plaques.
• Spasm of coronary vessels, which can occur against a background of stress, for example, or the impact of other external factors.
• Thrombosis of the arteries, if the plaque breaks away and with the blood flow is brought to the heart.

Factors that can provoke such states include:

• Hereditary predisposition to cardiac pathologies.
• A high content of "bad" cholesterol in the blood.
• The presence of such a bad habit, like smoking.
• Too much body weight.
• Arterial hypertension.

• Diabetes.
• A large number of fatty foods in the diet.
• Chronic stress.
• Some doctors also note the influence of psychosomatics, when the cause of the development of an infarction is excessive aggression, intolerance.
• Affiliation to the strong sex.
• Low physical activity.
• Age after 40 years.

It is necessary to take into account, if there is a combination of several factors, the risk of developing a heart attack increases.

Types of the disease

If we analyze such a pathology as an infarction (which we have already found out), cardiologists distinguish several forms of pathology depending on several criteria.

If we consider the stages of the disease, then they are isolated four, each of which is characterized by its characteristics. The size of the affected area is also taken into account in the classification. Allocate:

• Large-focal infarction, when tissue necrosis captures the entire thickness of the myocardium.
• Small-focal, a small part is affected.

The location is distinguished by:

• Heart attack of the right ventricle.
• The left ventricle.
• Interventricular septum.
• The side wall.
• Rear wall.
• The anterior wall of the ventricle.

Infarction can occur with complications and without, therefore cardiologists distinguish:

• Complicated heart attack.
• Uncomplicated.

The localization of pain can also be different, so the following types of infarction are distinguished:

• A typical form with a pain syndrome behind the sternum.
• Atypical form can be manifested by abdominal pain, shortness of breath, heart rhythm disturbance, dizziness and headache. Sometimes a heart attack develops in the absence of pain.

Types of infarcts are also allocated depending on the frequency of development:

• Primary pathology.
• Recurrent myocardial infarction.
• Repeated.

Life after a heart attack will depend on the severity of the pathology, its shape and timely assistance.

Stages of infarction

Necrotic changes in the heart muscle develop in a certain sequence, so the following stages of the infarction are distinguished:

1. Pre-infarction. The duration of this period is from a few hours to several weeks, at this time in the heart muscle is already formed small foci of necrosis, in their place and then develops a heart attack.
2. The most acute period can last from a few minutes to 2 hours. Myocardial ischemia is increasing.
3. The acute stage of the infarction lasts several days. During this period, a hearth of necrosis forms in the heart and a partial resorption of damaged muscle tissue is observed.
4. The postinfarction stage can last up to six months, the scar from the connective tissue is formed definitively.

Diagnosis of myocardial infarction

The diagnosis begins with a conversation with the patient. The doctor finds out when there are pains, what kind of character they have, how long they last, how the patient relieves heart attacks and whether there is a result from taking medications.

Then the risk factors are identified, for this the doctor specifies the lifestyle, culinary preferences, the presence of bad habits. An analysis of the family history is made - the doctor finds out if in the family someone has heart disease, whether there were cases of a heart attack.

The patient is then referred for the following examinations and tests:

1. A general blood test is done, it allows to detect an elevated level of white blood cells, a high rate of erythrocyte sedimentation, signs of anemia - all this begins to manifest itself when the cells of the heart muscle are destroyed.
2. The analysis of urine will help to find the accompanying pathologies, which can provoke heart attacks.
3. A biochemical blood test is performed to find out:

• Cholesterol content;
• The ratio of "bad" and "good" cholesterol;
• Presence of triglycerides;
• Blood sugar in order to assess the risk associated with arteriosclerosis of blood vessels.

If there is a suspicion of a heart attack, then a specific blood enzyme is examined.

A coagulogram is made, it gives blood clotting indicators that help to choose the right dosage of drugs for treatment.

Diagnosis of myocardial infarction is impossible without electrocardiography. The results specialist can determine the location of the pathology, the duration of development and the degree of damage.

An ultrasound examination of the heart is performed to study the structure and dimensions of the heart muscle, to assess the degree of vascular damage by atherosclerotic plaques.

X-ray helps to detect changes in the thoracic aorta, lungs and to detect complications.

Coronaroangiography is used to clarify the diagnosis, it allows to accurately determine the place and degree of vasoconstriction.

Computed tomography with contrasting allows you to obtain an accurate image of the heart, to reveal defects in its walls, valves, abnormalities in functioning and narrowing of the vessels.

After all the studies, you may need to consult a therapist.

Only after the diagnosis is clarified, the patient is assigned effective therapy, which will help to lead life after a heart attack in a normal way.

Symptomatology of pathology

As a rule, the infarction does not develop from scratch, usually the patient has already diagnosed angina or other cardiac pathologies. If a heart attack develops, the symptoms, the first signs in women and men can be as follows:

• The pain behind the breastbone becomes more intense and prolonged. The pain has a burning sensation, compression and compression can be felt, it can be delivered to the shoulder, arm or neck.

• There is an irradiation and expansion of the pain zone.
• The patient can not withstand physical exertion.
• The reception of "Nitroglycerin" does not already give such an effect.
• Even at rest there is shortness of breath, weakness and dizziness.
• There may be unpleasant sensations in the abdomen.
• The heart rhythm is broken.
• Breathing becomes difficult.
• There is a cold sweat, skin pale.

If you have any of these symptoms, you should urgently call a doctor.

First aid to the patient

If there is a suspicion of a heart attack, the symptoms, the first signs in women will only progress if not to render emergency help. It consists in the following:

• The person must be seated or put in a comfortable position.

• Unfasten the squeezing clothes.
• Provide air access.
• Give a tablet under the tongue "Nitroglycerin", if the attack is strong, then you can and two.
• If there is no Nitroglycerin, then you can use Corvalol or Aspirin.

Urgent help with a heart attack will help relieve pain during an attack and reduce the risk of complications.

Complications after a heart attack

It is very rare that there is a heart attack without complications, the consequences are almost always. They reduce life expectancy after the transferred pathology. The most common diagnoses are the following complications:

• Heart failure.
• Rupture of the heart muscle.
• Aneurysm.
• Cardiogenic shock.
• Violation of the rhythm of the heart.

• Postinfarction angina.
• Pericarditis.

Infarction can have late consequences, for example:

• A few weeks later, postinfarction syndrome may develop.
• Thromboembolic complications are often noted.
• Neurotrophic disorders of the nervous system.

Many patients are interested in the question of how much you can live after a heart attack? The answer will depend on several factors: the degree of damage to the heart muscle, the timeliness of first aid, the effectiveness and correctness of therapy, the development of complications.

According to statistics, about 35% of patients die, most of them even before they reach the medical facility. Those patients who have had a heart attack, are most often forced to change their field of activity or even leave work, many get a disability.

How to prevent a second infarction or to prevent its appearance at all

Everyone now is aware of a heart attack, that this is a very serious disease that can result in death or make an invalid. But everything is in the hands of the person - if you follow certain recommendations, you can significantly reduce the risk of developing this pathology:

1. Constantly keep under control the level of blood pressure, especially if there is a periodic increase.
2. Follow the blood sugar level.
3. In the summer, avoid being in direct sunlight for a long time.
4. It is necessary to revise your diet, reduce the consumption of fatty foods, semi-finished products and add fresh fruits and vegetables.
5. Increase physical activity, do not necessarily go to the gym, it is enough to take walks every day, walk a lot, ride a bicycle.
6. If health is more expensive, then you will have to give up smoking and alcohol abuse, and not get carried away with coffee.
7. Keep your weight in the norm, if you can not reduce it yourself, then you can visit a nutritionist who will help to make an individual nutrition program.
8. In the presence of chronic diseases it is necessary to treat them periodically, especially, it concerns cardiac pathologies, vascular diseases.
9. If relatives were diagnosed with myocardial infarction, then one should take their health more seriously, avoid heavy physical labor.
10. Annually it is necessary to arrange a proper rest away from the city bustle, you can go to the mountains or to the sea coast.
11. As little as possible to expose oneself to psychoemotional loads, to learn the methods of relaxation.
12. Regularly undergo a test and take all the necessary tests in order to timely detect an elevated level of sugar or cholesterol in the blood.

If the heart attack could not be avoided, then we must make every effort to prevent a second attack. To do this, you must follow all the doctor's recommendations, take prescribed medications and change your lifestyle.