disease develops as a result of sharply arisen discrepancy between cardiac oxygen demand and the ability of delivery coronary arteries.
Causes of myocardial infarction
Almost 99% of the principal causal factor is myocardial infarction atherosclerosis.This pathology is caused by a high content of cholesterol in the blood, changes in the vascular wall and other factors that result in the vessels of atherosclerotic plaques are formed.
Atherosclerosis can occur unnoticed for a long time.But if the capsule is damaged plaque, thrombus is formed on it, which leads to occlusion of the artery.As a result, limited blood supply to the heart or abruptly stops, and the muscle is subjected to ischemia and subsequent necrosis.
Sometimes the cause of a heart attack becomes a physical or emotional burden.Due to the strengthening of cardiac myocardium is experiencing greater than normal n
Symptoms of heart attack symptoms in women and men
preinfarction period manifested mainly angina, it can take from 2-3 minutes to 1-1.5 months.At this time, it is important to pay attention to these symptoms and start treatment - then a myocardial infarction can be avoided.
followed by acute period.A typical myocardial necrosis Clinic includes the following symptoms:
- sense of fear;
- such symptoms of heart attack in women, as a severe weakness and lethargy;
- impairment of consciousness (lethargy, apathy).
There are more rare clinical forms of myocardial infarction, for each of which are characterized by their symptoms.
- asthma attack;
Asthmatic option myocardial infarction manifested symptoms of pulmonary edema - shortness of breath, gurgling wheezing, cough.
For abdominal form is characterized by pain in the epigastric region of the abdomen, accompanied by hiccups, belching, vomiting, flatulence and diarrhea.
Cerebrovascular form of heart attack is characterized by a predominance of signs of acute cerebral blood circulation (dizziness, loss of consciousness, vomiting or nausea, speech disorders).
Sometimes myocardial infarction occurs in the form of arrhythmia, which are the main symptoms of palpitations, irregular heart up to ventricular fibrillation.Special difficulties in diagnosis occur when malosimptomno course of the disease.The only manifestation may be a pain in the left arm or heartburn, mild weakness.
consequences of myocardial
There are early and late effects of myocardial infarction.Early complications (within 10 days of the start of heart attack):
- cardiogenic shock;
- acute failure of the left ventricle;
- arrhythmias (supraventricular or ventricular);
- violation of cardiac conduction (sinoatrial block, AV block, bundle branch block feet);
- heart attack;
- aneurysm of the left ventricle;
- cardiac tamponade (blood gets into the pericardial cavity and compresses the heart);
- thromboembolic complications (thrombosis of arteries of the brain, of course);
- aseptic pericarditis.
- postinfarction angina;
- Dressler's syndrome (an autoimmune lesion of the pleura, lung, pericardium, joints);
- chronic heart failure;
- chronic aneurysm (protrusion) of the left ventricle;
- various arrhythmias.
Diagnosis When diagnosing a heart attack a lot of attention is paid to the patient's complaints and clinical symptoms.Within 1.5 hours from the beginning of pain attack observed motor excitation, then comes confusion.Noticeable pale skin, protruding sweat, cyanosis of the lips, fingertips, cold extremities.
On the 3rd day of illness develops toxic and necrotizing syndrome manifesting a rise in temperature, a headache.Auscultation observed decline sonority I pitch in the top of the heart, II of tones - the aorta, "gallop rhythm" as a result of overloading of the left ventricle, arrhythmias.On the second day can be friction noise pericardial leaflets that said accession aseptic pericarditis.
very valuable method of diagnosis is to determine the blood indicators of myocardial necrosis: cardiac troponin, creatine kinase MB fraction, myoglobin, lactate dehydrogenase, alanine aminotransferase and aspartate aminotransferase.The most specific sign of necrosis of the heart muscle is to increase the level of troponin I and troponin T. The test helps diagnose the disease even before the appearance of ECG changes.
- Electrocardiography: the ECG in different periods of the disease is found a decrease or an increase in the ST segment for several mm relative contour, there prong Q (pathological) disappears tooth of the R, observed various violations conductivity and rhythm (blockade, arrhythmia, beats).Depending on in which leads are changes can be assumed localization of myocardial infarction.
- Echocardiography: ultrasound of the heart, you can identify the affected areas of infarction, ventricular enlargement symptoms, to determine the presence of an aneurysm, assess the extent of violation of contraction, and other indicators of cardiac activity.
- Chest cavity: is conducted for the diagnosis of pulmonary edema, pneumonia and other complications of MI.
- Coronary angiography: is necessary in the event that is supposed to prompt treatment of the disease.This study is to determine which of the coronary arteries affected.
Principles of treatment
best way to IM treatment - surgery, during which removed the thrombus from coronary vessel angioplasty or held.As a result, it restored the viability of ischemic myocardial necrosis or restricted area.If emergency surgery is not possible, hold conservative therapy, which includes:
- motor mode;
Myocardial infarction, the following means:
- analgesics (narcotic and non-narcotic analgesics);
- Antiplatelet agents and anticoagulants (aspirin, clopidogrel, heparin, fraxiparine);
- diuretics (pulmonary edema).
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