Heart attack: symptoms, first signs
Myocardial infarction is a deadly disease, but not a sentence. The development of irreversible consequences can be prevented if the patient will be timely qualified medical assistance. Therefore every adult needs to know the first signs of a heart attack to when they occur, relative or passerby immediately be able to provide an ambulance.
The heart is very sensitive to lack of oxygen by the body, so when the cessation of blood supply to the heart muscle starts to ischemia and then necrosis – irreversible destruction. This is myocardial infarction.
Why it is so dangerous the disease is? It is important to understand that the damaged area of the heart muscle ceases to perform its function, that in General affect the activity of the heart. And the larger the area of necrosis (infarct may be small focal, transmural or large-focal – exciting the entire thickness of the heart wall), the more pronounced these violations.
Patients with myocardial infarction may die from acute heart failure, cardiogenic shock, myocardial rupture and cardiac tamponade (occurs due to the accumulation of blood in pericardial cavity surrounding the heart). The development of these complications can be prevented if early tromboliticescoy therapy and other therapeutic measures.
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What causes myocardial infarction?
The basis for the development of this pathological process is a violation of the blood supply to the heart muscle when impaired patency of the coronary arteries (vessels that provide blood to the heart). The reasons for such changes can be:
- Atherosclerosis of the coronary arteries. Obstruction (blockage) of blood vessels can occur when the formation of a large atherosclerotic plaque. In addition, clogging of the artery can clot, which is formed in the ground damages the inner lining of the vessel. Moreover, damage can be minimal – for example, the cracks that occur in hypertension and arrhythmias. It is important to understand that a healthy vessel is a solid wall, therefore, jumps in blood pressure for him is not terrible, but affected by the atherosclerosis is very vulnerable.
- Embolization of the coronary arteries (the ingress of pieces of blood clots from larger vessels).
- Spasm of the coronary vessels (heart attack may develop if the clearance overlap more than 70%).
What symptoms indicate a heart attack?
The main symptom of the outbreak of myocardial infarction is severe pain in the chest that does not disappear in the calm and after ingestion of Nitroglycerin tablets. Patients describe the pain as pressure, burning, radiates to left shoulder, arm, scapula, neck and jaw. Often, this pain attack is accompanied by feelings of fear, panic, nausea, and heavy sweating. Some patients (severe heart attacks the vast) there is shortness of breath and cough.
Unlike angina, heart attack and related pain occur most often in the morning, after rising. Doctors attribute this to the fact that transition the body from sleep to daily activity is associated with changes in levels of certain biologically active substances, irregular blood pressure and accordingly with the increased load on the heart. But this does not mean that a heart attack happens at a different time of day. To provoke its development can emotional stress, physical exercise (especially lifting weights), chronic fatigue, and other factors.
The appearance of the described symptoms should immediately call an ambulance, and then not to wait for the doctors, and to provide first aid to the patient: to stack, to open the window, give a pill of Nitroglycerin and Aspirin. Nitroglycerin can be taken every 5 minutes, but not more than 3 tablets. It is desirable to measure the blood pressure if it drops below normal levels (below top 100), use of Nitroglycerin should be discontinued.
It is also worth noting that the first manifestation of myocardial infarction, unfortunately, can be sudden death.
Atypical forms of myocardial infarction
Often myocardial infarction «does not behave according to the script», which makes very difficult the diagnosis and delay the provision of proper medical care. Such atypical (that is, occurring without the typical pain) forms of a heart attack include:
Let us consider the clinical characteristics of these variants of the course of myocardial infarction.
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When gastrolychnis the form of myocardial infarction patients concerned about abdominal pain, nausea, sometimes vomiting, and flatulence. In such situations people do not seek medical help because they think something I ate and being treated at home, losing precious time.
For the asthmatic form of the disease characterized by symptoms resembling an attack of asthma: increasing shortness of breath, wheezing, forced posture (sitting), etc. If the person is not sick with asthma, the appearance of these symptoms should alert.
Cerebral form of myocardial infarction is accompanied by dizziness, slurred speech, impaired consciousness and other neurological disorders. In such cases, guessing what was the cause of these symptoms (heart attack or stroke), it is impossible, you should immediately call an ambulance.
In the arrhythmic form of the disease, patients feel the disruptions in the heart or palpitations, but the typical heart attack pain may not be.
For edematous form is characterized by the appearance of swelling in the legs, swelling of cervical veins, enlargement and tenderness of the liver, shortness of breath. Develops a variant of myocardial infarction mainly in people with long-lasting arterial hypertension, and patients who already had a history of heart attacks.
Asymptomatic is the most insidious form of myocardial infarction. Most often it occurs in diabetic patients due to abnormalities in their sensitivity. About such people say, suffered a heart attack on legs. The only sign that something happened to the heart, can be severe fatigue and shortness of breath after exertion, which previously tolerated quite normal. Often, people discover that they have had a heart attack after ECG conducted is quite another matter.
To confirm the diagnosis, the person must be examined (only on complaints, very typical of a heart attack, the diagnosis is impossible). Most indicative of myocardial infarction are the following methods:
- Electrocardiography (ECG). The ECG will be visible to the typical changes of a heart attack, and the doctor will be able to determine the stage of the pathological process, which is necessary for treatment selection.
- Echocardiography (ultrasound of the heart). Allows you to specify the scope and depth of the lesion of the cardiac muscle.
- A blood test for markers of myocardial damage (cardiotropic proteins): CPK, aspartataminotransferase, lactate dehydrogenase, etc.
In subsequent patients need to undergo other studies (especially coronary angiography) that help to identify problems in the coronary circulation (system of blood vessels that provide blood to the heart), and to take curative measures to address them.