Symptoms of mild heart attack
Microfocal myocardial necrosis is called in medicine a mild heart attack. In the past, this pathology is mainly registered among men. Today, increasingly, this diagnosis is common among women. This article describes what it is, what causes and how clinically.
General characteristics. Etiology
Microinfarct was observed in the cell death of a minor plot in the heart. It is registered in about 20% of all clinical cases of myocardial infarction. A small infarct can go in extensive form, therefore, is regarded as predinfarktnoe state.
Sometimes clinical manifestations of this disease can be very minor. However, it sometimes happens, that the defeat of the zones, which are responsible for heart rate, arrhythmia are recorded that represent a danger to life. Particularly unfavorable prognosis in mild heart attack among the elderly, which on the background of atherosclerosis or other pathologies blood flow to the heart, and so greatly impaired.
In some cases, patients tolerate this defeat of the myocardium on the legs and are not even aware of it. Change of heart discover later, when the patient undergoes examination about the other, more complex cardiovascular disease. Causes of mild heart attack do not differ from those who are able to provoke extensive damage of the myocardium. Among them should be mentioned:
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- neuro-psychological overload;
- diabetes mellitus;
- the constant physical fatigue, or, conversely, physical inactivity;
- expressed atherosclerosis;
- Smoking and alcoholism;
- hypertension or other pathology of the cardiovascular system;
- high cholesterol;
- improper diet;
- violation of adhesion and aggregation of platelets, which contributes to the formation of blood clots, which can clog coronary arteries and lead to myocardial ischemia;
- a sudden spasm of the coronary vessels of healthy (e.g., due to severe fright).
How does a mild heart attack? Its diagnosis
Basically the first manifestations of the disease resemble a cold, so people are not always on time pay attention to change your health. Before the attack patients may feel General malaise and body aches, discomfort in the chest and a slight deviation in temperature from normal values.
Later a mild heart attack manifests itself in such complaints as difficulty in breathing, sudden pain in the left chest to shoulder blade and shoulder. Also, people who develop small focal lesions of the myocardium, register dizziness and loss of consciousness, blue lips and skin around the nose. May be tachycardia, which has a reflex character.
Typical symptoms of mild heart attack among men include the inability to palpate the pulse on the hands. The patient experiences fear and attacks of causeless panic. There are cold extremities and cold sweat. Typically, in men, symptoms of mild heart attack is clearly expressed (asymptomatic not typical). When you erased the clinic you receive the chest pain, pressure, or foreign body sensation in the chest, which disappears in about 2 – 3 hours.
In women, the flow of the microinfarct is slightly different. So, they appear painful sensations in the epigastric region, unexplained nausea and a swelling on the upper and lower extremities, which appear due to circulatory disorders. Also characterized by the sensation of freezing toes and hands, aching joints, excessive sweating. It is important to know that, with related headaches and hypertension, the woman should immediately consult a doctor.
The clinical course of microinfarct depends on the age of the patient. Young people have symptoms, and laboratory parameters and ECG changes are the same as infarct, but less pronounced. Hemodynamic disorders are also insignificant, so the severe complications are mainly not typical.
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In patients older small focal lesion of the myocardium, usually occurs on the background of coronary atherosclerosis and age-related changes, which cause the possibility of heart attack in the effect of the minor factors. The first signs of mild heart attack include the traditional symptoms of necrosis in the heart, but further striking feature is the prolonged duration of the lesion. So, even before the completion of the pathological process in the primary zone lesion, there are new areas of necrosis, which significantly worsens the prognosis of the disease.
It should be noted that rarely reported forms of microinfarct, which are characterized by atypical symptoms of a massive heart attack.
For the differentiation of myocardial necrosis patients spend potassium test. They take off an electrocardiogram at rest, then inside give potassium chloride and for 2 hours thereafter, record the ECG again. If the existing clinical symptoms associated with ischemia in the myocardium, the results will not change. In most cases, the record offset segment RS-T, various pathological changes of teeth T, which persist for 2 to 5 weeks after the attack. If the etiology of complaints of functional or metabolic in nature, pathological changes in the ECG disappear.
To confirm the development of microinfarct also conduct laboratory diagnosis. When evaluating the results of the detailed analysis of blood pay attention to the level of white blood cells. A few hours after the onset of pain syndrome observed leukocytosis, however, it does not exceed 15000.
If the leukocyte count is higher, it is considered a poor prognostic sign because it indicates more extensive myocardial damage. Carried fermentatively, which provides for the determination of the level of myoglobin, troponin and creatine kinase. The increased concentration of these compounds indicates the damage of cardiomyocytes and necrosis of fibers of the heart.
What are the effects of microinfarct?
Complications after small focal necrosis in the heart depend on the localization of the pathological site, age of the patient, his General condition and the presence of comorbidities. The most dangerous of them are repeated seizures, the development of extensive necrosis and thromboembolism, and arrhythmias contractions and conduction of the heart (especially dangerous are fibrillation or complete atrioventricular block). In severe cases develop heart failure. The acute form develops within minutes or hours and is manifested by the development of cardiac asthma and pulmonary edema.
Possible cardiogenic shock, which deteriorates the function of the heart. The man sharply turns pale, occasionally turn blue and loses consciousness. It has sharply reduced systolic blood pressure, pulse weak, extremities cold, auscultation marked muffled. With the progression of pathological changes in edema of the lungs, due to changes in the circulation in the kidneys reduces urine production, and hemodynamic disturbances in the brain lead to a stupor and complete loss of consciousness.
As can be seen from the above-described complications, at the slightest suspicion on the development of mild heart attack the patient should be immediately transported to the cardiology Department for diagnosis and provide the necessary assistance.