Sewerage

Heart attack. The first signs of a heart attack in women and men - how to provide first aid, treatment and consequences How to recognize a heart attack

From this article you will learn: what is a heart attack, what signs it manifests itself. First aid and treatment. How to prevent a recurrence.

Causes of a heart attack
Signs and symptoms of a heart attack
How to deal with a heart attack
Treatment
Later lifestyle
Forecast

A heart attack is the appearance of pain in the region of the heart, which is accompanied by additional unpleasant symptoms. This phrase serves as a common name for an acute form of coronary disease. The colloquial concept of "heart attack" roughly corresponds to the medical term "acute coronary syndrome" - a diagnosis that is made to the patient before a detailed diagnosis. After an additional examination, the diagnosis is changed to unstable angina or myocardial infarction.

That is, a heart attack can be understood as either an intense attack of angina pectoris, or a heart attack.

If it occurs, call an ambulance immediately. Depending on the severity of the condition, the patient may be hospitalized or receive medical care at home, and this will be enough. After a heart attack, you will need regular follow-up with a cardiologist.

Causes of a heart attack

Pain in the heart appears due to insufficient blood supply to the heart muscle - myocardial ischemia. It occurs due to the deposition of fats on the inner walls of the coronary vessels or the formation of blood clots.

Factors that provoke ischemia include:

hyperlipidemia (a metabolic disorder in which the level of fats in the blood is elevated);
smoking, alcohol abuse;
obesity;
physical inactivity or, conversely, excessive physical activity;
hypertension;
diabetes;
thrombophilia (tendency to form blood clots).

A heart attack itself can be triggered by an increase in blood pressure during times of stress or strenuous exercise. It can also occur for no apparent reason - when deposits on the coronary artery block its lumen by more than 70%, or when the vessel becomes clogged with a thrombus.

Symptoms

Signs of a heart attack can appear suddenly, and sometimes there are their precursors. It depends on the severity. An attack of angina pectoris usually appears suddenly (and ends just as suddenly). And myocardial infarction is often preceded by initial symptoms (preinfarction state).

Signs of a mild heart attack (with angina pectoris)

This case is characterized by the following symptoms:

Let's take a closer look at the main symptoms of a heart attack and the previous signs.

Harbingers of a heart attack

If a person has previously suffered from attacks of pain in the heart, then they become more frequent and intense. This indicates the transition of angina pectoris from a stable form to an unstable one. If the symptoms of chronic ischemia begin to bother you more often than usual, contact your treating cardiologist immediately. Treatment will need to be adjusted to prevent myocardial necrosis.

Often a heart attack is preceded by symptoms that not everyone takes seriously. It:

Some of these signs may even appear 20 to 30 days before a heart attack. Usually people who are attentive to their health complain about them. Those who are used to always delaying going to the doctor to the last may not even notice these harbingers.

If the symptoms listed in the list appear, even if they do not bother you much, contact the clinic for a preventive examination of the whole body.

Heart attack symptoms

The main symptom is severe pressing or burning pain behind the sternum. It can give to the left side (arm, shoulder, neck), less often - to the right side of the chest or to the stomach.

Pain does not go away within 15 minutes - 3 hours. Sometimes the pain can last for days, but with periods of relaxation.

The appearance of this symptom alone is a reason to call an ambulance.

Additional symptoms

Additional signs of a heart attack:

It is not necessary for all of these symptoms to appear at the same time. The clinical picture of a heart attack usually consists of the main symptom (chest pain) and two or three additional ones.

Sometimes such patients lose consciousness.

How to act during an attack

If you have a heart attack during physical activity, gradually stop all your activities, sit down, calm down, try to move less, do not panic.
If you've had these conditions before, take the pills your doctor has prescribed for you to relieve pain (usually nitroglycerin).

If the medicine does not work within 3-5 minutes, call an ambulance (describe all your symptoms as fully as possible on the phone).
While the medics are on the road, take an Aspirin. This is a very important part of first aid. Aspirin prevents the formation of blood clots and thins the blood, which facilitates blood circulation through a narrowed vessel. Thus, further myocardial death can be prevented. Even if in the end it turns out that you do not have a heart attack, but just an angina attack, Aspirin will not hurt.
If you are very worried about pain, you can drink another Nitroglycerin tablet, but not earlier than 5 minutes after the first. Before this, it is desirable to measure the pressure. If it is lowered, you can no longer drink Nitroglycerin. If you are prone to low blood pressure, it is better not to take Nitroglycerin until the doctors arrive.

If your relative or friend has signs of a heart attack, you need to act in a similar way. Have the patient sit in a comfortable position, open a window if possible. Ask if he had similar conditions before (it is advisable to report whether this is the first or a repeated attack when calling an ambulance). Call a doctor. Give me an aspirin.

Treatment

For any form of heart attack (and angina pectoris, and heart attack), the patient is shown as first aid:

With a heart attack, anticoagulants (Heparin) and thrombolytics (Streptokinase) are also administered, if pain persists - morphine.

Drugs for myocardial infarction

After a detailed examination, the patient may be prescribed an operation to restore the blood supply to the myocardium: coronary artery bypass grafting, coronary angioplasty or stenting of the coronary arteries.

Further treatment will be to prevent recurrent attacks of angina pectoris or myocardial infarction. Patients are prescribed such drugs:

Aspirin is mandatory for all patients with angina pectoris or a previous heart attack.
Statins - to control the level of fats in the blood.
Beta-blockers - to reduce pressure and eliminate arrhythmias.
Diuretics - relieve swelling, thereby reducing the load on the myocardium.
Nitroglycerin - for repeated episodes of heart pain.

Later lifestyle

If you do not want to have a heart attack again, follow these rules:

Forecast

It largely depends on how quickly medical care is provided. In case of a heart attack, treatment should be started within 40 minutes of the onset of heart pain or other symptoms. Therefore, it is important to call an ambulance in time.

The prognosis for any heart attack is conditionally unfavorable: ischemia cannot be cured completely. However, if you follow all the recommendations of the doctor, you can avoid a second attack and significantly extend your life.

What is a heart attack

In medical terms, a heart attack is a serious pathological condition of an organ that has arisen due to an acute lack of blood supply to the heart muscle. This occurs when the blood vessels are clogged with a thrombus or spasm of the artery that feeds the heart. The situation is dangerous because it provokes the death of heart cells. The irreversibility of the process leads to myocardial infarction, up to cardiac arrest and death.

Cardiac relapse can happen if the coronary artery is blocked by the formation of fatty deposits on the walls, that is, due to atherosclerosis. Plaque builds up and the artery narrows, blocking blood flow. When plaque ruptures, a blood clot may appear, completely blocking the artery of the heart. The artery no longer provides the heart muscle with the necessary volume of blood and oxygen. The muscle is damaged, which causes an attack. Scar tissue forms at the site of muscle damage.

How to recognize

A relapse may be accompanied by an increased frequency of heart contractions, manifested by a rapid pulsation. However, the state of a heart attack, first of all, is manifested by pain in the chest, after which it spreads to the neck and face, shoulders and arms, descending to the back and stomach, while it can last a few minutes or last several hours. However, chest pains do not always indicate a heart attack; it can also be intercostal neuralgia. The definition of the disease requires clarification of certain conditions:

How the pain started. The pain sensations characteristic of such a state are associated with physical or emotional stress, while with neuralgia they arise from a sudden movement or for no reason.
How the pain subsides. A heart attack passes against the background of taking nitroglycerin for a short time (several minutes), with neuralgia, the drug does not bring relief to the heart.
How pain manifests itself. Pressing, piercing-cutting pain is characteristic; with neuralgia, the pain is manifested by bouts of girdle character, aggravated by body movements, coughing, deep inspiration.

Symptoms

The attack has gender characteristics. For men, not only an earlier manifestation of the pathology is characteristic, but also a frequent exposure than in women. In addition, the pain syndrome is perceived differently by men and women, but the signs of a heart attack in men are essentially the same as for everyone:

shortness of breath, manifested with a minimum of activity, even at rest;
pain behind the sternum of a burning, pressing property;
dizziness to loss of balance;
cough;
blanching of the skin to a gray tint;
feeling of panic fear;
nausea;
cold profuse sweat;
vomit.

In men

The male half is at risk of a heart attack more than women, due to physical and psychological factors characteristic of them. Most of them smoke, lead an inactive lifestyle, and are obese. The circulatory system of the male body is slightly different, their heart rate is lower, the vast majority of men belonging to personality type A with a tendency to stress increases the risk of an attack. Among the precursors, there is an early weakening of male potency, while a common symptom of a male heart attack is acute chest pain.

Among women

Women, having a more resilient cardiovascular system, which is associated with childbearing, are less at risk of a heart attack, but during menopause, the chances of this problem are compared with men. Due to the fact that in women the small vessels of the heart are clogged, in contrast to the blockage in men of the main arteries, signs of a heart attack in women can be manifested by shortness of breath, pain in the arm, abdomen, neck, and dizziness. Pain behind the sternum in women often burns, rather than presses, manifests itself acutely.

pressure during a heart attack

When heart disease occurs, the pressure begins to rise. This happens on the first day, after which it falls, not rising to its original value. In hypertensive patients, the pressure may decrease. In some situations, the pressure remains normal for a long time. Normalization of pressure indicators is a positive trend in a heart attack, but with its progression, there is insufficient blood circulation of the heart, which leads to complications.

The first signs of a heart attack

For timely access to a doctor and prevention of complications, it is necessary to pay attention to warning symptoms in order to prevent the occurrence of a cardiac relapse:

fatigue, weakness, tiredness;
poor sleep, snoring;
anxiety for no reason;
swelling, heaviness in the legs;
increased heart rate, rapid pulse;
painful discomfort in the stomach, heartburn;
constant sweating;
exacerbation of periodontal disease.

The reasons

The reasons for the development of an attack are explained by a violation of the supply of the heart muscle due to narrowing, compression of the coronary vessels. The main category of patients are those with atherosclerosis, tachycardia, and cardiac ischemia. As the main risk factors, age is determined (for men from 45, for women from 55 years), hypertension, sudden severe stress (both positive and negative). Provocateurs of a heart attack condition can be diabetes, obesity, heat, physical overload, alcohol, nicotine, and genetic predisposition.

What to do

First of all, you need to be more attentive to the signals of your body and, if the harbingers of the disease appear, consult a doctor for diagnosis and treatment. If you suspect an aggravation of the condition, call an ambulance immediately. Even if the alarm was false, it will not do much harm, and in the event of a real heart attack, the patient must be immediately sent to the hospital, where the cardiologist has only a few minutes to open the artery and provide assistance, preventing serious consequences.

First aid

Timely urgent actions in the event of a heart attack can be decisive in the life of the patient:

Calling an ambulance is the first thing to do immediately.
Lay the sick person down with their head up.
Unfasten the belt, collar, loosen the tie, which will help relieve suffocation.
Provide air access to the room.
Give an aspirin tablet if it is not contraindicated, and nitroglycerin under the tongue (take no more than three tablets in total if the pain does not subside).
When severe weakness appears, raise the legs to a level above the head, give water to drink and no longer give nitroglycerin.
You can put a mustard plaster on your chest.
Do not leave the patient until the arrival of the doctor.
The doctor must show all the medications taken.

How to relieve a heart attack at home

It is important to know what to do if you have a heart attack when you are alone without medication. After calling the doctor, quickly, without panicking, exhale fully, then begin to cough strongly and many times. Repeat a deep breath with coughing on the exhale and so on with intensity every 2 seconds, until the doctor arrives. These respiratory actions during an attack compensate for the lack of oxygen to the heart, restoring its rhythm. Inhaling allows oxygen to enter the lungs, while coughing constricts the valves of the heart, stimulating blood circulation. All this helps the heart to enter a normal rhythm, reduce arrhythmia.

Effects

Most people experience changes in both physiological and psychological types after suffering an attack:

cardiac arrhythmia, angina pectoris;
negative psycho-emotional mood;
decrease in performance.

Serious complications, a threat to life for a person after an illness are:

heart failure;
vascular thrombosis;
aneurysm;
pericarditis;
pulmonary edema;
ischemic stroke.

Prevention

An active lifestyle is the main recipe for the prevention of all diseases, and a heart attack, myocardial infarction is no exception. In addition to playing sports, you need the right low-fat food, plenty of fruits and vegetables, reducing the intake of salt and carbohydrates, quitting smoking and alcoholic beverages, and playing sports. After 50 years, you will need to constantly monitor blood pressure, monitor blood sugar and cholesterol levels, pay attention to the weather - heat and magnetic storms are dangerous for heart function. It is important to be in a positive life mood, avoiding sources of stress.

Forecast

For someone who has had a heart attack, it is important to be aware of:

Damaged heart muscle is capable of healing.
The return of the patient to a normal lifestyle after an attack is realistic over time.
The resulting angina is treated.
There is no need to despair, to endure an attack is not yet an invalid sentence, it is simply necessary to start giving increased care to the heart and the whole body.

More than half of people return to their jobs after a rehabilitation period. Recovery can last up to six months, starting in the hospital with gradual physical actions. You need to load yourself gradually: walking around the ward, then go to the stairs. Only a doctor can recommend the exact dosage of activity, there is no need for initiative and haste. The patient needs patience and more positive.

Heart attack: definition

A heart attack is a serious violation of the blood supply to the myocardium. This condition is characteristic of an acute manifestation of ischemic disease. At this moment, the movement of blood through the coronary arteries stops or is significantly impeded, because on the way it meets an obstacle in the form of blood clots or cholesterol deposits that close the passage inside the vessel. The heart does not receive oxygen, its cells begin to experience hypoxia and are destroyed. Angina (mild heart attack) or myocardial infarction develops.

A heart attack often ends in death, so help must be provided immediately. It is urgent to call an ambulance at the first suspicious signs.

A life-threatening condition can occur when delivery of oxygen to the myocardium is difficult. Vasoconstriction is promoted by thrombosis or atherosclerosis, while the lumen between the walls is blocked by 70% or more. Acute cardiac ischemia is provoked by the following factors:

excessive fullness;
passion for alcohol and tobacco products;
a history of severe forms of diabetes mellitus;
reduced physical activity;
intense training for athletes;
adherence to fatty foods and plentiful portions;
VVD (vegetovascular dystonia);
abuse of nonsteroidal drugs;
prolonged stay in a stuffy room or in the open sun in the heat;
hypertonic disease;
age (less common in young people);
belonging to the male sex;
tendency to develop blood clots;
high blood cholesterol.

The situation is aggravated by a spasm of coronary vessels affected by cholesterol (in other words, a heart cramp), when the passage for blood flow can be completely blocked. This happens if blood pressure begins to rise, as well as with severe stress (fear, joy, anger or other nerve disorder), high physical stress. The risk of developing an attack increases in the presence of cardiac pathologies (atrial fibrillation, tachycardia, congenital and acquired malformations of the circulatory system, chronic left ventricular failure).

With partial blockage of the bloodstream, angina pectoris develops, complete blockage of the vessel leads to necrotic phenomena (myocardial infarction).

Symptoms and early warning signs of a heart attack

Excessive suspiciousness spoils a person's life, but sometimes increased vigilance to one's health still does not hurt. Without disregarding all the "strangeness" of his state of health, a person can warn the impending danger. There are signs that can help identify a possible approaching heart attack. The so-called harbingers make themselves felt long before the onset of the critical moment:

Here are the immediate signs of a heart attack:

burning in the chest, constricting pain, heaviness;
discomfort in the left half of the body;
fear of death;
muscle weakness, "cotton" legs;
white skin, nose, lips, fingers with a blue tint;
fainting;
shortness of breath, difficulty taking a deep breath;
pulse is frequent or intermittent;
cold profuse sweat.

A threatening condition can manifest itself in different ways in people of different sexes. So, the symptoms of a heart attack in women have their own characteristics.

Signs of a similar nature occur at a later age, after menopause. More often have a tragic outcome than in men.
In women, usually small arteries overlap, in the opposite sex - large ones. This is reflected in the symptoms in the development of a heart attack in men.
The manifestations of heart problems in the beautiful half are mostly atypical: heartburn, pain in the upper abdomen, bouts of nausea, the woman becomes very weak, cannot breathe normally, gets tired quickly.
Often there is an asymptomatic course of the attack.
Signs of an acute heart attack in women usually rule out chest pain.

A heart attack can go completely unnoticed. A quick and sudden death occurs if a large area of the heart is affected, or the person safely endures a silent attack without even suspecting it. In this case, it is realistic to recognize irreversible changes only with a planned medical examination.

Another scenario is that a person is worried about symptoms that he does not associate with heart disease. He does not go to the doctor at the right time, choosing expectant tactics, thus aggravating the situation. Meanwhile, life-threatening complications develop. Atypical signs of a heart attack:

pain in the right side of the chest;
possible pain in the abdomen with nausea and vomiting, bloating;
cold symptoms, sore throat.

Similar symptoms are also characteristic of some other conditions (osteochondrosis, intercostal, tonsillitis, neuralgia, diaphragmatic hernia, gastric disease, acute development of pancreatitis, and cholecystitis). But there are also specific features that help distinguish non-cardiac pathologies from myocardial infarction:

Heartburn, diarrhea, constipation, belching speak of digestive dysfunction.
Strong and sharp pains occur regardless of physical exertion or nervous tension, aggravated by palpation of the lower part of the ribs, this is a sign of neuralgia.
Pain is aggravated if a person moves his torso, arms, breathes deeply. Or unpleasant sensations are of a short duration, similar to tingling, stop on their own. Perhaps this is related to osteochondrosis.
Reception "Nitroglycerin" does not bring relief. So, the appearance of pain is not connected with the heart.

Age-related changes in a child in adolescence can also cause chest pain, but they are a variant of the norm.

First aid at home

When a heart attack occurs, you need to act quickly and competently. First of all, you need to call an ambulance. Next, you need to do the following:

Provide the victim with complete rest and a comfortable position. It is advisable to lay down with your head up.
Loosen all fasteners and locks that restrict the chest so that the person can breathe freely.
Open windows and vents, let in fresh air.
Provide emotional support, try to save a person from fear and panic.
Offer "Nitroglycerin" (under the tongue), if there is no effect, repeat the allowable dose after a few minutes. If the pressure began to drop significantly, this method cannot be used.
If you suspect a myocardial infarction to prevent blood clots, be sure to chew an Aspirin tablet. It is needed to thin the blood, helping it to flow more freely through constricted vessels.
With increased pressure, help the patient take an antihypertensive drug. Usually in hypertensive patients it is always at hand.
Place a mustard plaster on the chest, make a warm bath for the legs.
If the heart has stopped, you will need an indirect massage of this organ and artificial respiration.

Treatment

A patient with a heart attack can be treated both at home and in a hospital. If there is no suspicion of a heart attack, a person is observed on an outpatient basis, continuing to take drugs to prevent recurrent paroxysms and prevent the formation of blood clots. Usually these drugs are:

nitro-containing medicines ("Nitroglycerin");
painkillers ("Morphine");
antihypertensive drugs ("Metoprolol");
diuretics ("Furosemide");
drugs directed against the further development of atherosclerosis ("Atorvastatin");
anticoagulants ("Heparin");
thrombolytics ("Streptokinase");
antiplatelet agents ("Aspirin").

This scheme is followed in the postinfarction period.

In the case of the development of an acute infarction, an emergency surgical intervention is considered appropriate, it is possible to use electrocardiostimulation (in case of cardiac arrest).

Surgery for a heart attack:

balloon angioplasty (artificial expansion of a narrowed vessel using a catheter with a mini-balloon);
installation of a stent (special expanding frame) in the cavity of the damaged artery;
coronary artery bypass grafting (creation of additional blood pathways bypassing the affected area).

Surgical manipulations can stop the development of complications, but they are relevant only in the next hour and a half after the onset of the attack.

Complications

A heart attack is dangerous due to the complications it can cause. Moreover, the consequences occur both in the first hours of the development of the pathology, and within a few weeks after the end of the attack. Necrosis is a consequence of an acute violation of the coronary circulation. Dead cells cannot fully contract, which significantly impairs the functioning of the heart, resulting in myocardial insufficiency or re-infarction. An attack can also cause severe arrhythmia, rupture of cardiac tissues, the occurrence of cardiogenic shock (reduced blood delivery to other organs with impaired function). All these conditions lead to the death of the victim.

The prognosis of the outcome of such a pathology always depends on the amount of damage received, the speed of providing qualified assistance, as well as on age and other individual characteristics of the organism. The sooner treatment is started, the smaller area of the heart will be affected. Elderly patients, people with a weakened immune system and a history of chronic diseases are more difficult to count on a favorable development of events.

How to prevent a heart attack

To prevent primary and repeated attacks of acute coronary syndrome, a number of recommendations must be observed:

Strictly comply with medical prescriptions.
Categorically give up bad habits.
Monitor your weight, if necessary, get rid of extra pounds.
Strengthen the heart with moderate physical activity.
Observe a rational mode of work and rest.
Stick to a well-balanced diet, excluding foods rich in cholesterol.
Regularly monitor the level of pressure, sugar and cholesterol in the blood.
Getting a flu shot can help prevent heart problems.
Protect yourself from excessive emotional outbursts.

Don't joke around with a heart attack. Even if there is no certainty that the symptoms that have arisen indicate a deadly condition, it is advisable to seek help from medical personnel. It must be remembered that the signs of a heart attack may be atypical. In order not to risk your life, you need to be vigilant to any negative manifestations in the body. First aid does not require extensive medical knowledge and skills, but everyone should master these basics. Everyday habits and the established routine are very important for the prevention of heart disorders, and any person can change them for the better.

Heart attack - this is the concept most people used to describe a sharp sudden pain in the heart. It is colloquial in nature and means in the common people the same as the period of exacerbation of myocardial ischemia.

In the professional terminology, this phenomenon is called acute coronary syndrome.

After the necessary examinations, the diagnosis is specified, and a heart attack actually turns out to be one of two clinical syndromes - angina pectoris or myocardial infarction. About 17 million people worldwide die from them every year.

The main prerequisites for a heart attack are the pathologies of the cardiovascular system, metabolic disorders and other chronic diseases that a person has:

Hypertension and, as a result, a hypertensive crisis.
Ischemic heart disease (CHD).
Deviation in the functioning of the blood coagulation system, a tendency to form blood clots (thrombophilia).
Blockage of arteries and veins by blood clots (pulmonary embolism, thrombosis of the coronary arteries).
Chronic heart failure (CHF).
Circulatory disorders caused by cholesterol, fatty deposits on the walls of large and medium-sized arteries (atherosclerosis).
Diabetes mellitus in the stage of decompensation, due to the lack of proper treatment for a long time.
Various forms of atrial fibrillation, extrasystole.
Dissecting aneurysm of the thoracic aorta.

Older people are at risk, this is due to age-related changes in the state of the heart muscle and the elasticity of blood vessels. If we consider the incidence of heart attacks by gender, they are more likely to affect men. A person's standard of living can also lead to a heart attack. Therefore, the risk group includes people who are obese, smokers.

In recent years, the age of angina attacks and myocardial infarction has decreased significantly. Heart attacks are not uncommon in adults younger than 40 years of age. Moreover, in medical statistics, even cases of a heart attack at the age of 25 and in 16-18 year old teenagers are known.

A heart attack at a young age can happen due to many factors:

heredity;
drug use;
blood clotting disorders;
susceptibility to stress;
emotional instability;
atypical form of atherosclerosis.

An increased risk of developing angina attacks is observed in pregnant women with chronic heart disease. This is due to the lack of oxygen and increased stress on the cardiovascular system during pregnancy caused by an increase in total blood volume.

Additional provocateurs are: bad habits, excess weight, lack of physical activity or, conversely, excessive workload, stressful situations, age after 50 years.

Long-term use of high-dose non-steroidal anti-inflammatory drugs can also provoke an attack.

Symptoms and first signs

A heart attack is always accompanied by severe squeezing pain behind the sternum. Most often, it begins in the morning, after a person wakes up, when the transition from sleep to daytime activity supplies the heart with increased stress.

At this moment, a person feels difficulty in breathing, tightness in the chest does not make it possible to take a full deep breath and exhale.

The following comparative table will help in identifying and distinguishing angina pectoris and heart attack in time:

Symptoms of an angina attack	Heart attack symptoms
Pain sensations of a pressing and burning character are localized in the chest.	Pain and burning felt behind the chest.
The pain spreads to the area between the shoulder blades, to the area of the shoulder, neck. With irradiation of pain in the abdomen, clinical symptoms are accompanied by nausea.	Most often, the pain appears on the left side of the body, gives to the neck and shoulder girdle. The right side of the chest and the abdomen are less likely to experience pain.
Has no harbingers.	It has characteristic warning signs.
Relief of an attack is possible by taking nitroglycerin.	Taking medications that previously produced a therapeutic effect now do not have a result.

The suspicion that a heart attack is imminent may appear long before the attack itself, sometimes this period can be more than 20 days. People suffering from heart disease should be especially attentive to their health.

You should see your doctor right away if you have two or more of the following symptoms:

, feeling of lack of oxygen, discomfort when being in stuffy rooms;
a feeling of chest tightness, covering the entire upper body - head, neck, shoulders, arms;
stomach pain, nausea, heartburn;
numbness and pain in the left arm from the shoulder to the elbow or to the little finger
snoring in sleep, sleep apnea;
swelling of the lower extremities;
dizziness;
violation of the rhythms of sleep and wakefulness;
fatigue with minimal effort;
anxiety.

A timely visit to the doctor with the manifestation of the above symptoms will help to stop the attack, which is already approaching. This requires the cardiologist to correct the existing treatment.

In addition to the main symptoms in the form of pain and difficulty breathing, a person also experiences other signs by which one can understand the presence of a heart attack:

vegetative symptoms: chills, sweating (hyperhidrosis), pallor or blue (cyanosis) of the skin, frost and cold in the legs;
nausea, sometimes accompanied by heartburn, belching, vomiting, feeling of stuck food in the anterior abdominal wall;
stool disorder (diarrhea);
temperature may rise or fall sharply, may be accompanied by fever and fever
dizziness, blurred vision up to loss of consciousness;
intense heartbeat, heart rhythm disturbances;
psycho-emotional disorders: panic attacks, increased anxiety, fear, internal tremor (trembling, convulsions).

Symptoms of an attack in men and women are somewhat different. Women face life-threatening conditions later in life than men.

The female body is protected by natural adaptive mechanisms necessary for bearing and giving birth to a child. After menopause, the frequency of seizures in both sexes levels off. However, women are more likely to survive it than men.

The endurance of the female cardiovascular system is determined by their biological characteristics. The symptoms of an attack of young girls and women are less pronounced, they often endure it, as they say, "on their feet."

How to distinguish from neuralgia and PA?

Signs of a heart attack are similar in nature to the symptoms of intercostal neuralgia and panic attacks.

Intercostal neuralgia may occur as a result of thoracic osteochondrosis. It is caused by pinching of the spinal roots.

A panic attack is of a psychological nature, begins on a "nervous basis" and its physiological symptoms are due to strong emotional experiences of a person.

In order to recognize a panic attack and intercostal neuralgia or vegetovascular dystonia in a “pure form”, their symptoms should be compared with the characteristics specific to a heart attack.

This table will help you understand the difference between these states and find out their features.

Criteria for comparison	Heart attack	Panic attack	Intercostal neuralgia	VSD
How long does an attack last?	From half an hour to several hours.	Reaches peak values within 10-15 minutes.	From several hours, including the night period.	5 minutes to 8 hours
The nature of the breath	It is difficult for a person to breathe, breathing has a confused rhythm, accompanied by a feeling of chest tightness.	Breathing has a rapid rhythm, accompanied by a feeling of suffocation.	The respiratory rate does not change, but its depth is limited by the emerging intercepting pain sensations.	Shortness of breath, feeling short of breath, rapid breathing
The nature of pain	Pressing, burning, squeezing.	Pricking.	Piercing, aching.	Stitching, pressing, burning, squeezing
	The pain is constant, but with varying intensity	The pain is undulating, periodic	Increases with sudden movements, sneezing, coughing, lifting heavy objects	Change in pain sensation over time
Description of pain sensations and their localization	Presses in the chest and in the area behind the sternum, with an emphasis on the left half of the upper body, has extensive localization.	Pricks in the center of the chest, in the limbs, numbness in the fingers and toes. It does not have a clear localization.	The pain spreads along the trunk of the intercostal nerve, radiates to the region of the heart, between the shoulder blades, under the ribs and behind the lower back. . Has a clear point of localization.	Poorly localized pain in various parts of the abdomen, a feeling of interruptions in the work of the heart, tachycardia, cold extremities.
Pulse and blood pressure	Pulse quickens, blood pressure drops.	Increasing.	Doesn't change.	blood pressure lability
Psycho-emotional state	Fear of death from constricting sensation in the chest.	There are irrational fears, for example, the fear of suffocation, there is a feeling of unreality of what is happening.	Anxiety associated with determining the cause of the pain that has appeared.	Panic attack, fear of suffocation, imminent cardiac arrest or rupture

It should be remembered that a heart attack can provoke a panic attack and be accompanied by a whole range of symptoms characteristic of these two conditions. Often panic attacks occur in people who have already had a heart attack or stroke.

Patients describe their emotional state as a feeling of constant fear for the heart. Outwardly, this behavior does not look entirely rational, since there are no deadly circumstances and objective reasons for panic.

A person's fear can be so strong that it can provoke a new attack of a panic attack.

How to behave during an attack?

A heart attack is dangerous for a possible myocardial infarction. This condition does not tolerate delay, as it can lead to death.

An attack can come at the most inopportune moment: while flying in an airplane, in a dream, at work, or on the way home on the street or driving. He can also find a person at home alone, in which case he is forced to save himself.

If there are no other people nearby who can provide emergency first aid, the algorithm of self-help actions will help to survive:

Any form of physical activity must be stopped. It is advisable to take a comfortable position and behave as calmly as possible, without too much fuss.
Pick up the phone and dial the number "103", begin your appeal to the ambulance dispatcher with the words "I have a heart attack."
While medical workers are driving, you should drink aspirin and put a nitroglycerin tablet under the tongue. Aspirin thins the blood, preventing the formation of blood clots in the vessels. In the event of a heart attack, it will prevent progressive necrosis of the heart muscle. If you have already experienced attacks of pain in the heart, then you can additionally take the drugs prescribed by your doctor.
You can not give the patient: Validol, Valocordin, Corvalol. The action of these drugs is aimed at calming the nervous system, helping to fall asleep faster. It is forbidden to give painkillers to the patient: no-shpa, analgin, etc. Taking these funds will not only not help relieve the attack, but will also complicate the diagnosis of the disease for health workers, which may cause the patient to die.
If there is a tonometer nearby, then measure the pulse and blood pressure.
In order to increase the supply of oxygen to the lungs, you can cough. Coughing helps to activate blood circulation in the chest area. Before each time, you need to take a deep breath, cough on the exhale with maximum volume and a frequency of a couple of seconds.

The procedure for observing the correct and timely first aid to a person can save his life.

If in front of your eyes someone grabbed a heart, then you must perform the following sequence of actions:

Sit the victim up or lay them on a horizontal surface with their head up.
Call an ambulance.
Give the patient an aspirin to drink and place a nitroglycerin tablet under the tongue.
If possible, create an influx of fresh air into the room (open windows or doors).
Measure the patient's pulse and blood pressure. If it is elevated, the symptoms of an attack persist, then after 5-10 minutes you can give a second tablet of nitroglycerin. The maximum dose is 3 tablets.
If the victim has weakness, shortness of breath, excessive sweating, then it is necessary to give him a glass of water. After that, help lie down so that your legs are raised up.

Monitor the heart rate (HR), if the heart rate slows down, or there is a lack of pulse and breathing, then immediately start chest compressions. If you lose time, then a person has practically no chance of surviving, and he can die suddenly.

How is first aid provided?

Arriving doctors on the spot provide the patient with urgent assistance, after which they deliver him to the hospital for a more accurate diagnosis of the state of cardiac activity and subsequent treatment.

First aid measures for a heart attack include:

use of an oxygen mask (oxygen therapy);
to stop the pain syndrome, a dropper is placed with a solution of analgesic and neuroleptic drugs (Fetanil, Droperidol);
to reduce blood clotting and improve hemodynamics, an injection of Heparin or another anticoagulant is administered.

In emergency cases, when the victim loses consciousness and there is no pulse in the hands, resort to in combination with cardiopulmonary resuscitation. This is necessary in order to prevent cardiac arrest with the help of electrical impulse discharges and return it to a normal rhythm of contractions.

Hospital treatment

Upon admission of the victim to the hospital, the following laboratory and instrumental examinations are prescribed for an accurate diagnosis:

a blood test to detect the presence and concentration of cardiac enzymes;
cardiogram (ECG);
cardiac catheterization with the use of a contrast agent (if necessary);
chest x-ray.

Analysis of the anamnesis and data obtained during a comprehensive examination of the patient's cardiac activity are the basis for choosing measures for subsequent treatment.

The timing of therapy in a hospital setting will depend on the age of the patient and the severity of the heart attack. On average, these patients stay in the hospital for at least two weeks.

Treatment and recovery after a heart attack will be especially long. The first days of the patient is under the close attention of doctors in the intensive care unit or resuscitation. As a rule, earlier than three days, such patients are not transferred to the general cardiology department.

In total, recovery after a heart attack requires at least two to three weeks, after an attack of angina - up to one and a half to two weeks.

Patients are not recommended to stop rehabilitation therapy early and go home. When you stay at home, the risk of possible complications and recurrent attacks increases significantly. The patient's condition requires monitoring of cardiac performance with the help of special equipment, which is impossible at home.

Medical therapy

After the incident, the patient is prescribed medications that are necessary to prevent a recurrent attack of angina pectoris or myocardial infarction.

Comprehensive drug treatment and prevention of relapses involves taking drugs from several drug groups at once:

antiplatelet agents - prevent platelets from sticking together (Aspirin cardio, Acecor cardio, Aspecard);
beta-blockers - normalize heart rate and lower blood pressure (Sotahexal, Tenzol, Anaprilin, Blockarden);
cardioprotectors (prestarium, mildronat);
statins - medicines that lower cholesterol (Liptonorm, Lipostat, Rosulip);
diuretics - eliminate puffiness, remove excess fluid (Aldactone, Veroshpiron, Indapamide).

Surgical intervention

In order to restore normal blood circulation in the heart muscle, various methods of surgical intervention can be applied:

coronary (balloon) angioplasty or stenting is a procedure, the principle of which is the introduction of a balloon catheter into a narrowed vessel. The operation does not eliminate the cause of ischemia, but eliminates its consequences. In order for the vessel not to narrow again, a stent is inserted into it - a device made of thin material that acts as a spacer that fixes the width of the vessel.
coronary artery bypass grafting or heart vessel bypass surgery is an operation that allows you to restore blood flow in the arteries and large veins, bypassing clogged vessels. This is done through an artificially created bypass (shunt).

Rehabilitation

The recovery period will depend on the timeliness of the medical manipulations performed, the age of the victim and the degree of damage to the heart. The more extensive the lesion, the longer the recovery will continue.

On average, rehabilitation takes at least six months. The tactics of rehabilitation after a heart attack is based on bed rest with a gradual inclusion of physical activity and a systematic increase in physical activity.

After discharge from the hospital, the patient may be referred for sanatorium treatment. The duration of the tour is two to three weeks. The recovery period is largely determined by the general state of human health and the changes that it brings to the lifestyle after the attack.

In order to assess the patient's condition, a special stress test is performed a couple of months after the attack, which shows the general condition of the heart muscle.

If the patient has no complaints, during the ECG testing, no heart rhythm disturbances or ischemia are displayed, then the rehabilitation is considered successfully completed.

Prevention

In order to prevent a recurrent attack, it is necessary to completely reconsider your daily habits and change your lifestyle.

Maintain a normal weight level, avoid fatty, salty foods, and drink regularly. All foods and drinks that provoke an increase in blood pressure should be excluded from the diet. Fill your diet with healthy foods containing B vitamins. Be sure to consume foods high in potassium and magnesium.
If you smoke, you should quit immediately. Nicotine not only increases blood pressure, but also increases cholesterol deposits.
Exercise, walk more often, do not neglect therapeutic exercises. Elderly people should maintain their physical activity at the proper level. Physical education maintains vascular tone, stimulates blood circulation and will help you avoid an attack.
Check your blood pressure twice a day, in the morning and in the evening, and take your medications as directed by your doctor. People who have survived a heart attack are prescribed drugs for life that cause a decrease in blood viscosity and have an antithrombotic effect (for example, Cardiomagnyl).
Visit a cardiologist every six months. Skipping scheduled checkups can also shorten your life.
Perform relaxing, relaxation exercises, breathing exercises. Find for yourself an effective way to relieve mental stress, because against the background of stress, the heart has an increased load that it may not be able to withstand.

Forecast

The prognosis of a person's life after a heart attack will depend on many factors. Not the last role is played by the lifestyle that the patient will adhere to and the general condition of his body.

The presence of other chronic diseases, non-compliance with the doctor's recommendations can provoke complications, hinder the course of recovery processes.

The most favorable prognosis is for patients with a small degree of heart damage requiring simple methods of treatment.

Strict compliance with medical prescriptions quickly return them to a full life and will allow them to keep a working heart until old age.

First of all, it must be said that the concept of "heart attack" does not mean a specific disease. With these words, people call two different disorders that occur when the heart malfunctions.

As a rule, after a detailed examination, the patient is diagnosed with "acute coronary syndrome", which, as a result of additional diagnostics, is then changed to either "angina pectoris" or "myocardial infarction". Thus, one of these pathologies can be hidden under an abstract concept.

What pathologies are actually hidden behind the words "heart attack"? As you know, the heart is an organ that pumps blood throughout the body. When this process is disturbed, coronary disease occurs. Blood cannot move through the coronary arteries due to the obstacles that arise in its path.

It can be either blood clots (thrombi), or cholesterol plaques on the walls of blood vessels. Oxygen ceases to flow to the heart, and oxygen starvation sets in with further gradual death of the organ itself. Thus, angina pectoris occurs, which can then develop into a myocardial infarction.

The main reason for the development of this condition is the lack of oxygen by the myocardium, which is facilitated by a decrease in the lumen of the vessels. But there can be many factors that provoke the development of the disease:

overweight;
alcohol abuse, smoking;
diabetes;
hypodynamia or, conversely, excessive physical activity;
vegetovascular dystonia;
abuse of fatty foods;
lack of oxygen;
arterial hypertension;
elderly age;
predisposition to the development of thrombosis.

Symptoms

Cardiac ailments can occur unexpectedly, in the form of very minor deviations. But it happens that at first glance, frivolous symptoms indicate big problems, ignoring which threatens with irreversible consequences.

First signs

Sometimes the presence of a problem is indicated by harbingers that precede the development of an acute condition. It should be noted that angina pectoris usually occurs abruptly, unexpectedly, while a heart attack develops gradually.

Typically, symptoms of an angina attack are:

pain in the retrosternal space of a pressing or burning character;
irradiation of pain in the left (rarely right) arm, left side of the neck, left shoulder, can also radiate to the area between the shoulder blades or to the stomach;
sometimes joining nausea.

The following symptoms are characteristic of a pre-infarction state:

increased heart pain;
long-lasting pain syndrome;
shortness of breath, the appearance of interruptions in the work of the heart;
sudden weakness in the whole body;
swelling of the lower extremities;
a growing sense of anxiety;
sweating;
pallor of the skin.

In some cases, manifestations of myocardial infarction are atypical. This happens in patients with diabetes, in people of advanced age. Often, such patients complain of difficulty breathing, abdominal pain, feeling of general weakness, dizziness.

Differences in men and women

Heart problems can have significant differences depending on the gender of the patient. That is, both in women and in men, the disease has its own characteristics.

It is believed that one of the factors that increase the likelihood of a heart attack is male gender. While the development of pathology in women is characterized by absolutely specific symptoms of the course of the disease.

Diagnostics

Anginal attack is diagnosed based on the patient's complaints, as well as using an electrocardiograph. With its help, the specialist determines the degree of damage. Also, ultrasound and X-ray examination of the myocardium is used to make a diagnosis.

If, according to preliminary findings, the patient was diagnosed with a heart attack, then diagnostic procedures and treatment are carried out simultaneously, since the lost time can be a decisive factor. Also, to identify the cause of the pathological condition, the patient is prescribed biochemical blood tests for cholesterol, because the influence of vascular atherosclerosis cannot be ruled out.

Treatment

If a person has an attack of heart disease, you should immediately call an ambulance. But before her arrival, some actions can be done independently.

First aid home care

Until the ambulance arrives, you need to act according to a certain algorithm. First aid should include the following:

Medical therapy

After the patient arrives at the hospital, if Nitroglycerin does not work, intravenous administration of drugs such as Baralgin, Maksigan, Analgin is used. Simultaneously with analgesics, antihistamines are also administered, such as Diphenhydramine or Suprastin, as well as tranquilizers - Relanium, Seduxen. If there is an increase in blood pressure, drugs are prescribed to dilate blood vessels.

Drugs used in the treatment of this disease can be divided into the following groups:

drugs with nitroglycerin;
drugs with analgesic effect (Morphine);
means for pressure reduction ( , );
diuretics (Chlorthalidone, Furosemide);
drugs that prevent blood clotting (Heparin, Neodicumarin);
thrombolytics (Streptokinase, Lanateplase).

Surgical intervention

The expediency of a surgical operation is said in the event that the patient was admitted with an acute infarction. If cardiac arrest has occurred, pacing is used.

Operations in diagnosing a heart attack can be as follows:

It should be noted that surgery can significantly reduce the risk of further complications and stop the development of pathology, but it should be carried out only in the near future after an attack has occurred.

Lifestyle Correction

To prevent repeated heart problems of this nature, you need to follow certain rules and carefully monitor your health.

A prerequisite will be the implementation of the following recommendations:

All prescriptions of the doctor should be strictly followed. Carry out regular weight control and, if necessary, fight extra pounds.

You should also check your blood pressure, glucose, and cholesterol levels regularly. It would also be useful to avoid strong emotional stress on the body, and if you still failed to prevent stress, be sure to take sedatives.

If you find alarming symptoms in yourself: pain in the heart, sudden sweating, dizziness - in no case should you try to wait them out. Such delay can be very costly.

Even if there is no certainty that the state of health is a threat to life, but at least some of the characteristic symptoms were noted, it is necessary to contact a specialist who will conduct an examination and diagnostic measures and issue an appropriate verdict.

In cardiology, there is a group of deviations, which is called too generically to understand the essence of the phenomenon.

One of them is the so-called heart attack. This is a simple, philistine name.

According to the clinical classification, the pathological process corresponds to a heart attack or unstable angina in the active phase (just at the time of the attack).

The danger of the phenomenon is obvious. Regardless of the type, there is death or necrosis of the heart tissue, myocardium, a decrease in the intensity of contractions, a drop in blood output and, as a result, ischemia, a weakening of general hemodynamics. Possible death of the patient.

Treatment is carried out strictly in a hospital. At the outpatient level, therapy continues and is adjusted, the condition is monitored by a cardiologist in the clinic.

Regardless of the type of disease-causing process, the essence is approximately the same.

During the influence of one or another factor, there is a violation of the normal blood supply to the myocardium through special arteries, called coronary.

The result is acute ischemia (oxygen starvation) of tissues. A similar phenomenon corresponds to an attack of angina pectoris, and if the degree of blood flow disturbance is high, a heart attack.

During the episode, there is a slowdown or complete cessation of local hemodynamics, necrosis of cardiomyocytes (actually the units that make up the active muscle layer of the heart).

The process is accompanied by intense pain in the chest and other symptoms.

Outside of competent medical care, there is a decrease in myocardial contractility, blood output is insufficient.

Nutrition of the brain, organs and systems weakens. Hence additional manifestations, such as fainting and others.

The probability of death depends on the area affected. The larger the focus, the higher the risk of death.

A heart attack is an emergency condition accompanied by necrosis of cardiomyocytes and generalized symptoms, hemodynamic disturbances.

Recovery is carried out urgently, in a hospital or intensive care unit.

Classification

The main criterion is the nature of the pathological process. It has already been mentioned in passing that a heart attack is a simplified name for two phenomena.

Which ones:

angina pectoris

It proceeds relatively sluggishly, in addition, the indicators of the tonometer are unstable, and there is no significant increase in numbers. But this is the first wake-up call, he points to the need for treatment.

Transformation, progression occur in a short period of time, sometimes a few months are enough. Recovery under the supervision of a cardiologist.

Excessive stress on the heart leads to chronic malnutrition. Sooner or later, a heart attack will come. Angina pectoris is possible, but not required.

Diabetes. Systemic endocrine disease associated with insufficient production of insulin or a decrease in tissue sensitivity to it.

Both options have a poor prognosis without treatment. And therapy does not give a 100% guarantee of complete recovery.

The hallmark of the pathological process is a generalized vascular lesion, it is determined by stenosis, that is, narrowing.

Hence the secondary atherosclerosis, including the structures of the lower extremities, brain, coronary arteries.

Other diseases of the hormonal profile. There is hypercotricism, that is, excessive synthesis of thyroid substances, excessive production of cortisol by the adrenal glands, and other phenomena.

All of them are the culprits of vasoconstriction. Treatment is planned. Launched forms are stopped in a hospital under the supervision of a group of specialists in order to avoid fatal consequences.

Risk factors

Smoking. Patients who use tobacco have a 70% higher risk of having a heart attack than those who lead a healthy lifestyle. Studies show that not only experience plays a role, but also individual resistance to poisonous agents, which is genetically determined. Therefore, the same time of tobacco consumption will cause different consequences for two different people. A drop of nicotine does not always kill, but the results are inevitable. When they arise - in a month, a year or more, no one will say. It is necessary to monitor the patient's condition.
Alcohol consumption. Ethyl alcohol leads to general vascular disorders, blood pressure levels quite quickly. But again, individual resistance to ethanol plays a role, which is different for everyone.
Obesity. Not the increased weight itself matters, but what stands behind it. In this case, we are talking about a violation of lipid metabolism. Fats are unevenly distributed, there is a deviation of their normal deposition. The process is corrected with great difficulty, the main way to avoid adverse consequences is to change the very principle of nutrition (in other words, diet).
Insufficient or excessive physical activity. In the first case, stagnant processes begin, myocardial contractility and vascular stenosis decrease. In the other, there is proliferation of cardiac tissues, compression of the coronary arteries. Both options are unfavorable. If the former is potentially curable, the latter has negative prospects.
Age 45+, male.

trigger factors

Stressful situation. Associated with the release of large amounts of cortisol and adrenaline, which provoke stenosis of the coronary arteries. Depending on the amount of narrowing, one of two variants of a heart attack is observed.
Excessive physical activity. The required level of activity depends on the individual characteristics of the patient's body, his fitness. It is enough for someone to climb the stairs to the third floor to provoke an attack, for another, even a kilometer of running is not enough.
Hypothermia. Exception to the rule.

The causes of a heart attack are both cardiac and non-cardiac. A group of factors plays a role, in combination they lay the foundation for the pathological process. Eliminating a trigger or moment of risk is not enough. We need to fight all three categories.

Symptoms and early signs of a heart attack

Manifestations are specific, but there are no differences in symptoms in women and men. If you look closely, this gives reason to suspect an attack immediately.

Approximate clinical picture:

Pain in the chest of varying degrees of intensity are typical symptoms of a heart attack. Against the background of angina pectoris, it is medium in strength, burns, presses. Gives to the left hand and shoulder blade. Lasts no more than 30 minutes. With a heart attack, the manifestation is much more active, occurs suddenly, lasts over half an hour. Attempts to independently delimit the two states are futile. Instead of dubious exercises, it is better to call an ambulance.
Dyspnea. In complete peace. The patient is unable to take in air to meet the need. Such symptoms are determined by a violation of gas exchange.
Feelings of anxiety, panic, fear. Corresponds to a neurotic state.
Loss of consciousness. Up to several times in a row. An alarming sign, indicates a weakening of the power of the brain.
Cyanosis of the nasolabial triangle. Blueness around the mouth.
Paleness of the skin.
Arrhythmia by the type of bradycardia (weakening of the frequency of contractions).

Signs of a heart attack develop almost at once, and the duration of the episode is from 10 minutes to 30 minutes with angina pectoris, and more against the background of a current heart attack.

How to recognize an emergency?

It is not easy to do this without qualifications. A distinction is made between the main types of coronary insufficiency, it is also required to distinguish the described disease from intercostal neuralgia, perforated gastric ulcer, pneumonia and other phenomena.

What characterizes heart pain:

Lack of response to breathing. Inhalation and exhalation do not affect the intensity of the syndrome. What can not be said about the signs of extracardiac discomfort.
No change when moving. If you stand up, sit down, lie down - the power of manifestation will be the same. This is a feature of heartache.

With intercostal neuralgia, the pain intensifies both when inhaling and when moving.

A perforated ulcer is determined by a sharp, cutting sensation in the abdomen and epigastric region. It is this nature of pain that makes it possible to distinguish the state from others.

Pneumonia causes predominantly respiratory symptoms.

Diagnosis falls on the shoulders of doctors. It makes no sense to guess on the coffee grounds. The brigade should be called. You can recognize an attack by the nature of the pain, its duration, additional manifestations.

First aid

Before the arrival of doctors, at home, you only need to stabilize the patient's condition. Not to cure it, but only to normalize the situation.

Sample algorithm:

To seat the patient, put a roller of clothes or underwear under his back. It is impossible to fit, because normal gas exchange will be disturbed, pulmonary edema or other additional complications will occur.
Open the window, ensure the flow of fresh air into the room.
Give the patient a Nitroglycerin tablet to relieve pain. With a heart attack, the measure may be ineffective, but other drugs should not be taken. The state is unstable, any influence from the outside leads to an aggravation of the situation.
Loosen the collar, remove tight body jewelry.

Upon the arrival of the doctors, a brief description of the condition should be given. Transportation to a cardiological hospital is indicated.

Effective measures can only be taken in the hospital. First aid for a heart attack consists of two things: calling an ambulance, stabilizing the condition of the injured person.

Necessary examinations

Upon admission to the department, the diagnosis is carried out urgently. Usually, the results are not expected, urgent measures are shown to bring the main vital signs back to normal. Then more careful work is needed.

Indicative list of activities:

Oral questioning of the patient and collection of anamnesis. It matters, including what kind of attack, how often they occur (if they were before).
Measurement of blood pressure and heart rate.
Daily monitoring. Registration of the same indicators within 24 hours using a Holter monitor. It can be carried out repeatedly to clarify conditions. The study answers the question about the dynamics of blood pressure and heart rate throughout the day, depending on circadian phenomena.
Electrocardiography. Shows even a slight arrhythmia. All functional deviations are clearly visible.
Echocardiography. Demonstrates defects and degree of destruction of cardiac tissues. This visual technique, in fact, is a variant of ultrasound.
A blood test is general, biochemical and hormones.

Treatment

An approximate scheme of drug correction involves a long course of taking such drugs:

Angiagrengants. For blood thinning. Aspirin Cardio will do. This is a mandatory pharmaceutical product.
Statins. In order to eliminate cholesterol plaques in the coronary arteries and not only. Atoris as the main one. It is possible to use analogues at the discretion of a specialist.
Beta blockers. Metoprolol, Anaprilin.
Antihypertensives as needed. Reduce blood pressure.
Nitroglycerin for pain relief. They are not taken constantly, but as part of the removal of an uncomfortable sensation.
Diuretics. Regularly (several times a week) to remove excess fluid from the body.
Cardioprotectors. Mildronate and others like him.
Preparations of potassium, magnesium. In order to restore local metabolism.

Surgical treatment is indicated for vascular abnormalities, significant stenosis, or advanced atherosclerosis.

The nature of the intervention is determined by a specialist. Most often, stenting or shunting is performed.

The transferred attack imposes some restrictions on the patient's life:

It is necessary to completely give up smoking and alcohol.
You can't be physically overwhelmed. Only walking and light physical education, prescribed by a doctor.
You should also adjust your diet. Fatty and fried foods are excluded, fortification of the menu is shown. Salt no more than 7 grams per day.

An approximate list of products is indicated in the treatment table No. 10. Based on the list presented, conclusions can be drawn. All controversial points are recommended to be discussed with a nutritionist.

Forecast

Against the background of unstable angina pectoris of the first or second functional class, it is favorable.

The survival rate is close to 80-90%. 3-4 - already much worse. It is impossible to radically restore the original position. The probability of a lethal outcome is 30-50% or so.

A heart attack leads to death much more often. It is impossible to say anything specific. The issue is resolved individually, after a long period of dynamic observation.

Finally

A heart attack is a simple term for coronary insufficiency. The process is developing rapidly, gross changes without competent medical care are likely.

Treatment is urgent, carried out in a hospital. Depending on the cause, the duration of recovery is from six months to a lifetime.

It is difficult to predict the outcome. A group of factors is taken into account: from age and gender to heredity and the presence of somatic pathologies.

The name "heart attack" can hide a wide range of pathological conditions caused by diseases of the heart and blood vessels, which periodically or systematically remind of themselves in this way, even despite the fact that the patient is constantly taking treatment. These are life-threatening attacks, etc. Sometimes a heart attack occurs in people who, in general, are not very sick, but not very healthy either, whose nervous system is especially sensitive to any influences. This group includes patients diagnosed with her characteristic panic attacks and adjustment disorders.

Heart attack, but the reasons are different

Usually people call a heart attack everything that is accompanied by acute intense prolonged (20-30 minutes or more) pain in the heart and evaluate it with one word “bad”, which includes other symptoms (, arrhythmia attack,).

The reason for them may be:

, which is usually preceded by unstable angina;
, often developing as a result of a sedentary lifestyle in old age, thrombophlebitis of the venous vessels of the legs;
Exfoliating that occurs at any age against the background of arterial hypertension;
, formed as a result of a weakening of the contractility of the heart, the cause of which could be various diseases of the cardiovascular system (arterial hypertension, atherosclerotic, aortic defects, etc.)

All these diseases can complement each other, exist in isolation, but each of them can be asymptomatic or atypical, which is why the concept of “heart attack” is so widely used and it’s good, because a person who does not have a medical education will be able to explain the essence of the problem in a nutshell.

You don't have to be a doctor to distinguish a life-threatening attack from a condition that requires the use of sedatives, you just need to know the symptoms of a heart attack well. Life is such that any of us can find ourselves in a situation where another person needs help, and conscience will not allow to pass by, because myocardial infarction at the beginning of its development (before a diagnosis is made) is also called a heart attack.

Real heart attack

pain with a heart attack, which are based on the death of myocardial cells resulting from the closure of the vessel by a thrombus, or a sharp spasm of the arterial vessels, leading to a violation of the blood supply to the heart muscle (ischemia), quite long (up to half an hour). In addition, they are distinguished by a special intensity, and seizure relief with nitroglycerin or other drugs by mouth, usually has no effect , do not alleviate suffering by changing the position of the body, access to fresh air, ammonia and rest.

In addition to pain, the course of a heart attack, depending on its cause, may be accompanied or expressed by other symptoms:

A feeling of fear and anxiety (), forcing the patient to take a motionless frozen posture with a reflection of horror in the eyes.
Strong palpitations and / or heart rhythm disturbances.
Unpleasant sensations behind the sternum, in the arm, in the back and neck.
Feeling short of breath, shortness of breath, general weakness.
Vertigo, nausea, heaviness in the epigastrium, as if food were stuck, sometimes with heartburn and/or vomiting.
Sweating, pallor or cyanosis (cyanosis) of the skin, possibly a decrease in the temperature of the extremities.

It is not out of place to focus on such a heart attack, which is called a "silent heart attack", which proceeds almost imperceptibly, without any symptoms and can happen to each of us, but patients who suffer are more prone to such MI.

What to do in case of a heart attack?

It is better for the sick person to do nothing, it is advisable to call someone to have another person provide first aid for a heart attack.

In such situations, one must keep in mind the likelihood of myocardial infarction, therefore, tactics should be appropriate:

Measurement of pulse (number of beats, rhythm, filling, tension) and (if there is a tonometer);
under the tongue;
An urgent call on 103, starting with the words "heart attack", because with a heart attack, and other similar conditions, every minute counts.

Of course, heart problems can catch a person in any place where there is no apparatus for measuring blood pressure and nitroglycerin, so the very first aid for a heart attack should be to let the emergency medical workers know about the patient as soon as possible.

Call 103 - heart attack

A person who calls an ambulance about a heart attack cannot be accused of going out of his way and making a diagnosis. What kind of attack - the doctors will figure it out, and the spoken words have a magical effect: the station dispatcher knows that a catastrophe has occurred, the patient's serious condition is urgent, therefore, a cardio team is required. Sometimes it is these words that save lives, so it would be appropriate to briefly touch on some emergency cases that are difficult to diagnose in the first minutes.

The threat to human life is: an attack of shortness of breath, proceeding according to the type, can quickly transform into pulmonary edema or develop into in case of extensive myocardial infarction. An attack of tachycardia with a gallop rhythm, as a rule, complements the phenomena of suffocation. Patients suffering chronic heart failure, know what palpitations and painful sensations of acute lack of air are, accompanied by anxiety, sweating, cyanosis, they must constantly keep all the necessary medicines nearby, but, meanwhile, they are always very frightened, because in most cases these attacks "grab" at night. Needless to say, for people who are nearby, these phenomena will have the significance of a heart attack, which requires immediate call for an ambulance.

Video: recognizing and helping with a heart attack

Attack of the heartbeat, unusual in frequency and rhythm, arising against the background of some kind of cardiac pathology, often have to be attributed to heart attacks and life-threatening conditions. Patients who are often visited by attacks of arrhythmia also take heaps of medicines, they know when and what they themselves try not to take to the extreme or relieve an arrhythmia attack on their own (reception,). But ... anything happens, and when the situation gets out of control of the patient, he calls an "ambulance", which deals with the relief of an attack at the patient's home.

What is done for arrhythmias?

There are various types of arrhythmias, dangerous and not very dangerous, for example, if not everyone, then many have heard about such a rhythm disorder as atrial fibrillation. For the first time, an attack of this kind of arrhythmia frightens the patient, he feels that something terrible is happening to his heart, so the best solution would be to urgently seek medical help. In addition, this condition usually requires hospitalization. Of course, by calling 103, a person will report that he is having a heart attack.

An ambulance doctor can relieve an arrhythmia attack with the help of antiarrhythmic drugs, It is better for the patient and his relatives not to do this. An individual approach is needed here, drugs that restore the rhythm have their own indications and contraindications, and there is no single algorithm for stopping an attack of all arrhythmias. Usually, in such cases, verapamil is used, which is administered intravenously, and along the way, the issue of hospitalization in a specialized hospital is decided.

As for the attack of tachycardia, the patient usually copes with it himself with the help of β-blockers, for example. However, such self-activity is possible if the cause is known, the diagnosis is established and treatment is prescribed, otherwise, you need to consult a doctor.

Clue in the nature of pain

Sometimes it is really very difficult to distinguish between heart pain, and, accordingly, a heart attack from pain of another origin, including cardiac, but there are still differences:

gender, age, atherosclerosis

Probably, angina pectoris is one of the most frequent "affairs of the heart", more than half of people with problems of the cardiovascular system suffer from this disease. arterial vessels in general, and, in particular, is the main cause of the development of angina pectoris, the clinical expression of which can be considered a heart attack.

insufficiency of blood supply to the myocardium due to blockage of the coronary arteries with the risk of formation and occurrence of a heart attack

Heart failure in patients with atherosclerosis is formed when there is a disproportion between the needs of the heart muscle in oxygen and the possibilities of blood circulation in the arterial vessels of the heart. This is especially pronounced if a person receives additional physical activity, and the heart has to work hard to provide the tissues of the body with the necessary substances. The situation will be complicated by the insufficiency of detours with which the body could compensate for the violation of blood flow. In addition, a negative effect in this case is given by factors that negatively affect the arteries of the heart:

In the systole phase (myocardial contraction), the loaded heart muscle compresses the small arterial vessels, obstructing their blood flow.
Increased end-diastolic volume, increased pressure in the LV (left ventricle), reduced myocardial contractility leads to increased pressure within the heart muscle.

Symptoms of a heart attack stem from the formed coronary insufficiency. Due to the imbalance between the transport of oxygen with the blood and the need of the heart muscle for it, the myocardium begins to experience oxygen starvation and, under conditions of hypoxia, responds with ischemia. This should be remembered by people at risk for myocardial infarction (gender, age, weight, excessive exercise, bad habits, hypercholesterolemia, atherosclerosis).

Attack with unchanged vessels

It should be noted that signs of an angina attack are not excluded in people with unchanged heart vessels.

"Seize the heart" can in other cases:

Increased production of physiologically active substances (catecholamines) and their accumulation in the myocardium during psycho-emotional and / or physical stress causes the heart to work intensively which is manifested by rapid heartbeat. Under conditions of stress on the heart muscle, the myocardium requires an additional volume of oxygen, which cannot be delivered due to vasospasm and blood flow disturbance caused by catecholamines. These active substances include the so-called "hormone of fear" - adrenaline, the production of which is sometimes provoked by the patients themselves - lovers of various kinds of extreme sports. Contributes to a strong heartbeat, attacks of shortness of breath and angina pectoris another hormone of the adrenal glands - norepinephrine, called the "hormone of rage", which is actively synthesized during stress. People with vegetative-vascular dystonia are very familiar with paroxysms caused by the influence of the sympathetic-adrenal system. They are distinguished by a variety of symptoms and are often classified as a panic attack: the vessels are clean, the heart is healthy, and signs of an angina attack are evident.
Under the influence of the sympathetic-adrenal system, activation of coagulation factors of hemostasis. When there is no agreement in the processes of coagulation and anticoagulation, the prerequisites are created for the formation of disseminated intravascular coagulation (), which further exacerbates coronary insufficiency, if it occurs, and contributes to the development of myocardial ischemia.
If the movement of blood along the microcirculatory bed encounters an obstacle on its way, then it goes around along the lateral vessels (collaterals). This adaptive mechanism exists in case of unforeseen circumstances and is especially developed in women, which is programmed by nature (pregnancy, childbirth), and the male gender is considered a risk factor. Women are protected by collaterals, however, for the time being, until hormonal function fades with the onset of menopause. After 60 years, both sexes are equally likely to get a heart attack. Underdevelopment of collaterals(workarounds) reduces the body's defenses, and a heart attack will come faster in such people compared with patients who are all right in this regard. Clearly, young women of reproductive age benefit.

If a person is lucky, then during a heart attack, a sudden onset of acute coronary insufficiency can turn on mechanisms that compensate for blood circulation and thereby prevent the formation of an ischemic focus. In an attempt to adapt to circumstances, existing anastomoses are revealed, and new ones are urgently formed. In addition, the myocardium tries to supplement the supply of oxygen by increasing its extraction from the arterial blood. However The “coronary supply” is not bottomless, and as it depletes, the symptoms of a heart attack become more and more pronounced.