According to the observations of cardiac centers, an extensive heart attack refers to common pathologies requiring urgent medical care. High mortality due to this disorder is due to the lack of knowledge about the main manifestations of the disease. Consider them, calling the causes of pathology, the algorithm of first aid.
Extensive myocardial infarction
The term "extensive cardiac infarction (myocardium)" in cardiology is usually defined as a violation, in which there is a change in blood flow, accompanied by a decrease in the oxygen index, which leads to necrosis of the heart muscle. Part of the cells completely dies. In their place, the scar is formed over time. Depending on the location of the lesion, the location of the necrosis area, distinguish:
- infarction of the anterior wall;
- myocardial infarction.
At the first type of violation there is damage to the left artery. The lumen of it completely overlaps, which prevents the normal flow of blood to the heart. When the posterior wall is affected, the right coronary artery occludes. Among the possible causes of pathology, doctors put forward ischemia (98% of cases). In this case, the coronary arteries are prone to damage - atherosclerotic changes. In addition, an extensive heart attack can occur due to:
- coronary artery thrombosis ;
- malformations of the coronary arteries;
- blockage of large blood vessels by parts of neoplasms;
- an inflammatory process that affects the coronary arteries;
- stratification of the ascending aortic department and education after hematoma;
- the use of narcotic substances, which causes a spasm of the coronary arteries (coke, amphetamine);
- mechanical injury, electric shock;
- consequences of heart surgery.
Extensive heart attack - symptoms, first signs
Symptoms of an extensive heart attack are pronounced. The first thing noted by such patients is a strong, often tearing pain in the left half of the chest or behind the breastbone, which radiates into the arm, the lower jaw, and the left scapula. There are painful phenomena for at least 30 minutes. A distinctive feature of the disorder is the lack of therapeutic effect of Nitroglycerin .
After a short while, a feeling of lack of air is noted, the patient complains of what is choking. In addition, the following can be recorded:
- cold sweat;
- vomiting;
- nausea;
- lowering of blood pressure.
An extensive infarction refers to those pathologies for which the staging of symptoms is characteristic. There are 5 stages:
- The period of the prodrome (preinfarction). It is characterized by an increase in the number of episodes of angina attacks.
- The sharpest period. Lasts for 0.5-2 hours. Characteristic burning pains, sweat, changes in heart rate, blood pressure drop.
- A sharp period. The time lasts 2-10 days. It is characterized by the process of formation of the necrosis site in the cardiac muscle. The pain subsides, but the heart rhythm is broken, the body temperature rises.
- Subacute. Lasts 4-5 weeks. At this time, a scar is formed on the site of the dead tissue. The heart rhythm is restored, the pain syndrome disappears completely, the pressure is normalized.
- Postinfarction. The time takes 3-6 months. On the heart physicians register, with the help of ultrasound, an increase in the density of the scar tissue. The body is gradually getting used to the new conditions.
First aid for a heart attack
The disease requires urgent hospitalization. First aid for myocardial infarction should be provided on site. The algorithm of actions of associates or relatives should have the following sequence:
- Lay, unfasten the tight-fitting clothes, collar.
- If possible, soothe the patient.
- Give drugs that stop the pain: Nitroglycerin, Aspirin.
- Call an ambulance.
Extensive heart attack - consequences, chances to survive
With such a violation as an extensive heart attack, the consequences, the chances of a successful outcome depend on the time of the initiation of therapy. According to statistics, 40 patients out of 100 die at the prehospital stage. In addition, when forecasting physicians take into account the area of the affected area, which directly affects the outcome. Aggravating factors in this pathology are:
- elderly age;
- arterial hypertension in the anamnesis;
- the presence of signs of congestive heart failure.
Extensive myocardial infarction
The pathology itself has a high probability of death. Because of this, hospitalization should be performed within 30 minutes of the onset of the first symptoms. For this it is necessary to be able to accurately determine the extensive heart attack, the consequences of which can be as follows:
- Rupture of the heart muscle. It leads to death. Happens within one day of the infarction. In this case, the wall of the left ventricle directly affects.
- Cardiogenic shock. It is observed as a consequence of an extensive infarction in which the lesion of the anterior wall (coronary arteries) occurs. It develops when necrosis is fixed more than 40% of the area of the myocardium. With true cardiogenic shock, lethality reaches 90%.
- Pulmonary edema. An infarction in the absence of help can lead to alveolar edema. Such a complication is characterized by shortness of breath, weakened breathing, wet wheezing, coughing with foamy sputum of pink hue (an extensive simple heart attack).
In patients who have suffered such a violation in the early stages of the recovery period, complications are also possible:
- mitral insufficiency (in 25-50% of patients);
- aneurysm of the left ventricle (10-15%);
- thromboembolism (10%);
- heart rhythm disorder;
- atrial fibrillation.
Extensive myocardial infarction - consequences
This form of disorder often has less severe symptoms. Because of this, patients do not even suspect a large heart attack, the consequences of which are similar to those listed above. It should be noted that this type of pathology is characterized by a favorable prognosis - survival rate in case of posterior wall involvement is higher. Among the possible dangerous consequences of violations are:
- Dressler's syndrome;
- rhythm disturbance;
- thromboembolism;
- cardiogenic shock.
Extensive heart attack - treatment
Violation requires hospitalization and intensive care. With such a pathology as an extensive heart attack, the chances of surviving depend directly on how quickly hospitalization and emergency care was provided. According to medical experts, if a patient is taken to the hospital within 30 minutes from the moment of the onset of the attack, the appearance of the first signs, the probability of a favorable outcome is high. In this case, appoint:
- drugs to improve hemodynamics - Prasugrel, Plavix, Clopidogrel;
- drugs that reduce pain - analgesics, Nitroglycerin
- antiarrhythmic - Amiodarone;
- anticoagulants - Streptokinase, streptodeacase;
- thrombolytics - Heparin, Aspirin.
Extensive heart attack - heart surgery
Postponed extensive myocardial infarction often becomes an indication for surgical intervention. An effective technique in this case is angioplasty - restoring the patency of the coronary arteries by stenting. It gives vessels and arteries the necessary diameter, which causes the correct flow of blood, reduces the burden on the heart.
Stenting after a large heart attack
Postponed extensive myocardial infarction, the consequences of which are discussed above, almost always requires the restoration of patency of the vessels. This endovascular method is performed in the vascular section. The operation requires the availability of appropriate equipment and qualified surgeons. The stent itself is a strong tube, the diameter of which completely corresponds to that of the artery.
How many live after a large heart attack?
With such a violation as an extensive heart attack, the prognosis is due to the timeliness of the provision of medical care, the area affected by the heart muscle. It is worth remembering that the pathology itself is accompanied by angina pectoris. When it is unstable, 30% of patients die 1-3 months after the attack. According to statistical observations, among patients who underwent primary hospitalization, mortality is 10%.
Life after a massive heart attack
Compliance with the recommendations and instructions of the doctor - the basis for successful rehabilitation. Nutrition after an extensive heart attack should be balanced. From the diet doctors advise to exclude salty dishes, spicy and smoked. The first 10 days must adhere to a low-calorie diet, limit the intake of liquid. The basis of nutrition at the initial stage of rehabilitation are liquid cereals, fruits, mashed soups, vegetable purees.
A month later, when the scar begins to form, there is a need for products containing potassium. This microelement directly reduces puffiness, contributing to the removal of excess fluid of their body, increases the contractility of the heart muscle. It contains:
- peanut;
- cauliflower;
- almond;
- Walnut;
- prunes.