How to recognize the symptoms of myocardial infarction

Symptoms of myocardial infarction develop due to a sudden interruption in the blood supply to the heart muscle, as a result of which necrosis develops in it. Myocardial infarction refers to one of the forms of coronary heart disease.

In the development of infarction, the most important factors are blockage of the cardiac coronary vessels by a thrombus, leading to the formation of large foci of necrosis of the muscle, as well as constriction of the heart vessels due to the formation of atherosclerotic plaques.

If the narrowing of the lumen of the coronary arteries is widespread (two or more arteries are involved in the process), with the already existing myocardiosclerosis, a microinfarction develops. Symptoms are less pronounced than common lesions. Although this is a microinfarction, it can lead to the same complications and consequences that develop with large focal necrosis.

Symptoms of myocardial infarction

At the beginning of the disease, patients complain of the appearance of severe and prolonged pain behind the sternum. This is a classic version of the localization of soreness. The pain persists for several hours and does not go away after taking nitrates. There are other variants of pain localization, for example, it can appear in the stomach region (gastralgic or abdominal variant), in the epigastric region with concomitant dyspnea (asthmatic variant). Pain can be given in the back, neck, hand. Often, acute pain is so severe that cardiogenic shock occurs, with left ventricular failure and pulmonary edema. Often the habitual rhythm of the heart is broken, the palpitation becomes more frequent, and the arterial pressure on the contrary falls. If ventricular fibrillation occurs, clinical death may occur.

If in the first hours after the attack occurred on the cardiogram ectopic ventricular arrhythmias are recorded, this may indicate a restoration of the permeability of the coronary artery of the heart.

In addition to heart pain, the initial symptoms of a heart attack are high blood pressure, which, as a rule, passes with pain relief, palpitations, a rise in body temperature to a subfebrile condition. The temperature remains elevated to three to four days. In the blood, the number of leukocytes increases, the ESR increases and the level of nitrogenous slags (do not take this symptom for a uric acid infarction). All these are signs of an inflammatory reaction. In the first hours, growth of enzymes was noted: creatine kinase, ALT, AST, LDH.

The cardiogram for the infarction pattern is characterized by ST segment elevation, wide Q tooth, appearance of the QS ventricular complex in those leads where necrotic myocardium occurred. For more accurate diagnosis, especially with repeated infarctions, it is necessary to shoot a series of cardiograms.

If a microinfarction happened, the symptoms are often not so pronounced and the pain may not be so intense. A person can move it "on its feet" or take an angina attack, then it is accidentally detected on the ECG. Symptoms of a heart attack with a small focal lesion are usually observed in people who have been suffering from angina or cardiosclerosis for a long time. In those cases when it occurs in the initial stages of IHD, the microinfarction is, as it were, a harbinger of a vast transmural lesion.

In the first days of the patient may be unnecessarily euphoric, perhaps the resumption of pain in the heart, the occurrence of arrhythmias and extrasystoles.

As a complication, an aneurysm of the heart wall or the aorta, heart failure and pulmonary edema, embolism of blood vessels of organs and limbs can develop.

Treatment

Therapy for infarction must be performed in a stationary setting. Severe cases are treated in resuscitation. Nitrates are prescribed in the form of intravenous infusion, heparin in large doses, analgesics. Apply polarizing mixtures containing potassium, betta blockers, inhalation of oxygen. The patient must comply with bed rest and be as much as possible protected from stress and overexertion.