Two infarction in a row. Repeated myocardial infarction

23.06.2021

If you believe the statistics, the re-infarction of myocardium is observed in a third of the people who suffered the first attack. This disease can now be found increasingly and more often, but few know about him. Each adult should have an idea of \u200b\u200brepeated infarction, because he may encounter this anywhere and save the life of a person who fell into this situation.

Reasons for re-infarction

Atherosclerosis can be called the most common cause of re-attack. It is at this disease that the formation of special cholesterol plaques is observed, which significantly narrow the clearance of the vessel, resulting in obturation. As a result, myocardial cells do not receive the required amount of oxygen and beneficial substances, which is why they die with the further development of the necrotic process.

If this is a second heart attack in the patient and at the first cause was atherosclerosis, then when the myocardial infarction is re-infarction, the reason will remain the same, because the disease has not disappeared anywhere. But it is possible to defeat the other vessel and other sections of the heart muscle.

Factors that contribute to the development of atherosclerosis and repeated attacks of the infarction set, among which the main can be called:

sexual signs, because men according to statistics more often suffer from cardiovascular diseases;
age factor, since older people are more susceptible to the formation of atherosclerosis of the coronary blood vessels;
hereditary predisposition, which is considered one of the main factors of problems with the cardiovascular system;
existence of excess weight, which contributes to the appearance of diseases associated with the violation of the lipid metabolism of the human body;
the presence of such a disease as diabetes increases the risk of atherosclerosis several times due to the violation of the structure of the inner wall of the vessels;
arching hypertension, because with it the walls of the heart become thicker and require more oxygen, which causes ischemic changes in the structure of the heart muscle;
unbalanced and improper nutrition, which implies consumption of fried and oily foods;
the presence of elevated cholesterol levels, which is the main component in the formation of plaques on the inner wall of the vessels;
maintaining a low-effective lifestyle;
the presence of frequent stresses that lead to a pressure of pressure and cardiac rhythm.

All these reasons for re-infarction are sufficiently common in modern society, but there are also risk factors that significantly increase the risk of re-attacking a heart attack.

These include:

people who lead an asocial or low-active lifestyle;
non-compliance with the prescriptions of the doctor about the therapy of the primary attack;
professions that imply constant stress;
the presence of bad habits, which increases the risk of re-hitting several times;
the presence of frequent physical exertion.

These are the main causes and risk factors of the heart attack of the heart muscle. It is very important to know them because there is a high probability after the primary primary attack in the patient.

Symptomatology with a re-attack

After the first heart attack, the likelihood of the appearance with the re-hit time, which has the same symptoms.

The main complaint of the patient is discomfort and pain in the area of \u200b\u200bthe sternum and hearts. These pains are formed as a result of severe physical or psycho-emotional loads, but they are not rarely arising in a state of calm. The pain has a protracted and pressing character. She can also give to the left hand, back, neck or jaw. It is possible to observe the sick skin pale, as well as the release of cold sweat throughout the body. With the second attack of the infarction of the patient's complaints are endowed with a brighter character.

The emergence of additional complications, among which can be allocated:

shortness of breath;
scinting of skin;
seizures of suffocation;
loss of consciousness;
pressure drop.

These are all the doctors connect with the strongest edema of lungs, which can be observed in the terminal states of man.

The consequences of repeated heart attack are very unfavorable. They lead to various forms of lack of heart muscle. Possible ethics of lungs, the development of cardiogenic shock. There is a violation of the patient's cardiac rhythm. You can also detect the gaps aneurysm in the vessels of the heart or brain. Vessel thromboembolism is also a non-discovered phenomenon at a secondary myocardial infarction.

To prevent such consequences, each person should know the symptoms of the re-infarction of the heart muscle, because the assistance provided and adequately prescribed treatment can save human life.

First aid and treatment with myocardial infarction

If a person has a repeated ischemic lesion of the heart muscle, it is necessary to immediately cause ambulance, because the account of time goes for a minute.

Prior to arrival, it is desirable to provide assistance to the victim, the essence of which consists in three main points:

It is necessary to give a patient a comfortable position, lifting the head, as well as unbuttoning or removing interfering clothing. Provide access to fresh air source.
The victim urgently needs to be provided with nitroglycerin to give every 5 minutes before the arrival of ambulance. Also additionally you can give aspirin or cardiomagnet.
When stopping the breath or pulse, it is urgently to start indirect heart massage, which is usually accompanied by artificial ventilation of the lungs affected.

Therapy with a given disease is emphasized on lysis of thrombus and on angioplasty. The liquidation of thrombus implies the use of special medicines, with the help of which it can be achieved. This normalizes the blood supply to myocardium, which has undergone a heart attack. Thrombolysis is used only when re-infarction.

It is strictly forbidden to use this method in the presence of a patient with hemorrhages of any scale and localization, as well as for malignant neoplasms or violation of the rheological properties of blood.

Angioplasty is used to expand the diameter of the vessel with a cylinder, which is used to inflate the vascular walls. This method is safer, since it has a smaller number of complications compared to thrombolytic therapy.

Also in the treatment of re-attack the following drugs are prescribed:

inhibitors angiotensin-converting enzyme;
drugs of the group of anticoagulants;
drugs of the group of antiagregants;
andreoblockers beta groups;
statins and liberins;
nitroglycerine.

The re-infarction of myocardium can provoke a large number of unpleasant complications, but if you have a sick help on time, they will be avoided. Mortality in the first week after the attack can be observed in the quarter of cases. Over time, this indicator falls.

In order to prevent the re-infarction of myocardium and protect yourself and their health from unpleasant consequences, you need to constantly observe the doctor in order to notice the deviations in the work of the heart or the vascular system.

It is worth remembering that when a myocardial infarction is repeated, the bill of time goes for a minute, because the disease has high mortality and a wide range of complications. Therefore, in order to protect yourself from this, you need to follow your health and if any symptoms need to immediately contact the doctor, because only he can help preserve the most valuable - human health.

09.05.2017

Custody of a heart attack - and in its consequences and riskrepeated infarcityWho can happen in a person two or more times, with each new case, the health of the heart muscle is worsening.

According to open sources, a heart attack is repeated about 25-29% of cases.

It is impossible to predictsecond infarction With 100% accuracy, even when complying with all the recommendations of the doctor after the first heart attack, patients may encounter relapse or repeat of the pathological condition.

It is important to distinguish between recurrence and repeat them seems similar, but recurring call the attack, which happened after 1.5-2 months from the previous one, and the re-infarction, which happened later than in 2 months.

W. repeated infarcity Often the same localization as the first defeat. There are extensive and small-fought heart attacks. As for the consequences, they may be different - if the next heart attack has arisen distantly from the location of the scar, which remained earlier than the infarction, it will not really affect the work of the heart. If the area of \u200b\u200btissue lesion is the same, and necrosis is relating to large-scale, thenrepeated myocardial infarction It leads more often to the fatal outcome.

Causes of the newly happening infarction

Factor provokingfirst And the following heart attacks, becomes atherosclerosis, accumulation of cholesterol plaques inside blood vessels. Such formations in different degrees are closed by the clearance of the vessel, disturbing blood circulation, and as the thrombus clusters accumulates, the artery can be blocked at all.

In medicine, this condition is called occlusion. As a result, blood is not supplied to myocardium, and without the delivery of oxygen, myocardial cells are dying, such a state is called necrosis. Considering that atherosclerosis, as it was, and remains the cause of problems with the heart and vessels, it is not possible that through the time of the bleach cholesterol can again clog the blood vessel and cause the death of fabrics. If the same artery is clogged, as the first time, necrosis will be located at the site of the scar from the past attack. If another artery is clogged, then necrosis can be localized on a different wall of the heart.

There are risk factors that increaseprobability of 2 infarction:

belonging to the male floor. The female organism is equipped with sex hormones providing some protection to a specific age. After the occurrence of Klimaks, representatives of female and male risk of heart attack comes to balance;
age in 45 years due to the reduction of the adaptation abilities of the body;
heredity. If close relatives had a repeated heart attack, there is a high probability of the same development of events;
overweight. If the waist in the amount of more than 102 cm in men and 88 cm in women, and BMI above 25, talking about obesity. BMI is the so-called human body mass index is not difficult to calculate independently, if the mass per kg is divided into growth in square meters. For example, for a person weighing 70 kg and 70 / (1.7 * 1.7) \u003d 24.22 will be 70 / (1.7 * 1.7) \u003d 24.22;
diabetes. The disease poorly affects the condition of the arteries, aort, veins, capillaries;
increased pressure. Hypertension causes the deterioration of the contractile ability of the heart, the growth of the wall thickness, as a result, it requires more than earlier than the volume of oxygen, and the arteries do not cover such needs;
cholesterol is elevated, it provokes plaques on the walls of the vessels;
unbalanced nutrition. Consumption of animal fat provokes an increase in cholesterol;
hydodine. If you minimize the number of daily movements, it leads to an increase in the number of lipids, and the heart and other muscles of the body lose the tone;
smoking and alcoholism. Harmful habits destroy vessels;
chronic stress. The nervous situation leads to an increase in pressure indicators, tachycardia.

Symptoms of attack

Detects no earlier than they will end 2 months from the first case. Mature men face with him. The second heart attack is suffered hard, in most cases the arrhythmic and asthmatic forms detect. The clinical picture manifests itself not so bright as with a primary attack, since the myocardial sites affected in the past are not sensitive.

In general, each next attack can have a similar course and signs as the previous one. The pains in the heart remain characteristic of the left forearm and the entire hand, the left blade, neck and possibly in the lower jaw.

The pain attack can be a gulling or stitching, nitroglycerin can only slightly reduce pain, and that is not always.

Against the background of discomfort in the chest, the skin pallor arises, increased sweating. Each new infarction is fraught with a general deterioration in the state, consequences. Speaking of symptoms, do not forget that some forms of heart attack pass without pain. They are characterized by: fainting, lung swelling, blue skin, breathing problems, pressure drop.

Urgent Care

Those who are near the person who has been manifested above the symptoms should be as quickly and clearly provided to the first help:

raise
place a person in a half-time position, weaken the gulling clothes, open the windows indoors;
every 10-15 minutes, nitroglycerin is put under the patient;
necessarily give aspirin (1 patient's tablet must dear);
if the patient disappears the pulse and breathing, you need to ventilate the lungs and the heart massage. How to stabilize the patient and try not to give him to die before the emergency arrival - you can learn from another article.

Diagnostics of repeated attack

To correctly, the diagnosis of doctors will need a last cardiogram for comparison with the current one. Therefore, it is important if in the past there was a heart attack, save the ECG and provide a doctor as needed. Do not always, do not always suspect the attack in the situation when necrosis is in the artery zone, which was let down in the past. Also it difficult to diagnose may have flickering arrhythmias and some other states. If the doctors will suspect the pathology of myocardial activity, they are focused on the available symptoms, and prefer to deliver a patient to cardiology as soon as possible, where it is possible to conduct a hardware examination.

Signals about the presence of a cardiac attack on the cardiogram will be:

signs of necrosis of any of the myocardial walls (on the tape, the manifestation of a deep and extended q teeth in proper leads on the background of the Stump of ST segment, negative teeth);
signs of a previously case infarction are able to disappear. If the heart attack is revealed on the front wall, then the tracks of the scar on the back wall are not detected on the past cardiogram;
the shortage of data on the cardiogram on the presence of a re-infarction does not confuse the doctors, even a short-term increase in the ST segment can speak about the attack as a signal of the acute stage of the pathological process.

In addition to the usual cardiogram, doctors can carry out a more informative study - echocardiography, which reveals the myocardial sections with a violated reduction, gives an assessment of the work of the heart - studies the impact volume, as well as the emission fraction, which pressure in cameras, vessels, etc.

Relying on the data obtained from the laboratory analyzes, the cardiologist can determine the re-infarction. These are research on troponins, LDH, Asat and KFK, Alat. Doctors are interested in specific data:

kFK rates range to 110 months, but it is necessary to consider that KFK - MV increases after 3 hours from the beginning of pain attacks and after 48 hours it returns to normal;
troponin indicators are the following - troponin I - about 0.07, and troponin T 0.2 - approximately 0.5 nmol / l. The digital data of the first in the blood is revealed for about 7 days, and the following is about 2 weeks;
lDH indicator is about 250 U / l. During the heart attack, it will grow about 3 days, then returns back to about 10 days;
asaT - about 41 U / L is characteristic of heart pathologies, and the figure of Alat speaks of problems with the liver. Indicators are increased within 24 hours, and come back to normal after 7 days. In order to differentiate the pathology of the heart and the liver, the Ritis coefficient is calculated - the AsaT is divided into an alote. Digital indicators above 1.33 talk about a likely infarction, if lower - probably, pathology is associated with the liver.

In addition to these blood tests, urine analysis is prescribed, blood biochemistry, ultrasound organs, yondgen breasts, etc.

Treatment of infarct

The indisputable condition in the treatment of the first and subsequent infarction is an operational response. If you have time to deliver the patient in resuscitation no later than 12 hours from the beginning of pain symptoms in the chest, the good effect of doctors plan to get from thrombolysis and balloon angioplasty.

Thrombolysis is a deliverance from the blood closure, which violates the circulation of blood flow in the vessel, with the help of specialized drugs. Medicines (Urocking, Alplaza) will help restore blood supply to the desired portion of myocardium. The indication to the appointment of such drugs will be a sharp infarction if the response time does not exceed 24 hours. Bleeding, which occurred in the body of the patient (uterine, in the stomach and intestines, etc.) become contraindiculary to thrombolysis. Thrombolysis is not provided if states are revealed: a stroke, an intracranial tumor that occurred injuries or surgery for the last 60 days, exhausting aneurysm, insufficient blood clotting.

Balloon angioplasty is called an operation on the intravascular installation of a cylinder, which under pressure is inflated and restores the lumen in the blood vessel. The introduction of the cylinder is carried out under control on an x-ray.

Angioplasty is carried out in an emergency, if no more than a day has passed since the beginning of pain in the heart attack, or in the delayed mode 5 days after thrombolysis, the operation can also be carried out in a planning order in the future, if the doctors solved the problem, dissolving traffic thrombolesis. Indications for the operation becomes the inefficiency of thrombolysis, which can be seen according to the persistent greed after 2 hours from the reception of drugs and the ECG. Contraindications are individual.

Tablets from repeated heart attack

Medical therapy begin the doctors of the umbrella during the transportation of the patient in the clinic. It is necessary to properly combine drugs:

betaadrenoblockers (metoprolol, carvedilol);
anticoagulants and antiagregants (aspirin tablets, heparin, platform, clopidogrel);
nitroglycerin and analogs (pecterol, nitrosorbide);
statins that reduce cholesterol (rosevastatin and atorvastatin);
aCE inhibitors (drugs Enalapril and Perindopril).

Prevention of heart attack

Make less risk of angina after the attack and subsequent infarction can be adhered to all the recommendations of the doctor, namely:

continuously take appointed drugs - antiagregants, statins, betaadrenoblastors;
change the image of your life so that you can call it without reservation. In particular, to abandon smoking and alcohol in large quantities, balance their diet and enrich useful products, stay away from stress and excessive physical exertion;
during the acute period (2-3 days), the bed regime must be observed, the physician is assigned to the physician. After discharge from the hospital home you need to move daily - walk on foot for certain distances, so as not to overcome, but we gradually train the heart and vessels;
well, if you can go on sanatorium-resort treatment;
employees of a special commission will solve the situation with disabilities or recovery of the patient in the ability to work. With a re-attack, the hospital sheet is issued for 3-4 months, and if a reconstructive operation was carried out on cardiac vessels, the hospital is issued for a year. Even if the heart and vascular system recovered, after the response again, the infarction is not allowed to return to work to the drivers, pilots, air traffickers and representatives of other significant professions. It is impossible to work at a height, daytime, in the specialties associated with walking on long distances. Accurate list will tell the attending physician.

Possible complications

With another infarction, the predicted complications are even more serious than when the first. Cardiac insufficiency can develop, a cardiogenic shock, swelling in the lungs, heart rate failure, the blockage of the pulmonary artery, breaking the aneurysm in the left ventricle is. Complications are early and late, detected by one or a complex of unpleasant states. It all makes sense to list them, it is only possible to say that the doctors have learned the probable options and can react in time if you don't like to inform them about changing your condition.

To minimize the risk of complications, you need to react on time to changes in the body's condition, the appearance of pain in the heart. Regularly need to take medicines and attend a physician with agreed periodicity.

Forecast

If the re-infarction is characterized by a small lesion, the forecast is favorable. With large-scale (extensive), the perspective infarction is not so comforting as complications in this case are developing frequently, the fatal outcome in the first 2 weeks is about 20% of all cases. According to statistics, from the once again infarction to 19% of women and 14-15% of men of old years die every year.

To reduce the risk of a re-cardiac attack and recover after the previous one, it is necessary to take measures about which was mentioned above. Briefly is the correction of the diet and day mode, life without bad habits, normalized physical exertion and reception of prescribed medicines. In addition, it is important to maintain the stability of the emotional sphere, learn not to be nervous on trifles. A temporary disability recommended by the doctor must be observed - forcing events should not, the body needs time to restore and adapt to new working conditions.

Summing up, it should be noted that the heart attack is already detected not only in people in the elderly age, but also younger. It is important to take into account - suddenly the infarction does not appear nowhere, it is preceded by the accumulation of adverse factors, including vessel diseases. That is, if a person follows health and takes measures on time, he may not face myocardial infarction at all.

If the attack still occurred, every minute on the account, if for 6 hours the patient will not be provided with adequate assistance, he will perish. Therefore, it is important to maintain contact with relatives, be aware of your diseases, and also regularly go to the doctor.

A quarter of patients who suffered a myocardial infarction, a recurrence develops some time. Depending on the time of occurrence, the re-and recurrent myocardial infarction is distinguished. If after the first attack passed less than 2 months - we are talking about a recurrent infarction, if more - about repeated. It is difficult to predict the risks in advance, the likelihood of recurrence is reduced by observing precautions, but it is impossible to guarantee security. Most often, the re-infarction of myocardium arises throughout the year after the first case, men and elderly are most exposed.

Myocardial infarction is associated with atherosclerosis and the formation of plaques on the walls of the coronary arteries. As the plaques increase, the clearance of the vessel gradually overlaps, its full blockage can occur. In this case, necrosis occurs those sections of the heart muscle, which blood supply to the affected vessel. If, with a repeated manifestation, the blockage of the same artery occurs, which is primary, - cells die along the periphery of the scar, if another vessel is affected - a new scar arises. Risk factors include:

Male gender.
Age older than 40 years, with equal probability of men and women.
Genetic tendency, the presence of myocardial infarction in relatives.
Sugar diabetes, overweight.
Arterial hypertension (the reduction of the heart muscle is worse, its walls are thicken and need more oxygen).
Increased cholesterol level contributes to the formation of plaques.
The abundance of oily, fried food.
Harmful habits (alcohol, smoking).

After a heart attack, a patient needs special care so as not to provoke a re-attack. If you do not comply with the recommendations of the doctor, continue to abuse fatty food and harmful habits, not to normalize physical exertion, there is a chance of a repeated heart attack. The patient can be protected from experiences and stress, any emotional shocks.

We go on a latter road

The most characteristic feature becomes pain in the chest area, it can continue from 10-15 minutes to several hours. In some patients, painful sensations apply to the upper limb, back, neck or jaw. Pain syndrome is accompanied by general weakness, increased sweating.

It is important on time to provide adequate medical care, otherwise a person can die!

Compared to the first attack, the re-infarction of myocardials can manifest itself more pronounced signs. There are complications in the form of suffocation, pulmonary edema, which is accompanied by the skin of the skin and mucous membranes. The overall condition of the patient is characterized as severe, with late medical care, a fatal outcome is possible.

The re-attack can proceed painlessly, it is possible to recognize it only by general weakness. There are several atypical forms of infarction flow:

Arrhythmic - manifested by impaired heart rhythm, rapidly either slowdown heartbeat, the appearance of a pause in the heart of the heart. The ECG is diagnosed with extrasystole, flickering arrhythmia, as well as other rhythm disorders.
Astmatic form arises in the case of complication of pulmonary edema. Clinically, it manifests itself difficult breathing, choking, short, coughing. Wets contain blood impurities and foam.
With abdominal form, pain in the abdominal cavity, nausea and vomiting becomes characteristic symptoms. The heart attack is necessary to differentiate from sharp inflammatory diseases of the digestive tract, otherwise the risk of adverse outcome increases.

The final diagnosis is based on clinical signs and additional laboratory studies. It is necessary to make an electrocardiogram (ECG), and then compare the results of the survey at the first and re-attacks. If the re-infarction of myocardium arises due to thrombosis of the same artery, the method may be uninformative, then the doctor decides on hospitalization on the basis of clinical manifestations.

What to do urgently

The pattern of therapy is no different from the one that is carried out during the primary seizure. Medical treatment implies the use of ACE inhibitors, anticoagulants, adrenobloclars, nitroglycerin and drugs with a similar effect. The main directions in infarction therapy:

Thrombolysis is a method that is prescribed for clearing thrombus. The use of such medicines is contraindicated in strokes, blood coagulation disorders, intracranial injuries or tumors.
Balloon angioplasty is assigned if thrombolysis turned out to be ineffective. This is a way in which the damaged vessel is installed in the lumen and the lumen is restored during its help.

Any treatment is most effectively if the patient appeals to the doctor for 12 hours after the attack.

During the 12-hour period after the attack, the doctor's treatment will be the most effective!

How to avoid re-attack?

After myocardial infarction, the doctor prescribes a special gentle regime that the patient must observe throughout life to prevent a repeated attack.

Caring for the patient in the post-infarction period is not only his own task, but also his loved ones.

If any changes in the state of the person who suffered a heart attack is noticeable, it is better to appeal to doctors for re-diagnosing the heart, since the disease may not be accompanied by painful sensations.

Diet in the post-infarction period

Excess weight is one of the main causes of various heart pathologies, including myocardial infarction. From the diet, the patient is excluded fried, oily, flour food, measures are introduced to reduce weight as necessary. The diet is aimed at preventing the appearance of plaques in coronary vessels, which become the cause of thromboembolism. Special recommendations, how to avoid re-infarction with a diet:

The percentage of fats in the daily diet should be reduced. It should be preferred by products that contain unsaturated fats: fatty varieties of fish, seafood, vegetable oils, bean plants.
With elevated pressure, it is worth reduce the amount of salt, but it is not fully refused to abandon salty dishes.
After myocardial infarction, it is worth consulating 1 g of fish oil per day. Omega-3 fatty acids contribute to the regeneration of myocardial cells, rapid restoration of the functions of the heart muscle.

Observe the nutrition mode is not difficult. Most of the usual dishes can be saved, it is only worth changing the way they are prepared, replacing fried food on boiled or baked. The effectiveness of the diet depends on the patient's consciousness, since it is recommended to adhere to life for the prevention of re-infarction.

To avoid a re-attack, it is necessary to quit all the bad habits!

Fighting bad habits

To care for the sick after the heart attack will have to be close or relatives. One of the reasons for the development of a re-attack is smoking, which leads to the formation of blood clots in the heart vessels. What to do, if you do not accidentally refuse the harmful habit, informs the doctor. It is possible to prescribe substitution therapy with the help of nicotine preparations (patches or tablets), which reduce the need of the body in nicotine and contribute to the natural development of nicotinic acid.

The more smoking experience in the patient, the harder it is to get rid of psychological dependence on tobacco.

In this case, the responsibility lies not only on the patient, but also on his loved ones, which will have to control the compliance with the regime for some time. It is also not worth refusing to consult a psychologist, if it is impossible to cope with the problem yourself.

Control of physical loads

Both excessive and insufficient physical activity have a negative impact on the functional state of the heart muscle. Athletes after the attack assign a gentle mode so that the critical condition does not happen. Renewing the loads start with daily aerobic exercises: walking, running, swimming, not recommended to be returned to serious sports loads even after a long time after a heart attack. Exercises are better to perform under the guidance of a coach who can competently dose the loads, monitor the patient's performance during the training and maximize the patient from the re-attack.

Medical supporting therapy

Drugs are prescribed individually to each patient, depending on his age, lifestyle, gravity of lesions. During the rehabilitation period, drugs are used:

Anticoagulants - reduce blood clotting level, prevent the formation of thrombus.
Beta-adrenoblays - limit the negative effect of catecholamines (adrenaline, norepinenaline), slow down the frequency and strength of heart cuts, thereby reducing its need for oxygen.
ACE inhibitors are prescribed with hypertension, possess the vasodilatory effect.

To avoid re-infarction, it is worth performing all the recommendations of the doctor. Any medicines have side effects and contraindications, therefore appointed by a doctor after a comprehensive examination.

The person who suffered a myocardial infarction once may encounter a seizure again.

What is the danger?

Proper care for the patient does not guarantee that myocardial infarction will not happen at all: all patients who have already suffered the risk are at risk. The consequences are individual for each patient, depend on the age and gravity of the lesions of the heart muscle:

Disturbances of the heart rhythm, both safe (bradycardia, tachycardia) and endangering the patient's life (complete absence of abbreviations, cumulative arrhythmia).
Chronic heart failure.
Cardiogenic shock.
Heart aneurysta (Popping wall, extra cavity formation).
Heartbreak.

Complications can be associated with disorders of not only the cardiovascular system, but also any other systems if the blood clots continue to form in important vessels. The prognosis is favorable if the attack is repeated in the form of small-scale damage to the heart muscle, and in large-scale or extensive lesions, mortality is up to 20% of patients.

Myocardial infarction (im) is a very serious disease associated with the defeat of the heart muscle as a result of blood closures of blood closures. The location where the diefing tissue occurred is covered by the scar. A new attack that happened for two months after the first is called a recurrent infarction. If the disease occurs after a two-month period after the first attack and the completion of the scarring of the hearth, the infarction is considered repeated. By time, the recurrent and repeated myocardial infarction never coincide, the first is always the second earlier. Very often repeated them begins during the first year. In the risk area there are male people and old age. The attack proceeds more complicated than in the first case, but the painful sensations are expressed weakly, and maybe there is no. The disease is difficult to diagnose, so the percentage of mortality is higher than with primary it.

Features of repeated im.

The re-infarction of myocardium, as mentioned earlier, occurs after the focus is finally cut after the first attack. A number of factors affect his clinical picture:

the duration between the first and second attacks;
the dimensions of the new myocardial damage;
the initial state of the heart muscle.

The recyclable course is heavier the primary. Acute, and then chronic form of heart failure. Often there is an atypical course of illness: there is an asthmatic version of the heart attack, or it is manifested by various forms of arrhythmia. The diagnosis of repeatedly with the use of electrocardiographic research presents great difficulties.

Sometimes there is a false normalization of the ECG. A positive Tuster t appears on it instead of a negative or S-T interval will deteriorate into an isoelectric line. To identify the localization of focal changes, several ECG sessions are carried out, and then comparative analysis of the results, using the data of the previous disease. If, on the basis of an ECG comparison, the re-infarction of myocardial is doubtful, then the exact conclusion about the presence of new foci of damage to the heart muscle is confirmed by conducting a thorough analysis of the disease clinic, comparing blood tests, the patient's condition, body temperature, symptoms.

Reasons for re-im.

With an individual inclination to the formation of thromboms in vessels, a new attack of the disease may occur in the following cases:

Termination of drug reception. Medicines appointed by the doctor after the first attack of the disease are aimed at removing painful sensations in the field of the heart, and most importantly, to prevent the formation of new thrombans and changes in the tissues of vessels. The patient, feeling better, compensatently stops their reception or reduce their dosage, which is categorically impossible to do.
Failure diet. Proper nutrition contributes not only to restoration after transferred, but also prevents the appearance of the myocardial repeated infarction. The use of oily, salty, sharp, fried food leads to the formation of blood clots and blood clogs. It should be remembered that the diet must be adhered to all life.
Bad habits. A man who suffered a heart attack and continuing to smoke and drink alcohol, has a greater chance of learning repeatedly.
Physical activity. Large loads are forced to work a sore heart in a tense mode, so it is not recommended to engage in sports disciplines that require great efforts. Moderate physical activity has a beneficial effect on the processes of recovery of the heart muscle. It is recommended to perform therapeutic gymnastics, perform long walks, perform aerobic exercises to prevent the myocardial repeated infarction.
Emotional condition. Frequent stressful situations, endless unrest and experiences for any reason also contribute to the re-attract. During stresses, the need of myocardium in oxygen increases due to an increase in heart rate, and due to circulatory disorders in coronary vessels, it is not desirable, so it is necessary to avoid unnecessary mental injuries.
Changing climatic conditions. After the suffering disease, it is not desirable to change the climate to be drastically so as not to provoke adverse physiological reactions of the body.

All the reasons for the re-infarction of myocardium are associated with the way of life of the patient and the fulfillment of the recommendations of the attending doctor, so the disease can be prevented and avoided.

Symptoms of repeated name

The patient should be very careful to his health in order to notice signs on time. They do not coincide at all with those that were in the first case. The patient appears:

acute short-term chest pain that gives her neck and a lumbar department;
nausea and vomiting;
sticky dermis;
dizziness and vomiting:
drowsiness and weakness;
general malaise;
dry dumping cough;
severity in the chest;
various forms of arrhythmia.

Under any of the above symptoms of the re-infarction of myocardial and deviations in a state of health, differing from ordinary, and not even related to the work of the heart, the individual has already been infarction, you should contact the doctor and pass the survey so as not to miss a re-illness.

Diagnostics

To make a diagnosis of repeatedly apply to them:

ECG diagnostics - often the difficulties arise due to the preserved changes after the previously transferred disease.
Laboratory studies - determination of the concentration of troponins in the blood. Assessment of the measurement results of this indicator makes it possible in acute repeated myocardial infarction to differentiate severe pain in the chest.
Echocardiography - with it, it is revealed by new foci of myocardial lesions and evaluate the muscle contraction feature.
Coronoangiography - allows you to conduct a study on the permeability of the vessels feeding the heart.

Treatment of repeated im.

The main task of therapeutic process is to restore blood flow in a damaged vessel. The patient with a repeated myocardial infarction (ICB-10 code I 22) is necessarily hospitalized and the following treatment is carried out:

Medicate. It is assigned from the first day of the disease and includes the following groups of drugs: nitrates, statins, ACE inhibitors, anticoagulants, anti-aggregants, beta-adrenoblocators.
Thrombolysis - the introduction of drugs for the dissolution of the thrombus.
Balloon angioplasty - blood flow is restored in a damaged vessel. To do this, a catheter with a cylinder is introduced into the vessel, heaving it expanding the clearance, and the blood begins to flow into the damaged area.
Aorticoronary artery shunting - surgical intervention is applied, the bypass vessel is applied, thereby restoring the impaired blood flow.

After discharge from the healthcare institution, treatment continues at home.

Repeated heart attack of myocardium

This is an acute abnormal state, accompanied by necrosis of cells located along the bottom wall of myocardium. It arises due to the lack of oxygen due to the blockage of the romb of the right coronary artery. The lack of blood flow recovery for half an hour threatens with a fatal outcome. The disease most often suffers from people from forty to sixty years. Just after the forty years of age, there is an increase in the formation of atherosclerotic plaques. The following factors contribute to this:

coronary artery disease;
suffered infarction;
harmful habits: smoking and alcoholic beverages;
obesity;
hypertension;
small physical activity.

Of particular importance in the development of this disease has a genetic predisposition. The degree of severity of the symptoms of the re-lower it depends on the damage to the number of layers of the lower wall of myocardium. Often the disease is sharply and accompanied by the following symptoms:

strong stubble pain that gives in hand;
dyspnea;
the emergence of an attack at night or early in the morning;
increased sweating;
the emergence of a feeling of fear;
a gastric or bronchial version of the flow of heart attack is possible.

The development of the disease and the forecast depends on the in time of the medical care provided, the physical condition of the patient and the time spent on the first attack them.

Consequences of heart attack

After the transferred secondary, they often occur various complications. Most often, the consequences of the re-infarction of myocardium may be:

Violation of cardiac rhythm - It is found almost in all patients.
Heart failure - appears a few months after the disease and is associated with a violation of the pump function of the heart. As a result of this pathology, congestion phenomena of blood are formed in various organs and tissues followed by hypoxia. The following features are inherent in the disease: cough, shortness of breath, dizziness and general weakness.
Heart aneurysm - there is a thinning of the site of the heart muscle, a contractile ability is lost. The patient disrupts the heart rhythm, shortness of breath appears, palpitis is rapidly, the attacks of cardiac asthma arise.
Cardiogenic shock - dramatically decreases the contractile ability of the heart muscle. The blood supply to vital organs is disturbed. As a result, the pressure drops sharply, the limbs become cold, Oliguria arises, heartbeat, weakness, the swelling of lungs and fainting is possible.
Thromboembolic complications are caused in the body anomalous processes in the form of circulatory disorders, the occurrence of inflammatory processes.
The gap of the heart is rare and leads to the instant death of man.

To prevent the occurrence of repeated, it is necessary to maintain the right lifestyle, eat well, to take drugs appointed by the doctor.

The recovery process after a repeated myocardial infarction begins in the hospital under the supervision of doctors and continues after the patient is discharged. During this period, the task of the individual is to gradually resume physical opportunities and reduce the risk of developing complications. This requires:

Exercise stress. In the first days after returning home, the patient is recommended to rest more, and how to use walking on the stairs or short-term walks as a physical activity. Every day, it should be gradually increased physical activity for several weeks and strictly monitor the state of well-being. Cardiologist councils will help the cardiologist. It can include various exercises, but preference is given to aerobic classes that strengthen the heart improve blood circulation and reduce blood pressure. The patient is allowed to ride a bike, quickly walk and swim.
Life need. People who suffered a heart attack, cardiologists advise constantly take two groups of drugs: anti-aggregants affecting blood clotting and overwhelming blood cloves and statins lowering cholesterol. This is especially necessary for patients who put the stent. Some patients in their reasons stop the reception of these important medicines, and then there are a repeated myocardial infarction after stenting, which ends with a fatal outcome.
Diet. Changing the diet helps to reduce the risk of complications and subsequent infarction. Every day it is desirable to eat dishes from vegetables and fruits. They contain minerals and vitamins. To reduce blood cholesterol, it is necessary to prepare dishes from herring, mackerel, sardine, salmon, there are seeds, nuts, olive oil and an avocado oven fruit. In addition, cardiologists recommend using a cook salt in minimal quantities. This will help reduce the likelihood of many ailments.

Doctors learned to treat them, and for patients, he often flows unnoticed. It is important to remember that the process of formation of plaques in vessels and blood clots does not stop after the recovery of the patient. For those who suffered primary and, moreover, repeated them, the risk of development of the subsequent attack is very large.

First aid with repeated them

With the appearance of painful sensations in the chest, a strong sweating, violation of the heart rhythm, a general alert should give him a nitroglycerin tablet and immediately call an ambulance.

It must be remembered than before qualified medical assistance will be provided with a re-infarction of myocardium (ICD-10 code I 22), the greater the chances of successful treatment. The patient is necessarily hospitalized, it makes a cardiogram. Well, if you can compare results with previous research. According to existing methods, cardiologists can immediately restore blood flow on the affected artery, reducing the damage to myocardium. For this purpose, special medicines contributing to the dissolution of thrombus, or conduct angiography, followed by stenting the damaged vessel. Both techniques give a positive effect only in the first hours after the start of the attack. This once again says that the patient is required to urgently deliver to the medical institution, and not to wait for the end of the end of the attack.

Prevention of repeated im.

The following activities are recommended for the prevention of recurrent and re-infarction of myocardium:

Healthy nutrition. As a result of irregular nutrition, atherosclerosis often occurs with the formation of blood clots in the blood vessels, which can get to the blood flow into the heart cavity. Therefore, it is necessary to remove products rich in cholesterol from the diet, but to use more vegetable food.
Conducted in the medical institution, during the discharge of the patient does not end. He must constantly take on demand all the drugs that the doctor appointed. Otherwise, the third heart attack is possible.
Physical activity. For the prevention of the re-infarction of myocardium, it should be abandoned from the exhausting exercises, and go to the study of therapeutic physical education and perform long-time walks in the fresh air.
Follow the body weight, prevent obesity.
Refuse bad habits - smoking and alcohol.
Constantly control blood pressure.
Exclude stressful situations.

The quality of life will be much higher, if carefully refer to your health and fulfill the recommendation of the doctor.

Conclusion

The recurrent and re-infarction of myocardium sharply reduces the contractile activities of the heart muscle, which contributes to the rapid progression of heart failure. People suffering from which provokes a heart attack, should be taken care of their health and carefully fulfill all the prescriptions of the doctor. This can be avoided by severe consequences.

Specialists gave advice

For many years, doctors do not get tired of inspiring their patients: a re-infarction of death is similar. And if you do nothing, every fifth myocardial infarction in the next three years risks again to encounter a repeated heart attack or stroke and even die due to cardiovascular complications. Such is the statistics. Moreover, the re-catastrophe may happen even if the patient did not experience heart problems in the first year after myocardial infarction.

How to prevent the repetition of the cardiovascular catastrophe? How to behave the patient if this happened? And what does medicine offer today to save such patients? We told the leading specialists in this area about this and many other things.

As you know, blood circulation disease is now widespread not only in Russia, but also in many developed countries of the world. In our country, these diseases are leading among the causes of mortality: their share accounts for more than 54% of all deaths. In 2016, for example, the pathology of blood circulation took the lives of more than 900,000 people (almost half of all deaths in the country). And dying from these diseases not only the old people: about 30% of deaths - people of working age. One of the causes of diseases of the circulatory system is the aggravation of ischemic heart disease. And one of the most fatal manifestations of heart ischemia is acute coronary syndrome. It carries such consequences as unstable angina and acute myocardial infarction. And this will already require not only the efforts of doctors, but also the financial costs of the state: to provide emergency medical care, for long-term costly therapy, for rehabilitation. But there are no comparable to human losses associated with premature mortality of the working-age population, they are irreparable.

At the present stage of the development of medicine, the main role in the treatment of acute coronary syndrome is allocated to the speedy restoration of coronary blood flow. One of the modern and most effective methods is considered percutaneous coronary intervention (CCV).

Percutaneous coronary intervention will help, but not everyone

The problem of acute coronary syndrome and high mortality associated with it is truly global, - stressed Professor of the Department of Preventive and Emergency Cardiology of the First MGMU. I.M. Schechenova, D.M. and the main freelance cardiologist of the Ministry of Health of the Moscow Region Maria Glezer. - Despite explicit success in his treatment, the expenditures on therapy of such a serious disease lay down a huge burden on the budgets of many countries of the world due to significant socio-economic damage. This includes expenses of health systems for emergency hospitalization of patients, and for expensive operations, in particular to stenting vessels, and for exercise. Plus economic losses due to the long-term disability of patients, their disability and mortality in working age. All this makes you think about how to reduce the risk of developing acute coronary syndrome, as well as the emergence of repeated cardiovascular problems.

The most dangerous and severe form of acute coronary syndrome is a myocardial infarction, in which due to the blockage of the vessel thrombus, blood supplying heart, the death muscle cells occurs. This can be a threatening condition for the sickness of the patient, cause heart rate disorders, sharp heart failure and even entail a fatal outcome.

Help "MK". In 2016, in Russia only myocardial infarction caused the death of more than 60,000 Russians (5 thousand per month!). It is important that the patients "do not succeed" the diagnosis. If the characteristic symptoms of the infarction (pain behind the sternum, dizziness, nausea, vomiting, etc.), it is necessary to urgently cause an ambulance. Time from the treatment of a patient for medical help before arriving in the hospital should be not more than 90 minutes. When the patient is rapidly delivered to a vascular clinic, mortality from acute heart attack decreases by 60%. If during the first hours not to open the clearance of the vessel and not to restore the blood flow, myocardial death will begin. But today, according to statistics, each second death from heart attack occurs at home, before the arrival of the doctor.

You also need to know: every third infarction passes without special signs or with weakly pronounced symptoms. Even the ECG does not always show violations in the vessels. It is necessary to be especially vigilant in the cold season of the year cores (a 16-year study showed the connection of cold weather with heart attack) and those who have already happened a heart catastrophe (the risk of re-infarction is from 10 to 20% in the first year).

With any symptoms, allowing to suspect the development of acute coronary syndrome, it is important to cause "ambulance" without delay to provide first aid to the patient as soon as possible, - advises the deputy director for the scientific work of the Medical Scientific Educational Center of Moscow State University. MV Lomonosova, Ph.D., Member of the Russian Academy of Sciences, Professor, Member of the Presidium of the Russian Cardiology Society Simon Matskeplishvili. - It is very important to quickly deliver the patient to the hospital and immediately begin treatment. Only so you can prevent the majority of the life-degrading consequences of this state.

Stenting, balloon, laser angioplasty - What else?

As our experts explained, today the treatment of myocardial infarction in our country, as well as abroad, is carried out mainly by means of minimally invasive methods. In the acute period, doctors spend coronary artwork, detect a problem artery and expand its special devices. This procedure is called "percutaneous coronary intervention". It is carried out immediately after the patient's admission to the medical institution, without waiting for the effect of therapy, or when other methods have already been exhausted. True, with acute myocardial infarction, the risk of complications in coronary photography significantly increases compared with the planned procedure. But no choice: none of the drugs can restore blood flow in the affected artery so quickly and well, as can be done using the mechanical elimination of this problem - percutaneous coronary intervention.

And this is a number of methods intended to reduce stenosis (narrowing) of coronary arteries: stenting, laser angioplasty and other modern techniques. All of them have their own testimony and contraindications. Experts briefly described some of them.

For example, "balloon coronary angioplasty was first used for persons with stable angina, later with a unstable angina and for patients in the acute phase of myocardial infarction. The method of expansion by atherosclerotic plaque arteries of the heart has long been worked out: a catheter supplied with a balloon is introduced into the vessel on the thigh or on his hand under local anesthesia, and promoted it to the place of stenosis (narrowing) of the coronary artery under X-ray control in a specially equipped operating room. In the scene of the stenosis, the balloon is inflated, and the pressure created in this way destroys the plaque and restores the clearance of the vessel. "

Stenting is also used for a long time. Allows you to quickly restore blood flow in a tombstone heart vessel and prevent repeated disorders of the coronary blood circulation. This method of doctors is often combined with balloon coronary angioplasty, which reduces the risk of developing repeated heart attacks. In recent years, in order to prevent the reproduction of vessels, drug-coating stents are used, which allows you to prevent an increase in atherosclerotic plaques. Stenting can be planned and emergency. It is carried out under local anesthesia and under the control of radiological equipment. After the operation, it is necessary to periodically undergo a survey of vessels and make a supporting dose of aspirin (8 mg / day), as experts advise.

And still mechanical (surgical) removal of blood clots from affected vessels with special catheters.

But one of the most effective methods of treating complex lesions of coronary vessels, according to experts, - laser coronary angioplasty. "A laser radiation is supplied to the place of blockage or narrowing the vessel on a special fiber-optic catheter, and the thrombus is destroyed. The method is good in that the vessel is less damaged, in addition, the laser does not allow platelets to glue. "

Of course, all these methods do not eliminate the cause of the disease (do not affect atherosclerosis), but only reduce the pathophysiological effect of atherosclerotic plaques, experts warn. But they allow you to improve the distant disease forecast, prevent re-infarction, and the attacks are less likely. As a result, mortality is reduced. Such an effect is possible only if these saving methods are applied to the patient after a vascular disaster, an experimental specialist and in the presence of an appropriate equipment in the clinic.

But, alas, such clinics and such specialists today are far from everywhere.

Popigism of our patients does not know borders

The quality of the life of patients after the myocardial infarction depends largely depends on the patient himself, experts emphasize. Yes, today there are many steps in Russian health care for saving the life of patients with acute coronary syndrome: more regional vascular centers have become; The number of surgical procedures has grown; Innovative drugs appeared, allowing preventing blood clots. Nevertheless, the number of myocardial infarction remains high. It means that the case is also in the behavior of the patients themselves after what has happened to the vascular disasters.

The key factor affecting the risk of re-infarction, remains how clearly the patient follows the recommendations of the doctors, "says the head. Department of Resuscitation and Intensive Therapy GKB №29 M. Moscow, Senior Researcher of the Laboratory of Cardiology FGBU "Federal Scientific and Clinical Center of Physical and Chemical Medicine" FMBA Alexey Erlich. - Often the patient may seem that he is already healthy, he does not hurt anything, and he does not make sense for so long (during the year) to take medicines. But practice shows: if the patient stops receiving special medicines (especially in the first 6 months after a heart attack), the risk of death will increase by 2.7 times! And if patients belonged more responsibly to their disease, we would not discuss many years to the problem of high mortality from repeated cardiovascular pathologies in our country.

But the pofigism of our patients, even cores, does not know borders.

It was possible to reduce the death rate in the treatment of such patients in hospitals, which does not occur in the outpatient conditions. True, with an outpatient treatment, patients and doctors face a variety of unsolvable problems. First of all, with inaccessibility for such severe patients of effective drugs, even within the framework of preferential support. And they must be taken at least a year, and sometimes longer, which reduces the risk of developing repeated cardiovascular diseases. The clinics lack and well know the problem of blood circulation of narrow specialists, special equipment. The problem of this multifactorial, requires attention both from the Ministry of Health of the Russian Federation and the patients themselves.

Yes, the lifestyle of patients after myocardial infarction, knowledge of the rules of behavior, and especially following these rules are no less important than competent therapy. No medicine, the efforts of doctors will not save, if the person himself after the vascular disaster will continue to smoke, drink alcohol, there is a harmful food, do not take the medicine on time ...