According to statistics, only in Russia the proportion of myocardial infarction accounts for 39% of deaths. This is a dangerous disease that takes more and more lives every year. Is it possible to defend against it, and is it treated?
Features of the disease
Myocardial infarction is characterized by the appearance of a dead cell site in the myocardium, which is caused by a lack of oxygen. With the transmural form of the infarct, all layers of the heart are affected, so it is recognized as the most dangerous.
According to statistics, about 500 and 10 women suffer from transmural infarction per 100 thousand of able-bodied population.
Next we will tell you about the transverse and other types of transmural infarction.
Classification and forms of
There are several stages of a heart attack. So, depending on the stage, the forms are distinguished:
- acute - up to 2 hours.from the onset of a heart attack;
- acute - up to 10 days.from the onset of a heart attack;
- subacute - from 10 to 56 days;
- scarring period - from 56 days to 6 months;
Depending on the location, the transmural infarction in acute form can be classified as:
- Anterior wall of the myocardium:
- anterior OBD;
- anterolateral;
- anteroposterior;
- frontseptal;
- Bottom wall:
- diaphragm wall;
- lower back;
- lower BDU;
- is lateral;
- With other specified localization:
- apical-lateral;
- lateral BDU;
- true;
- basal-literal;
- posterior basal;
- Partition BDU;
- posterior septal;
- posterolateral transmural infarction;
- Unspecified localization.
A large-scale( large) and small-focal form of transmural myocardial infarction is also distinguished. Extensive heart attack is characterized by a large defeat of the heart muscle and that carries a huge danger to the body.
Causes of
A transmural infarction appears against a background of ischemic disease, caused by atherosclerosis of the vessels in 90%.Atherosclerotic plaque narrows the lumen of the vessel and worsens the blood flow. Gradual ischemic symptoms increase, leading to thrombosis.
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The opinion of doctors. .. & gt; & gt;
In order for ischemia to develop into an infarction, there is not enough only one narrowing of the vessel. However, even a small stress or physical load can load the heart so that it does not cope with the load. Risk factors are identified that increase the risk of myocardial infarction by several times. These include smoking, obesity, diabetes mellitus, the presence of angina pectoris in the anamnesis and hereditary predisposition.
Symptoms of
Severity of symptoms depends on the general condition of the person and obstruction of the disease. If you summarize the symptoms, then most patients note:
- Tachycardia and a feeling of cardiac fading.
- Cardiac asthma, which is caused by stagnation in the lungs.
- Pale skin, mucous membranes.
- Cold sweat.
But the main symptom of a heart attack is pain. Pain in the transmural form has an acute course and constrictive character. In this case, the pain does not focus in any one place, and give first to the scapula, jaw, then in the ears and hands, can paralyze the left arm. The pain lasts longer than 10 minutes and nitroglycerin is not removed, so it should be stopped by specialists.
About ECG and other methods of diagnosis of signs of transmural myocardial infarction, we will discuss further.
Diagnosis of
If suspected of myocardial infarction, diagnosis should be performed urgently, since the patient's health depends on the timeliness of the prescribed treatment. Diagnosis begins with standard procedures:
- Collecting anamnesis of complaints. The patient should tell you how long pain has appeared, how it is felt and how long it lasts, which accompanies painful attacks, whether there was shortness of breath and fainting.
- An anamnesis of life that helps to identify risk factors for myocardial development. The patient is found out the presence of bad habits, culinary preferences and way of life.
- Physical examination. During the examination, the doctor evaluates the skin color, the presence of wheezing in the lungs and noises in the heart, measures blood pressure and pulse.
Survey data help to suggest myocardial infarction and determine further steps in diagnosis. The exact diagnosis is based on:
- General anthrax of urine and blood, allowing to detect leukocytosis, increase in the rate of erythrocyte sedimentation, to detect concomitant diseases and complications of myocardial infarction.
- Biochemical for blood, aimed at identifying risk factors, that is, increased levels of cholesterol, triglycerides and sugar.
- Investigations of blood enzymes. With myocardial infarction, heart cells break down and release protein enzymes into the blood.
- Coagulogram, which helps to choose the dosage of drugs for treatment.
- ECG, the results of which help not only to identify a heart attack, but also to learn about its location, prescription and size.
- Echocardiography assessing vascular lesions, the size and structure of the heart muscle.
- Chest X-ray. The study allows to detect changes in the aorta due to atherosclerosis, complications of the infarction.
- Coronary angiography, which helps to determine the extent and localization of the narrowing of the coronary artery.
In the presence of indications and equipment, additional studies can be carried out, for example, MSCT with contrast, which allows to obtain an accurate image of the heart muscle. Depending on the complications, additional consultations can be scheduled with other specialists.
Next, we will talk about the treatment of acute and other forms of transmural infarction of the anterior, lower, posterior wall of the myocardium, left ventricle and other types of localization.
Treatment of transmural myocardial infarction
Therapeutic measures are carried out under stationary conditions, because only in this way can they be ensured. The basis of them is the reception of medications and its combination with therapeutic recommendations. In some cases, surgical intervention is required.
Therapeutic
During inpatient treatment, the patient must comply with bed rest.
- No physical activity or stress is prohibited until the condition stabilizes, as this may aggravate the course of the disease.
- No less important is the rejection of bad habits, that is, alcohol and tobacco.
- During the treatment it is necessary to observe a diet with a low content of cholesterol and salt. A special place in dietary nutrition is occupied by cereals, fruits with a high content of vitamin C, lean meat and fish.
If the patient arrived in a hospital in a serious condition, he is given oxygen supply through the mask.
Medication
Urgent treatment is aimed at managing the patient's condition. For this, he is assigned:
- analgesics;
- is sedative;
- beta-blockers, dilating the vessels;
- calcium antagonists that alter the heart rate;
- nitrates relieving pain;
Secondary treatment is aimed at stabilizing the patient's condition, reducing the risk of complications and restoring the heart. For this, group drugs are used:
- Anticoagulants that prevent blood clots and reduce blood clotting activity.
- Disaggregants, blood thinning.
- Thrombolytics, dissolving blood clots.
- Beta-blockers.
- ACE inhibitors if there are contraindications to taking beta-blockers.
Additional drugs that lower blood pressure, diuretics, and others may also be prescribed.
Operation
Often a heart attack, especially its extensive form, leads to serious damage to the heart muscle, which causes the need for surgery. As the main methods use:
- Coronary angioplasty. A metal tube is installed in a narrow vessel, which restores its lumen. Aortocoronary bypass. During the operation, a bypass is created, which helps to deliver blood to the vessels affected by ischemia.
Because aortocoronary bypass surgery is a serious operation, it is prescribed only in the absence of the effect of drug therapy.
The following video is a process of surgical intervention in the treatment of transmural infarction:
Folk remedies
It is strictly forbidden to treat infarction with folk remedies, as this leads to complications of the disease. Folk remedies can be taken in conjunction with medication. Usually, take decoctions of herbs that are beneficial to the heart:
- hawthorn fruit;
- valerian;
- peppermint;
- lemon balm;
- motherwort;
The above mentioned plants are taken as decoctions.
Prevention of disease
Preventive measures are aimed at reducing risk factors for myocardial development. Important:
- To exclude tobacco smoking.
- Reduce alcohol consumption.
- Balance nutrition: reduce the intake of cholesterol and vegetable fats, lean on fruits and vegetables.
- Eliminate stress.
- Follow the body weight.
- Monitor blood pressure and blood cholesterol.
- Do physical exercises. Particular attention is paid to dynamic cardio training: running, biking and the like.
It is equally important to monitor the condition of the heart muscle. For this purpose it is enough to visit the cardiologist once every 6 months.
Complications
Complications are divided into early, occurring during the acute phase, and late, appearing after 3 weeks from the onset of a heart attack. The early ones are:
- all arrhythmias;
- pericarditis;
- aneurysms;
- acute heart failure;
- rupture of the heart wall at the site of the infarction;
At later stages and without adequate treatment, the patient may develop a postinfarction syndrome, clots or neurotrophic disorders may occur. The most serious complication is sudden cardiac death. It is important to provide the necessary medical assistance in time.
Forecast
Prognosis for transmural infarction is unfavorable. Even if the patient survives the development of transmural infarction, it often suffers from concomitant complications and diseases, in some cases, loses its ability to work. Nevertheless, it is important to go through rehabilitation after ailment and keep to a diet.
The following training video will not only tell you about the different types of acute myocardial infarction, but also tell you what to do in case of an illness: