Often patients with myocardial infarction carry the disease on their feet, however, until a certain time, until the disease gives complications. If some forms of heart attack respond well to treatment, then the extensive threatens the patient with a fatal outcome.
Can it be avoided? Yes, if you know about the risk factors and treatment of an extensive myocardial infarction all.
Features of the disease
Extensive heart attack, perhaps the most dangerous form of pathology. If, in the case of a small focal form, the blood flow is disturbed in small areas of the heart, then the large area of the cardiac muscle is covered with a large area. According to statistics, men have a heart attack about 4 times more often than women.
After extensive myocardial infarction, patients can be given a third disability group if they lose their ability to work, or they have symptoms of heart failure. In some cases, patients are entitled to an indefinite disability if further treatment has an unfavorable prognosis.
Classification and Forms
Extensive in itself is a form of myocardial infarction, so it has no specific classification. The disease is classified by localization, so, most often an extensive form of myocardial infarction strikes:
- the anterior wall of the left ventricle of the heart;
- interventricular septum;
- posterior wall of the myocardium;
There are several stages of the state:
- 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 days.up to 8 months;
- scarring period - from about 8 weeks to 6 months;
Also pathology can occur with edema of the lungs or without it, which happens more often. About the symptoms and the first signs of an extensive heart attack read below.
The causes of extensive myocardial infarction
The main cause of heart attack is atherosclerotic plaques, which are formed due to the same-named disease of atherosclerosis. Atherosclerotic plaques narrow the blood vessels, which leads to insufficient blood flow and a lack of oxygen in the heart.
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Several risk factors can be identified that multiply the risk of developing a heart attack. The most aggressive factor is smoking, because it itself narrows the blood vessels. No less serious factors can be considered alcohol use and genetic dispositions, while others include:
- diabetes mellitus;
- chronic kidney disease;
Symptomatology largely depends on the localization of the lesion and the stage of the disease. An indicative symptom is pain in the sternum, which radiates into the shoulder blades, shoulder, lower jaw, can lead to numbness of the left arm. The pain is compressive and acute, it is not stopped by nitroglycerin.
Usually, a heart attack accompanies:
- shortness of breath;
- blue skin;
- cold sweat;
- cardiac asthma if there is pulmonary edema;
If the posterior wall is affected, poisoning symptoms may occur: heartburn, vomiting, diarrhea, abdominal pain. In very rare cases, the infarction can be tolerated almost asymptomatically, or with atypical symptoms, for example, in the right arm.
The diet should be described in the following way:
The doctor can make a primary diagnosis even when he visits the patient for the first time, since the myocardial infarction has symptoms characteristic of the condition. First, the doctor collects an anamnesis of complaints and life, finding out when the patient began to feel pain, which accompanies these conditions, whether he has addictions to bad habits and fatty foods. Then the patient undergoes a physical examination and auscultation, where the shade of the skin is evaluated, and noises in the heart and lungs are detected, blood pressure and pulse are revealed.
Already on the basis of these studies, the doctor prescribes symptomatic treatment, which most often turns out to be correct, and assigns further, already hardware, examinations, for example:
- General an-z urine. Helps to identify associated pathologies and complications of the disease.
- Total anth of blood. Helps to determine the increase in the rate of erythrocyte sedimentation and to detect leukocytosis.
- Biochemical an-z of blood. It is necessary to determine whether the patient has risk factors that contribute to the development of the myocardium, for example, high cholesterol, sugar and triglycerides.
- Studies of blood enzymes that detect the presence of protein enzymes in the blood. These enzymes are released due to the destruction of the heart cells against the background of a heart attack.
- ECG.The basic study, because it not only confirms the presence of a heart attack, but also shows its localization, vastness and prescription of the course.
- Echocardiography. It is necessary to assess the state of the vessels, as well as the size and structure of the heart.
- Coagulogram. It is necessary for the selection of optimal doses of drugs.
- Chest X-ray. Shows the condition of the aorta, the presence of complications of a heart attack.
- Coronarography. It determines the localization and the site of narrowing of the artery.
Depending on the presence of complications, concomitant pathologies, and also equipment in the hospital, the patient may undergo other studies. For example, an expensive MSCT, which visualizes the heart muscle completely.
Treatment of an extensive heart attack is carried out in a hospital, because the patient needs to be monitored constantly. At the first stages of treatment consists in the combination of the drug method with the therapeutic one.
However, drug therapy is often not enough, so surgical intervention is required.
The basis of therapy is the restriction of any motor activity. The patient should observe peace both physically and emotionally, since the opposite can worsen the course of the disease.
For the duration of the whole treatment it is recommended to follow a diet with limited intake of animal fats, alcohol, salt and caffeine. A special place in dietary nutrition is given to foods that contribute to the recovery of the organism, that is, cereals, fish, low-fat meat, vegetables and fruits.
If necessary, the patient may be given oxygen through a mask.
Drug therapy is aimed at stabilizing the patient's condition and preventing the development of complications. For this,
- Aspirin, Plavix, Ticlopidine and similar drugs are used, which activates blood flow to the affected area.
- Narcotic and non-narcotic analgesics for the removal of pain symptoms.
- Lidocaine, Amiodarone and analogs to eliminate arrhythmia.
- Anticoagulants for the prevention of thrombosis.
- Thrombolysis for resorption of blood clots.
Calcium antagonists and beta-blockers have shown good efficacy. About what types of surgery are performed with a large heart attack, read below.
An extensive heart attack often responds poorly to drug therapy. In this case, the patient is assigned:
- Coronary angioplasty, which involves the insertion of a stent into the vessel to maintain a normal lumen in it. Aortocoronary bypass. A complex operation, which creates a bridge from a healthy vein, which ensures optimal delivery of blood above the narrowing.
Sometimes operations also do not give a positive effect and defeat starts to develop and become more complicated. In such cases, heart transplantation is indicated.
The procedure for stenosing with extensive myocardial infarction can be judged from the following video:
The preventive measures are aimed at preventing the development of heart disease. To do this:
- Give up smoking, which increases the risk of developing a heart attack by almost 50%.
- Limit alcohol consumption.
- Form a mode of day and rest, in which at least 7 hours will be spent on sleep.
- Limit the amount of animal and vegetable fats in the diet.
- Eat more protein foods, beans, fruits, lean meat and fish.
- Do physical exercises and cardio exercises.
Along with the above, it is necessary to constantly monitor blood pressure and cholesterol level and reduce the performance when increasing.
On how life can develop after a massive myocardial infarction, and what are the consequences for the heart, read on.
Extensive infarction often gives complications even with timely treatment. Among them we can distinguish:
- local necrosis and scar tissue of the left ventricle;
- myocardial rupture at the site of myocardial infarction;
- is an inflammation in the serous membrane of the heart;
- mitral valve failure;
- autoimmune complications;
- edema of the lungs with extensive myocardial infarction;
- formation of thrombi, thromboembolism;
Nonspecific complications associated with circulatory disorders can also be observed. About how many live after resuscitation of an extensive myocardial infarction, and what the general prognosis is with its consequences, read below.
Prognosis for treatment of extensive myocardial infarction is extremely unfavorable.
- With this form, slightly more than 50% of patients survive.
- At the same time more than 10% do not live more than a year and die from complications of the disease.
The statistics are averaged, since in hospital conditions the lethality is very small, however, many patients simply do not survive to ambulance and subsequent rehabilitation.
On how to provide first aid for an extensive myocardial infarction, the video will be described below: