Description of myocardial infarction

Acute myocardial infarction (AMI) is one of acute forms ofischemic heart disease. Generally we can say that coronary artery disease is a disease in which there is a blockage of a blood vessel clot – thrombus, embolus – such as in the legs (venous thrombosis of the lower limb), lungs (pulmonary embolism), heart (different forms of ischemic heart disease) and brain (eg stroke).

The result of clogged arteries can flow oxygenated blood and thereby nourish the tissue most nutrient – oxygen. This process leads to tissue necrosis, which then can not work properly according to their specialization.

It is the same with myocardial infarction. Heart, one of the most important organs, we can imagine a bunch of blood vessels arising from the pump. If one of the heart (coronary) arteries become blocked, usually precipitates already mentioned, there is a partial or total restriction of blood flow. Heart tissue in the affected area is not enough oxygen and dies (ischemia) – of myocardial infarction.

Most frequently AIM occurs in the left ventricle of the heart.

In 95% of cases precedes AIM hardening of the coronary arteries (so called. Coronary atherosclerosis – reduction of the arterial lumen, where its side anchor themselves small sraženinky, those forms fat and other substances that, over time, fully closed).Generally, we can describe the mechanism of AIM in this sequence of events: atherosclerosis (not required) – closure of a coronary artery – the lack of oxygen in tissue – tissue necrosis (ischemia) – loss of contraction of the heart muscle – pain – decreased flow of oxygenated blood throughout the body (hypotension) – up stop the heart – death.

Myocardial infarction is divided by impaired cardiac wall. This division, however, is determined by the physician ECG (electrocardiogram). The first type is transmural AMI at which the affected heart wall over their whole width. When netrasmurálním AIM is affected only part of it.

Statistics show that more cases of AMI occur in men. Another factor is age over 50 years, but even that is not a requirement. Increasingly, it is possible to record AIM at a young man (from 25 years), which is exposed to frequent stress and improper diet. Despite the great development of medical care, diagnosis and examination of the disease, the mortality of about 25%.


Risk factors for myocardial infarction

Risk factors can be divided into uncontrollable and controllable.

Among the instable factors include age, gender and family history. As mentioned above, the risk is greater in men and in patients over 50 years. Furthermore, in humans, which in the family history of heart attack, coronary artery disease, atherosclerosis or coronary heart disease. There is no requirement that if you meet one of these points that you AIM occurs, but you should try to prevent this disease.

You can especially affect your lifestyle. Among the major modifiable factors include: obesity,smoking, stress and a sedentary lifestyle. These factors are very closely related and provide for the formation processes that can cause AIM.

In 90% of people suffering from obesity, increased levels of cholesterol (hypercholesterolemia) which causes narrowing of the blood vessels (sclerotherapy – fat in the vessel wall).

Furthermore, obesity is closely related to high blood pressure (hypertension), which is another risk factor for AMI.

A sedentary job or little sporting activity in turn affects the overall processes in your body.

You should also avoid stressful situations and overall stress load, at which the leaching of thehormone adrenaline. It has a variety of effects, but also causes spastic contraction (spasm), which may be from the wall to release the accumulated fat and clog another blood vessel, or may cause the contraction of AIM.

As an additional risk factors can indicate past or existing illnesses such as diabetes (diabetes mellitus), AMI, angina or other forms of ischemic heart disease, high blood pressure (hypertension), high cholesterol (hypercholesterolemia).


Prevention of myocardial infarction

Prevention of myocardial infarction can be divided into primary and secondary.

Primary prevention is meant the influence of risk factors, particularly in patients with a greater probability of developing the disease (men over 50 years of age, family history, etc.). Weight reduction in obese people, the treatment of high blood pressure, high cholesterol. Maintaining physical activity – for people over 50 are often advised to cycling. Stop smoking – it is found that after one year since the last cigarette, the risk is reduced! Trying to cope with stressful situations and avoid them.

Secondary prevention occurs after myocardial infarction first, since it is very likely to occur next.Some people may be behind seven heart attacks, but he never knows when he comes last! Hence the need for regular checkups to the doctor and follow their regulation.

It is recommended to immediately quit smoking – mortality in patients who stop smoking are twice lower. Further attention is paid to weight reduction, which is limited mainly animal fats and increases the proportion of fruit and vegetables in the diet.

And then cares for pharmacological prevention when receiving antiplatelet agents andanticoagulants (drugs that counteract the clotting – the most commonly used is Anopyrin – reduce the risk of another heart attack or death by 25%), beta-blockers (which causes high blood pressure and high heart rate) , lipid lowering drugs (medicines to lower cholesterol levels – within five years down the risk of death by 30%) and others, according to the patient’s condition.

Your doctor will determine important physical activity and extent appropriate, according to the state – rehabilitation, aerobic exercise, cycling etc.

(Note .: Daily ingestion of medications containing aspirin – Aspirin .: example, Anopyrin, Aspirin – prevent the occurrence of myocardial infarction, used as a secondary prevention in cardiovascular problems and always about taking consult your doctor to !!!)


Signs and symptoms of myocardial infarction

Symptoms always divided into two groups – subjective (a condition that describes the patient) andobjective (status, measured device and doctor). Myocardial infarction has very distinctive symptoms in both groups. Exceptionally attack without symptoms.

On view is sick pale saddle-up (lack of oxygen in circulation), very moist skin, shortness of breath (especially with impaired left ventricle) and holds a hand on the sternum.

The patient shows intense stabbing pain when burning behind the breastbone (angina pectoris), which locates fist or palm of your hand – never just a finger. This pain may extend to the back, hands (mostly left) jaw, upper abdomen. Pain is the same in each position, the inhale and exhale, and takes more than 20 minutes. Pain persists after administration of nitroglycerin and occurs mostly at rest (differentiation from angina pectoris).

Furthermore, side effects are nausea, vomiting, confusion, sometimes aggressiveness. The patient feels anxiety and fear of death, especially when large breathlessness.

Objective symptoms will be determined after the arrival of the emergency services at the hospital or turning the ECG. EKG curve characteristic is present Paardeho wave, which EKG curve we see year after a heart attack – thanks to her, we can estimate the disease without symptoms. In the laboratory, after the withdrawal of blood for an elevated erythrocyte sedimentation rate, leukocytes (white blood cells) and cardiac enzymes.


Treatment of myocardial infarction

Acute myocardial infarction is the most common call to exit emergency services, since 70% occur outside hospitals.

Already after the arrival of the emergency services starting initial therapy. After measuring blood pressure, pulse rate, ECG examination and after determining that it was a heart attack followed by medical treatment and preparation for rapid transport to the hospital. Throughout the monitoring of vital signs, ensuring venous access (venous cannula – mostly at the hands of my elbow) for the supply of the required drugs.

Do pharmacotherapy belong sedation (alleviate pain and soothe the patient – Fentanyl, Morphin, Diazepam) and antiaggregation anticoagulation (stopping the growth or dissolution of thrombus – Heparin, Anopyrin, Aspirin), and others, according to the state. Administering oxygen oxygen mask.

Following these basic steps, the patient urgently transported to the hospital for a coronary care unit or intensive care unit (ICU) for constant monitoring of vital functions as threatening move the patient into shock state to sudden cardiac arrest.

The hospital continues to monitor the patient’s condition, oxygen therapy, pharmacotherapy, and must be complied with absolute bed rest. In the aftermath of chest pain begins with a gradual rehabilitation and secondary prevention described above.

In severe myocardial or complications may occur surgical treatment of coronary angioplasty (ie.PTCA = in the groin into the femoral artery introducing tube (catheter) at the end with the balloon in a coronary artery, where the balloon is inflated, there is allowed to act, after surgery remains vessel again stretched) or by-pass (we can imagine this as a detour affected artery, which connects the aorta – the main artery in the body – and other heart artery).


How can I help myself

This question can ask from three perspectives. From disease, myocardial infarction, first aid at its inception and procedures in the treatment of disease.
First, it is important to try to avoid the aforementioned risk factors and thereby reduce the likelihood of onset of disease.

If you suspect that you or heart attack occurs’re around a person who has typical symptoms, do not hesitate to call an ambulance (155 or 112).

Disabled person back to a half-sitting position, loosen clothing she withdraws from the neck area (eg collar shirt). Do not party too much movement, since each activity requires an increase in oxygen consumption, which at this time has run out.

If you’re handy tablet of aspirin (aspirin Anopyrin) let her suck the victim before medical help arrives. Always check whether a person is allergic to aspirin, which contain. These drugs have anti-clotting effects that may (but need not 40% – depending on the AIM) act as a quick first aid.

Until the arrival of medical personnel guard the victim, that breathes, has a pulse and not fall into the shock state. In severe heart attack can very quickly go into shock from which it is one step from unconsciousness and possible cardiac arrest. Upon arrival, the doctor describe the sequence of events happening.

If you have already had a heart attack, it is important to stick to your doctor’s instructions. These guidelines are secondary prevention (described above) before the occurrence of another heart attack.


Complications of myocardial infarction

Complications that can occur are numerous, depending on the patient’s condition. The more affected left ventricle, the lungs receive less oxygenated blood and can occur edema of the lungs (pulmonary edema).

By changing the activity of the heart muscle can lead to life-threatening arrhythmias.

The tissue after a heart attack heals fibrous scar, which may bulge (aneurysm) of flowing blood pressure.

Cardiac tissue can crack (rupture of the heart). Blood pours into the pericardium (fibrous packing heart, pericardium), which oppresses the heart gradually until there is a cardiac arrest.

Other names: infarction, acute myocardial infarction, AMI, transmural myocardial, netransmurální attack, Q-IM, IM nonQ-, Q-wave, nonQ heart attack, heart failure, ischemic heart disease, coronary artery disease

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