Myocardial infarction - is one of the serious complications of ischemic heart disease. You already probably know what CHD. When coronary artery disease of the heart is a disturbance of blood supply due to narrowing of the coronary arteries of atherosclerotic plaques. Atherosclerotic plaques - this is the main manifestation of atherosclerosis. They consist mainly of cholesterol and calcium, and deposited on the walls of many blood vessels, including arteries of the heart. If these plaques are deposited on the walls of arteries feet, there are pains in the leg when walking.
Risk factors of acute myocardial infarction include:
Diseases of the cardiovascular system, such as coronary heart disease (CHD)
Myocardial infarction in the past,
Episodes of cardiac arrhythmia,
Age older than 40 years,
Increased blood concentrations of triglycerides,
High blood pressure,
Furthermore, an additional risk factor for myocardial infarction is also used in women of combined oral contraceptives.
The manifestations of myocardial infarction include chest pain of varying intensity (usually expressed), shortness of breath, nausea, vomiting, palpitations, sweating and anxiety, as well as fear.
Often, women have observed several other symptoms of myocardial infarction than men. These are symptoms like shortness of breath, weakness and fatigue. Approximately one-third of heart attack symptoms.
According to WHO, in 2002 the share of deaths from myocardial infarction accounted for almost 12.6%. Coronary heart disease is the leading cause of death in developed countries but in developing countries, CHD is the third largest after the AIDS and infectious diseases of the lower respiratory tract infections. So, what happens in myocardial infarction, and why he was so afraid of? When a heart attack is a sudden blockage of the lumen of the coronary artery affected by atherosclerosis, resulting in a certain area of the heart muscle can no longer flow blood. The area and depth of the site depends on the level at which there was a blockage of the vessel. As a result of acute disorders of blood flow - and hence the delivery of oxygen to the tissues of the heart - it is necrosis (necrosis). All this shows severe pain behind the breastbone.
Diagnosis of myocardial infarction
WHO recommends that the diagnosis of myocardial infarction can be placed under the following criteria:
Chest pain for more than 20 minutes
The corresponding changes in the electrocardiogram,
Increase or decrease in the blood of specific cardiac markers such as creatine kinase, troponin I and lactate isomer.
EKG - one of the main objective diagnostic of myocardial infarction. This method allows to determine the localization of myocardial damage. In myocardial infarction, the ECG appearance of an arched back like a cat. Gradually, after a heart attack the character of the ECG changes, and it remains so forever (You do remember we were told that a heart attack otherwise impossible the formation of muscle tissue).
Cardiac markers - is determined in the blood enzymes that are released from the cells of the myocardium when it is damaged, that is, a heart attack. Up until the 1980s as a cardiac marker used in AST and LDH. Later it became clear that myocardial infarction is characterized by imbalances of fractions M and B creatine kinase (CK). Currently used as a marker of troponins. However, increasing the level of cardiac markers is observed only in a day from the beginning of an attack of myocardial infarction. Therefore, all patients with complaints of chest pain is carried out preventive treatment of myocardial infarction, that is, in such a way that there is a heart attack, has not yet revealed the diagnosis.
Angiography is used in case of difficulty of diagnosis, or when it is possible to restore blood flow through methods of endovascular surgery. Angiography is the fact that through the femoral artery to the coronary vessel is fed a catheter that is inserted through a radiopaque substance. Further X-rays performed in real time, and the monitor can see narrowing or blockage of the place of the vessel. Immediately after that, you can perform angioplasty with stenting.
Why is it so terrible a myocardial infarction? The fact is that even if the later is ideal to restore blood flow in the occluded artery, if you still have time to myocardial necrosis occur, the return authorization process does not occur. Gradually replaced by connective tissue necrosis, which, in contrast to the myocardium can not contract. Consequently, depending on the size of the irreducible part of the heart, there is an infringement of the heart, which manifests itself in a weaker "pumping" of blood through the vessels of the body. Developing heart failure. With a large and deep lesions, infarction, the heart may stop pumping blood adequately, especially in the brain, which could result in death.
Depending on the depth of myocardial infarction can be transmural, when affected the entire thickness of the myocardium, and subepi-subendokardialny when the affected area under the epicardium or endocardium. Of course, the greater the depth of the myocardium, the worse the prognosis.
Treatment of myocardial infarction is, as is clear from his reasons for removing blockages in the coronary artery. To do this, different methods are used today, such as:
Thrombolytic therapy when the patient entered a drug dissolves the clot, plugged the lumen of the vessel,
Endovascular surgery, which consists of introducing into the coronary artery of a special catheter, through which the plaque is removed plug the gap and the gap widens a narrowed vessel,
And coronary artery bypass grafting, which is a workaround for the blocked section of the vessel.
In addition, the applied drug therapy, which is the use of blood thinning medication (eg, heparin, aspirin) to prevent the further growth of the thrombus and to reduce infarct area, as well as pain relievers - mainly drug type.