What is a heart break

Rupture of the heart usually occurs due to a heart attack due to a violation of the integrity of the heart muscle - myocardium. There is an opinion that a rupture of the heart can occur from fear or with a big shock. But it is wrong. The gap does not occur suddenly for no apparent reason. The heart is a very strong organ, consisting of muscles, and only serious changes in its main tissue can violate its integrity.

Main reasons

The myocardial muscle is very strong and elastic, so it cannot burst by itself.

This condition may occur due to changes occurring in the structure of the myocardium:

1. The most common cause is called myocardial infarction (necrosis). The rupture can occur during the first day after a heart attack or on one of the days over the next two weeks.
2. With necrosis, a rupture of the left ventricle of the heart occurs. This organ bears a large load during the work of the heart. There are times when the septum between the ventricles of the heart can rupture.
3. Inflammatory processes of the inner heart membrane - endocarditis, tumors or other metabolic disorders can lead to rupture. They cause changes in the heart muscle and often lead to rupture.
4. A rupture can occur due to an injury received during a powerful blow, injury, or in the event of an accident.

Some believe that a gap can occur in a person due to experienced fear or a sharp fright. There are cases when a person suddenly dies due to severe shock or excitement. Then an autopsy often shows that this happened from a heart rupture, but the main factor remains a heart attack, provoked by a stressful situation, fear and other experiences.

Provoking factors and types of gaps

With a heart attack, a heart rupture can occur, and the reasons for this are not only tissue necrosis, but also a number of factors that can lead to the fact that the muscle tissue of the heart can rupture:

• age over 50, when regeneration processes are slowed down, in addition, many older people have heart problems such as coronary disease or wear and tear of the heart muscle;
• a powerful load on the muscle of the myocardium is capable of exerting increased blood pressure;
• heart attack treatment not started on time;
• excessive motor activity of the patient with a heart attack, as well as lifting weights;
• small body weight, exhaustion;
• taking hormonal and nonsteroidal drugs.

Rupture of the heart is divided into several types, it depends on which area was damaged, after what time period the pathology manifested itself:

1. By the time of occurrence, ruptures can be early and late. Early happens usually on the first day after myocardial infarction. The reason is necrosis, which results in the death of heart muscle cells in the absence of a scar. A significant area of ​​damage to the heart causes a rupture. Late rupture appears only on the seventh day after a heart attack. Its cause is the stretching and death of a portion of the myocardium, while the patient has high blood pressure. It turns out that the heart, which has not yet been restored after necrosis, receives an additional strong load.
2. Breaks can be internal or external. Externally, the rupture involves the ventricle. External tears are usually diagnosed in women 40-55 years old, as well as in people suffering from hypertension.

It happens in two stages:

• pre-rupture - at this time the patient experiences acute pain radiating to the shoulder blade, it does not go away even after taking Nitroglycerin or analgesics;
• a sharp decrease in pressure and a state of shock, a person may even lose consciousness.

External ruptures are very difficult, a person can die from a lack of blood flow, which provokes a state of shock. Internal tears are usually milder, but they also require surgery.

Symptoms

The symptoms of heart rupture are affected by the area of ​​distribution of the focus of damage in the muscle, hemopericardium and hemodynamics (to what extent it is impaired).

If the defect is small, then blood does not penetrate into the cavity of the heart at all, or it accumulates in small quantities. Symptoms appear consistently over several hours.

The patient at this time feels:

• severe pain that is localized in the chest area;
• internal anxiety;
• he may be disturbed by shortness of breath;
• the skin becomes cyanotic;
• edema appears.

If the symptoms of acute heart failure progress, then the patient's pulse becomes thready, blood pressure decreases, consciousness changes or fainting occurs. At this time, there is a load on the liver, as there is stagnation of venous blood, as a result, edema appears. The patient usually complains of pain in the right side.

If the gap progresses slowly, then the patient cannot relieve pain attacks with Nitroglycerin. They may subside and then reappear. In this case, there is a frequent pulse, sticky sweat, hypotension. This condition is dangerous because the myocardium at this time does not receive enough blood in the right volume. Against this background, its hypoxia develops, which leads to insufficiency.

With an acute rupture of a large size, the aorta of the heart ruptures, aortic bleeding begins, and systemic blood flow is disturbed. The result is the death of the patient.

Sharp pains in the region of the heart, which do not subside after taking analgesics, become harbingers of an incipient heart rupture. The patient becomes very pale, and in some places the skin may even turn blue, his pulse can be difficult to find, his consciousness is confused.

Symptoms that are present during an external tear:

• loss of consciousness;
• puffiness;
• severely swollen veins in the neck;
• breathing is not observed;
• lack of pulse and pressure, shock.

This condition occurs both with a heart attack and with ruptures during damage due to injury or damage to the aorta.

Symptoms can increase every minute, as a result of which a fatal outcome will inevitably occur. The electrocardiogram at this moment shows the absolute absence of cardiac work.

Diagnostics

Diagnostics is carried out as follows:

• the doctor’s study of the patient’s medical history and his current complaints, the cardiologist will be interested in the presence / absence of any congenital or existing heart disease in the patient, cases of chest injury, previous myocardial infarction;
• analysis of the patient's lifestyle - the presence of hereditary diseases, taking hormonal drugs, the risk of sudden death;
• visual examination of the patient, listening to the heart rhythm, measuring pressure;
• general blood sampling, urinalysis;
• blood material for biochemistry;
• coagulogram;
• electrocardiogram;
• catheterization.

Surgery

Rupture of the heart involves emergency surgery and intensive care after it:

• In the case of suturing the gap, an open operation is performed. Above the area where the rupture occurred, the surgeon will install a specially designed synthetic "patch".
• Rupture of the interventricular septum involves the installation of a "patch" under the control of x-ray equipment, and a closed heart operation is performed.

• If the rupture has affected the area of ​​the aneurysm, then the operation involves the removal of the damage zone of the left ventricle with the urgent installation of a “patch”.
• Coronary artery bypass grafting is performed in case of deep atherosclerotic damage to the coronary vessels. As a result, blood flow is restored, and a scar is formed at the site of ischemia and rupture.
• Surgery to replace the valve with a mechanical prosthesis (perform only if the heart valve is damaged).
• Surgery to remove the apex of the heart at the same time as the area of ​​the rupture. Such an intervention is carried out if the gap is in the upper zone of the heart.
• If a suitable donor heart is available, the patient can be transplanted in a complex organ transplant operation.

An operation will be needed, even if the rupture of the heart is small and closed by a thrombus on its own. Without surgery, in this case, the patient can live no more than 60 days.

But even with an operation performed on time, the patient may die, since the sutures that are placed in the myocardial zone may break.

Prevention

In order to avoid heart failure, the following preventive measures must be observed:

• stop smoking and drinking alcohol, eating fatty foods;
• if the patient has problems with cholesterol, then it is necessary to control its level and carry out the necessary therapy with appropriate drugs;
• monitor changes in pressure;
• contact the clinic in time if heart attacks last more than five minutes;
• detection and treatment of coronary heart disease - this will also ensure the prevention of a heart attack;
• a person who has had a heart attack must be cured to the end and follow all the recommendations that the doctor has prescribed;
• patients with a heart attack must comply with the mode of physical activity - for a long time, bed rest will be required, then activity increases, but loads will have to be abandoned;
• if the patient has a heart attack, then it is necessary to transport him to the clinic very carefully;
• patients at risk of heart rupture should completely exclude situations that increase internal cardiac pressure - severe coughing, vomiting, heavy lifting, straining during constipation.