How many lie in intensive care and stay on sick leave after a heart attack

Myocardial infarction is an acute clinical manifestation of coronary heart disease requiring immediate hospitalization. The main sign of a heart attack is considered to be severe pain inside the chest, extending to the left side of the body: the arm, shoulder, jaw and space between the shoulder blades. The cause of pain is necrosis of myocardial tissue due to impaired blood supply to the heart. If the patient is not delivered to the intensive care unit in time, the outcome can be fatal. How many are in intensive care after a heart attack? The timing depends on the severity of the attack and other factors.

Resuscitation measures

If the medical team is delayed, relatives or close people should provide first aid. In the case when the patient is conscious, you need to put him on a bed with a raised headboard, give a sedative (for example, Corvalol) and any analgesics to relieve pain. Cardiac arrest requires cardiopulmonary resuscitation. To do this, the victim is placed on a hard surface, a roller is placed under the neck and his head is thrown back. Next, you need to conduct an indirect heart massage and mouth-to-mouth breathing.

Such activities will help prevent the death of brain cells. If help is provided in the first minutes after the onset of an attack, the patient has a good chance of survival.

What do doctors do in intensive care for a heart attack?

1. Ensure lack of physical activity and bed rest.
2. Isolate the patient from relatives and friends.
3. Carry out constant monitoring of the patient's condition.
4. Perform diagnostics regularly.

The last point allows you to determine the severity of the changes that have occurred in the body.

Diagnosis of the disease

Before treatment, the doctor conducts the following studies:

1. MRI (magnetic resonance imaging). Thanks to this expensive examination, it is possible to identify even the smallest areas of damage.
2. ECG (electrocardiogram) reveals signs of a heart attack, the procedure is quick and inexpensive.
3. EchoCG (echocardiography) is a safe ultrasound procedure that reveals the location of the lesion, the state of blood vessels and blood flow, and the presence of blood clots.
4. Myocardial scintigraphy. Thanks to the injected contrast agent, the affected area is clearly visible in the picture.
5. Analyzes for biochemical markers. An increase in some indicators usually indicates a heart attack, but can be caused by other reasons.
6. Cardiac catheterization.

The scheme of subsequent treatment depends on the results of the diagnosis and the severity of the myocardial infarction.

Treatment in a hospital

Relatives of the patient are always interested in when it is possible to transfer from intensive care to the cardiology department. Usually the patient is kept for at least three days.

It is not advisable to reduce the length of stay in the intensive care unit, since there are all conditions for continuous monitoring of the patient's pulse, pressure, blood composition, as well as for quick assistance in critical cases.

Therapy after a heart attack in most cases is medical. The patient is injected intravenously with drugs that thin the blood and restore heart function.

1. Stenting is a minimally invasive operation. A special stent is inserted through an artery (most often on the leg), which expands the lumen in the coronary arteries.
2. Coronary artery bypass grafting is the installation of shunts in those parts of the coronary vessels where the lumen narrows. Shunts are placed around the affected area.
3. Often, after a heart attack, an aneurysm develops - a bulging of the affected area. In such cases, excision is performed.
4. The installation of a pacemaker may be necessary with insufficient heart rate or with atrioventricular blockade. The operation is minimally invasive.

What drugs to take after discharge

While in the hospital, not all patients know what drugs and for what purposes the doctor prescribes them. But after discharge, it's time to think about it.

1. Antiplatelet agents that reduce blood viscosity and prevent the formation of blood clots. These include Aspirin, Curantil, Dipyridamole and others.
2. Beta-blockers that limit the action of adrenaline and prevent re-infarction. These are Anaprilin, Bisoprolol, Timolol.
3. Statins inhibit an enzyme that promotes the formation of bad cholesterol. This group includes Cardiostatin, Anvistat, Torvakard.
4. Nitrates quickly reduce the workload on the heart by dilating blood vessels. Reduce pressure and relieve pain. The most common drug is nitroglycerin, but there are others.
5. Sartans are used to lower blood pressure. These include Enalapril, Atenolol and others.

It is also desirable to take preparations containing magnesium and calcium: these trace elements maintain vascular tone and regulate heart function.

Each case is individual, and each drug has contraindications, so they should be taken only as prescribed by the attending physician.

The duration of medication is also determined by the doctor. Patients with a high degree of necrosis have to take pills for the rest of their lives.

Post-discharge lifestyle modification

Medical therapy is not everything. A patient who has had a heart attack should review his life schedule and make the necessary changes to it.

1. Physical activity should be gradually increased. In the resuscitation period, it is completely excluded. Further, simple exercises are gradually introduced, and after discharge it is useful to do special restorative physical education. Special attention should be paid to the work schedule. It is better to refuse heavy physical work during the recovery period. In other cases, you need to take breaks and not overexert yourself.
2. The use of alcoholic beverages, smoking, caffeinated drinks during the rehabilitation period is recommended to be completely excluded.
3. Constant monitoring of blood pressure, heart rate, weight and cholesterol levels will help prevent unexpected deterioration in health.
4. Food also needs to be adjusted. More on this below.
5. After discharge, regular visits to the doctor and diagnostics (ECG, echocardiography, urine and blood tests) are necessary. In the first month, these procedures are carried out once a week, from a month to six months - once every 2 weeks, up to a year - once a month, and then once every 3 months.

Nutrition

The main cause of a heart attack is the blockage of blood vessels with cholesterol plaques - atherosclerosis. When compiling a diet during the rehabilitation period, it is important to limit the number of foods that increase cholesterol.

In the first week after a heart attack, food should be pureed. You should eat 6 times a day, the total caloric content of the diet should be about 1200 Kcal. In the second and third weeks, the calorie content rises to 1700 calories, and when scarring occurs, to 2200. The food should be easily digested and not cause fermentation.

Low-calorie and fractional (5-6 times a day a little) food reduces the load on the heart and gastrointestinal tract and helps to reduce body weight.

• animal fats;
• smoked meats, grilled dishes;
• flour: bread, pastries, pasta;
• confectionery - sweets, cakes;
• alcohol;
• dairy products with high fat content;
• egg yolk;
• fatty meat, fish, poultry (you can lean chicken without skin);
• soups, broths;
• spicy seasonings;
• conservation, carbonated drinks;
• by-products, fat.

The basis of the diet in the postinfarction period is vegetables and fruits, lean meat and fish, wholemeal bread and low-fat sour-milk products.

Sanatorium treatment after a heart attack

Restoration of health in a sanatorium after a heart attack is not shown to everyone. It depends on the severity of the attack.

1. First class: absence of angina attacks and complications.
2. Second class: heart failure 1 degree, complications are small.
3. Third class: complications in the form of hypertension and arrhythmia. Heart failure above the second degree.
4. Fourth grade: severe condition, possible risk of sudden death.

Patients with the fourth class of severity are not prescribed sanatorium treatment. The rest is desirable not to refuse such an opportunity to restore health. In sanatoriums, vacationers are offered moderate physical activity, tempering procedures, massages, oxygen baths. A special diet and adherence to the regimen play a significant role in the restoration of the body.

Disability

If an attack of myocardial infarction has led to irreversible changes in the body, the patient is assigned a disability group. Moreover, not everyone manages to fully restore health.

An indication for the appointment of disability is the degree of disability and independence in self-service.

1. The first group is prescribed for complete disability and partial loss of the ability to self-service.
2. The second group is assigned to those who are able to work, but for this he will have to change the field of activity, find a job with less physical or emotional stress.
3. The third group is assigned to those who can work at their previous job with minor changes in working conditions.

In some cases, the commission refuses to assign a group: if professional activity is not related to physical or mental stress; when the treatment led to a complete recovery; if the patient can take care of himself without difficulty.

To pass the commission, the following documents are needed: referral, application, passport, SNILS, medical card with examination results, a copy of the work book and a description of professional activity. Passing the ITU (medical and social examination) with a medical policy is absolutely free.

Sick leave for a heart attack

Previously, after a heart attack, the patient was recommended to stay in bed for 6-8 weeks, but now more and more doctors do not support this practice. Long stay in bed leads to thromboembolic disorders, pneumonia and other complications. What is the duration of sick leave after a heart attack?

1. In the absence of complications and severe pain - from 60 to 90 days.
2. If complications are present - from 90 to 130 days.
3. With a second attack - from 90 to 120 days.

If the period of incapacity for work lasts no more than 15 days, the sick leave is issued by the attending physician. To extend this period, a medical commission is needed, which is appointed by the head of the medical institution. If 4 months have passed, and the sick leave needs to be extended, the patient is sent to the ITU.

Patients are also concerned about how sick leave is paid after a heart attack. Payment is made in accordance with current legislation. The first 3 days of sick leave are paid from the employer's funds, then from the social insurance fund. To calculate the amount, the patient's total income for the last 2 years (excluding tax deductions) is taken and divided by the number of days worked. The result obtained is multiplied by the number of days in the period of disability and by the length of service coefficient.