5 stages of myocardial infarction and their signs

Myocardial infarction is a pathological condition, as a result of which blood circulation in the heart is disturbed, which can lead to irreparable changes in the heart muscle tissue. In most cases, the cause of the condition is the narrowing of the vascular lumen as a result of atherosclerosis. Allocate stages of myocardial infarction, differing in symptoms, severity of consequences.

Characteristics of the pathological condition

A heart attack is a serious threat to a person's life. When the condition occurs, the blood supply to the myocardium is disrupted. The tissues of muscle areas that do not receive enough blood begin to die.

In many cases, the cause of the development of a heart attack is atherosclerosis of the coronary vessels, as a result of which the vascular lumens narrow. Also, in patients, the formation of blood clots in an acute form is noted, which leads to a violation, a complete cessation of blood supply to certain areas of the heart.

• arterial hypertension;
• overweight;

• diabetes;
• alcohol abuse, smoking;
• excess animal fats in the diet;
• stress on the nervous system.

At risk are men after 45 years, since at this age they often have atherosclerotic changes in blood vessels. Women are more susceptible to the development of pathology after 65 years.

Classification

Allocate forms of heart attacks depending on the depth of tissue necrosis.

1. Subepicardial - characterized by tissue necrosis in the area of ​​\u200b\u200bfitting the epicardium (the outer shell of the heart).
2. Subendocardial - necrotic changes affect the area of ​​\u200b\u200bfitting the endocardium (inner shell).
3. Intramural - damage is observed in the thickness of the muscle.
4. Transmural - there is tissue necrosis of the entire thickness of the heart wall.

• small-focal - observed in 20% of cases, proceeds moderately, the risk of serious complications is reduced, it is characterized by minor damaged areas; may develop into a macrofocal type;
• macrofocal - observed in the predominant number of cases, it is considered an acute circulatory disorder, may be complicated by an aneurysm, rupture of the heart muscle, ventricular fibrillation.

There are numerous types of tissue necrosis.

• septal - the interventricular septum is damaged;
• necrosis of the tissues of the left ventricle - noted in many cases;
• tissue necrosis of the right ventricle;
• basal - the upper parts of the posterior wall undergo pathological changes.

Also distinguish damage to the diaphragmatic, lower walls, mixed types.

Establishing the location is carried out during instrumental diagnostic procedures.

Diagnostic Measures

Diagnosis is necessary to confirm the development of a heart attack, determine the type, nature of the pathology.

• ECG (electrocardiogram) is an informative diagnostic method, it is possible to conduct a study at home.
• Echocardiography (or ultrasound diagnostics) - is used to identify the area affected by necrosis, allows you to detect the presence of blood clots, examine the condition of the heart valves.
• MRI (magnetic resonance imaging) - the method allows you to get comprehensive information about the heart, blood vessels, to identify small lesions of organs.
• Scintigraphy is performed by introducing a small amount of radioactive isotopes to the patient, performing an organ scan, used to study the functionality of the myocardium in the presence of ischemic disease, after a heart attack.

• A blood test for biochemical markers of necrotic lesions - allows you to accurately diagnose. In the presence of necrosis as a result of a heart attack, certain elements are present in the blood plasma, directly indicating pathological changes in the myocardium.

As diagnostic procedures, palpation is also performed to determine the point of the myocardium, listening to the heart, and tapping the chest wall. Timely diagnostic measures and treatment can reduce the risk of dangerous complications.

Possible consequences

• cardiogenic shock - extreme degree of left ventricular failure;
• aneurysm;
• broken integrity of the walls of the organ (rupture);
• blockage of blood vessels by a thrombus;
• arrhythmia;
• organ conduction problems.

Factors increase the risk of death, can provoke the cessation of the functioning of the body.

The late period can be complicated by pleurisy, pericarditis, mental disorders of a different nature.

Stages of development

Using an electrocardiogram, you can diagnose a heart attack, set a statute of limitations, since the pathology has stages of development.

1. Pre-infarction stage - there is an increase in angina attacks, general well-being worsens, sleep is disturbed, and a feeling of anxiety arises.
2. The most acute (ischemic) stage - the duration is from 30 minutes to 2 hours. It is characterized by the appearance of intense retrosternal pain, radiating to the cervical region, the left arm. The pain can be undulating, manifested by a feeling of squeezing, bursting, burning. Prolonged pain syndrome indicates the expansion of the area of ​​necrotic damage. Patients have shortness of breath, a feeling of weakness, nausea, the skin becomes pale, the heart rhythm goes astray, loss of consciousness is possible. If a person has wet rales, then this indicates pulmonary edema. A characteristic manifestation of the period is also a sudden glaciation of the extremities.
3. The acute stage is the necrotic stage of myocardial infarction, during which the pathological focus is separated from normal tissues. Duration can be from 2 days to 10 or more. At this stage, signs characteristic of acute myocardial infarction appear. In many cases, the patient's intense pain disappears. The period is considered the most dangerous. At this time, serious complications are possible: ruptures of the heart muscle, arrhythmia, disorders of cerebral circulation. If the blood supply to the brain is disturbed, headaches, dizziness, epileptic seizures, and speech disorder may occur. At this stage, the elements of the decay of necrotic tissues enter the blood fluid, which provokes intoxication. A person has an elevated temperature up to 39 ° C, the volume of leukocytes increases.
4. Subacute stage - lasts for 1-2 months, is characterized by the beginning of scar formation. The delimitation of necrotic tissues is completed, they are replaced by connective tissue. In many patients, during this period, there is a decrease in signs of arrhythmia. The volume of leukocytes in the blood, body temperature are normalized. Restoration of normal conduction of the heart often takes three weeks, but in some patients the disturbances may persist. Manifestations of pulmonary congestion are reduced or disappear. There is a possibility of complications such as pneumonia, inflammation of the serous membrane of the heart, joint pain. The persistence of symptoms of angina at the subacute stage may indicate a multi-vessel form of damage.
5. The post-infarction stage is the final stage of scarring. The patient finally undergoes the formation of a scar in the area of ​​necrotic tissue damage. The duration of the period can be 6 months from the onset of necrosis, sometimes it lasts for many years throughout the subsequent life of a person. In healthy areas, compensatory hypertrophy begins to develop. In the case of minor lesions, the elimination of symptoms of myocardial insufficiency is recorded, resistance to physical activity is restored. With extensive areas of damage, signs of insufficiency persist, since in such cases only partial compensation is possible. Blood parameters are gradually normalized.

Graphic images of the stages during electrocardiography are different, which allows doctors to establish the correct diagnosis.

The development of the small-focal form is characterized by less pronounced signs of acute, subacute periods, the rare occurrence of arterial hypertension, muscle failure as complications. Anginal pains are shown moderately. It is important to note that the pathology of a small-focal nature poses a serious danger, as it can develop into a large-focal form.

Therapy

1. Statins - help to eliminate cholesterol plaques, which is the main cause of problems with blood flow. These include: Cardiostatin, Vasilip, Lipostat, Crestor, Liptonorm. In the presence of high cholesterol, in addition to taking medication, you must follow a diet. Limit the use of foods high in cholesterol.
2. Nitropreparations - eliminate angina pain, normalize blood pressure. The group includes Nitroglycerin, Isomak, Olikard. Used for prophylactic purposes in angina pectoris.
3. ACE inhibitors - reduce blood pressure, help maintain blood vessels. You can select "Enalapril", "Ramipril", "Captopril".
4. Beta - blockers - help to normalize the pulse with tachycardia, lower blood pressure. The drugs include Korgard, Glukomol, Anaprilin, Nebivolol, Celiprolol.
5. Antiplatelet agents - prevent the formation of blood clots. Medications are considered an effective blood thinner. The group includes Cardiomagnyl, Plavix, Lamifiban.

During therapy, it is important to adhere to a healthy diet, avoid intense physical activity, nervous strain, stop smoking, drinking alcoholic beverages. It is necessary to monitor the parameters of blood pressure, cholesterol levels.

Thus, the disease is now common. The causes of occurrence are often atherosclerotic changes in blood vessels, which causes problems with blood supply. The disease develops in several stages, each of which is characterized by certain symptoms, negative consequences. The occurrence of an attack with a high degree of probability can be fatal. It is important to note that the disease is characterized by relapses. Therapeutic measures after an experienced attack include taking appropriate medications, dieting, giving up bad habits, avoiding stress, and emotional stress. In the presence of cardiac problems, it is important to visit doctors regularly, undergo examinations in order to prevent life-threatening attacks.