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A pre-infarction state is nothing more than an unstable one. It can be classified as the most dangerous heart disease. But it's still not a heart attack. With timely first aid and further competent treatment, an attack may recede.

Not all patients respond correctly to the first signs of a formidable disease, and therefore an unreasonably large percentage of deaths from a heart attack. This is unfortunate, because today cardiologists have the richest modern arsenal of effective methods for treating the most complex cardiac pathologies.

Coronary angiography

When examined coronary vessels. A contrast agent is injected into the blood, thanks to which the coronary vessels become clearly visible. You can see where the vessel is narrowed, how dangerous the situation is. This study helps to develop a plan for future treatment.

Holter monitoring

The work of the heart can be traced for 24 hours. Using a small device, a cardiogram is recorded. A special computer program processes the results. This method allows you to identify hidden cardiac arrhythmias and myocardial ischemia. Also controlled. Using this method, the development of a pre-infarction state is usually monitored. With a heart attack, it is not suitable, since time in this case goes by minutes.

In addition to hardware methods for examining the heart, the patient is shown to take biochemical blood tests. Increased enzyme content troponin and may indicate the development of myocardial infarction or progressive unstable angina.

Emergency Methods

The main thing that needs to be done is to stop the pain syndrome and prevent a heart catastrophe. First of all, the patient should get rest and fresh air. Before the arrival of the ambulance should be taken (1-2 tablets). If after taking the medicine you feel dizzy or have a headache, there is no need to panic - this is not dangerous and usually passes after a while.

You can not take a large dose of nitroglycerin - this can lead to a sharp drop in blood pressure.

Instead of glycerin, you can put a validol tablet or a few drops of a liquid agent on sugar under the tongue. If the patient was previously helped to eliminate the pain of valocordin or corvalol, then these drugs can also be used. They can also improve myocardial blood supply by dilating blood vessels.

You can reduce the likelihood of blood clots with an aspirin tablet. Aspirin thins the blood, which significantly improves the prognosis of the disease.

Video: myocardial infarction - how to recognize, first aid

Therapeutic measures

Treatment of a pre-infarction condition is aimed at preventing the actual heart attack. It is not much different from the treatment of advanced angina. To reduce the load on the heart muscle, bed rest is prescribed.

Medical therapy

Myocardial oxygen requirements are reduced when taking beta-blockers. When they act, the strength and frequency of heart contractions, which inhibit the conduction of the myocardium, decrease.

Reduce the need of the heart muscle for oxygen and also contribute to its better transportation through the vessels prolonged preparations of the nitroglycerin series - Sustak, Sustonitis, Trinitrolong, Sustabuccal, as well as nitroglycerin itself.

To prevent coronary heart disease, an old proven remedy, heparin, is used as an alternative to aspirin. This medicine exhibits not only anticoagulant properties, but also reduces the number of angina attacks. Also, when using this drug, lipid metabolism improves, which is important for the treatment of a pre-infarction condition.

If the cause of anginal attacks is a spastic component, then it is recommended to take medicines representing the group. When the concentration of calcium cations in the cells of the myocardium and blood vessels decreases, the arteries of the heart expand. As a result, blood flow improves, oxygen supply to the heart muscle. Such antispastic agents include corinfar, nifedipine, isoptin and others.

During treatment, the state of the heart muscle and blood vessels is monitored using an ECG. Physical activity is prohibited during this time. Sometimes it is recommended to extend the rest mode to one month or more. Usually during this time, coronary insufficiency is compensated, and the patient is on the mend.

In more severe cases, when drug therapy does not give the desired result, surgical treatment is performed - usually this is. It should be said that the operation does not guarantee a complete cure.

In the case of an attack, the patient needs to understand that under unfavorable conditions for the body, atherosclerotic plaques in the coronary vessels will reappear and the lumen of the arteries will inevitably decrease.

How to avoid illness

For the prevention of ischemic attacks it is necessary:

• Regularly take prescribed medications;
• Monitor blood counts, especially;
• Quit smoking;
• Move more;
• Control blood pressure;
• Lose weight;
• Avoid stress.

Video: about preinfarction and heart attack prevention

Video: TV program about preinfarction

Myocardial infarction is a serious damage to the heart, as a result of which there is a violation of the blood supply to the heart and some cells die. It is for this reason that it is important to recognize the pre-infarction condition in time in order to take urgent first aid measures in time.

What it is

Unfortunately, in such cases, people do not always go to the doctor and bring the matter to a heart attack.

Common signs of a pre-infarction condition in men and women are pain in the region of the heart, which is difficult to suppress

Diagnosis of a pre-infarction condition is the work of a cardiologist. It is possible to make a conclusion about the presence of such a condition in a patient only after a series of examinations. External signs of the disorder can be deceiving and are not always guaranteed to mean the onset of angina pectoris.

• First of all, when diagnosing, the doctor studies the patient's complaints, the nature and time of the onset of symptoms.
• It is important to know whether the patient underwent surgery, whether there are cases of heart disease in the patient's family;
• One of the most important procedures is an electrocardiogram (ECG), the cheapest and most effective way to detect abnormalities in the heart;
• Magnetic resonance therapy.

And only after a full range of examinations, the specialist makes a conclusion about the presence or absence of the disease.

ECG is the most accessible diagnostic method for detecting heart disorders

In a pre-infarction condition, it is very important to provide first aid, this will not only save a person’s life, but also save you from serious complications. First aid for a pre-infarction condition is of particular importance, because if it is indicated correctly and in a timely manner, the condition will not turn into a heart attack.

At the prehospital stage it is necessary:

• Provide the patient with complete rest, in the form of bed rest, it is better to relieve his irritants. The most optimal body position for heart pain is half-sitting.
• Be sure to call the doctors.
• Remove anxiety, calm the patient. To do this, use such sedatives as: motherwort tincture, valerian, corvalol, etc. It is better to use those sedatives that the patient is used to.
• Avoid any physical activity.
• Provide a normal temperature in the room, with a flow of fresh air. In this case, hypothermia should be avoided.
• Remove clothing that restricts movement and breathing. It is best for the patient to wear simple and light home clothes.
• It is advisable to take a nitroglycerin tablet or similar preparations.
• and based on this, give pills to increase or decrease pressure.

Treatment

Treatment of a preinfarction condition is carried out in a hospital. The patient is prescribed bed rest, the pain syndrome is relieved by medication. The goal of treatment is not just to relieve pain, the main task is to avoid an impending myocardial infarction.

In therapy, drugs are used that reduce the heart's need for oxygen, such as:

• Sustonitis;
• Nitroglycerine;
• Sustabukkal and others.

As needed, drugs are administered to improve blood flow, for example:

• Nifedipine;
• Isoptin and others.

In cases where medications were not effective, they are usually prescribed. Unfortunately, the operation does not guarantee a cure.

Among other things, the patient is advised to reconsider his lifestyle in order to avoid repeated attacks.

• light physical activity;
• walks in the open air;
• rejection of bad habits;
• minimization of stressful situations.

Prevention

Prevention of a pre-infarction condition is of particular importance, because if you do not follow the doctor's recommendations, the condition will recur and is likely to worsen.

Prevention is doubly necessary for those who once suffered a heart attack, since in the case of a repeated case, the probability of death increases several times.

In order to maintain your body in a normal state, you must follow the following rules:

• Regular intake of vascular and cardiac drugs, in accordance with the prescription of the doctor. Violation of recommendations, overdose or refusal to take can lead to death.
• Controlling blood pressure and cholesterol levels.
• Diet. Refusal of fried, fatty, salty foods. Overeating ban. It is best to consume more vegetables and fruits. It is best to steam food, use lean meat. It is also recommended to avoid coffee, carbonated drinks, strong tea.
• Balance between work and rest, avoiding overwork. Moderate exercise, avoidance of nervous overexertion. You can do physical therapy. Healthy sleep in a ventilated room.
• Specialist visit. It is advisable to visit the hospital from time to time and take all the necessary tests in order to identify pathological disorders in the early stages and begin treatment.
• Avoidance of stress, nervous strain.

It is important to remember that all these measures do not give a 100% guarantee that a person will no longer encounter diseases. But, only compliance with these rules, visiting a doctor and following his recommendations significantly reduce the likelihood of a recurrence of a pre-infarction condition or death.

Myocardial infarction - this diagnosis, like fire, is feared by the elderly and all those who have problems of a cardiovascular nature. The specificity of this form of coronary heart disease is such that it requires urgent surgical intervention. Missing the moment, you can say goodbye to life. It is for this reason that it is very important to know what signs characterize a pre-infarction condition in order to help yourself or a loved one in time.

Alarm signals that should not be ignored

Symptoms indicating an approaching danger are moved to a separate clinical condition. By recognizing them in time and taking appropriate measures, you can protect yourself from such a serious and terrible diagnosis as a heart attack. What is the essence of these manifestations?

The basis of pathological symptoms is an increase in the wall of occlusion in a particular coronary artery. The reason for this phenomenon can be, for example, an increase in thrombosis. The heart attack itself is not an exceptionally acute condition, but it causes the necrosis of a certain proportion of the tissues of the heart muscle. As a result, cardiac arrest or rupture may occur. In any case, emergency treatment is required, the count goes literally for seconds.

Under the influence of the described condition, ventricular fibrillation can occur and acute heart failure can form. These factors cause serious, often irreparable damage to health. The conclusion suggests itself: if you recognize the signs of a pre-infarction condition in time, you can save the life of someone who has these symptoms. In this case, the signals that the body gives will depend on its characteristics, including the location and size of the dead zone of the heart.

Key forms of manifestation

People who have a pre-infarction condition are diagnosed with unstable angina. It can be divided into several types:

1. First time angina pectoris.
2. Progressive angina pectoris, when previously this condition has already taken place, but recently the cases of its manifestation have become more frequent; symptoms are also characterized by the occurrence of prolonged and much more intense pain with a change in their location and spread beyond the heart.
3. Rest angina, in which pain occurs after physical exertion.
4. Early postinfarction angina is characterized by pain attacks, starting from the first days to a month from the date when myocardial infarction occurred.
5. Angina pectoris after bypass surgery, which is performed in case of critical narrowing of the arteries due to cholesterol plaques.
6. Prinzmetal's angina occurs as a result of spasm in the coronary arteries, accompanied by severe pain attacks, mainly appears in the morning.

The diagnosis of "unstable angina" is made to people with a pre-infarction condition

Symptoms

Considering the symptoms of an anxiety state, it is important to note that it is characterized by the active progression of angina pectoris with an advanced stage. If this condition is not treated, and even constantly exposed to stress and other types of complications, myocardial infarction may soon occur, which is more common in men than in women. Often, independent relief of angina pectoris is noted, due to which the patient can recover.

A pre-infarction condition that progresses can be suspected with increased pain behind the sternum. Another hint is the increase in pressure. There is a bright pain syndrome in the area behind the sternum, similar to angina pectoris.

However, unlike it, the manifestation of pain can be eliminated with the help of nitroglycerin. In a state preceding a heart attack, nitroglycerin does not relieve pain, and the number of attacks increases during the day, sometimes up to 30 per day.

All these attacks gradually lead to necrosis of a certain part of the heart. Pain is given to the collarbones, arms, under the tongue and to the right side of the sternum. These manifestations occur in both men and women. The patient is thrown into a cold sweat, anxious and agitated, the heart is pounding furiously, there is a fear of death, especially if an additional symptom has appeared - suffocation.

An atypical scale of the pre-infarction state is also possible, in which the patient is worried about dizziness, weakness, disturbing sleep, or even its absence. Pain, however, is not observed. If the pathology proceeds in this form, shortness of breath and cyanosis usually occur, which appear without any obvious prerequisites and during rest. Diagnosis in this case is possible only with the help of an electrocardiogram.

Atypical picture

Symptoms of this course are usually seen in older people over the age of 80 years. In some individual cases, an abdominal syndrome appears, which is characterized by the localization of pain in the left hypochondrium and the upper half of the abdominal region. The patient complains of heartburn, believing that the cause of the pain is the stomach. However, the pain can be stabbing, cutting, aching. Increases with excitement and after physical exertion, including walking. The state of rest, as well as the intake of nitrates, will help eliminate pathological manifestations.

Abdominal pain, nausea, and vomiting may also be symptoms of pre-MI in the elderly.

Companions of this condition can serve as vomiting and nausea, pain in the abdomen, hiccups, increased flatulence. In some cases, there are pains in the throat, neck and lower jaw. However, signals of an imminent heart attack may be limited to shortness of breath or disturbance in the rhythm of the heart. The cerebrovascular form of the pre-infarction state may be accompanied by fainting, nausea and dizziness.

Corrective action

Symptoms of an anxiety state indicate that the threat of getting a heart attack is very close and immediate treatment is required. In this case, it is focused on preventing a possible myocardial infarction.

In other words, the treatment is designed to eliminate the severe form of angina pectoris. In this case, the patient is prescribed bed rest, which helps to reduce the load on the heart. Due to this, its energy requirements are reduced.

An acute condition preceding a heart attack, both in men and women, requires emergency medical attention. Before the ambulance arrives, the patient should receive one tablet of Nitroglycerin under the tongue. If earlier the patient eliminated this kind of symptomatology with the help of Validol, then this time it can also be applied.

Treatment with other drugs, such as Valocordin and Corvalol, is possible. You can stop the attack with the help of intramuscular injection of Papaverine, Platifillin or No-shpy. Excessive hypertension must be treated with intravenous injection of Eufillin diluted with saline.

Prevention

What to do to prevent trouble? What kind of prevention is needed? These questions are especially relevant for men and women who have previously had a heart attack. The first thing that is needed is a change in lifestyle, for which a diet, quitting smoking and alcohol, and establishing a regimen are prescribed. The diet involves eating light, low-cholesterol foods. This means that you will have to give up fried, smoked foods, most confectionery and meat products.

Regular intake of cardiac and vascular drugs is an important method of preventing a heart attack.

Prevention also involves regular intake of cardiac and vascular drugs, including antiplatelet agents, beta-blockers, etc. Blood pressure control, analysis of cholesterol and lipoprotein levels in the blood are very important.

Adequate, healthy sleep plays an important role in recovery. Sometimes treatment of ischemia of the coronary vessels is required, in which case the best solution is surgery, but this can only be done if there are no contraindications.

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It is important to know not only the first signs, but also how to prevent a heart attack. Increasingly, a heart attack can be observed both in people of mature age and in the younger generation. Preinfarction symptoms and first signs in women need to be known, because. The disease has long ceased to be only a disease of the elderly. Pre-infarction condition is one of the most dangerous for human life. This will help save the life and health of loved ones.

Causes of the disease

A heart attack is called damage to the heart muscle, and partial tissue death occurs. The reasons for this are a violation in the blood supply system and blockage of the artery.

The manifestation of a pre-infarction condition can occur for a number of different reasons:

• the presence of bad habits, including alcohol abuse and smoking;


• the use of foods with a high cholesterol index, which negatively affects the vessels in the body (cholesterol slowly begins to kill them, contributing to the appearance of plaques on their walls);
• diabetes mellitus (people who suffer from this disease are at risk);
• great physical activity;
• regular strong stresses that accompany a person literally everywhere.

It is the latter reason that most often provokes a preinfarction state.

Symptoms in women

In men and women, the symptoms of this disease are slightly different. The most striking symptom of a preinfarction state is the appearance of pain. It affects the chest and has the same character as exertional angina. One of the features of such pain can be called the fact that it is simply impossible to eliminate it with the help of nitroglycerin. Attacks are quite frequent, about 20-30 times a day.

Most often, the pain syndrome occurs at night when a person is sleeping. It can last up to half an hour. This condition will inevitably lead to the gradual development of necrosis of the heart muscle.

The pain is felt in the chest and radiates to the right side of the body, usually the arm and collarbone. The main signs of a pre-infarction condition in women include:

• the appearance of a feeling of anxiety, there is a strong excitement;
• loss of ability to take deep breaths
• the appearance of cold sweat;
• feeling of pain in the shoulder area;
• there are difficulties with coordination of movement.

At the same time, not everyone with a pre-infarction state will show exactly the listed symptoms. Sometimes the disease manifests itself in a completely different way. Apathetic behavior appears in the patient, he feels weakness, constant dizziness, insomnia is observed, he is constantly sick. The person becomes irritable and aggressive, shortness of breath may appear.

Initial stage and first signs

The pre-infarction state does not appear in one day. Therefore, it is possible to recognize the symptoms at an early stage and start treating the disease in time. Signs to look out for:

• periodically there is pain in the region of the heart, in the side on the right or in the right shoulder blade;
• sometimes there is weakness;
• there was a feeling that there was not enough air.

With these symptoms, the key word is "periodically". This is not a regular phenomenon, it occurs sometimes and then goes away. That is why many do not take it seriously. Although, if such symptoms are detected, you should already consult a doctor for an examination.

Deterioration of the situation and when an ambulance is required

If the patient ignores previous symptoms, his condition worsens. Pain in the region of the heart becomes stronger, felt more and more often. It also increases their duration. The pain ceases to go away on its own, the patient has to take medication to get rid of it. After taking the drugs, the state of health improves, the pain disappears. At this stage, you should immediately consult a doctor.

If you ignored the second stage of the development of the disease, it will begin to progress. If there is severe pain in the region of the heart that restricts your movement and breathing, taking medication does not improve the condition. In this case, it is recommended to call an ambulance. In most cases, these signs are characteristic of the onset of a heart attack and the patient needs urgent medical care.

What to do when signs are detected and what is the prevention of the disease

If, when the first signs of a pre-infarction state appear, you do not consult a doctor, this will end in myocardial infarction. That is why, at the slightest suspicion, you should visit a cardiologist.

ECG

Diagnosis of this disease comes down to examining the patient by a doctor and conducting an ECG, which the cardiologist will subsequently decipher. After that, usually the patient is placed in a hospital, as a rule, this is the intensive care unit. Treatment consists in taking special medications. Also, the patient will be provided with complete rest, silence and a sparing diet, in which there will be a minimum cholesterol content.

After the patient is on the mend, he is discharged. However, for some time he continues to be observed by a doctor and constantly makes an ECG in order to understand how intensively the patient is recovering.

Also, the patient must independently monitor blood pressure. You should give up strong loads, emotional and physical, try to stick to proper nutrition and get enough sleep.

Those who have pathologies of the cardiovascular system should carefully monitor their condition and be constantly monitored by a doctor. For everyone who is at risk of developing a pre-infarction condition, there are special preventive recommendations to avoid the appearance of a pre-infarction condition. Among them:

• taking drugs for the cardiovascular system, which the doctor should prescribe;
• regular monitoring of blood pressure;
• proper nutrition and monitoring of cholesterol levels;
• rejection of bad habits;
• maintaining an active and healthy lifestyle;
• observe the regime of good rest and sleep.

Consequences

Many are in no hurry to perceive signals from the body, because they are not aware of the consequences that a heart attack can entail. It affects the work of the whole organism. When there is a failure in the blood supply to the heart muscle, this leads to necrosis of some of its parts. In some cases, a heart attack leads to heart failure. In the acute form, rapid breathing and regular attacks of suffocation are observed. The patient's skin turns pale, frothy sputum begins to form. This is one of the main signs of pulmonary edema.

Tachycardia begins to develop, accompanied by high blood pressure, nausea and a constant feeling of anxiety. A few weeks after the attack, a heart aneurysm can be observed. Its symptoms are shortness of breath, a feeling of weakness and fever.

A heart attack can provoke the development of pericarditis, when the pericardial sac becomes inflamed. Signs of the disease are an attack of fever, chest pain, shortness of breath, dry cough, and sometimes vomiting.

There are quite a few consequences of a pre-infarction state. And all of them significantly worsen human health and quality of life. That is why it is important to pay attention to the signs of the disease in time and not to ignore your malaise. With timely and proper treatment, regular monitoring of the state of health, it is possible to avoid not only negative consequences, but also the heart attack itself.

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Causes of pre-infarction condition

Three factors involved in the development of a preinfarction state:

1. Mismatch between demand and oxygen delivery

Unstable angina occurs due to an increase in myocardial oxygen demand or due to a decrease in its delivery through the coronary arteries.

The increased need of the heart muscle for these substances can be caused by:

aortic stenosis

Reduced oxygen delivery can be caused by:

• anemia
• hypoxia (decrease in blood oxygen saturation);
• decrease in blood pressure.

Doctors believe that the mismatch between the request and delivery of oxygen to the heart muscle is responsible for about a third of cases of pre-infarction.

2. Rupture of atherosclerotic plaque and thrombosis

Most cases of unstable angina are caused by a sudden narrowing of the lumen of the coronary artery, due to which there is a decrease in the blood supply to part of the heart muscle. This narrowing most often develops as a result of atherosclerosis, a disease in which fats and cholesterol are deposited in the inner layer of the arteries, forming plaques (atheromas). As the atherosclerotic plaque grows, it gradually causes narrowing of the lumen of the artery, causing the development of symptoms of stable angina.

Most cases of preinfarction are caused by atheroma rupture. At the site of damage to the vascular wall, a thrombus is formed, which sharply worsens the blood flow through the affected artery and causes symptoms of a pre-infarction state. This place is unstable, at any moment a blood clot that has arisen in it can completely block the coronary artery and cause MI.

3. Spasm of the coronary arteries

Rarely, a pre-infarction state can be caused by a spasm of the arteries, which temporarily cuts off blood flow and causes an angina attack. In most of these cases, atherosclerotic plaque is also involved in the occurrence of vasospasm. Other causes include cocaine use, cold weather, and emotional stress.

coronary spasm

Characteristic symptoms

Signs of a pre-infarction state practically do not differ from the symptoms of a myocardial infarction, therefore, if they occur, it is urgent to consult a doctor. They belong to:

The clinical picture of unstable angina has the following characteristics:

Compared with men, women with a pre-infarction condition are more likely to experience shortness of breath, nausea, pain in the back or lower jaw. Although the main first signs of unstable angina in both sexes are pain or discomfort in the heart area.

Diagnostics

Sometimes, based on the clinical picture, even an experienced cardiologist cannot distinguish a pre-infarction state from a real MI. To establish the correct diagnosis and determine the tactics of treatment, a patient with pain in the heart area is carried out:

• Electrocardiography (ECG) is a test that records the electrical activity in the heart using electrodes attached to the patient's skin. Abnormal impulses may indicate oxygen deficiency in the myocardium. In many patients with a pre-infarction state, the ECG may be normal, especially if it is not recorded during an attack. In some patients, it is impossible to distinguish unstable angina pectoris from small-focal myocardial infarction using ECG.


• Blood tests that detect certain substances that enter the bloodstream when heart cells die. With the help of these tests, a differential diagnosis is made between a pre-infarction state and myocardial infarction.
• Echocardiography is an examination of the heart using ultrasound, which can be used to evaluate the contractile function of the heart, as well as to identify its structural disorders.

Treatment Methods

Treatment of a preinfarction condition consists of two stages:

To choose the right treatment tactics, doctors assess each patient's risk of developing cardiovascular complications in the near future. This assessment is carried out on a special scale, which includes the following indicators:

Based on an assessment of the risk of developing MI, doctors choose a conservative or invasive strategy for treating patients.

Conservative treatment strategy

A conservative strategy for the treatment of a pre-infarction state is used when the patient is at low risk of developing a heart attack in the near future. It involves the conduct of drug therapy, including the following groups of drugs:

• Antiplatelet agents - prevent the formation of blood clots at the site of a damaged atherosclerotic plaque, worsening the aggregation (gluing) of platelets. It has been scientifically proven that the use of antiplatelet agents in patients with a pre-infarction condition reduces the risk of MI and stroke. The most commonly prescribed drugs in this group are aspirin, clopidogrel (Plavix) and ticagrelor (Brilint). The main side effect of antiplatelet agents is an increased risk of bleeding.
• Anticoagulants are drugs that affect blood clotting factors and prevent the formation of blood clots. These drugs are prescribed only in the acute period of the pre-infarction state. These include heparin, enoxaparin, fondaparinux.
• Statins are drugs that lower blood cholesterol levels. These include atorvastatin, simvastatin, rosuvastatin.
• Beta-blockers are antiarrhythmic drugs that lower blood pressure and pulse rate. Due to these effects, beta-blockers reduce the workload on the heart and reduce the risk of MI. This group includes metoprolol, nebivolol, bisoprolol, carvedilol.
• Angiotensin-converting enzyme inhibitors are drugs that help relax blood vessels, lower blood pressure and reduce the workload on the heart. These include ramipril, perindopril, lisinopril.
• Nitrates are drugs that dilate blood vessels. Thanks to this action, they improve the blood supply to the myocardium and alleviate an attack of angina pectoris. Despite being effective in relieving cardiac pain, nitrates do not reduce mortality or the risk of MI. The most commonly used drugs include nitroglycerin and nitrosorbitol.

If medical therapy fails to relieve pre-infarction symptoms, doctors recommend an invasive treatment strategy.

Invasive treatment strategy

An invasive treatment strategy is used in patients with unstable angina who are at high risk of developing MI or when conservative medical therapy has failed.

The goal of the invasive strategy is to locate the narrowing of the coronary artery that is responsible for the onset of the preinfarction condition and to eliminate it.

Click on photo to enlarge

To detect the pathology of the coronary arteries, coronary angiography is performed - a minimally invasive examination, during which a contrast agent is injected into the lumen of these vessels using a thin catheter and x-rays are taken. After performing coronary angiography and identifying places of narrowing of the arteries of the heart, doctors can restore their patency using:

With the help of these operations, in most patients, it is possible to significantly improve the blood supply to the heart muscle and avoid the development of myocardial infarction. It should be remembered that surgical treatment of unstable angina does not mean that drug therapy can be abandoned.

Lifestyle change

Regardless of the chosen treatment strategy, all patients with a diagnosis of "preinfarction" are recommended to adhere to the rules of a healthy lifestyle, which includes the following:

Forecast

The prognosis for unstable angina depends on many factors that affect the risk of myocardial infarction. According to statistics, the pre-infarction condition leads to the death of 4.8% of patients within 6 months.

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Pre-infarction condition: causes

The following factors contribute to the development of this condition in humans:

1. Strong psycho-emotional overstrain and stress.

2. Excessive physical fatigue.

3. Overheating in the sun.

4. Frequent use of alcoholic beverages.

5. Frequent smoking (including passive smoking).

6. Overdose of certain types of drugs.

7. Hypothermia.

8. Obesity.

9. Progressive hypertension (hypertensive crisis).

10. Excessively intense sports training.

11. Elevated levels of cholesterol in the blood, which clogs the vessels of the heart.

12. Acute or chronic heart failure.

13. Severe heart disease, which gave complications in the form of unstable angina.

Pre-infarction condition: symptoms and signs

It is not difficult to identify this condition in a sick person, since it is almost always accompanied by such characteristic signs:

1. A person suddenly has a panic fear of death. At the same time, his heart rate will become more frequent, his head will be spinning and his limbs will go numb. This state is somewhat similar to a panic attack.

2. The patient may experience drowsiness or vice versa, insomnia, which will be accompanied by anxiety and agitation. Also, this usually causes nausea and fear to stand up (due to dizziness).

3. There is a feeling of cutting pain in the chest area, which increases even more with physical exertion. Usually the pain syndrome disappears after taking cardio drugs.

4. A person may have shortness of breath and burning sensation in the area of ​​the pancreas.

5. Sometimes there is a cold sweat, sudden failures in the work of the heart. The person can neither walk nor lie still.

It's important to know, that in some cases, the pain syndrome can be given to the neck and shoulder area. At the same time, doctors often perceive this symptom as a manifestation of osteochondrosis, thus losing time.

Pre-infarction syndrome is considered especially dangerous in adolescents, since their cardiovascular system is not yet working well enough. Moreover, there are documented cases of instantaneous death during exercise in those adolescents who suffered from heart failure for a long time, but it was not treated at all.

Pre-infarction condition: first aid and treatment

The main task of emergency ambulance in a pre-infarction condition is to prevent the development of a heart attack and relieve acute pain.

Thus, in this state:

1. Lay the person in a horizontal position on high pillows so that he is in a semi-sitting state.

2. Reassure the patient and give him a tincture of valerian or motherwort.

3. Open a window to make it easier to breathe. You also need to rid the patient of a tight tie, loosen the belt or replace a sweater with a tight neck.

4. It should be controlled that a person in this state does not get up and in no case engage in physical activity, as this can give impetus to the development of an acute heart attack.

5. To prevent thrombosis, a person can be given the drug Heparin. It will not only have its anticoagulant effect, but also reduce the severity of an angina attack. Moreover, this drug will improve lipid metabolism, which plays a very important role in the treatment of acute angina.

6. Also, the patient can be given one tablet of Nitroglycerin. After taking it, a person may feel dizzy, but this is not dangerous, since such an effect of the drug quickly passes.

7. It is very important to periodically measure the patient's blood pressure until the ambulance arrives. With obvious tachycardia, you can give a person one tablet of Anaprilin.

In a pre-infarction state, stopping an angina attack alone will not be enough. A person must be hospitalized in a hospital, examined and prescribed medical therapy.

Pre-infarction condition: methods of treatment

Immediately after hospitalization, the patient undergoes a cardiogram of the heart. After that, the doctor writes an individual treatment plan. It is aimed at preventing the development of necrosis of the heart muscle (prevention of a heart attack).

Traditional therapy includes:

1. Appointment of antispasmodics for chest pain.

2. Appointment of anticoagulants and beta-blockers.

3. The patient must be sure to observe bed rest and reduce the load on the heart as much as possible.

4. A therapeutic diet is shown. It provides for a complete rejection of salty, fatty, fried and sweet. All meals should be very light and well digestible. It is desirable for a person to eat cereals, vegetable soups, cottage cheese and kefir.

5. The patient needs to constantly monitor the indicators of the heart and blood pressure.

6. Appointment of antiarrhythmic drugs (Cordinorm).

7. Without fail, a person must be prescribed drugs from the calcium antagonist group. They will help supply oxygen to the muscles of the heart. The best drugs in this group are Nifedipine and Corinfar.

In the absence of clinical improvement in the patient's condition (with drug therapy), the patient is prescribed surgical treatment. As a rule, a person undergoes coronary artery bypass grafting. It is important to perform such an operation no later than six hours after the first signs of pain appear. Using this procedure, you can prevent the development of myocardial infarction.

Pre-infarction condition: treatment, prevention

To reduce the risk of developing a pre-infarction condition, the following recommendations from a cardiologist should be followed:

1. Control your weight and prevent obesity, because in this state an even greater burden is placed on the human heart. If you can’t lose extra pounds on your own, then you need to contact a nutritionist and gastroenterologist who will prescribe an individual diet and a general weight loss program.

2. Avoid experiences, nervous strain and stress. At the same time, it is worth learning to control your psycho-emotional state and remain collected even in critical situations.

3. Quit smoking and taking alcohol, because apart from total harm to the body, these habits do not bring absolutely any benefit.

4. Avoid severe physical overwork and hypothermia.

5. At least once a year, contact a cardiologist and conduct a preventive examination. Moreover, people over the age of forty are advised to examine their heart every six months.

6. It is very important to eat right. At the same time, the diet should be rich in fiber (most of all found in vegetables, herbs and fruits), vitamins, protein foods (fish, meat, eggs) and other useful substances. Moreover, you need to completely abandon the use of fatty, fried foods, as well as minimize the consumption of animal fats. This is justified by the fact that such dishes contribute to an increase in the level of cholesterol in the blood, which has a bad effect on the functioning of blood vessels.

7. Monitor laboratory blood counts (with high cholesterol, follow a diet).

8. Be physically active. This does not mean that you need to squeeze all the "juice" in the gym, but yoga, walking or swimming regularly will be very useful.

9. With hypertension, you should always control your blood pressure and avoid its sudden changes.

10. In case of chronic heart disease, it is imperative to drink all prescribed drugs. Also in this state, you should maintain a special daily regimen and follow a diet.

11. When the first signs of a pre-infarction state appear, one should not panic and try to wait until the simple disease goes away. It is best not to endanger your health and immediately call a doctor.

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What is a heart attack?

myocardial infarction- this is the cessation of nutrition of the heart muscle due to a violation of the conduction of the coronary arteries.

Insufficient blood flow through the main artery to the heart muscles leads to a lack of oxygen and oxygen depletion of myocardial cells, and as a result they die, which leads to a heart attack. At the site of cell death, a rough connective tissue is formed, which is not able to perform contracting movements.

On the wall of the heart of the myocardium, a hard scar is formed from the connective tissue, it does not allow the organ to function fully.

Coronary artery disease- the main harbinger of a heart attack, since this is already a violation of the blood supply and nutrition of the heart muscle of the heart (myocardium). What disrupts the blood supply? Atherosclerotic plaque. This problem occurs due to the deposition of fats, cholesterol and other lipids (plaque is their accumulation). So the lumen of the vessel begins to narrow.

Over time, after plaque detachment thrombus develops and grows. It can occupy the entire lumen of the artery and, accordingly, disrupt the supply of oxygen, which leads to cell death (necrosis).

The first signs of a pre-infarction

Up to 50 years old female sex hormones (especially female estrogen) protect them from the formation of cholesterol plaques. As hormonal disruptions and other diseases in women increase, estrogen in the body becomes less. Namely, it promotes the expansion of coronary vessels and protects the female body from an early heart attack. Symptoms of preinfarction in women are different from men.

Another bad news is that women are much more difficult to tolerate a heart attack. Women, unfortunately, are simply inattentive to their body when it signals problems.

There are two types of signals of this disease:

1. distant- their appearance is a signal of a violation of oxygen supply, a lack of oxygen in myocardial cells;
2. Late- this is a signal of the body about a critical state and cell death in a few hours.

In a pre-infarction state, you can stay from 3 days to 3 weeks or even more. This is an individual feature of each person and his body.
Treatment of a preinfarction is possible and necessary.

Pay special attention to your heart if you have any of the following symptoms:

• If you hold your breath at night or snore (don't think this is just a male problem).
• If you find it difficult to breathe, you may experience shortness of breath at rest.
• If your fatigue, as it seems to you, is unreasonable and does not go away even after a long rest.
• If you suffer from insomnia.
• If you have frequent urination, especially at night.
• If your face feels swollen in the morning.
• If you have advanced periodontal disease.
• If you feel discomfort in the stomach area or you have an upset stomach for no reason you understand.
• If you started to suffer from arrhythmia and tachycardia.
• If you feel panic or inexplicable anxiety, or even fear of death.

Read more about the first signs of myocardial infarction here.

Call your doctor if you have more than two of the above symptoms. Perhaps this will give you the very first aid for a preinfarction.

Symptoms and manifestation of pre-infarction condition

Women have their own characteristics of the body and they are less likely to suffer from this disease:

• the female heart muscle is smaller;
• heart contraction in women in one minute more often (90 beats and 70-75 in men);
• estrogen is the main protector of female coronary vessels.

But a heart attack and its symptoms in women are less studied. The fact is that women tolerate pain better, they are more tolerant and, accordingly, do not pay due attention to health problems.

The most important symptoms of myocardial infarction are:

1. severe chest pain that occurs suddenly, the heart contracts, something presses on it, and the pain palpably radiates to the neck, back or shoulder. Often pills do not relieve pain;
2. shortness of breath during preinfarction, shortness of breath at rest.

Sometimes the symptoms are invisible or subtle, the disease may have atypical symptoms, for example, women with diabetes. They should pay special attention to their health. They may be asymptomatic in their preinfarction state.

Late signals of a pre-infarction state:

• the temperature rises to 38 degrees;
• profuse sweating, which is cold and clammy;
• starts to feel sick;
• pain in the abdomen and behind the sternum (due to the structural features of the female diaphragm, pain may occur in the abdomen);
• neck, shoulder, or left arm pain;
• blood pressure drops sharply;
• rapid pulse;
• numbness of the extremities (hands and fingers);
• headache often due to pain in the back of the head;
• weakness, turning into dizziness or even fainting.

What to do with a preinfarction?

First aid for preinfarction should be provided quickly and efficiently:

1. Call an ambulance;
2. put the patient down;
3. it is necessary to ensure the supply of fresh air;
4. measure the pressure;
5. give 1 tablet of nitroglycerin under the tongue;
6. give an aspirin tablet (500 mg);
7. give the patient a sedative (Valocordin, Corvalol);
8. give the patient a pain reliever.

A biochemical blood test shows the presence of enzymes in large quantities. These are some kind of markers that indicate necrosis in the region of the heart. Troponin is considered the main indicator, since the level of troponin rises and lasts from 4 hours to 12 days after a heart attack. But even a general blood test, as a rule, shows a large number of leukocytes.

Causes of the disease

People suffering from atherosclerosis are at particularly high risk for a heart attack. Change the wrong way of life - as this is the main cause of this disease. If atherosclerosis is inherited from relatives, then it is especially important to adhere to a healthy lifestyle.

The main causes of the disease in women:

• age over 50;
• overweight, obesity;
• bad habits: smoking and alcohol;
• diabetes;
• high blood pressure;
• lack of physical activity;
• emotional exhaustion;
• stress, nervous exhaustion.

How to prevent a heart attack?

• No bad habits. No nicotine and alcohol.
• Start treatment for atherosclerosis.
• Healthy food. It is very important.
• Weight control. With a healthy diet, this problem should not be.
• If there is a need to take blood thinners, be sure to take such medicines.
• Make it a rule to undergo an annual medical examination (with a blood test for sugar and a general one) and an ECG.
• Acetylsalicylic acid (Aspirin). It is essential for your health if you are over 50 for many reasons.

Be attentive to your health and well-being.

Heart attack treatment

Treatment depends on the extent and location of possible or existing damage.

Medical therapy

This technique has a number of contraindications. The effectiveness of treatment reaches 70%.

Such treatment only dissolves the thrombus, but the atherosclerotic plaque remains:

• Thrombolytics (Metalise, Actilyse, Streptokinase)
• Narcotic painkillers (Morphine, etc.) to reduce pain.
• Sedative drugs for a sedative effect.
• Nitroglycerin intravenously to expand the coronary arteries and improve the nutrition of the heart muscle.
• Heparin intravenously to eliminate the risk of recurrent thrombosis.

Other medicines are prescribed by the doctor with careful monitoring of the course of the disease and the condition of the patient on an individual basis.

If no surgical intervention is necessary

If it is impossible to do without surgical intervention, then it is carried out:

1. open intervention(coronary bypass grafting) - is performed quite rarely due to the huge risk of death. The operation is performed under general anesthesia using a heart-lung machine (AIC). At the same time, the patient’s heart is stopped for a while, which makes it possible to carry out all manipulations;
2. mini invasive procedure(stenting, angioplasty, coronary angiography) - which is considered less dangerous and better tolerated. This is especially important for patients with diabetes or other complications. The narrowed place of the vessel is inflated with a special balloon, and a special mesh (stand) is installed to stabilize the vessel wall.

Consequences of a heart attack

If the treatment of pre-infarction was not positive and nevertheless a heart attack occurred, then one must be prepared for post-infarction complications. They can be mechanical (ruptures), ischemic, electrical, and so on.

Let's look at some of the complications below:

• Cardiogenic shock- one of the most severe post-infarction complications, especially common in diabetics, women, or patients with a second heart attack. Unfortunately, it leaves no chance for almost 20% of patients. The main reason is the loss of precious time when you can still change something.
• Mitral insufficiency- a common complication that can be treated both medically and with the help of emergency surgery. It is more common in patients who have had a heart attack of lower localization.
• Heartbreak. This is perhaps the worst thing that can happen to the patient. Rupture of the heart is practically not treated. It takes about 3% of patients. Undoubtedly, the most dangerous complication for women, since their heart often cannot withstand heavy stress, improper or late treatment, which provokes a rupture.
• Dressler syndrome. It occurs as a reaction of the immune system to substances that have come from cardiomyocytes. The immune system does not perceive these substances and, accordingly, the body begins to fight foreign bodies. Happens in 5% of cases.
• Thromboembolism- after surgery, there is a particular risk of blood clots, especially the first 5 days. To prevent this from happening, heparin is administered to patients in the fastest lines after a massive heart attack. On the second day warfarin is taken.
• Post-infarction syndrome is the response of the body's immune system to cell death. As a result, there may be inflammation of the pleura, in the lungs or pericardium (separately or simultaneously). Treatment consists of hormonal drugs.

After a heart attack, you must be especially careful about the prevention of new complications.

Know your numbers, namely:

1. blood glucose level;
2. cholesterol level;
3. blood pressure (should be checked regularly).

Try to keep these indicators normal, the quality and duration of your life largely depend on them.

I repeat that the prevention and reduction of the risk of a heart attack is the main rule of those who have encountered this disease or have a genetic predisposition.
The main change in the lives of women who have suffered from this disease should be their diet.

You need to follow a special diet, specially designed by experts in this field. Give preference to stewed, or boiled, or baked dishes, they need to be salted immediately before taking. Remember that some products are strictly prohibited.

Long live healthy eating

• Green tea (rich in antioxidants, they reduce bad cholesterol and help normalize blood pressure).
• No fats in your diet. Be careful with fats, they can harm you.
• Olive oil - replace regular sunflower oil with it.
• More foods that contain coarse fiber (you can buy bran in any supermarket, and it is better to choose bread from whole grains).
• Replace fatty meat with fish. Fish oil is also a good option.
• Drink juice. The best choice is orange fresh, tomato, grape juice.
• Fresh vegetables and fruits are your best bet. Take advantage of the huge selection of fruits and vegetables. Love cabbage - white, cauliflower, Brussels sprouts, broccoli.
Pain in the sternum when inhaling on the left

The pre-infarction state in most cases is associated with a deterioration in the nutrition of the heart muscle - the amount of blood that circulates through the coronary vessels decreases significantly or stops altogether. Such a period can last from several hours to two to three weeks - it all depends on the age and health of the sick person. It is believed that this condition ends with a heart attack, but with the right and timely help, this can be avoided.

Preinfarction state: symptoms. In order to notice such a deviation in a person, it is necessary to know all the signs that may arise.

Symptoms of a pre-infarction state begin with an attack of angina pectoris. In this case, there is a burning sensation and severe pressing pain in the sternum. Pain syndrome occurs periodically, and lasts an average of two to six minutes, although in the presence of progressive diseases of the cardiovascular system, this time may increase. The pain, as a rule, spreads to neighboring areas - it gives to the arm, shoulder blade, side, neck, lower jaw and even the tongue. Unlike pain relief with nitroglycerin is almost impossible.

In this condition, blood pressure may rise, although this does not always happen. The person complains about the skin becoming pale. There are also effects on the part of the nervous system - the patient has a terrible attack. As a rule, people in this state are afraid to even move.

A pre-infarction state with an atypical course is also known. In this case, there is no pain. The patient suffers from insomnia, often complains of increased fatigue, dizziness, chronic fatigue and excessive irritability. A person is always tormented by shortness of breath - even in a state of complete rest. The skin becomes bluish in color.

A pre-infarction state occurs in people prone to heart disease, but in most cases the cause is an external factor - for example, frequent stress, physical overstrain, severe fear, drinking large amounts of alcohol or drugs - it is these actions that stimulate the development of a heart attack.

Pre-infarction condition: first aid rules. An attack of angina pectoris requires immediate help. First you need to lay a person, provide him with peace and fresh air. The loan should be given to him some kind of drug that will expand the coronary vessels and resume the blood supply to the myocardium. It can be nitroglycerin, valocardin, validol. In some cases, you can take an aspirin tablet, as this agent thins the blood, prevents the formation of blood clots, and, therefore, facilitates the flow of blood through the vessels. Of course, it is strictly forbidden to take several pills at once, and even in large doses, as you can provoke fainting and even collapse.

As soon as the attack ends, you must immediately go to the hospital to prevent a second attack and stop the degeneration of the heart muscle. If, despite taking the pills, the pain syndrome does not go away, you should immediately call a team of paramedics.

Treatment should be carried out only in a hospital, where the patient will be constantly monitored. For this purpose, anticoagulants and antispasmodic drugs are used to help eliminate the cause of blockage of the coronary vessels. To eliminate the pain syndrome, the patient is usually injected with nitroglycerin intravenously.

It should be understood that if an angina attack is over, this does not mean at all that you are safe. You should also be wary if such attacks are repeated constantly - at first only during physical and emotional stress, and then at rest. It is better to once again seek medical advice.