Heart attack - danger sign one of the many vascular and myocardial diseases that annually cause the death of more than 17 million of the world's population. The paroxysmal nature and suddenness of its manifestations not only make early detection of the disease difficult, but also often deprive the patient of the opportunity to get to a medical facility.

First aid for heart attack and a timely call to an ambulance can save a person: most deaths from this disease occur in the first hours after the onset of symptoms.

A heart attack is a pathology that occurs as a result acute shortage blood supply to the myocardium. Termination of admission nutrients and oxygen is most often associated with thrombosis or spasm of the area coronary artery near atherosclerotic plaques. Cardiac ischemia - a decrease in tissue supply due to weakening or complete cessation of blood flow - leads to its necrosis. This phenomenon is called myocardial infarction.

TO characteristic features heart attack include:

• Occurs during night sleep or early morning.
• Increased likelihood of development after psycho-emotional stress(funeral, stressful situation, conflict) and with an increase in blood pressure.
• Dependence of risks of occurrence on quantity physical exercise in the next few hours before the attack (chest pain can appear not only during exercise, but even at night after a busy day).
• Occurs when the body is dehydrated (being in a bathhouse, on a hot street or in a heated room, using diuretics) or in the next 12 hours after excessive consumption of alcoholic beverages.

To the group increased risk Experts attribute manifestations of a heart attack to the following reasons:

How to recognize a heart attack?

Signs of a heart attack in women are less obvious, so first aid is often too late for them. Symptoms of cessation of blood supply to myocardial tissue in male patients are in most cases more pronounced: there is a clear indication of the localization of the pathology pressing pain, discomfort. In women, due to the specificity of pain perception and the location of ischemic foci clinical picture may be limited to difficulty breathing, dizziness and dull ache in the upper body, arm, or neck. The decision to call an ambulance is made too late, after the full picture of ischemia and infarction has developed, and the effectiveness of the fibrinolytic drug is reduced.
Despite this, on average, men are much more likely to die from the consequences of a heart attack. Doctors suggest that this distribution and more old age patients are associated with hormonal levels.

Women are more susceptible to blockage small vessels, and representatives of the stronger sex – thrombosis of the main coronary arteries.

How to determine the causes of chest pain

The first signs of a heart attack can be disguised as other diseases - osteochondrosis, intercostal neuralgia, gastric ulcer, inflammation of the pancreas or gall bladder. How to recognize a heart attack in time and what to do if the symptoms are not obvious?

Possible causes of pain in thoracic region and their signs.

What should you not do if you have a heart attack?

A patient with symptoms of ischemia and angina pectoris is strictly prohibited from doing the following:

• Stand up abruptly, move around, eat, drink coffee and tea, and smoke until medical personnel arrive.
• Take acetylsalicylic acid when peptic ulcers Gastrointestinal tract and taking the drug during the day.
• Use nitroglycerin and its analogues when systolic pressure below 100 mmHg, severe weakness, dizziness, sweating and signs of stroke (head pain, aphasia, loss of coordination and clarity of vision, epileptic seizure).

Algorithm of actions for first aid

First aid for a heart attack at home should aim to alleviate or prevent the deterioration of the patient’s condition. It is necessary to strictly follow the algorithm of pre-medical actions:

If the symptoms disappear, this does not mean that the heart is healthy again. It is necessary to immediately call a doctor at home and then follow his recommendations, especially during the patient’s first attack.

1. If the pain persists 5 minutes after taking the medicine, re-put the nitrate capsule/tablet under the tongue and urgently call a team emergency care. If a new dose of the drug does not help after 10 minutes, repeat the action a third time.

If the necessary medications are not available, and the pain does not go away after 5 minutes, it is necessary to urgently call the doctors and not too tightly tighten the thighs (20 cm from the groin) and arms (10 cm from the shoulder) with tourniquets for 15-20 minutes. Waiting for " ambulance“, you need to monitor the patient’s breathing and pulse. In case of cardiac arrest, indirect massage through the sternum and artificial respiration are performed.

What needs to be done before the doctor arrives

In addition to providing first aid for a heart attack, which should be done as soon as possible, the attending physician will need information and documents such as:

• a list of medications taken by the patient the day before;
• a list of medications that cause allergies in the patient;
• all available ECG records, certificates and extracts from hospitals, arranged in chronological order.

Information about the patient’s age, location and intensity of pain, accompanying symptoms The medications taken to stop the attack and their dosages are also transmitted to the dispatcher when calling the team, along with the home address or maximum accurate description locations.

For hospitalization, a patient needs his documents ( medical information, policy and passport), hygiene items, change of linen and shoes.

A heart attack can happen at any time: at home, in transport, in a store or on the street. Timely recognition of symptoms and provision of emergency care before doctors arrive reduces the risk of death from a heart attack.

Characteristic signs (symptoms) of a heart attack (myocardial infarction):

• Sudden (paroxysmal) pressing, squeezing, burning, aching pain in the chest (behind the sternum) lasting more than 5 minutes;
• Similar pains are often observed in the area of ​​the left shoulder (forearm), left shoulder blade, left half of the neck and lower jaw, both shoulders, both arms, the lower part of the sternum along with top part belly;
• Lack of air, shortness of breath, severe weakness, cold sweat, nausea often occur together, sometimes following or preceding discomfort/pain in the chest;
• It is not uncommon for these manifestations of the disease to develop against the background of physical or psycho-emotional stress, but more often with some interval after them.

Not characteristic features which are often confused with a heart attack:

• Stitching, cutting, pulsating, boring, constant aching pain for many hours and not changing its intensity in the heart area or in a specific clearly defined area chest.

Algorithm of urgent actions:

If you or someone else suddenly has the above characteristic signs of a heart attack, even at mild or moderate intensity, and lasting more than 5 minutes. – don’t hesitate, call an ambulance immediately. Do not wait more than 10 minutes - in such a situation it is life-threatening.

If you have symptoms of a heart attack and there is no way to call an ambulance, then ask someone to take you to the hospital - this is the only right decision. Never drive yourself unless complete absence another choice.

In the most optimal option if a heart attack occurs, you must follow the instructions received from your doctor; if there are no such instructions, then you must follow the following algorithm:

• Call an ambulance;
• Sit (preferably in a chair with armrests) or lie in bed with the head of the bed raised, take 0.25 g of acetylsalicylic acid (aspirin) (chew the tablet, swallow) and 0.5 mg of Nitroglycerin (put the tablet/capsule under the tongue, first bite the capsule, do not swallow); free your neck and provide fresh air (open the vents or windows);
• If after 5-7 minutes. After taking acetylsalicylic acid (aspirin) and nitroglycerin, pain persists, you need to take nitroglycerin a second time.
• If after 10 min. after taking the second dose of nitroglycerin, the pain persists, it is necessary to take nitroglycerin a third time;
• If after the first or subsequent doses of nitroglycerin there is severe weakness, sweating, shortness of breath, you need to lie down, raise your legs (on a bolster, etc.), drink 1 glass of water and then, as with a severe headache, do not take nitroglycerin;
• If the patient has previously taken medicines lowering blood cholesterol levels from the statin group (simvastatin, lovastatin, fluvastatin, pravastatin, atorvastatin, rosuvastatin) give it to the patient usual dose and take the drug with you to the hospital.

ATTENTION! A patient with a heart attack is strictly forbidden to get up, walk, smoke or eat until specifically authorized by a doctor.

Do not take aspirin (acetylsalicylic acid) if intolerance to it ( allergic reactions), as well as with obvious exacerbation of gastric and duodenal ulcers.

Nitroglycerin should not be taken if severe weakness, sweating, as well as severe headache, dizziness, acute impairment of vision, speech or coordination of movements.

REMEMBER!

• That only caused in the first 10 minutes. from the onset of a heart attack ambulance medical care, allows full use of modern highly effective methods inpatient treatment and reduce mortality from these diseases many times;
• What is aspirin ( acetylsalicylic acid) and nitroglycerin taken in the first minutes can prevent the development of myocardial infarction and significantly reduce the risk of death from it;
• What's the condition alcohol intoxication is not a reasonable basis for delaying calling an ambulance in the event of a heart attack - about 30% of people who died suddenly at home were intoxicated;
• What indoor massage cardiac examination, carried out in the first 60-120 seconds after sudden cardiac arrest, allows up to 50% of patients to be brought back to life.

Signs of a heart attack include pain in the chest area, which may radiate to left hand, shoulder blade, hands, left half neck and lower jaw, both arms, shoulders, top part belly. The pain can be pressing, squeezing, burning or intense aching. If the pain is characterized as stabbing, cutting, aching, intensifying when changing body position or breathing, then we cannot talk about staging accurate diagnosis heart attack. Often the pain may be accompanied by weakness, shortness of breath, and severe sweating. The pain is felt for more than 5 minutes.

First aid for a heart attack

1.Accept sitting position, it is best to lie in bed so that the head of the bed is raised, or sit in a chair with armrests;

2. It is necessary to free the neck and give access fresh air. You can open a window or vents;

3.Give the patient aspirin and nitroglycerin. If severe weakness, sweating, shortness of breath or a sharp headache appears after taking nitroglycerin, the patient should be laid down, legs raised (on a pillow, cushion, etc.), given 1 glass of water, and no longer take the medicine. If the pain disappears and the condition improves after taking medications, you must call a doctor and follow his instructions;

4.If the pain persists, then you still need to take nitroglycerin and call an ambulance. If 10 minutes after taking nitroglycerin for the second time, the pain does not subside, then you need to take it a third time.

What not to do if you have a heart attack

1. A person with a heart attack should not get up, walk, smoke, or eat until the doctor’s permission;

2. If you are intolerant to aspirin or you took it that day, then you should not take it. Also, aspirin should be avoided if the problem is clearly aggravated. peptic ulcer stomach and duodenum;

3.If blood pressure blood levels are low if there is severe weakness, sweating, and severe headache, dizziness, acute disorder speech, vision or coordination of movements, then you should not take nitroglycerin.

Waiting for an ambulance

While you are waiting for the ambulance to arrive, provide first aid: make sure that the patient is sitting or lying down. Free the patient from constrictive clothing and do not leave him unattended until doctors arrive.

It is more difficult to provide first aid for a heart attack if the person has lost consciousness. First of all, you need to check your pulse and breathing. To do this, you need to approach the patient’s mouth and nose with your cheek, feel his breathing and at the same time you need to monitor the movements of the chest. Try to feel your pulse carotid artery, which is located just under the jaw on the side of the neck.

If a person's heart has stopped and you cannot feel them breathing, you need to perform cardiopulmonary resuscitation (CPR). By performing indirect body massage, even without the skills, you can save a person’s life. If CPR is not performed, a person’s chances of surviving cardiac arrest decrease by 7-10% every minute. Thanks for what was done on time indirect massage heart, you can double or even triple the chances of your heart working again.

Before the arrival of the ambulance, you need to prepare all the medicine packages or the medicines themselves taken by the patient the day before; scroll medicines, which can cause allergies in the patient or are intolerable to him. If there are films with recordings of electrocardiograms, then you need to arrange them in order, if time allows, according to the dates of their recording. If you found any medical documents(extracts, certificates), it is also advisable to arrange them in chronological order.

No one is immune from a heart attack, but since this critical condition most often develops in middle-aged and elderly people, it is this category of the population that needs to be especially vigilant. It is useful to know the signs of a myocardial infarction and the actions that need to be taken to provide emergency assistance.

Heart attack (or myocardial infarction, MI) is a disease from a clinical group called ischemic disease hearts. During the development of this pathology, necrotic damage to the myocardium develops, caused by partial or complete cessation of blood circulation.

During the development of a heart attack, there are four stages, of which the largest is clinical significance has the most acute (lasts the first 6 hours from the onset of MI) and acute (its duration is 12-14 days from the onset of the attack). (According to wikipedia.org).

When MI develops, it is very important to promptly initiate appropriate treatment. To do this, the pathology with characteristic symptoms. In some cases, first aid can save the patient’s life, so it is important to know the basic steps that need to be taken before doctors arrive.

Video: Heart attack || How to recognize and provide first aid in case of a heart attack?

Heart Attack Symptoms

A heart attack is a life-threatening emergency that requires quick action. Even minor symptoms of a heart attack should not be ignored. Immediate treatment reduces damage to the heart and saves lives.

Characteristic symptoms

They vary from person to person. Not all heart attacks begin with the sudden, crushing chest pain that victims most often report. In some cases, no symptoms occur, especially when the patient is diagnosed with diabetes.

Most often, pain and discomfort occurs that extends beyond the chest and spreads to other parts of the upper half of the body (one or both arms, back, neck, abdomen, teeth and lower jaw).

The clinical picture of a heart attack may begin slowly, with a feeling of mild pain and discomfort in the chest. Sometimes it happens that the patient rests or performs physical activity and suddenly feels sharp pain in the area of ​​the heart. The severity of signs of MI largely depends on the age, gender and health of the patient.

Warning Symptoms

Usually defined:

• Chest discomfort, felt as pressure, fullness, or squeezing pain, lasts more than a few minutes or goes away and returns.
• Unexplained shortness of breath or a feeling of difficulty taking a full breath, with or without chest discomfort

Additional symptoms may include:

• Cold sweat
• Fear of death
• Pale skin
• Fast and weak heartbeat
• Nausea or vomiting
• Dizziness, weakness
• Anxiety, upset stomach.

Women are more likely than men to have additional symptoms, such as neck, shoulder, upper back, or abdominal pain.

Symptoms of a heart attack that may occur a month before it occurs

Chronic stress and a busy work schedule contribute to the development of a heart attack. But prevention emergency is a separate topic, so now only the signs by which you can recognize an approaching threat will be indicated.

1. Fatigue and “eternal drowsiness” - when the blood vessels are excessively and long time taper, central nervous system is the first to react to a lack of oxygen, since it is very sensitive to this. At the same time, signs such as drowsiness, melancholy, and fatigue appear, occurring for no apparent reason.
2. Shortness of breath - if the heart begins to work incorrectly due to lack of oxygen, then the normal process of gas exchange in the lungs is also disrupted. Therefore, dysfunction cardiovascular system immediately affects the activity of the lungs and is most often expressed in intermittent breathing.
3. Attacks of “cold” - some patients experience a feeling of cold throughout the body a few days before a heart attack, they were frozen and it seemed that the flu was developing. In such cases, an important difference from infectious disease- temperature is within normal limits. If this has been observed in close relatives, then you need to visit a cardiologist without delay.

First aid for a heart attack

If a person experiences chest discomfort or other symptoms of a heart attack in a loved one, they should immediately call emergency medical services. While the first instinct may be to rush the heart attack victim to the hospital, it is better to receive or provide emergency assistance at the scene. At the same time, emergency medical personnel can begin treatment while en route to a medical facility. They are trained to provide resuscitation if a person's cardiac activity stops (heart stops).

If you cannot contact an ambulance, you need to take the victim to the hospital. If the victim is you yourself, you need to go to the hospital if there is no other way out.

In many cases, treatment is delayed because doubts arise as to whether a heart attack has actually occurred? Often, victims in such cases do not want to worry or worry about their friends and relatives.

It is important to remember that a heart attack is a critical condition, so it is always better to worry once again, but be safe than to be sorry later.

Acting quickly can save lives. If necessary medications will be used as quickly as possible after the development of the first symptoms, the risk of death and occurrence of various complications. In particular, drugs are used to thicken the blood and widen the arteries, which can stop the progression of a heart attack, and even a closed blood vessel can open when catheterized with a stent inserted.

The longer the time passes from the onset of the attack to treatment, the lower the chances of survival, since the degree of damage to the heart becomes more severe.

About half of those who die from heart attacks seek help an hour or more after the onset of the clinical picture.

First aid provided in case of a heart attack before the arrival of doctors:

• You need to try to make the injured person calm down.
• The patient needs to be laid down or seated.
• If a person is not allergic to aspirin, chew or swallow the appropriate dose, usually 0.3 g. (Aspirin works faster if you chew it rather than swallow it whole).
• Nitroglycerin, which should be taken in a dose of 0.5 g, can improve blood circulation.
• If the patient stops breathing, a person nearby who is appropriately qualified or skilled should immediately perform cardiopulmonary resuscitation (CPR). If you don't know how to perform CPR, an ambulance operator can help with it before the medical team arrives.

First aid to yourself when there is no one around

During a heart attack, people are often left alone with themselves and at such moments it is extremely difficult to reach anyone. A person can be at home, in the evening on a deserted street, or somewhere on the road in a car. In this case, it may happen that the phone is discharged, and there is no one nearby at all.

It is important to know that only a few minutes can pass from the moment a myocardial infarction begins to loss of consciousness due to lack of oxygen, and during this time you need to improve your condition enough to get to the nearest hospital.

To slow down the development of myocardial infarction, you need to do the following:

1. Actively cough - before doing this, you need to take a deep breath and then cough just as deeply, approximately every two seconds for several minutes. This action will allow the lungs to fill with oxygen and restore normal cardiac activity. Ideally, this coughing should be done before the ambulance arrives.
2. It is important not to panic, but to try to calm down and relax, although with MI, on the contrary, the fear of death is often overcome. But anxiety only contributes to the narrowing of blood vessels and poor circulation (since during stress, adrenaline is released, which narrows the arteries), so this will only worsen the course of the attack.
3. You should definitely try to call an ambulance or turn to someone for help. In such cases, there is no shame in even knocking on closed windows and doors, since life depends on it.
4. If you have aspirin and nitroglycerin with you, then you need to take them in a dose of 0.3 and 0.5, respectively. It is better not to use other heart medications, as there is a risk of only worsening the course of the disease.

Cardiopulmonary resuscitation

CPR or cardiopulmonary resuscitation is an emergency life-saving procedure performed when the heart stops beating or breathing stops.

Immediate CPR can double or triple your chances of surviving cardiac arrest. This procedure is especially necessary when there is no other medical equipment like a defibrillator to start the heart.

Preserving blood circulation - even partial - increases the possibilities for successful resuscitation while waiting for medical personnel to arrive on the scene.

CPR is a critical step in the chain of survival as outlined by the world's cardiology organizations. Today, there are five links in the out-of-hospital chain of survival for adults:

1. Determining cardiac arrest and calling an ambulance.
2. Early CPR with emphasis on chest compressions.
3. Rapid defibrillation.
4. Basic and emergency medical services.
5. Active life support and care after cardiac arrest.

A well-organized chain of survival can reduce the risk of death and improve the patient's recovery process after cardiac arrest.

Most reliable way performing CPR- use of an automated external defibrillator (AED). The devices can significantly increase a victim's chance of survival after a heart attack. To minimize defibrillation time in cardiac arrest patients, preparation for the procedure should not be limited to trained individuals (although training is still recommended).

Performing CPR

There are two widely known ways to perform CPR:

1. For medical workers and trained persons: traditional CPR using chest compressions and mouth-to-mouth breathing at an appropriate ratio of 30:2. In adults suffering from cardiac arrest, rescuers should be required to perform chest compressions at a rate of 100 to 120/ min and to a depth of at least 5 cm for the average adult, avoiding excessive depth of chest compression (6 cm). Otherwise, complications such as rib fractures, etc., may occur.
2. For people who witness an adult fall suddenly: CPR is performed using hands-on compressions only. Hands-Only CPR is mouth-to-mouth CPR without breathing. This method is recommended for use by people who have seen an adult fall suddenly in a non-hospital setting (eg, at home, at work, in a park, or other public place).

Hands-Only CPR consists of two simple steps:

1. You need to call an ambulance or send someone for medical workers.
2. The victim should be placed on a flat surface with the CPR provider's hands placed in the center of the chest and rhythmic pressure applied back and forth.

CPR can be performed by anyone, including bystanders who happen to be near the victim. There are five important components successful CPR:

1. Minimize interruptions when pressing on the chest.
2. Carrying out chest compressions at an adequate speed and to the required depth (in adults, 5-6 cm).
3. Avoid leaning on the victim between compressions.
4. Ensuring proper hand placement.
5. Prevention of overactive ventilation.

Thus, even unprofessional CPR can, in some cases, keep a person in a state acceptable for revival.

It is important to prepare in advance for a heart attack

No one can plan for a heart attack or know where or how it will happen, so it's best to be prepared in advance. This is especially true for those people who have an increased risk of developing myocardial infarction. Steps you can take before symptoms begin include:

• Memorize a list of heart attack symptoms and warning signs.
• Remember that you need to call an ambulance within 5 minutes after the attack begins.
• Talk to family and friends about warning signs and the importance of immediate call ambulance.
• Know your risk factors and do everything you can to reduce them.
• Create an immediate response plan for a heart attack that includes information:
  • about the medications you need to take;
  • about possible allergic reactions;
  • about the telephone number of the attending physician;
  • about all relatives who need to be contacted if you have to go to the hospital.

You need to store this information in your wallet or other quickly accessible place.

Additionally, you need to think about your wards in advance and talk with those who can take care of them if an emergency arises.

Video: HOW TO RECOGNIZE AND PREVENT A HEART ATTACK IN A MONTH

An emergency condition, unfortunately, cannot always be identified. Probably each of us has at one time or another encountered similar situation: a man lies on the ground, and a crowd passes by him indifferently. A rare passer-by calls an ambulance, and the rest label the person who is lying down as having too much alcohol.

However, such a “dream” may actually be a loss of consciousness due to an unexpected emergency, and in front of you lies a person who is on the verge of life and death who requires immediate medical attention.

Unfortunately, very often such terrible attacks catch people in the most “inappropriate” places, and it is extremely important that each person is not indifferent to the other and is able to detect in time this state and provide the necessary first aid.

Emergency conditions is a set of symptoms in a person that requires immediate emergency medical care and, often, hospitalization. This process can momentarily cause deterioration in health. The greatest danger of an emergency condition is that without timely assistance, death often occurs.

Conditionally emergency conditions are divided into:

• External - they are caused by any environmental influences;
• Internal – caused by pathologies occurring inside the body.

This classification is relative because large number pathological processes may be the result external influence, and their rapid development(which happens very often) is caused by external factors.

Emergency medical care

In case of an emergency, it is extremely important to quickly provide emergency medical care - a set of manipulations necessary to carry out in case of sudden illnesses that have a risk of death.

Emergency and emergency medical care differences

It should be noted that despite the similar names, these types of assistance are different.

Emergency medical care is required for such diseases or conditions when the patient’s life is in serious danger. Everyone must provide it medical institutions, urgently.

Emergency medical care, in turn, is also required in dangerous situations of the patient, but in those that do not pose a direct threat to human life. It belongs to the primary health care and ends up in hospitals.

What conditions are considered emergencies?

In medicine, there are a huge number of severe cases that require immediate intervention, states. The most famous and frequently encountered are:

• myocardial infarction;
• ischemic stroke;
• blood loss;
• poisoning with toxic substances;
• epilepsy;
• injuries;
• peritonitis.

Despite various manifestations of these diseases, they have the same mechanism of action on human body. Emergency conditions trigger a response defensive reaction body, which leads to a rapid disruption of its functionality.

Attention. One of immune mechanisms is vasoconstriction. It stops blood circulation in almost all internal organs(except for the heart, brain and lungs), which leads to disruption of tissue function and accelerates the approach of death.

In a situation where acute pathological process occurs in the brain, due to lack of oxygen, the death of neurons responsible for the functions of the cardiovascular and respiratory systems, which seriously threatens the patient’s life.