It's called a heart attack. Symptoms and methods of treatment of acute myocardial infarction. Types of myocardial infarction

Myocardial infarction is a focus of necrosis of the heart muscle that develops against the background of an acute circulatory disorder in the coronary arteries. If we talk about myocardial lesions in general, infarction is the most common pathology. This condition is a direct indication for hospitalization of the patient in a specialized department, since without the provision of qualified medical care it can lead to death.

Considering the danger of pathology, it is better to prevent it than to treat it. That is why, if you suspect heart disease (IHD) or other disorders of the heart, it is important to immediately seek help from a specialist in order to prevent the formation of a disease such as myocardial infarction.

Causes

To understand what a heart attack is, it is extremely important to understand the reasons that cause it. One of the most important reasons against which this condition develops can be confidently called atherosclerosis. This is a disease whose pathogenetic basis is a violation of fat metabolism in the body.

Against the background of excess cholesterol and lipoproteins, they are deposited in the lumen of blood vessels with the formation of characteristic plaques. In case of blockage of the coronary arteries, a heart attack occurs. In more detail, there are three main components of atherosclerosis, which can cause circulatory disorders in the coronary arteries, namely:

Narrowing of the lumen of blood vessels as a result of the deposition of plaques on their walls. This also leads to a decrease in the elasticity of the vascular wall.
Vasospasm, which can occur due to severe stress. In the presence of plaques, this can lead to acute coronary circulatory disorders.
Separation of plaque from the vascular walls can cause arterial thrombosis and, worse, myocardial infarction (damage).

Thus, atherosclerosis is the main cause of myocardial infarction, which is a rather dangerous condition and must be corrected.

The risk of developing a disease such as a heart attack is significantly increased by the following factors:

Bad heredity. Pathologies of the cardiovascular system in close relatives play a role.
Poor nutrition and sedentary lifestyle. These factors lead to the formation of a condition such as obesity in a person.
Obesity. Excess fat leads to direct deposition of plaques on the walls of blood vessels.
Bad habits. Drinking alcohol and smoking lead to vasospasm.
Endocrine disorders. Patients with diabetes are more prone to changes in cardiac circulation. This is due to the negative effect of this disease on blood vessels.
A history of heart attacks.

Blood pressure disorders, manifested by persistent hypertension, and constant stress can also cause a heart attack.

Symptoms

The symptoms of myocardial infarction directly depend on its stage. During the damage stage, patients may not have any complaints, but some have unstable angina.

In the acute stage, the following manifestations are observed:

Severe pain in the heart area or behind the sternum. Irradiation is possible. The nature of the pain varies from person to person, but most often it is pressing. The severity of pain directly depends on the size of the lesion.
Sometimes there is no pain at all. In this case, the person turns pale, blood pressure rises greatly, and the heart rhythm is disturbed. Also, with this form, the formation of cardiac asthma or pulmonary edema is often observed.
At the end of the acute period, against the background of necrotic processes, there may be a significant increase in temperature, as well as an increase in hypertensive syndrome.

In the case of an erased course, manifestations are completely absent, and the presence of a problem can only be suspected when an ECG is performed. This is why it is so important to undergo preventive examinations from specialists.

It should be said about atypical forms of the acute period. In this case, the pain syndrome may be localized in the throat or fingers. Very often, such manifestations are typical for older people with concomitant cardiovascular pathologies. It is worth noting that an atypical course is possible only in the acute stage. Subsequently, the clinical picture of myocardial infarction in most patients is the same.

In the subacute period, with myocardial infarction, gradual improvement occurs, the manifestations of the disease gradually become easier, until they disappear completely. Subsequently, the condition normalizes. There are no symptoms.

First aid

Understanding what it is - the occurrence of myocardial infarction, it is important to realize that first aid plays an important role. So, if you suspect this condition, it is important to take the following steps:

Call an ambulance.
Try to calm the patient down.
Ensure free access of air (get rid of tight clothing, open the windows).
Place the patient in bed so that the upper half of the body is higher than the lower half.
Give a nitroglycerin tablet.
If you lose consciousness, begin performing cardiopulmonary resuscitation (CPR).

It is important to understand that the disease called myocardial infarction is a life-threatening condition. And the development of complications and even the life of the patient depends on the correctness of first aid, as well as the speed of initiation of medical measures.

Classification

Heart attacks are classified according to the following criteria:

Size of the lesion.
Depth of damage.
Changes in the cardiogram (ECG).
Localization.
Presence of complications.
Pain syndrome.

Also, the classification of myocardial infarction can be based on stages, of which four are distinguished: damage, acute, subacute, scarring.

Depending on the size of the affected area - small- and large-focal infarction. It is more favorable to involve a smaller area, since complications such as cardiac rupture or aneurysm are not observed. It is worth noting that, according to studies, more than 30% of people who have suffered a small-focal heart attack are characterized by transformation of the hearth into a large-focal one.

According to ECG abnormalities, two types of disease are also noted, depending on whether there is a pathological Q wave or not. In the first case, instead of a pathological wave, a QS complex may form. In the second case, the formation of a negative T wave is observed.

Considering how deep the lesion is located, the following types of disease are distinguished:

Subepicardial. The affected area is adjacent to the epicardium.
Subendocardial. The affected area is adjacent to the endocardium.
Intramural. An area of necrotic tissue is located inside the muscle.
Transmural. In this case, the muscle wall is affected to its entire thickness.

Depending on the consequences, uncomplicated and complicated types are distinguished. Another important point on which the type of heart attack depends is the localization of pain. There is a typical pain syndrome localized in the heart or behind the sternum. In addition, atypical forms are noted. In this case, the pain can radiate (give) to the shoulder blade, lower jaw, cervical spine, and abdomen.

Stages

The progression of myocardial infarction is usually rapid and cannot be predicted. Nevertheless, experts identify a number of stages that the disease goes through:

Damage. During this period, there is a direct disruption of blood circulation in the heart muscle. The duration of the stage can range from one hour to several days.
Spicy. The duration of the second stage is 14-21 days. During this period, the beginning of necrosis of some of the damaged fibers is noted. The rest, on the contrary, are being restored.
Subacute. The duration of this period varies from several months to a year. During this period, the final completion of the processes that began in the acute stage occurs, with a subsequent decrease in the ischemic zone.
Scarring. This stage can continue throughout the patient’s life. Necrotic areas are replaced by connective tissue. Also during this period, in order to compensate for myocardial function, hypertrophy of normally functioning tissue occurs.

The stages of myocardial infarction play a very important role in its diagnosis, since changes in the electrocardiogram depend on them.

Variants of the disease

Depending on the characteristic manifestations, there are several options possible for myocardial infarction, namely:

Anginous. It is characteristic that for myocardial infarction, it is the most common option. It is characterized by the presence of severe pain, which is not relieved by taking nitroglycerin. The pain may radiate to the left shoulder blade, arm or lower jaw.
Cerebrovascular. In this case, the pathology is characterized by manifestations of cerebral ischemia. The patient may complain of severe dizziness, nausea, severe headaches, and fainting. Neurological symptoms make it quite difficult to make a correct diagnosis. The only symptoms of myocardial infarction are characteristic changes on the ECG.
Abdominal. In this case, the localization of pain is atypical. The patient has severe pain in the epigastric region. Characterized by vomiting and heartburn. The abdomen is very swollen.
Asthmatic. Symptoms of respiratory failure come to the fore. Severe shortness of breath is expressed, a cough with foamy sputum may appear, which is a sign of left ventricular failure. The pain syndrome is either completely absent or appears before shortness of breath. This option is typical for older people who already have a history of a heart attack.
Arrhythmic. The main symptom is irregular heart rhythm. The pain syndrome is mild or completely absent. In the future, shortness of breath and a decrease in blood pressure may occur.
Erased. With this option, manifestations are completely absent. The patient does not make any complaints. The disease can be detected only after an ECG.

Given the abundance of options possible for this disease, its diagnosis is an extremely difficult task and is most often based on an ECG examination.

Diagnostics

For this disease, specialists use a number of diagnostic techniques:

Collection of medical history and complaints.
Study of the activity of specific enzymes.
General blood test data.
Echocardiography (EchoCG).
Coronary angiography.

In the medical history and life history, the doctor pays attention to the presence of concomitant pathologies of the cardiovascular system and heredity. When collecting complaints, you need to pay attention to the nature and localization of pain, as well as other manifestations characteristic of the atypical course of the pathology.

ECG is one of the most informative methods for diagnosing this pathology. When conducting this survey, the following points can be assessed:

Duration of the disease and its stage.
Localization.
Extent of damage.
Depth of damage.

At the stage of damage, a change in the ST segment is observed, which can occur in the form of several options, namely:

If the anterior wall of the left ventricle is damaged in the area of the endocardium, the location of the segment below the isoline is observed, in which the arc is directed downward.
If the anterior wall of the left ventricle is damaged in the area of the epicardium, the segment, on the contrary, is located above the isoline, and the arc is directed upward.

In the acute stage, the appearance of a pathological Q wave is noted. If the transmural variant occurs, the QS segment is formed. With other options, the formation of a QR segment is observed.

The subacute stage is characterized by normalization of the location of the ST segment, but the pathological Q wave remains, as well as negative T wave. In the cicatricial stage, the presence of a Q wave and the formation of compensatory myocardial hypertrophy may be noted.

To determine the exact location of the pathological process, it is important to evaluate in which leads the changes are determined. In the case of localization of the lesion in the anterior sections, signs are noted in the first, second and third chest leads, as well as in the first and second standard leads. There may be changes in lead AVL.

Lesions of the lateral wall almost never occur independently and are usually a continuation of damage to the posterior or anterior walls. In this case, changes are recorded in the third, fourth and fifth chest leads. Also, signs of damage must be present in the first and second standard. In case of posterior wall infarction, changes are observed in lead AVF.

A small focal infarction is characterized only by changes in the T wave and ST segment. Pathological teeth are not detected. The large-focal variant affects all leads and reveals the Q and R waves.

When conducting an ECG, the doctor may encounter certain difficulties. Most often this is due to the following characteristics of the patient:

The presence of scar changes causes difficulties in diagnosing new areas of damage.
Conduction disorders.
Aneurysm.

In addition to the ECG, a number of additional studies are required to complete the determination. A heart attack is characterized by an increase in myoglobin in the first few hours of the disease. Also in the first 10 hours there is an increase in an enzyme such as creatine phosphokinase. Its contents return to full normal only after 48 hours. Afterwards, to make a correct diagnosis, it is necessary to evaluate the amount of lactate dehydrogenase.

It is also worth noting that during myocardial infarction there is an increase in troponin-1 and troponin-T. A general blood test reveals the following changes:

Increase in ESR.
Leukocytosis.
Increase in AsAt and AlAt.

EchoCG may reveal impaired contractility of cardiac structures, as well as thinning of the walls of the ventricles. Carrying out coronary angiography is advisable only if occlusive lesions of the coronary arteries are suspected.

Complications

Complications of this disease can be divided into three main groups, which can be seen in the table.

According to the time of occurrence, late and early complications are distinguished. The later ones include the following:

Dressler's syndrome.
Endocarditis.
Chronic heart failure.
Innervation disorders.

In addition to classic complications, gastric ulcers and other acute gastrointestinal pathologies, mental disorders, and others may occur.

Treatment

The first thing to understand is that to achieve maximum effect, treatment must be started as quickly as possible. Initially, reperfusion therapy (thrombolysis, angioplasty) is necessary. The goals of treatment are:

Relief of pain syndrome. Initially, nitroglycerin is used sublingually for this purpose. If there is no effect, intravenous administration of this drug is possible. If this does not help, morphine is used to relieve pain. In order to enhance its effect, it is possible to use droperidol.
Restoring normal blood flow. The effect of the use of thrombolytics directly depends on how early therapeutic measures were started. The drug of choice is streptokinase. In addition to it, it is possible to use urokinase, as well as tissue plasminogen activator.
Additional treatment. Also used for heart attacks are aspirin, heparin, ACE inhibitors, antiarrhythmic drugs and magnesium sulfate.

In any case, therapy for myocardial infarction should be comprehensive and begin as quickly as possible. In the absence of adequate drug therapy, not only the early development of complications, but also death is possible.

If coronary artery disease is diagnosed, surgery may be necessary. Methods such as balloon angioplasty, stenting and bypass surgery are used.

Prevention

Considering the causes of myocardial infarction, one can easily understand that by following preventive measures, the risk of developing the disease is greatly reduced. For the purpose of prevention, the following rules must be observed:

Control your body weight. The main goal is to prevent obesity, since this factor is decisive in the formation of atherosclerosis - one of the main causes of myocardial infarction.
Dieting. Reducing salt intake, as well as reducing the intake of fats from food, can not only reduce the risk of obesity, but also normalize blood pressure.
Maintaining an active lifestyle. Adequate physical activity helps normalize metabolic processes, reduce body weight, and generally strengthen the body. If you have a history of a heart attack or other cardiovascular pathologies, you should consult your doctor about the amount of exercise.
Rejection of bad habits.
Cholesterol control.
Pressure control.
Measuring sugar levels.
Carrying out preventive examinations with a specialist.

Thus, given the etiology of myocardial infarction, we can say with confidence that prevention plays an important role. If you follow the above recommendations, the risk of developing the disease is reduced significantly.

Cardiovascular diseases are practically the first cause of death in many countries. One of the most common pathologies is a heart attack. What kind of disease is this, for what reason does it develop, is it possible to prevent the disease and how to help the patient? We will try to answer all these questions in detail.

Heart attack - what is it?

Almost everyone knows that this is a dangerous condition, but the mechanism and causes of development are not always of interest, although this must be known in order to prevent such a pathology. A heart attack develops as a result of a disruption in the blood supply to areas of the heart muscle.

This pathology is also called one of the forms of the heart. If the blood supply is disrupted for more than 15-20 minutes, then necrosis of living tissue occurs, which is accompanied by severe pain and can be fatal.

Cardiologists note that in the male population, heart attacks occur much more often, because in the female body, estrogens control the level of cholesterol in the blood. If before the development of a heart attack was 55-60 years, now it is relatively younger. Cases of pathology are diagnosed even in young people.

A heart attack does not always end in death for a person, but you need to know that after an incident there is always a scar left on the heart, so many patients become disabled after suffering such a disease.

How does a heart attack develop?

The formation of a heart attack begins long before its manifestation. It all starts with the formation of atherosclerotic plaques, which begin to form in blood vessels from bad cholesterol. The culprits of its appearance in the blood are dietary errors and a sedentary lifestyle. These plaques gradually narrow the lumen of the blood vessels, disrupting normal blood circulation.

The process gradually worsens, the plaques become so large that any pathological impact on them leads to rupture. At this point, the blood coagulates, forming a blood clot, which clogs the vessel, preventing blood from passing further. This is exactly the process that occurs in the heart area during a heart attack.

Reasons for the development of pathology

If a heart attack develops, the causes may be different, but the main one is the cessation of blood flow to certain areas of the heart muscle. This most often occurs due to:

Atherosclerosis, as a result of which the walls of blood vessels lose their elasticity, the lumen is narrowed by atherosclerotic plaques.
which can occur due to stress, for example, or exposure to other external factors.
Arterial thrombosis, if a plaque breaks off and is carried through the bloodstream to the heart.

Factors that can provoke such conditions include:

Hereditary predisposition to heart pathologies.
High levels of “bad” cholesterol in the blood.
Having a bad habit such as smoking.
Too much body weight.
Arterial hypertension.

Diabetes.
A large amount of fatty foods in the diet.
Chronic stress.
Some doctors also note the influence of psychosomatics, when the cause of a heart attack is excessive aggression and intolerance.
Belonging to the stronger sex.
Low physical activity.
Age after 40 years.

It is necessary to take into account that if there is a combination of several factors, the risk of developing a heart attack increases.

Types of disease

If we look at a pathology such as a heart attack (we have already found out what it is), then cardiologists distinguish several forms of pathology depending on several criteria.

If we consider the stages of the disease, there are four of them, each of which is characterized by its own symptoms. The size of the affected area is also taken into account in the classification. Highlight:

Large-focal infarction, when tissue necrosis covers the entire thickness of the myocardium.
Finely focal, a small part is affected.

By location they are distinguished:

Right ventricular infarction.
Left ventricle.
Interventricular septum.
Side wall.
Rear wall.
Anterior wall of the ventricle.

A heart attack can occur with or without complications, so cardiologists distinguish:

Complicated heart attack.
Uncomplicated.

The localization of pain can also be different, so the following types of heart attacks are distinguished:

Typical form with chest pain.
The atypical form can be manifested by abdominal pain, shortness of breath, heart rhythm disturbances, dizziness and headache. Sometimes a heart attack develops in the absence of pain.

Types of heart attacks are also distinguished depending on the frequency of development:

Primary pathology.
Recurrent
Repeated.

Life after a heart attack will depend on the severity of the pathology, its form and timely assistance provided.

Stages of heart attack development

Necrotic changes in the heart muscle develop in some sequence, therefore the following stages of infarction are distinguished:

Pre-infarction condition. The duration of this period ranges from several hours to several weeks, at which time small foci of necrosis are already forming in the heart muscle, and in their place a heart attack then develops.
The most acute period can last from several minutes to 2 hours. Myocardial ischemia increases.
The acute stage of a heart attack lasts several days. During this period, a focus of necrosis forms in the heart and partial resorption of damaged muscle tissue is observed.
The post-infarction stage can last up to six months; the connective tissue scar is completely formed.

Diagnosis of myocardial infarction

Making a diagnosis begins with a conversation with the patient. The doctor finds out when the pain began, what nature it has, how long it lasts, how the patient relieves heart attacks, and whether there is any result from taking medications.

Then risk factors are necessarily identified; for this, the doctor clarifies the features of lifestyle, culinary preferences, and the presence of bad habits. A family history is analyzed - the doctor finds out if anyone in the family has heart disease, or whether there have been cases of heart attack.

A general blood test is done, it allows you to detect an increased level of leukocytes, a high erythrocyte sedimentation rate, signs of anemia - all this begins to appear when the cells of the heart muscle are destroyed.
A urine test will help detect concomitant pathologies that can provoke heart attacks.
A biochemical blood test is performed to determine:

cholesterol content;
the ratio of “bad” and “good” cholesterol;
presence of triglycerides;
blood sugar levels to assess the risk due to vascular atherosclerosis.

If there is a suspicion of a heart attack, then a study of specific blood enzymes is carried out.

A coagulogram is done; it gives indicators of blood clotting, which help to choose the correct dosage of drugs for treatment.

Diagnosis of myocardial infarction is impossible without electrocardiography. Based on the results, a specialist can determine the localization of the pathology, how long ago it developed and the degree of damage.

An ultrasound examination of the heart is performed to study the structure and size of the heart muscle, to assess the degree of damage to blood vessels by atherosclerotic plaques.

X-rays help identify changes in the thoracic aorta, lungs and detect complications.

Coronary angiography is used to clarify the diagnosis; it allows you to accurately determine the location and degree of vasoconstriction.

With contrast, it allows you to obtain an accurate image of the heart, identify defects in its walls, valves, abnormalities in functioning and narrowing of blood vessels.

After all the research, you may need to consult a therapist.

Only after the diagnosis has been clarified, the patient is prescribed effective therapy, which will help bring life back to normal after a heart attack.

Symptoms of pathology

As a rule, a heart attack does not develop out of nowhere; usually the patient has already been diagnosed with angina or other cardiac pathologies. If a heart attack develops, the symptoms and first signs in women and men may be as follows:

Chest pain becomes more intense and prolonged. The pain has a burning character, squeezing and squeezing is felt, and can radiate to the shoulder, arm or neck.

Irradiation and expansion of the pain zone appears.
The patient cannot tolerate physical activity.
Taking Nitroglycerin no longer gives such an effect.
Even at rest, shortness of breath, weakness and dizziness appear.
There may be discomfort in the stomach.
The heart rhythm is disturbed.
Breathing becomes difficult.
Cold sweat appears, the skin turns pale.

If at least some of the listed symptoms appear, you should urgently call a doctor.

First aid to a patient

If there is a suspicion of a heart attack, the symptoms and first signs in women will only progress if emergency assistance is not provided. It is as follows:

The person must be seated or placed in a comfortable position.

Unfasten tight clothing.
Provide air access.
Give a Nitroglycerin tablet under the tongue, if the attack is severe, then two are possible.
If there is no Nitroglycerin, then you can use Corvalol or Aspirin.

Emergency care for a heart attack will help relieve pain during an attack and reduce the risk of complications.

Complications after a heart attack

It very rarely happens that a heart attack goes away without complications; there are almost always consequences. They reduce life expectancy after suffering from pathology. The most commonly diagnosed complications are:

Heart failure.
Rupture of the heart muscle.
Aneurysm.
Cardiogenic shock.
Heart rhythm disturbances.

Post-infarction angina.
Pericarditis.

A heart attack can also have late consequences, for example:

After a few weeks, post-infarction syndrome may develop.
Thromboembolic complications are common.
Neurotrophic disorders of the nervous system.

Many patients are interested in the question of how long can one live after a heart attack? The answer will depend on several factors: the degree of damage to the heart muscle, the timeliness of first aid, the effectiveness and correctness of therapy, and the development of complications.

According to statistics, about 35% of patients die, most of them, without even reaching a medical facility. Those patients who have suffered a heart attack are most often forced to change their field of activity or leave work altogether; many receive disability.

How to prevent another heart attack or even prevent its occurrence

Everyone now understands about a heart attack that it is a very serious disease that can result in death or leave you disabled. But everything is in the hands of the person himself - if you follow some recommendations, you can significantly reduce the risk of developing this pathology:

Keep your blood pressure level under control at all times, especially if it increases periodically.
Monitor your blood sugar levels.
In summer, avoid being in direct sunlight for long periods of time.
It is necessary to reconsider your diet, reduce the consumption of fatty foods, processed foods and add fresh vegetables and fruits.
Increase physical activity, you don’t have to go to the gym, it’s enough to take walks every day, walk a lot, ride a bike.
If health is more important, then you will have to give up smoking and alcohol abuse, and also not get carried away with coffee.
Keep your weight normal; if you can’t reduce it on your own, you can visit a nutritionist who will help you create an individual nutrition program.
If you have chronic diseases, they need to be treated periodically, especially for heart pathologies and vascular diseases.
If your relatives have been diagnosed with myocardial infarction, then you should take your health more seriously and avoid heavy physical labor.
Every year you need to arrange a good rest for yourself away from the bustle of the city; you can go to the mountains or to the sea coast.
Expose yourself to psycho-emotional stress as little as possible, learn relaxation techniques.
Be regularly examined and take all necessary tests to promptly detect elevated blood sugar or cholesterol levels.

If a heart attack could not be avoided, then every effort must be made to prevent another attack. To do this, you must follow all the doctor’s recommendations, take prescribed medications and change your lifestyle.

Aspirin (acetylsalicylic acid) has been used for decades to prevent thrombosis and coronary artery disease, but long-term use of it can lead to problems with the gastrointestinal tract, such as heartburn, gastritis, nausea, stomach pain, etc.

To reduce the risk of such undesirable consequences, it is necessary to take drugs in a special enteric coating. For example, you can use the drug "Trombo ACC®"*, each tablet of which is coated with an enteric film coating that is resistant to the effects of stomach hydrochloric acid and dissolves only in the intestines. This avoids direct contact with the gastric mucosa and reduces the risk of developing heartburn, ulcers, gastritis, bleeding, etc.

* There are contraindications; before use, you must consult a specialist.

Which is accompanied by a significant insufficiency of coronary blood flow and death (necrosis) of one or another part of the heart muscle. This pathology is much more common in men over 60 years of age, but after reaching 55-60 years of age, it can develop in women with equal probability. Such changes in the myocardium lead not only to significant disturbances in the functioning of the heart, but also in 10-12% of cases threaten the patient’s life. In our article we will introduce you to the main causes and signs of this serious cardiac pathology, and such knowledge will allow you to “recognize the enemy by sight” in time.

Statistics. General information

According to statistics, over the past 20 years, the mortality rate from this disease has increased by more than 60%, and it has become significantly younger. If earlier this acute condition was found among people 60-70 years of age, now few people are surprised by the detection of myocardial infarction in 20-30 year olds. It should also be noted that this pathology often leads to disability of the patient, which makes significant negative adjustments to his lifestyle.

In the event of a myocardial infarction, it is extremely important to immediately seek medical help, since any delay significantly aggravates the consequences of a heart attack and can cause irreparable damage to one’s health.

Causes and predisposing factors

In 90% of cases, myocardial infarction is caused by coronary artery thrombosis, which is provoked by atherosclerosis. Blockage of this artery by a fragment of an atherosclerotic plaque causes a cessation of blood supply to a section of the heart muscle, against the background of which oxygen starvation of the tissues develops, insufficient supply of nutrients to the muscle and, as a result, necrosis of the myocardial section. Such changes in the structure of the muscle tissue of the heart occur 3-7 hours after the cessation of blood flow to the muscle area. After 7-14 days, the area of necrosis is overgrown with connective tissue, and after 1-2 months a scar forms on it.

In other cases, the following pathologies become the cause of myocardial infarction:

spasm of coronary vessels;
thrombosis of coronary vessels;
heart injuries;

Predisposing factors (conditions and diseases that contribute to impaired coronary circulation) also play an important role in the occurrence of myocardial infarction. The following factors significantly increase the risk of developing such an acute condition:

a history of myocardial infarction;
smoking;
adynamia;
obesity;
increased levels of “bad” cholesterol (LDL) in the blood;
postmenopausal age in women;
diabetes;
frequent stress;
excessive physical and emotional stress;
blood clotting disorders;
alcoholism.

Classification

During myocardial infarction, areas of muscle tissue of various sizes may undergo necrosis, and, depending on the size of the lesion, cardiologists distinguish the following forms of this pathology:

finely focal;
macrofocal.

Also, myocardial infarction can be classified depending on the depth of damage to the heart wall:

transmural – the entire thickness of the muscle layer is exposed to necrosis;
intramural – necrosis is located deep in the heart muscle;
subepicardial – necrosis is located in areas where the heart muscle adheres to the epicardium;
subendocardial – necrosis is located in the area of contact between the myocardium and the endocardium.

Depending on the location of the affected areas of the coronary vessels, the following types of infarction are distinguished:

right ventricular;
left ventricular.

Depending on the frequency of occurrence, this heart pathology can be:

primary – observed for the first time;
recurrent - a new area of necrosis appears within 8 weeks after the primary one;
repeated - a new area of necrosis appears 8 weeks after the previous infarction.

Based on clinical manifestations, cardiologists distinguish the following types of myocardial infarction:

typical;
atypical.

Signs of myocardial infarction

Characteristic signs of myocardial infarction are the following manifestations of this heart pathology:

Long-term intense pain, which lasts more than half an hour and does not disappear even after repeated administration of nitroglycerin or other vasodilators.
Most patients characterize the pain as burning, stabbing, tearing, etc. Unlike an attack of angina, they do not subside at rest.
Sensations of burning and squeezing in the heart area.
Pain most often appears after physical or strong emotional stress, but can also begin during sleep or at rest.
The pain radiates (gives) to the left arm (in rare cases, to the right), scapula, interscapular area, lower jaw or neck.
The pain is accompanied by severe anxiety and a feeling of unreasonable fear. Many patients characterize such worries as “fear of death.”
The pain may be accompanied by dizziness, fainting, pallor, acrocyanosis, increased sweating (cold and clammy sweat), nausea, or vomiting.
In most cases, the heart rhythm is disrupted, which can be seen by the patient’s rapid and arrhythmic pulse.
Many patients report shortness of breath and difficulty breathing.

Remember! In 20% of patients, myocardial infarction occurs in an atypical form (for example, pain is localized in the abdominal area) or is not accompanied by pain.

If you suspect a myocardial infarction, you should immediately call an ambulance and begin first aid measures!

Symptoms of a typical myocardial infarction

The severity of symptoms during myocardial infarction depends on the stage of the disease. During its course the following periods are observed:

pre-infarction - not observed in all patients, occurs in the form of exacerbation and increased frequency of angina attacks and can last from several hours or days to several weeks;
acute – accompanied by the development of myocardial ischemia and the formation of an area of necrosis, lasting from 20 minutes to 3 hours;
acute – begins from the moment of formation of a focus of necrosis on the myocardium and ends after the enzymatic melting of dead muscle, lasts about 2-14 days;
subacute – accompanied by the formation of scar tissue, lasts about 4-8 weeks;
post-infarction - accompanied by scar formation and adaptation of the myocardium to the consequences of changes in the structure of the heart muscle.

The most acute period in a typical course of myocardial infarction, it manifests itself with pronounced and characteristic symptoms that cannot go unnoticed. The main symptom of this acute condition is severe pain of a burning or stabbing nature, which, in most cases, appears after physical exertion or significant emotional stress. It is accompanied by severe anxiety, fear of death, severe weakness and even fainting. Patients note that the pain radiates to the left arm (sometimes to the right), neck, shoulder blades or lower jaw.

Unlike pain with angina pectoris, this cardialgia is characterized by its duration (more than 30 minutes) and is not eliminated even by repeated administration of nitroglycerin or other vasodilators. That is why most doctors recommend immediately calling an ambulance if heart pain lasts more than 15 minutes and is not eliminated by taking the usual medications.

Relatives of the patient may notice:

increased heart rate;
(pulse becomes arrhythmic);
severe pallor;
acrocyanosis;
the appearance of cold sticky sweat;
temperature rise up to 38 degrees (in some cases);
an increase in blood pressure followed by a sharp decrease.

IN acute period the patient's cardialgia disappears (pain is present only in the case of inflammation of the pericardium or in the presence of severe insufficiency of blood supply to the peri-infarction zone of the myocardium). Due to the formation of an area of necrosis and inflammation of the heart tissue, the body temperature rises, and the fever can last about 3-10 days (sometimes more). The patient's symptoms of cardiovascular failure persist and increase. Blood pressure remains elevated

Subacute period A heart attack occurs in the absence of heart pain and fever. The patient's condition is normalized, blood pressure and heart rate are gradually approaching normal, and manifestations of cardiovascular failure are significantly weakened.

IN post-infarction period all symptoms completely disappear, and laboratory parameters gradually stabilize and return to normal.

Symptoms for atypical forms of heart attack

In some patients, myocardial infarction begins with acute abdominal pain.

The atypicality of the symptoms of myocardial infarction is insidious in that it can cause significant difficulties in making a diagnosis, and in its painless version the patient can literally endure it on his feet. Characteristic atypical symptoms in such cases are observed only in the most acute period, after which the infarction proceeds typically.

Among the atypical forms, the following symptoms may be observed:

Peripheral with an atypical location of pain: with this option, the pain makes itself felt not in the sternum or in the precordial region, but in the left upper limb or in the tip of the left little finger, in the lower jaw or neck, in the scapula or in the cervicothoracic region spinal column. The remaining symptoms remain the same as in the typical clinical picture of this heart pathology: arrhythmias, weakness, sweating, etc.
Gastric - with this form of heart attack, the pain is localized in the stomach and may resemble an attack of acute gastritis. During an examination of the patient, the doctor may detect tension in the muscles of the abdominal wall, and he may need additional research methods to make a final diagnosis.
Arrhythmic - with this type of heart attack, the patient exhibits atrioventricular blockades of varying intensity or arrhythmias (, paroxysmal tachycardia,). Such heart rhythm disturbances can significantly complicate diagnosis even after an ECG.
Asthmatic - this form of this acute cardiac pathology in its onset resembles an asthma attack and is more often observed in the presence of cardiosclerosis or repeated heart attacks. Pain in the heart is mild or completely absent. The patient develops a dry cough, suffocation increases and develops. Sometimes, the cough may be accompanied by foamy sputum. In severe cases it develops. When examining the patient, the doctor determines signs of arrhythmia, decreased blood pressure, wheezing in the bronchi and lungs.
Collaptoid - with this form of infarction, the patient develops cardiogenic shock, in which there is a complete absence of pain, a sharp drop in blood pressure, dizziness, cold sweat and darkening in the eyes.
Edema - with this form of infarction the patient complains of shortness of breath, severe weakness, and the rapid appearance of edema (even ascites). When examining the patient, an enlarged liver is revealed.
Cerebral - this form of infarction is accompanied by impaired cerebral circulation, which is manifested by confusion, speech impairment, dizziness, nausea and vomiting, paresis of the limbs, etc.
Painless - this form of heart attack occurs against a background of chest discomfort, increased sweating and weakness. In most cases, the patient does not pay attention to such signs, and this significantly aggravates the course of this acute condition.

In some cases, myocardial infarction occurs with a combination of several atypical forms. This condition aggravates the pathology and significantly aggravates the further prognosis for recovery.

The danger of myocardial infarction also lies in the fact that already in the first days after necrosis of a section of the heart muscle, the patient may develop various severe complications:

atrial fibrillation;
sinus or paroxysmal tachycardia;
extrasystole;
ventricular fibrillation;
cardiac tamponade;
pulmonary thromboemolius;
acute cardiac aneurysm;
thromboendocarditis, etc.

Most deaths after myocardial infarction occur in the first hours and days after the development of this acute form of coronary heart disease. The risk of death largely depends on the extent of damage to myocardial tissue, the presence of complications, the age of the patient, timeliness and concomitant diseases.

How the human heart works. Myocardial infarction.

Myocardial infarction

What is myocardial infarction

Myocardial infarction is a clinical form in which an acute disruption of the blood supply occurs and, as a result, necrosis (infarction, necrosis) of a section of the heart muscle, accompanied by impaired circulation.

Myocardial infarction in 90% of cases occurs due to long-term progression. Men aged 42-67 years are most often affected. The heart is supplied with blood through the right and left coronary arteries, which arise from the base of the aorta. As a result, the vessels form plaques that block the lumen of the coronary arteries.

Normally, the coronary arteries, due to their expansion, are capable of increasing coronary blood flow 5-6 times to compensate for physical activity and stress. When the arteries narrow, this compensatory mechanism does not work: any load leads to oxygen “starvation” (ischemia) of the myocardium.

Myocardial infarction can develop without load, with a sharp blocking of coronary blood flow, for example, with rupture and thrombosis of an atherosclerotic plaque, as well as with a sharp spasm of the coronary artery.

Clinical signs of a heart attack appear if the lumen of the artery decreases by more than 80%. Necrosis of the bloodless myocardium occurs 30-90 minutes after the cessation of blood supply. Therefore, doctors have only 1-2 hours to prevent the death of the heart muscle using drugs and/or intervention aimed at opening the blocked artery. Without this, irreversible damage develops - myocardial necrosis, which forms within 15-60 days.

Myocardial infarction is an extremely dangerous condition, the mortality rate reaches 35%.

Causes of myocardial infarction

In 95% of cases, the disease manifests itself against the background of atherosclerotic lesions of the coronary arteries. In the remaining cases, necrosis develops due to a sharp spasm of the coronary arteries. There are factors that contribute to the progression and increase the risk of developing myocardial infarction:

smoking;
past infections;
low levels of high-density lipoproteins in the blood;
sedentary lifestyle;
elderly age;
poor environmental conditions in the place of residence;
excess body weight;
, ;
history of myocardial infarction;
congenital underdevelopment of the coronary arteries;
long-term use;
oncological diseases.

Symptoms of myocardial infarction

Here are the classic signs of a heart attack:

acute strong pressing, bursting pain behind the sternum, radiating to the neck, left shoulder, between the shoulder blades;
shortness of breath, cough;
feeling of fear;
pale skin;
increased sweating.

Symptoms for atypical forms of myocardial infarction

Abdominal form - characterized by pain in the upper abdomen (episgastric region), hiccups, bloating, nausea and vomiting.

Asthmatic form - occurs after 50 years and is manifested by intense shortness of breath, suffocation, dry and wet, medium and coarse wheezing in the lungs.

Painless form - occurs in 1% of cases, usually in patients with. It manifests itself as weakness, lethargy, and lack of subjective sensations. A previous heart attack is detected by routine electrocardiography (ECG).

The cerebral form is characterized by impaired blood supply to the brain. In 40% of cases it occurs with infarction of the anterior wall of the left ventricle. Clinic: dizziness, impaired consciousness (muscle paresis), disorientation in time and space, loss of consciousness.

The collaptoid form is a manifestation of cardiogenic shock, which is the most dangerous complication of myocardial infarction. Clinic: a sharp drop in blood pressure, dizziness, darkening of the eyes, profuse sweating, loss of consciousness.

The edematous form is manifested by shortness of breath, weakness, edema, accumulation of fluid in the chest and abdomen (ascites), enlargement of the liver and spleen (hepatomegaly) due to increasing right ventricular failure.

The combined form is characterized by various combinations of atypical forms of infarction.

Classification of myocardial infarction by stages

The most acute stage lasts up to 120 minutes from the cessation of blood supply.

The acute stage lasts up to 10 days; at this stage, the heart muscle has already collapsed, but the formation of necrosis has not begun.

The subacute stage lasts up to 2 months. Characterized by the formation of scar tissue (necrosis).

The post-infarction stage lasts up to six months. During this period, the cardiac scar is finally formed, the heart adapts to new operating conditions.

Based on the prevalence of the pathological process, large and small focal infarctions are distinguished.

Large-focal (transmural, or extensive) infarction - damage to a large area of the myocardium. The process is developing very quickly. In 70% of cases, changes in the heart are irreversible. The patient can avoid severe complications of a large-focal infarction, in particular, if medical assistance is provided no later than 3-4 hours.

Small focal infarction - damage to small areas of the heart muscle. It is characterized by a milder course and less pronounced pain syndrome than large-focal. In 27% of cases, a small-focal infarction develops into a large-focal one. Occurs in every fourth patient. The prognosis is favorable, complications occur in 5% of cases, usually with delayed treatment.

Diagnosis of myocardial infarction

The disease is diagnosed using an ECG. Additionally, ultrasound of the heart, coronary angiography, myocardial scintigraphy and laboratory tests are prescribed: complete blood count, cardiotropic proteins in the blood (CF-CK, AST, LDH, troponin).

Treatment of myocardial infarction

At the slightest suspicion of myocardial infarction (retrosternal pain), you need to call an ambulance.

The disease is treated only in a hospital and even in an intensive care unit. Strict bed rest is required for 3-7 days. Then motor activity is expanded on an individual basis. Medicines prescribed include painkillers (Morphine, Fentanyl), antiplatelet drugs (Acetylsalicylic acid, Clopidogrel), anticoagulants (Heparin, Enoxaparin), thrombolytic drugs (Streptokinase, Alteplase), beta-blockers (Propranolol).

The most effective and promising method of treatment is emergency (up to 6 hours) opening of a blocked coronary artery using balloon angioplasty with the installation of a coronary stent. In some cases, urgent coronary artery bypass grafting is performed.

The recovery (rehabilitation) period lasts up to six months. During this time, patients gradually increase physical activity, starting with 10 steps per day. Medicines are taken for life.

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Myocardial infarction– acute form of coronary heart disease. Myocardial infarction occurs when blood flow to one or another part of the heart muscle stops.

Already 15-20 minutes after the cessation of blood flow, irreversible changes begin to develop in the heart muscle. This is commonly called myocardial infarction.

Why does blood stop flowing to one or another part of the myocardium? This occurs when a thrombus (a blood clot formed as a result of blood swirling due to atherosclerotic plaque) blocks the lumen of a coronary vessel.

That is why it is very important to promptly treat atherosclerosis of the coronary arteries, since it is plaques and the blood clots that form due to them that are the fundamental cause of myocardial infarction.

This is vital! If you are worried about any discomfort in the heart area, not to mention pain, immediately make an appointment with our cardiologist. A timely visit and professional diagnosis can literally save your life.

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Myocardial infarction in women

Myocardial infarction in women occurs most often after 50 years, after menopause. Why? The thing is that during this period in a woman’s body the production of specific female sex hormones - estrogens, which protect blood vessels from various harmful factors and prevent the formation of atherosclerotic plaques, is significantly reduced.

Myocardial infarction: symptoms

Symptoms of myocardial infarction depend on the speed of blockage, the diameter of the affected vessel, the degree of myocardial damage and a number of other factors.

The main symptom of myocardial infarction is acute chest pain, which usually occurs during severe physical exertion or emotional distress. The danger is that many people do not associate this pain specifically with the heart, since it is felt somewhat lower, and, as a result, they think that this is a temporary harmless phenomenon that will go away on its own.

Pain during myocardial infarction has characteristic features that are important to know:

The pain is sharp, squeezing, squeezing, burning, suddenly appears in the chest area on the left side of the body

Lasts more than 5 minutes

Does not go away after taking nitroglycerin

Increasingly, it radiates to the neck, left arm and jaw

In addition to the characteristic pain, myocardial infarction is manifested by other symptoms:

Increased sweating, sweat is sticky and cold

General weakness - you can hardly move

Skin turns pale

Dizziness

Nausea and even vomiting (due to decreased blood pressure)

Rarely, at the acute stage of a heart attack, symptoms of cardiogenic shock appear: lips turn blue, limbs turn white, pulse cannot be palpated

Myocardial infarction: depth of damage

Based on the depth of damage to the heart muscle, there are:

Large-focal or extensive myocardial infarction
An acute disturbance of blood flow in the large branches of the coronary arteries, which occurs as a result of thrombosis.

Small focal myocardial infarction
Develops as a result of thrombosis of small branches of the coronary arteries with a limited area of ischemic damage to the heart muscle.

How does myocardial infarction occur?

The course of myocardial infarction includes 5 periods:

Prodromal period. Its duration varies from several hours to 30 days. The main feature is that there is a recurring pain syndrome and electrical instability of the myocardium, which is manifested by tachycardia.

The most acute period ranges from 30 minutes to 2 hours, that is, from the appearance of severe myocardial ischemia to the formation of signs of death of a section of the heart muscle. Most often - in 70-80% of cases - it manifests itself in the form of an anginal attack - characteristic chest pain. Pain syndrome often provokes feelings of fear, excitement, anxiety, as well as various autonomic disorders, among which increased sweating is usually found.

Acute period. A focus of necrosis (a dying area of the heart muscle) is formed. The so-called resorption-necrotic syndrome occurs, which is caused by the body’s general reaction to the absorption of necrotic cells into the blood. This syndrome is accompanied by disturbances in the functioning of the cardiovascular system. If myocardial infarction occurs without complications, the acute period usually lasts about 7-10 days.

Subacute period. In the subacute period of myocardial infarction, a scar gradually forms at the site of necrosis. The duration of the subacute period varies widely and mainly depends on the volume of the necrosis focus, the state of the surrounding myocardium, untouched by the necrotic process, the presence or absence of concomitant diseases and complications of myocardial infarction. Typically, the duration of the subacute period ranges from 4 to 6 weeks.

Post-infarction period. In the post-infarction period, the scar thickens and finally forms. At the same time, a number of compensatory mechanisms are launched that help the body adapt to the new state.

Myocardial infarction: atypical forms

The most acute period of myocardial infarction can take on atypical forms, which are important to know about in order not to be confused with other diseases and to take the necessary measures in time:

Asthmatic form
There is a lack of air and shortness of breath, often provoking panic, which in turn aggravates the situation as a whole. It is impossible to breathe deeply. During inhalation, bubbling occurs as excess fluid accumulates in the alveoli.

Gastralgic form
Rarely seen. It manifests itself as abdominal pain, sometimes hiccups, belching, vomiting, and this is the main danger: diagnosing a heart attack quickly with such pain is difficult even in the clinic, since the symptoms are similar to those of acute appendicitis or poisoning.

Cerebrovascular form
They manifest themselves as a stroke or deep fainting, against which paresis, paralysis occur, brain failure and other pathological changes develop.

Arrhythmic form
The arrhythmic form is manifested by disturbances in heart rhythm, but the main danger is that atrioventricular blocks are formed, as a result of which the heart rate decreases.

Note! Chest pain is the main symptom of myocardial infarction. But there are many that you may mistake for signs of other diseases or simply being unwell.

Be especially vigilant if you have already been diagnosed with coronary artery disease: at the first serious symptoms, immediately call an ambulance.

If you have even minor discomfort in the heart area, do not engage in useless self-medication and do not turn a blind eye to it in the hope that it will go away. If there really are problems, they will not go away on their own and will only get worse.

By trying to solve the problem yourself, you waste precious time and risk provoking a number of life-threatening complications. Only specialists can accurately diagnose the cause of discomfort or pain and provide professional treatment that will truly help you.

Make an appointment with our cardiologist right now.

Make an appointment

Causes of myocardial infarction

Myocardial infarction continues to be most common among older people, as well as those who are inactive and obese. Although this dangerous disease has been rapidly becoming “younger” in our country in recent years: myocardial infarction occurs even in young men and women who are not yet 30.

It is important to note: A healthy lifestyle and exercise do not guarantee 100% protection against myocardial infarction.

Here are the main risk factors that can lead to the development of myocardial infarction:

High cholesterol
Cholesterol is the main cause of plaque formation on artery walls, which causes blood clots to form that block the lumen of blood vessels.

Hypertonic disease
Myocardial infarction is one of the main consequences of this pathology.

Diabetes
Elevated blood sugar levels lead to deterioration of blood circulation in small vessels with the subsequent development of metabolic disorders in tissues, including the myocardium.

Bad habits
Please note - this is not only alcohol and smoking, but also drugs and toxic drugs.

Low physical activity
Your muscles should contract. It is very important. If you don't like sports, try to walk at least 2 kilometers a day.

Frequent overeating
It is better to eat 3-4 times a day, but little by little, than 1-2 times, but densely.

Serious emotional stress
Stress and anxiety have a detrimental effect on the tissues of the heart muscle.

Note: if you want to reduce the risk of developing myocardial infarction to a minimum, eliminate all harmful factors, play sports and don’t get nervous over trifles.

Myocardial infarction: consequences

The consequences of myocardial infarction are early and late.

Early complications (within 10 days after a heart attack):

Arrhythmias are the most common complication. The most dangerous are ventricular tachycardia (when the ventricles of the heart begin to be responsible for the rhythm) and ventricular fibrillation (when the walls of the ventricles contract randomly)

Arterial hypertension, which occurs due to the heart's greater need for oxygen and tension in the wall of the left ventricle, as a result of which the infarction area increases and stretches

Mechanical pathologies (for example, rupture of the interventricular septum or cardiac aneurysm) - as a rule, form in the first week after myocardial infarction and very often lead to death if surgery is not performed on time

Cardiac tamponade - when blood enters the pericardial cavity and compresses the heart

Cardiogenic shock

Cardiac conduction disorder

Thrombosis of the arteries of the brain and limbs

Aseptic pericarditis

Late complications (10 days after myocardial infarction):

Weakening of the contractility of the heart, proportional to the size of the infarction (chronic heart failure) - occurs in a third of patients.

Constantly recurring pain - even after the clot is dissolved or removed

Dressler's syndrome - due to the formation of antibodies, a complex of symptoms occurs, including inflammation of the heart sac, pleura, as well as inflammatory processes in the lungs themselves

Post-infarction angina

Chronic protrusion (aneurysm) of the left ventricular myocardium

Various cardiac arrhythmias that usually progress

As a rule, extensive and transmural infarctions lead to complications. And any of them can be fatal.

Diagnosis of myocardial infarction

The diagnosis of myocardial infarction includes:

Clinical picture
Laboratory research
Instrumental diagnostics

Clinical picture

Often, a general clinical picture is enough for an experienced doctor to diagnose myocardial infarction. Acute pain in the chest, in which a person instinctively grabs his heart, inability to breathe, nausea, vomiting, blueness of the lips and fingertips, protruding sweat, inability to speak - these signs are enough to suspect a myocardial infarction and immediately begin providing the necessary assistance.

Laboratory research

A blood test helps identify damage to heart muscle cells and thereby confirm the diagnosis.

A particularly characteristic indicator of cardiac muscle necrosis is an elevated troponin level. If a heart attack has occurred, a troponin test will show this even earlier than an ECG.

Instrumental methods

Electrocardiography
At different periods of the disease, the ECG shows specific pathological changes characteristic of myocardial infarction, as well as various rhythm and conduction disturbances.

Echocardiography
Ultrasound of the heart shows the affected areas of the myocardium, allows you to detect dilation of the ventricles, see an aneurysm, assess the degree of contractility impairment and other indicators of heart function.

X-ray of the chest cavity
Helps diagnose pulmonary edema, pneumonia and other complications of myocardial infarction.

Coronary angiography
Helps identify affected arteries. It is prescribed when it is necessary to understand whether surgery is needed.

Treatment of myocardial infarction

The main goal of treatment for myocardial infarction is to restore blood circulation in the affected area of the heart muscle as quickly as possible.

Note! The mortality rate from myocardial infarction is high. Studies have shown that mortality from myocardial infarction directly depends on its severity, time of hospitalization and initiation of treatment. However, if you take the necessary measures in time, 70-80% of people can be saved.

It is not for nothing that in cardiology there is the concept of “golden hour”, which means the period of initiation of treatment during which the patient has the highest chance of surviving.

Why is the time factor important?

The process of tissue death develops catastrophically quickly. Irreversible changes in the heart muscle appear within 30–40 minutes, and after 3–6 hours all myocardial cells in the ischemic zone die.

Thus, urgent diagnosis of a heart attack and properly timely treatment are the main conditions for preserving the viability of the myocardium and saving the patient’s life.

Drug treatment

It is important not only to restore blood circulation through the affected coronary artery. There are a number of other tasks that are vitally important to solve during drug treatment of myocardial infarction: limit the size of the infarction, reduce the myocardial oxygen demand, relieve pain, restore normal heart rhythm, and generally maintain normal vital parameters throughout the treatment: blood pressure, breathing, pulse, kidney function.

Drugs for the treatment and rehabilitation of a person who has suffered a myocardial infarction are selected strictly individually and are used in various combinations depending on the complexity of each specific case.

Surgery

The most effective way to restore the patency of the coronary artery and blood flow to the affected area of the myocardium is surgical interventions - coronary artery angioplasty and coronary artery bypass grafting.

Coronary artery angioplasty

The doctor inserts a catheter with a small balloon at the end through the skin into the artery, monitoring its movement and position with an X-ray machine. When the narrowed section of the coronary artery is reached, the doctor inflates the balloon, widening the vessel.