Characteristics of stages of myocardial infarction, description and symptomatology
Myocardial infarction refers to a condition in which the circulation of blood in the heart is disturbed, and this leads to the necrosis of the tissues of the organ. A common symptomatology of this condition is burning pains in the chest, a feeling of fear without a cause, cold sweat, difficulty in breathing. Age group of patients who have an increased risk of myocardial infarction are men from 40, women from 50 years.
- What it is?
- Infarcts, but not myocardial damage
- Diagnostic Techniques
- Stages of
- The sharpest period
- Acute period
- Subacute period of myocardial infarction
- Postinfarction stage
- Small focal lesions
What it is?
An infarcted condition is acute myocardial ischemia. This condition occurs in 98% of cases as a result of clogging of the coronary vessels with cholesterol plaques as a result of their lesion by atherosclerosis. This leads to a narrowing of the lumen of the vessel. Together with plaques, many patients develop blood clots, which leads to disruption / cessation of blood supply to individual sites.
Important! According to statistics, myocardial infarction leads to fatal consequences for a third of patients. One of six sudden deaths is caused by a heart attack..
There are a number of unfavorable factors that increase the risk of a heart attack:
- excess weight;
- alcohol / nicotine dependence;
- regular neuro-psychological stress;
- unexpected emotional shakes;
- excessive physical overload;
To timely seek medical help at any degree of severity of myocardial infarction, it is worth knowing the main symptoms of heart failure:
- chest pain;
- burning after the breast bone;
- blanching of the skin;
- fainting condition;
- severe or irregular heartbeat;
- shortness of breath, suffocation;
- copious cold sweat;
The stages of myocardial infarction in terms of time and type in many respects affect the symptomatology and revealing it to some extent.
Classification of myocardial infarction is based on certain parameters. In the depth of necrosis:
- Subepicardial - with it, the necrosis of the areas that are located in the zone adjacent to the epicardium occurs.
- Subendocardial - necrotic zone is located near the endocarditis, this is also called myocardial infarction without a Q wave.
- Intramural - with this type of dying of the cardiac muscle occurs in the myocardium, it suffers almost the entire body volume.
- Transmural - necrotic process affects the entire thickness of the heart wall, this form is always large-focal. This type is more common in men of retirement age. This is a heart attack with a Q wave.
Separation according to the size of the lesion:
- Small-focal - this variant occurs in 20% of cases of diagnosing the disease. Such a form can subsequently acquire a large-focal character. In general, this type is represented by ischemic lesions and small necrotic foci on the tissues of the heart. The course has less pronounced symptoms. An infarction is not aggravated by an aneurysm and a heart rupture. In rare cases, leads to thromboembolism, ventricular fibrillation, heart failure.
- Large-focal - the form at which blood circulation occurs is disturbed on a large area. Often this is a consequence of spasm of the arteries, thrombosis.
There is a division by the number of myocardial infarctions:
- Primary - this is the one that happens for the first time.
- Recurrent - that is, occurring earlier than 2 months after the primary.
- Repeated - occurs after 2 or more months after the primary.
Infarcts, but not myocardial damage
There are a number of conditions that are confused with myocardial infarction:
- Lacunar infarction is the cessation of blood flow in one of the perforating cerebral vessels.
- The urine is a non-hazardous transient change in the kidneys. It occurs almost in every newborn.
The diagnosis is made primarily with the help of ECG. In this case, the prongs that are projected onto a piece of paper after examining the condition of the heart are examined. Thus, the appearance of a pathological Q wave indicates transmural necrosis. The examined condition shows split teeth or teeth with barbs. It is worth remembering that it is only the cardiologist who can correctly decipher the ECG, it is not necessary to deal with this independently.
Depending on the external and internal manifestations, five stages of large-heart attack of the myocardium are distinguished:
- Pre-infarction stage.
- The sharpest, it is also called ischemic.
- Acute is the stage of cell death.
- Subacute - organizational.
- Postinfarction - the stage of scarring.
The periods of the infarction have their signs, according to which one can judge the type of heart failure.
Symptoms of this stage of myocardial infarction development are:
- Systematic attacks of angina with increased intensity.
- Deterioration of well-being.
- Signs of heart failure: shortness of breath, weakness, fatigue. which does not pass even after rest.
- The emergence of insomnia.
- Deterioration of mood.
Important! The pre-infarction stage on the ECG will show itself as transient changes and electrical instability of the myocardium..
The sharpest period
This phase is often called ischemic, it lasts from 30 minutes to 2 hours. Just during this period of myocardial infarction, irreversible changes occur in the tissues of the heart. As for the symptoms, the most frequent is a sharp, severe pain behind the sternum. She sometimes gives to other parts of the body - neck, shoulder, hands, jaw. Therefore, this pain is often associated with other conditions.
Among other features:
- Shortness of breath and other symptoms of acute heart failure: cyanosis and blanching of the skin, tachycardia.
- Cold sweat.
- Severe weakness.
- Feeling of fear of death.
- Sharp decrease in pressure. This can lead to cardiogenic shock.
- Strong, sharp cooling of hands and feet.
- As stagnant phenomena develop in the lungs, wheezing may appear.
Pain is always present at this stage of myocardial infarction. Pain sensations can be different, most often they are described as follows:
- crushing, breaking.
Regardless of the type of manifestation, the pain at a certain time seizes and is held for 2-3 hours. Sometimes rolls undulating. Infarction is rarely painless, and this is due to the individual characteristics of the person.
The acute stage occurs after acute. The duration is two days, during this time there is a restriction of the focus of death from healthy heart tissues. The mechanism of the development of myocardial infarction with a recurrent type of lesion is somewhat different. In this case, the duration of the acute period is 10 or more days.
In this phase, pain can disappear or persist. Just in this period there are irreversible changes. complications develop:
- impaired cerebral circulation;
- aneurysm formation;
In this period, there is arterial hypotension, myocardial insufficiency, cardiac rhythm failure. Often the acute phase is accompanied by an elevated temperature of up to 38 degrees.
Subacute period of myocardial infarction
Subacute stage of myocardial infarction follows acute. This period lasts about a month. During this time there is a dissociation of the necrotic area from healthy tissues, a gradual replacement with connective tissues. Gradually, the body compensates for the loss.
In a subacute period it is noted:
- development of myocardial insufficiency;
- occurrence of arrhythmias;
- electrical instability of the heart.
These manifestations may increase or decrease. The heaviness in the chest becomes less pronounced. Often, all signs disappear after 3 weeks, that's what you need to restore the conduction of the heart. Other conditions, in particular, stagnation in the lungs and breathing problems decrease their severity and completely disappear. If normalization of all parameters of the condition has not occurred, there is a risk of complications.
The post-infarction period is the last stage, it is also called the phase of scarring. On the dead end the scar is finally formed, the duration of this process is about 6 months. If the lesion is too large, the symptoms do not disappear over time. A person's condition worsens. According to statistics, a third attack occurs in 1/3 of the patients within 3 years after the infarction.
Small focal lesions
If the foci of necrosis are small, then there are no clear stages of development of the disease. This form does not cause serious complications, but there is a risk of transformation into a large-focal heart attack. Therefore, if you have anxious pain in the heart, you should immediately consult a doctor.
Myocardial infarction is a condition that requires the help of a qualified physician. If the medical help does not arrive on time, the patient may die... .