Myocardial infarction is a focus of ischemic necrosis of the heart muscle, the cause of which is an acute violation of the coronary circulation.
What causes it? What are the consequences for the body? Do they give disability or not? Myocardial infarction, unfortunately, is a common problem, and therefore a little more attention should be paid to this topic now.
Status Brief
Most often this problem affects men aged 35 to 60 years. A heart attack also occurs in women, but less often, and even then - over 50 years old. Because until this point, their vessels are physiologically protected from atherosclerosis by sex hormones (estrogen in particular).
But after 55-60 years, the incidence among both sexes is equalized. Unfortunately, the mortality rate is high - about 30-35%, according to modern statistics. About 15-20% of sudden deaths are due tomyocardial infarction. “Give or not disability in this condition?” - a logical question, given such information. But more on that later.
It is possible to save a person and his he alth. But here the most urgent help is needed, since a violation of the blood supply to the myocardium, lasting 15-20 minutes, leads to the development of irreversible changes in the heart muscle and further disruption of its activity.
Due to acute ischemia, most of the functional muscle cells die, that is, necrosis occurs with further replacement with connective tissue.
Periods and symptoms
So, what is a myocardial infarction, clearly. But how does this state develop? It is customary to single out several periods.
The first one is prodromal. He's also pre-infarction. It is characterized by an increased frequency and intensification of angina pectoris attacks, which can last from several hours to weeks. Symptoms: angina progresses unsteadily. But 43% of heart attacks occur suddenly.
The second one is the sharpest. The development of ischemia and the subsequent appearance of necrosis takes from 20 minutes to 2 hours. Symptoms: the patient is struck by intense pain - it occurs in the chest, and can radiate to the collarbone, ear, neck, shoulder, teeth, interscapular zone.
The nature of sensations can be anything - sharp, squeezing, pressing, bursting, burning. The pain lasts from 30 minutes, but can drag on for hours, sometimes even for a day. It is impossible to stop it with nitroglycerin. In parallel, a person feels weakness mixed with excitement, as well as a feeling of fear and shortness of breath.
Also, the second period is characterized by blanching of the skin, the appearance of cold sticky sweat, anxiety and acrocyanosis. The pressure rises, but then drops sharply or moderately.
The third is spicy. From the second period to the enzymatic melting of the tissue already covered with necrosis, it takes from two days to two weeks. Symptoms: pain disappears. But a fever develops, which can last from 3-5 days to 10 days. There are also increasing signs of heart failure and hypotension.
The fourth one is subacute. Lasts from 4th to 8th week. Scars begin to form, granulation tissue develops. Symptoms: the condition improves, the temperature returns to normal. Systolic murmurs and tachycardia also disappear.
Fifth - post-infarction. The scar matures, and the myocardium adapts to the new conditions in which it has to function. Physical data are normalized, the listed clinical manifestations disappear completely.
Classification
In short, forms of myocardial infarction should also be studied. It can be small-focal and large-focal - it depends on how large the lesion is. Symptoms vary. A small-focal state is not fraught with rupture of the heart and aneurysms. And it is less likely to be complicated by thromboembolism, ventricular fibrillation, and failure.
Here are the criteria by which the form of myocardial infarction can be determined:
- Depth of defeat.
- Changes recorded on the ECG.
- Topography data.
- Multiplicityoccurrence.
- Appearance and development of complications.
- Presence of pain syndrome and its localization.
- Period and dynamics of development.
It is important to mention that there are also atypical forms. They are characterized by localization of pain in the fingers of the left hand, throat, left shoulder blade, in the lower jaw, even in the cervical spine.
There are also forms that are not accompanied by any sensations. Signs in such cases are suffocation, cough, edema, collapse, dizziness, arrhythmias and clouding of consciousness.
These are very unusual symptoms. Myocardial infarction in women and men of this form can happen if the patient suffers from circulatory failure, cardiosclerosis, or he has already experienced one attack.
But atypicality is typical only for the most acute period. When it passes, the state becomes normal for such cases.
It should also be noted that the erased course of a heart attack may well proceed without pain. Often it can only be detected on an ECG.
Complications
Above it was told about the symptoms of myocardial infarction in women and men. Now we need to discuss the complications.
Often they occur in the first hours and even days. In the next three days, the following states may appear:
- Extrasystole.
- Atrial fibrillation.
- Intraventricular block.
- Paroxysmal or sinus tachycardia.
- Ventricular fibrillation, capable of turning intofibrillation, which is fraught with the death of the patient.
The following complications can also overcome the patient:
- Pulmonary edema.
- Congestive rales.
- Cardiac asthma.
- Cardiogenic shock.
- Low systolic pressure.
- Impaired consciousness.
- Decreased urine output.
- Cyanosis.
- Cardiac tamponade characterized by bleeding into the pericardial cavity.
- Pulmonary embolism.
- Failure of scar tissue, fraught with bulging and further development of an acute aneurysm.
- Mural thromboendocarditis.
- Embolism of vessels of the brain, lungs and kidneys.
- Postinfarction syndrome.
- Pleurisy.
- Arthralgia.
- Pericarditis.
- Eosinophilia.
And these are just some of the complications that myocardial infarction entails in the elderly. Everything is individual here, so the condition may be supplemented by other unpleasant phenomena.
Give or not disability?
Myocardial infarction is a serious condition, after which it is difficult for people, especially the elderly, to return to normal life. In addition to the he alth consequences, there are also material problems. And therefore, at first, employed citizens receive benefits, the basis for which are sick leaves.
In general, the authorities have several mechanisms for helping citizens in this case. Retirement is the most common. However, to get it, you must first passa medical commission that will confirm the disease and confirm the fact that the person really has the right to receive it.
Give or not disability? Myocardial infarction is fraught with serious consequences, so yes, it’s possible to arrange a group. However, it will have to be constantly confirmed.
The period for which it is issued is strictly regulated by certain standards. When it comes to an end (and, therefore, the right to receive a pension too), the patient must return to the clinic for a second thorough examination.
Commission passing
Specialists evaluate the following factors:
- Degree of damage to the heart walls.
- Complication rate.
- How weakened the ability to perform production tasks at work.
- The presence of physical and emotional stress.
After evaluating the results, the ITU commission decides how long to release the patient from work. He is assigned a group and transferred to light work.
The process doesn't end there. First, a sick leave is extended to a person for up to four months. Then the ITU Commission again conducts a survey. If the condition is the same, the sick leave is extended for another year. And only after its expiration, a disability group is assigned.
Passing through a collegiate medical examination, in which physicians of various speci alties participate, is necessary. Because only by its results it is possible to determine the degree of recovery of the patient's he alth.
What factors define a group?
Talking about howwhat is it - myocardial infarction and how to apply for disability with it, you need to answer this question.
It seems possible to determine the group only after doctors find answers to the following questions:
- Is the person capable of performing work tasks?
- To what extent can it be loaded?
- How does his body react to normal, habitual movements?
- What kind of professional qualities does the position he currently holds require?
After that, doctors study the degree of recovery of the patient. This process requires the study of the following indicators:
- The nature of the heart attack.
- Severity and severity of complications.
- Characterization of heart failure and indications of anamnesis.
- How the body responds to the prescribed treatment, and whether it is effective at all.
When answering the question of how to apply for disability after a myocardial infarction, it is necessary to make a reservation that a person may be denied this. This happens in the following cases:
- The degree of heart attack experienced by a person is small.
- His heart is beating normally.
- No complications.
- The muscle has the ability to work.
- A person works in easy, harmless working conditions.
The decision is made collectively, since the MES includes doctors from various fields. All specialists from the side of their speci alties determine the state of he altha patient claiming a disability.
Characteristics and features of groups
This topic should also be touched upon with attention. With myocardial infarction, a disability group, whatever it may be, is assigned under certain conditions. There are three in total.
The first is claimed if any work is contraindicated for a person. He needs to observe strict bed rest, undergo long-term rehabilitation, and, finally, undergo he alth spa support in one of the recommended sanatoriums.
Such citizens are treated in the cardiology department. They have to be observed by sanatorium specialists for years for the purpose of prevention.
If he alth stabilizes, the patient can be transferred to the second group. But this is only after going through all the stages of recovery. The translation must also be approved by the commission.
The second group is assigned if a person works in a position that involves emotional stress and physical activity. He will have to change such a job to a new, calmer one, but it often turns out to be not so highly paid. Therefore, the benefit pension will come in handy, given that the medicines needed for recovery are expensive.
In what cases is a 3rd disability group prescribed for a disease? In those when patients successfully pass the rehabilitation period. But, nevertheless, they need time to return to a normal lifestyle, without exhausting themselves with unnecessary overloads. As a rule, these are patients who have undergone ischemia and stenting of the heart (or the installation of a stent or frame on it duringoperations).
Rehab
Having discussed the specifics of obtaining disability after a myocardial infarction, we can move on to this topic. Restoring he alth is a very important process. And, of course, there are many restrictions after a myocardial infarction.
Sit on the bed with legs dangling is allowed only for 4-5 days. A week after the attack, you are allowed to take the first steps. After two - slowly walk around the ward, if the doctor allows. They are allowed to enter the corridor only from the third week of stay in the hospital.
At this time, a medical worker or one of the relatives is always next to the patient to monitor his condition, measure blood pressure and heart rate.
If the rehabilitation is successful, the person is transferred to a suburban cardiology sanatorium. There, the patient will engage in physiotherapy exercises under the supervision of specialists, as well as take dosed walks on foot, diet and take medication.
Sanatorium treatment
It must be passed before registration of disability after myocardial infarction. This is a classic therapy scheme: a heart attack - a hospital - a sanatorium. Then either the formation of the group, or the return to work.
The purpose of a patient's stay in a sanatorium after a myocardial infarction is to develop he althy eating habits, as well as normal physical activity. If he adjusts his lifestyle with the help of specialists, this will help him prevent repeated ischemic attacks.
In general, the benefits of spa treatmentcan be identified in the following list:
- The patient is always monitored by qualified cardiologists.
- In the course of treatment, those physiotherapeutic methods are used that have already proven their effectiveness more than once.
- Comprehensive examinations are carried out regularly.
- Treatment is carried out using innovative equipment.
- The patient is individually developed dietary nutrition, taking into account the underlying disease, as well as all concomitant diseases, if any.
- The correct daily routine is being compiled.
- The patient is in nature.
- An individual load regime is compiled.
- There is an entertainment program that helps to improve the psychological state of the patient.
Directly on the heart muscle is influenced to achieve the following goals:
- Improve coronary blood flow.
- Transferring the muscle to a calm, economical mode of operation.
- Saturation of myocardial cells with oxygen.
- Restoration of the nervous regulation of vascular tone.
Another important task is to reduce the stress state of the patient, as well as to restore confidence in his recovery. Upon completion of treatment, he will be able to switch from enhanced drug therapy to a gentle one.
The result of spending time in a sanatorium is the expansion of the motor regime and the strengthening of the body's defenses. To achieve the latter goal, by the way, the patient takes sun and air baths, makesdouches and contrast treatments, swims in the pool.
If the sanatorium is located on the seashore, then wiping with sea water, swimming and morning walks are required.
What is included in the treatment package? As a rule, the list is as follows:
- Accommodation in a comfortable room.
- Five or six specialized meals a day.
- 24-hour medical assistance.
- Regular examination by a cardiologist. At first - every day, then once every 3-5 days is enough.
- He althy school classes.
- Consulting with a rehabilitologist, nutritionist, neuropathologist, endocrinologist, physiotherapist, psychotherapist, as well as other narrow-profile doctors.
- Diagnostics including ultrasound, ECG (normal and monitored), stress testing, blood tests, pulse oximetry, etc.
- Therapeutic exercise - both regular and cardio.
- Visit the pool and take breathing exercises.
The list of procedures can be much wider. It often includes oxygen and carbon dioxide baths, circular showers, inhalations, reflexology, massages, taking mineral waters and medicinal teas, etc. It all depends on which sanatorium the person goes to.
Since the state allocates funds from the regional budget, a ticket is usually issued to a nearby resort institution. And this is the best solution - climate change can provoke a relapse.
Sanatorium treatment lasts from 18 to 24 days. The direction to it can bereceive at the clinic at the place of residence, providing an extract from the medical history, which is issued in the hospital. Then the patient goes through a commission, which gives a recommendation regarding the type and duration of the course.
