Myocardial infarction (MI) is a very serious disease associated with damage to the heart muscle as a result of blockage of blood vessels by blood clots. The place where the tissue died off is covered with a scar. A new attack occurring within two months of the first is called a recurrent heart attack. If a disease occurs after a two-month period after the first attack and the scarring of the focus is completed, the heart attack is considered repeated. The terms of recurrent and repeated myocardial infarction never coincide, the first is always earlier than the second. Very often, recurrent MI begins within the first year. At risk are males and the elderly. The attack is more difficult than in the first case, but the pain is mild, or may be absent. The disease is difficult to diagnose, so the mortality rate is higher than with primary MI.
Features of repeated MI
Recurrent myocardial infarction, as mentioned earlier, occurs after the fin althe focus will heal after the first attack. His clinical picture is influenced by a number of factors:
- duration between first and second attacks;
- size of new myocardial lesion;
- initial state of the heart muscle.
The course of a recurrent disease is more severe than the primary one. Acute and then chronic form of heart failure develops. An atypical course of the disease often occurs: an asthmatic variant of a heart attack occurs, or it manifests itself in various forms of arrhythmia. The diagnosis of recurrent MI using an electrocardiographic study is very difficult.
Sometimes there is a false normalization of the ECG. A positive T wave may appear on it instead of a negative one, or the S-T interval will stretch into an isoelectric line. To identify the localization of focal changes, several ECG sessions are performed, and then a comparative analysis of the results is made using data from the previous disease. If, based on a comparison of the ECG, a repeated myocardial infarction is in doubt, then the exact conclusion about the presence of new lesions of the heart muscle is confirmed by conducting a thorough analysis of the clinic of the disease, comparing blood tests, the patient's condition, body temperature, symptoms.
Reason for MI
With an individual tendency to form blood clots in the vessels, a new attack of the disease may occur in the following cases:
- Stopping medication. Medications prescribed by the doctor afterthe first attack of the disease, are aimed at relieving pain in the region of the heart, and most importantly, at preventing the formation of new blood clots and changes in vascular tissues. The patient, feeling better, arbitrarily stops taking them or reduces their dosage, which is absolutely impossible to do.
- Failure to diet. Proper nutrition contributes not only to recovery after suffering, but also prevents the occurrence of recurrent myocardial infarction. The use of fatty, s alty, spicy, fried foods leads to the formation of blood clots and blockage of blood vessels. It should be remembered that dieting is necessary for life.
- Bad habits. A person who has had a heart attack and continues to smoke and drink alcohol is more likely to have a second MI.
- Physical activity. Heavy loads make the sick heart work in a stressful mode, so it is not recommended to engage in sports disciplines that require great effort. Moderate physical activity has a beneficial effect on the recovery processes of the heart muscle. It is recommended to perform therapeutic exercises, take long walks, perform aerobic exercises to prevent recurrent myocardial infarction.
- Emotional state. Frequent stressful situations, endless worries and worries for any reason also contribute to a second attack. During stress, myocardial oxygen demand increases due to an increase in heart rate, and due to circulatory disorders in the coronary vessels, this is not desirable, thereforeunnecessary mental trauma must be avoided.
- Change of climatic conditions. After a disease, it is not advisable to change the climate drastically so as not to provoke adverse physiological reactions of the body.
All causes of recurrent myocardial infarction are related to the lifestyle of the patient and the implementation of the recommendations of the attending doctor, so the disease can be prevented and avoided.
Symptoms of Recurrent MI
The patient should be very attentive to his he alth in order to notice the signs of MI in time. They do not match at all with those that were in the first case. Patient has:
- acute short-term chest pain radiating to the neck and lumbar;
- nausea and vomiting;
- sticky dermis;
- dizziness and vomiting:
- drowsiness and weakness;
- general malaise;
- dry hysterical cough;
- chest heaviness;
- various forms of arrhythmias.
For any of the above symptoms of a recurrent myocardial infarction and abnormal he alth conditions that differ from the usual, and even not related to the work of the heart, an individual who has already had a heart attack should consult a doctor and undergo an examination so as not to miss a second disease.
Diagnosis
To diagnose recurrent MI use:
- ECG diagnostics - often there are difficulties due to preserved changes after a previous illness.
- Laboratory studies - determination of the concentration of troponins in the blood. Evaluation of the measurement results of this indicator makes it possible to differentiate severe chest pain in acute recurrent myocardial infarction.
- Echocardiography - with its help, new foci of myocardial damage are detected and the function of muscle contraction is assessed.
- Coronary angiography - allows you to conduct a study on the patency of the vessels that feed the heart.
Treatment for Recurrent MI
The main task of the treatment process is to restore blood flow in the damaged vessel. A patient with a repeated myocardial infarction (ICD-10 code I 22) is necessarily hospitalized and undergoes the following treatment:
- Medical. It is prescribed from the first day of the disease and includes the following groups of drugs: nitrates, statins, ACE inhibitors, anticoagulants, antiplatelet agents, beta-blockers.
- Thrombolysis - the introduction of drugs to dissolve a blood clot.
- Balloon angioplasty - restores blood flow in the damaged vessel. To do this, a catheter with a balloon is inserted into the vessel, inflating it expands the lumen, and blood begins to flow into the damaged area.
- Aortocoronary bypass grafting - surgical intervention is applied, a bypass vessel is applied, thereby restoring impaired blood flow.
After discharge from the he alth facility, treatment continues at home.
Repeated infarction of the lower myocardial wall
This is an acute abnormal condition,accompanied by necrosis of cells located along the lower wall of the myocardium. Occurs due to lack of oxygen due to blockage by a thrombus in the right coronary artery. Failure to restore blood flow within half an hour is fatal. The disease most often affects people from forty to sixty years. Just after the age of forty, an increase in the process of formation of atherosclerotic plaques is observed. The following factors contribute to this:
- ischemic heart disease;
- postponed heart attack;
- bad habits: smoking and drinking;
- obesity;
- hypertension;
- small physical activity.
Genetic predisposition is of particular importance in the development of this disease. The severity of symptoms of repeated lower MI depends on the number of layers of the lower myocardial wall affected. Often the disease manifests itself acutely and is accompanied by the following symptoms:
- severe retrosternal pain radiating to the arm;
- shortness of breath;
- occurrence of an attack at night or early in the morning;
- excessive sweating;
- the emergence of a feeling of fear;
- possible gastric or bronchial variant of the course of a heart attack.
The development of the disease and the prognosis depend on the timely medical care provided, the physical condition of the patient and the time elapsed from the first attack of MI.
Consequences of a heart attack
After suffering a secondary MI, various complications often occur. Most often the consequences of a repeated heart attackmyocardium may be:
- Irregular heart rhythm - occurs in almost all patients.
- Heart failure - appears a few months after the disease and is associated with a violation of the pumping function of the heart. As a result of this pathology, congestion of blood is formed in various organs and tissues, followed by hypoxia. The disease is characterized by the following symptoms: cough, shortness of breath, dizziness and general weakness.
- Aneurysm of the heart - there is a thinning of the area of the heart muscle, contractility is lost. The patient's heart rhythm is disturbed, shortness of breath appears, the heartbeat quickens, attacks of cardiac asthma occur.
- Cardiogenic shock - the contractility of the heart muscle is sharply reduced. The blood supply to vital organs is disrupted. As a result, the pressure drops sharply, the limbs become cold, oliguria occurs, the heart rate increases, weakness, pulmonary edema and fainting are possible.
- Thromboembolic complications - cause abnormal processes in the body in the form of circulatory disorders, the occurrence of inflammatory processes.
- Rupture of the heart - rare and leads to instant death of a person.
To prevent recurrent MI, you need to lead a he althy lifestyle, eat well, take your doctor's prescribed medications.
Recovery after secondary MI. Advice from a cardiologist
The process of recovery after a second myocardial infarction begins in the hospital under the supervision of doctors and continues after the patient is discharged. DuringDuring this period, the task of the individual is to gradually restore physical capabilities and reduce the risk of complications. For this you need:
- Physical activity. In the first days after returning home, the patient is recommended to rest more, and to use walking up the stairs or short walks as physical activity. Every day, you should gradually increase physical activity over several weeks and strictly monitor your state of he alth. The advice of a cardiologist will help to draw up a cardiorehabilitation program. It may include a variety of exercises, but preference is given to aerobic activities that strengthen the heart, improve blood circulation and lower blood pressure. The patient is allowed to ride a bicycle, walk fast and swim.
- A lifelong necessity. Cardiologists advise people who have had a heart attack to constantly take two groups of drugs: antiplatelet agents that affect blood clotting and suppress the formation of blood clots and statins that lower cholesterol. This is especially necessary for patients who have a stent. Some patients stop taking these important medicines for their own reasons, and then there is a repeated myocardial infarction after stenting, which ends in death.
- Diet. Changing your diet can help reduce your risk of complications and subsequent heart attacks. Every day it is desirable to eat dishes from vegetables and fruits. They contain minerals and vitamins. To reduce blood cholesterol, you need to cook dishes from herring, mackerel,sardines, salmon, seeds, nuts, olive oil and the overseas fruit avocado. In addition, cardiologists recommend using table s alt in minimal quantities. This will help reduce the likelihood of many ailments.
Doctors have learned how to treat MI, and for patients it often goes unnoticed. It is important to remember that the process of formation of plaques in the vessels and blood clots on them does not stop after the recovery of the patient. For those who have suffered a primary and, moreover, a repeated MI, the risk of developing a subsequent attack is very high.
First aid for recurrent MI
If a person has chest pain, severe sweating, heart rhythm disturbance, general malaise, give him a Nitroglycerin tablet and immediately call an ambulance.
It must be remembered that the sooner qualified medical care is provided for recurrent myocardial infarction (ICD-10 code I 22), the greater the chances of successful treatment. The patient is necessarily hospitalized, he is given a cardiogram. It is good if there is an opportunity to compare the results with the previous study. According to existing methods, cardiologists can immediately restore blood flow through the affected artery, reducing myocardial damage. To do this, use special medications that help dissolve blood clots, or angiography is performed, followed by stenting of the damaged vessel. Both techniques give a positive effect only in the first hours after the onset of an attack. This again indicates thatthe patient needs to be urgently delivered to a medical facility, and not wait for the end of the attack.
Prevention of recurrent MI
To prevent recurrent and recurrent myocardial infarction, the following measures are recommended:
- He althy eating. As a result of malnutrition, atherosclerosis often develops with the formation of blood clots in the blood vessels, which can enter the heart cavity with the blood flow. Therefore, it is necessary to remove foods rich in cholesterol from the diet, and eat more plant foods.
- Drug treatment. Therapy carried out in a medical institution does not end when the patient is discharged. He must constantly take without fail all the drugs prescribed by the doctor. Otherwise, a third heart attack is possible.
- Physical activity. To prevent a recurrent myocardial infarction, one should abandon exhausting exercises, and switch to physical therapy classes and take long walks in the fresh air.
- Watch your weight, avoid obesity.
- Give up bad habits - smoking and alcohol.
- Constantly monitor blood pressure.
- Exclude stressful situations.
The quality of life will be much higher if you are attentive to your he alth and follow the doctor's recommendations.
Conclusion
Recurrent and repeated myocardial infarction sharply reduces the contractile activity of the heart muscle, which contributes to the rapidprogression of heart failure. People suffering from coronary heart disease, which provokes a heart attack, should take care of their he alth and carefully follow all the doctor's instructions. Only in this way can serious consequences be avoided.
