Myocardial infarction is a disease resulting from blockage of the coronary arteries by a thrombus. As a result, oxygen starvation of the heart muscle occurs, in the absence of prompt medical care, some of the cells may die, and scar tissue forms in their place. The heart muscle, which has undergone cardinal changes, loses the ability to function normally. The main treatment is provided in the hospital, after discharge the patient needs a long-term rehabilitation to avoid relapses, which occur in 20-40% of cases.
Stages of recovery
Rehabilitation after a myocardial infarction consists of several stages, the purpose of which is to prevent heart attacks and complications, the resumption of normal life.
Main steps of the process:
- Drug treatment.
- Gradual increase in physical activity.
- Diet therapy.
- Psychological rehabilitation.
The tactics of rehabilitation measures are chosen by the doctor, based on the gener althe patient's condition, age, causes of pathology. The severe course of the disease is accompanied by complications - heart failure, arrhythmia or other changes in the work of the heart. In such cases, rehabilitation activities are carried out in specialized cardio centers under the supervision of specialists.
Stages of the rehabilitation period
Depending on the severity of the lesion, the recovery period takes at least a year after the onset of myocardial infarction. Physical rehabilitation has the following stages:
- Stationary. The patient is in the intensive care unit with subsequent transfer to the cardiology department. Medical measures are being implemented until a satisfactory condition of the patient is achieved.
- Post-stationary - includes rehabilitation activities aimed at restoring body functions. The implementation of tasks takes place in specialized cardiocenters, a day hospital, at home. The end of the period is considered the possibility of returning to full-fledged work activity.
- Sustaining - includes ongoing preventive measures. These include an annual visit to the cardiology dispensary for a certain period of time to monitor the condition, the development of physical activity and supportive procedures.
Infarction and vascular stenting
Myocardial infarction is often accompanied by narrowing of one of the coronary arteries. To correct the situation, stenting of the vessel is performed. The surgeon introducesa special metal mesh tube (stent) that expands the lumen and allows the heart to function normally.
Operations are carried out within a few hours after the attack, the longer the intervention is delayed, the more necrotic tissue is formed on the myocardium. Rehabilitation after a heart attack and stenting takes a long time and requires more effort from the patient. The patient is recommended to go to a sanatorium or dispensary after the hospital to continue recovery. The principles of rehabilitation are the same as those for a non-surgical heart attack, but the return to normal life will take more than a year.
First steps in hospital
Rehabilitation of patients after myocardial infarction, not aggravated by complications, begins in a hospital. The doctor recommends starting exercise therapy on the 2nd or 3rd day after the patient arrives. In severe forms of damage, dosed physical activity is prescribed after 7-8 days.
During the period of the patient's stay in the hospital, the exacerbation that caused the attack is relieved. Medical rehabilitation of inpatient myocardial infarction consists of the following steps:
- The patient is ordered to bed for several days.
- On the 4th or 5th day, the patient may occasionally take a sitting position, hang his legs out of bed.
- After a week, if the diagnosis of the condition allows, the patient is recommended to move nearbed.
- In 2 weeks, with favorable dynamics, movement within the ward is necessary.
- At the beginning of the 3rd week, the patient, accompanied by medical staff or an exercise therapy instructor, can move along the wall of the corridor and go down the stairs to walk into the yard.
Principles of Physical Rehabilitation
The main principle of the restoration of physical functions is the gradual increase in the load on the muscles, the respiratory apparatus and the cardiovascular system. At each stage of increasing the load, it is necessary to control the pulse, with an increase in performance, the exercises are stopped and resumed along with the stabilization of the heart rate.
In case of a favorable prognosis, based on observations of the patient's condition, the patient is recommended to be hospitalized in a rehabilitation cardio center, where treatment will be carried out under the supervision of doctors. Also, a specialist can make individual appointments with a detailed description of actions and lifestyle, if he considers it possible to undergo a recovery period at home.
Physical activity
Physical rehabilitation of patients after myocardial infarction is an essential step towards recovery. The patient receives the first skills of gradually increasing efforts in a hospital under the supervision of doctors; in the future, the rate of increase in the load should progress as scarring of the myocardial tissue. The main part of the recovery procedures is carried out at home or dispensary conditions.
The standard recommendation for physical activity is to complete a set of exercises for 15 minutes with a further increase in time and intensity of exercise.
Passion for exercises and unauthorized complication of the load can lead to another attack. A set of exercises is selected by the attending physician, based on the indicators:
- No dyspnea at rest.
- No heart pain.
- Removal of electrocardiogram parameters (demonstrates a stable condition).
Caution and perseverance
According to the observations of doctors, the most effective physical activity is walking on level ground. A lot of exercises have been developed, a specialist can recommend several options, the patient's task is to strictly follow the algorithm in order to avoid another myocardial infarction.
Rehabilitation is considered successful if, after walking or exercise therapy, the patient's pulse does not exceed 120 beats per minute, and after 10-14 days the frequency drops to 90-100 units.
The recovery process is significantly accelerated by physiotherapeutic measures - massage, breathing exercises. The resumption of sexual life is recommended approximately 2 months after the attack, subject to positive dynamics in the restoration of the functions of the cardiovascular system and the absence of objections from the attending physician.
Diet and its features
Rehabilitation after myocardial infarction involves making adjustments to the diet, sometimesto patients, innovations seem radical, since many need to change food habits and lose extra pounds. After an attack, a diet is prescribed, mainly consisting of small portions of pureed soups and other products. S alt and spices are either completely excluded or contained in a minimal amount.
Failure to follow the recommended nutritional system can provoke complications or the next myocardial infarction. Rehabilitation includes changing the established menu according to the diet reflected in the principles of dietary table No. 10I. The therapeutic diet is designed for different stages of pathology.
- The first diet is indicated for patients with an acute stage of the disease. Dishes are boiled or steamed. Spices and s alt are excluded, food is rubbed, the patient eats small portions up to 7 times a day. The amount of liquid you drink is limited - no more than 700 ml.
- The second diet is introduced with the onset of the second or third week after the attack. The principle of cooking remains the same, s alt and spices are excluded. Food is served in crushed or mashed form no more than 6 times a day, the amount of liquid taken is increased to 1 liter.
- The last type of diet is prescribed with the onset of the process of scarring of myocardial tissue (about three weeks after the attack). The principles of preparation and use of spices remain the same, the number of servings per day is limited to 5 meals. At the discretion of the doctor, no more than 4 grams of s alt is allowed and an increase in the amountdrinking water up to 1.1 liters.
Overweight and restrictions
Rehabilitation after myocardial infarction at home is associated for patients with a large number of temptations, while the consumption of a rather impressive list of products should be significantly limited. Overweight people, in addition to following the rules of nutrition, need to get rid of extra pounds, but do it gradually, no more than 3 kg per month.
Nutritional principles for successful weight loss after myocardial infarction:
- Reducing the number of calories in food.
- Avoiding the practice of snacking on carbs to improve mood or problem eating.
- Leave only a small amount of animal fats in the diet.
- Complete rejection of spicy foods and condiments (sauces, spices, etc.) that stimulate the appetite.
- Cut down your s alt intake (to 5 grams).
- Limit fluid intake (to 1.5L).
- Meals should be taken no more than 5 times in very small portions (a reference point for volume is a palm folded in a boat).
Getting rid of excess weight significantly improves cardiac activity, relieves additional stress from the heart. Normalization of weight and improvement of overall tone through exercise significantly reduce the risk of relapse.
Medicated treatment
In the hospital, the patient receives a full range of measures to stop myocardial infarction. Rehabilitation at home involves taking medicationsstrictly according to the doctor's prescription.
In the postinfarction period, the following groups of funds are prescribed to the patient to achieve such goals:
- To reduce blood viscosity.
- For the prevention of atherosclerosis.
- Stimulators of metabolic processes.
- Antioxidants.
- For the treatment of angina pectoris, arrhythmia and other diseases that have served as provocateurs of a heart attack.
The list of mandatory drugs, the regimen, the dosage is prescribed individually, depending on the diagnostic indicators. In addition, the patient may be prescribed a course of multivitamins, restorative drugs. Before discharge from the hospital, you need to find out about the analogues of prescribed medications, side effects and the possibility of replacing medications.
Psychological rehabilitation
Anxiety often accompanies patients with heart disease. The stages of rehabilitation of patients with myocardial infarction include mandatory psychological assistance. Depression and anxiety develop in about 20% of people who have had an attack. A negative state of mind damages the recovery of the body - it reduces the overall tone, causes fatigue and indifference. This situation worsens the quality of life and may cause a recurrence of an attack.
All patients with myocardial infarction are prescribed to see a psychologist individually or as part of support groups. Doctors also prescribe a course of antidepressants, recommend leisurely walks, positive emotions with a calm background.
Relapse Prevention
If the first heart attack could not be prevented, then every patient can avoid the recurrence of the disease.
To prevent the condition, it is enough to follow a set of measures:
- Developed system of moderate physical activity (exercises are performed daily).
- Rejection of bad habits (alcohol, smoking, etc.).
- Removing light carbohydrates from the diet (sweets, cakes, refined foods, etc.).
- Significant reduction in the number of cups of coffee and tea drunk.
- Caring for the nervous system (avoiding stress and strong unrest).
In the postinfarction period, the patient must constantly take a number of medications, which is also included in the set of preventive measures.
