First aid for an attack of acute myocardial infarction

Many people are familiar with such a dangerous condition as myocardial infarction. Someone hearsay, someone had to survive this disease, and others even had the luck to take part in saving someone's life, because it is the first aid for myocardial infarction that often predetermines the course of events. A person can help himself or a person who will do everything to save him, and the patient will have a real chance to return to normal life. Otherwise, you can not even wait for the arrival of an ambulance or simply not reach the hospital.

What is myocardial infarction?

Do not think that myocardial infarction is a special kind of life-threatening pathology that develops from scratch. In fact, this condition is an acute consequence of coronary heart disease, in which blood supply to the heart muscle is impaired.

Violation of the circulation of blood by itself is not fatal. Yes, it inhibits the supply of oxygen and nutrients to the heart, which greatly complicates the work of the most important organ of living beings. However, if you struggle with this condition, by prescription of a doctor taking antiaggregants, beta-blockers, antiarrhythmics, drugs and products containing useful for the heart of Omega-3 fatty acids, you can live a completely happy life.

It is important to understand that in the vast majority of cases, the violation of the coronary circulation is caused by a pathology such as atherosclerosis of the vessels, when harmful cholesterol settles on the walls of the vessels, reducing the clearance through which blood flows. The more the intake of such cholesterol into the body, the harder the situation, because with time, cholesterol plaques on the walls of blood vessels become more and more, and at some point can almost completely block the blood flow.

With more or less preserved blood flow, it makes sense to talk about atherosclerosis of the vessels and coronary heart disease associated with it, but as soon as the volume of blood entering the heart becomes too small or the blood circulation at some site stops at all, it is already about the development of myocardial infarction.

The cause of acute circulatory disorders can be and thrombosis of blood vessels, therefore, in the pathologies of the heart and blood vessels it is very important to monitor the viscosity of the blood, taking anticoagulants that prevent it from folding. Curled blood is able to form clots that, in their motion along the vessels, can form a serious obstacle to the blood flow in the place of constriction of the arteries and veins.

The severity of a condition with a heart attack depends on how much the coronary circulation is severely disturbed. If a cholesteric plaque or thrombus completely blocks the blood path, an acute condition develops. The person in the reserve remains for 20 to 40 minutes, after which the heart cells begin to die due to a critical lack of oxygen.

If there was not a blockage but a severe constriction of the blood vessels, which is why the blood flow became very weak, and the heart ceased to receive oxygen as needed, a pre-infarcted condition occurs, the symptom of which can only be the pain behind the breastbone for a long time. Symptoms or lack of symptoms become an obstacle to the timely diagnosis of a dangerous condition that could prevent myocardial infarction. The patient and the people around him can simply ignore such manifestations of a very life-threatening disease, and they seek help from doctors when the symptoms become acute and at any time can lead to death.

The necrosis process of the heart cells is irreversible. There are no magic pills capable of restoring dead cells, so the affected area of the heart remains a weak point, which can lead to repeated heart attacks in the future.

According to statistics, myocardial infarction often occurs in people older than 65 years. At a younger age, this diagnosis is mainly made for men. The probability of disease in women is much lower due to specific sex hormones. An interesting point is that among the black population of the planet, the percentage of people who underwent myocardial infarction is significantly higher in comparison with the incidence rate among the fair-skinned inhabitants of the planet.

Risk factors for the development of myocardial infarction are:

• bad habits, and in particular smoking,
• high blood pressure (hypertension),
• a sedentary lifestyle (hypodynamia),
• overweight,
• a high level of cholesterol in the blood, which contributes to the development of arteriosclerosis of blood vessels,
• a violation of carbohydrate metabolism, manifested in an increase in the level of sugar in the blood, which, in the absence of appropriate measures, leads to the development of diabetes mellitus.

Myocardial infarction is an irreversible process of cardiac cell death, so it is easier to prevent it, than to treat it and for the rest of your life to be subject to repetition of a life-threatening condition.

Symptoms of acute myocardial infarction

In order for first aid in case of myocardial infarction was timely, it is necessary to know the symptomatology that precedes the cardiac arrest due to oxygen starvation and death of its cells. It is necessary to understand that here time goes on minutes and seconds, therefore, the earlier the patient will be rendered effective help, the more chances to save a person's life.

How to understand that a person had a myocardial infarction? This issue worries many, because this pathology can ruin even a young man, and outsiders will not even suspect that he has heart problems.

We are used to think that IHD, atherosclerosis, hypertension and similar pathologies of the cardiovascular system are old diseases, which young people should not worry about. This is fundamentally wrong. Therefore, if the following symptoms are observed in young people and middle-aged patients, it is necessary not to invent a logical reason, but urgently to provide emergency care before the arrival of doctors.

So, what are the symptoms that can indicate acute myocardial infarction, which requires taking immediate measures to save the patient's life:

• A strong gripping heart pain behind the sternum, which lasts more than 15 minutes (sometimes even for 2 hours). With myocardial infarction, the pain is felt not only in the heart, it is peculiar to give to the interscapular region, neck, shoulder or hand on the left side, which is a little confusing to a person who is not knowledgeable in medicine.

This mandatory symptom of myocardial infarction, however, is peculiar to a pathology such as angina pectoris. A distinctive feature of pain in case of a heart attack is that it can not be completely stopped with the help of a strong cardiac analgesic, which enhances blood circulation, which is considered to be nitroglycerin, which helps with acute pain in the heart.

Nitroglycerin can only reduce pain, which will ease the patient's condition, so you should not completely refuse to take it.

• Pale skin. You can see that the face and other open parts of the human body with an infarction acquire an unhealthy whitish or yellowish hue. This is understandable, because it is a violation of blood supply, not only the heart muscle, but the whole body. Therefore, such a symptom must certainly alert people from outside. In parallel, there may also be phenomena such as dizziness, chills, difficulty breathing, especially with inhalation, nausea.
• Hyperhidrosis. During an attack of myocardial infarction, a cold sweat appears on the forehead, face and back of the patient, which, against a background of increased pallor, may indicate the possibility of fainting. In many cases, this is what happens. The patient can several times briefly lose consciousness and come to himself, so it will be quite difficult to communicate with him.
• Quite often, patients with myocardial infarction begin to experience a sudden fear of death, begin to panic, exhibiting an inadequate physical activity. Some of them even have auditory and visual hallucinations. A person can carry nonsense, try to get up and run somewhere, it is difficult to keep in place, which is vital in this situation.
• More than half of patients with myocardial infarction can observe obvious symptoms of arrhythmia and heart failure: shortness of breath, shortness of breath, cough without spitting (cardiac cough), violation of the heart rate detected by palpation of the pulse. Arterial pressure is not indicative of myocardial infarction: some patients have elevated blood pressure, others have pronounced hypotension.
• Some patients may complain of rather strange pain symptoms. Some speak of incomprehensible pain in the fingers, others complain of a sudden pain in the teeth and jaw, while others complain of pain in the abdomen.

All of the above symptoms are the first clear signs of a heart attack that indicate necrotic changes within the patient's body. First aid for the first signs of a heart attack is not only in calling an "ambulance", but also in caring for the patient before the arrival of "ambulance".

Of particular danger are atypical forms of myocardial infarction, the symptoms of which in many ways resemble other pathologies that do not indicate no problems with the heart. For example, the abdominal (gastralgic) form of the infarction is characterized by symptoms of gastrointestinal disorders. In such patients, complaints are reduced mainly to weakness, nausea, often accompanied by vomiting, severe pain in the epigastric region, bloating, digestive disorders. In parallel with these symptoms, it is possible to diagnose a fall in blood pressure and signs of tachycardia.

Symptoms of asthmatic form in general are similar to an attack of bronchial asthma. Patients may complain of shortness of breath, sudden sudden dyspnea, a feeling of lack of air. They become restless and look for a position of the body that makes it easier to breathe. At the same time, the patient's breathing rate is 2-2.5 times higher than normal. Because of hypoxia, they are clearly expressed pallor of the skin, cyanosis of the lips, there is an abundance of cold sweat. Stagnant phenomena in the lungs lead to the fact that breathing in patients becomes loud with bubbling, a cough appears, with the appearance of a reddish sputum.

There are no strong heart pains with this form, therefore the idea of a heart attack occurs mainly only when the drugs that facilitate breathing do not give an effect. The danger of this condition is that, in the absence of medical care, there are stagnant phenomena in the lungs that cause edema of the organ, which is no less dangerous than the myocardial infarction itself.

Quite a rare, but the most insidious state is considered to be the silent (mute) form of a known pathology. With this form, there is even a mandatory specific symptom - pain. Patients can talk about incomprehensible strong weakness, reduced efficiency, intolerance to physical exertion, deterioration of the general condition, which was previously not felt.

An uncommon variant of myocardial infarction can be called stress angina, the symptoms of which are detected in 1 out of 10 patients who have a heart attack. Often the only manifestation of this disease is the chest pain from the heart area that occurs during walking and active movements. Infarction in such patients is found in most cases by chance, when they go to a polyclinic with complaints of heart pain, and the results of an electrocardiogram confirm myocardial damage.

It is clear that it is difficult for a layman to diagnose a myocardial infarction by such unusual symptoms for a given disease. The only thing that can be done in this situation, if it is not yet critical, is to create a patient's peace and seek medical help by calling an ambulance.

First aid for suspected heart attack

As we see, the symptoms of a typical myocardial infarction are quite numerous, so that it is possible to diagnose pathology more or less accurately before the arrival of doctors and provide first aid to the patient. It is clear that first of all you need to take care of calling an ambulance or help a patient to get to the hospital as soon as possible, stopping passing transport.

Calling "ambulance" must be sure to clarify that he is eating all suspicions of myocardial infarction. In this case, usually comes out a special team from cardiology or intensive care team. If the patient is on the street, you need to specify his exact location and wait for the car along with the patient.

However, we recall that with the deadly pathology, which is myocardial infarction, the time goes not for hours, but for minutes and seconds, which means that the patient can not wait for the car without our help. It is urgent to take all measures to save human life that are available to anyone.

To begin with, a person should be given a comfortable position. It should be comfortably seated or laid on your back, with something under your head, so that the upper part of the trunk noticeably rises above the lower one. The head should be thrown back slightly, and the legs should be raised and bent at the knees. It is desirable that the surface on which the patient is lying should be flat and firm. This position of the patient with myocardial infarction can reduce the burden on the heart and allows you to gain valuable time.

As already mentioned, a specific symptom of myocardial infarction is the fear of death, which causes incredible anxiety in patients, which makes it difficult to lay them down and force them to remain in this position until an ambulance arrives. To cope with excessive anxiety, it is recommended to calm the patient with words or give him a sedative. Usually in such cases "Valocardin", "Barbovale", valerian and other medicines with similar effect are used. Sometimes you even have to use physical strength to keep the patient from active movements that are dangerous for him in this state.

Since frequent symptoms of myocardial infarction are shortness of breath due to oxygen starvation, measures should be taken to facilitate access to oxygen for the patient. If there was a crowd of curious people, you must make her part ways. And in the event that a person has a heart attack in the room, it is necessary to turn on the air conditioner or fan if possible, open the windows wide and do not interfere with the access of air to the bed of the patient.

It is necessary to try to release the neck and chest of the patient from the tightening clothes, unbuttoning buttons or unknitting the laces on clothes.

To expand the vessels and stop the severe pain syndrome, which even in itself sometimes causes premature death, you can apply "Nitroglycerin". The tablet should always be put under the tongue of the patient, if necessary holding the lower jaw, so that the medicine does not fall out of the mouth. The next pill can be given to the patient not earlier than in a quarter of an hour. Strengthen the analgesic effect of nitroglycerin can be done with "Analgin" or other analgesics or NSAIDs.

But to rely only on "Nitroglycerin" and analgesics in case of myocardial infarction, as we know, is not worth it. In addition, it is recommended to give the patient "Acetylsalicylic acid" (just over half the tablet) or a tablet of 325 g "Aspirin". This drug is a drug that liquefies the blood and facilitates its easier movement through the vessels, preventing thrombosis.

With the help of "Nitroglycerin" and "Aspirin", in most cases it is possible to slightly improve blood circulation and slow down the process of necrotic tissue of the heart. However, the patient will still need the help of a cardiologist or cardiac surgeon.

If the process develops too quickly and the measures taken do not give the expected result, you need to closely monitor the patient's condition before the arrival of an ambulance, checking the pulse, breathing, palpitation. If possible, it is also necessary to check blood pressure, which decreases significantly when the heart is weakened.

If a person has lost consciousness, his pulse became weak and intermittent, like breathing, and his heartbeat is not audible, there is a high probability that, despite all diligence, the patient's heart stopped. This is the most crucial moment during first aid in case of myocardial infarction. Here, in no case can you get lost, panic or fall into a stupor, because the life of a person is now hanging by a thread.

The first thing to do is to hold a pericardial stroke. This procedure, despite the seeming cruelty and the possibility of injury in the form of fracture of the ribs, in many cases helps to start the heart and save a person's life. The impact is applied once in the sternum to the heart. You need to beat your fist quickly and quite strongly.

If such a procedure did not bring an effect, it's time to start artificial respiration and perform an indirect heart massage. Usually, these manipulations are taught to children from the school and student's bench, but information without practice is quickly forgotten, and not everyone in a state of excitement is able to quickly navigate and carry out the necessary manipulations, which in fact are not particularly difficult.

Indications for cardiopulmonary resuscitation is the absence of 2 of 3 vital signs: respiration, pulse, consciousness. In the absence of all three signs of life, biological death sets in, and there is no sense in carrying out resuscitation.

To carry out an indirect heart massage, the hands are brought together, crossing their fingers with each other, and with the palms they begin to press rhythmically and quickly to the chest of the patient in the area between the mammary glands. The frequency of pressure is approximately 2 times per second. Hands during a massage from the chest can not be torn off, to prevent the shift to the side.

The force of pressure should be such that the compression of the chest is not less than 5 cm. To stop the indirect cardiac massage is possible only during the time of artificial respiration and checking the pulse in the region of the carotid artery.

In the intervals between direct heart massage, artificial mouth-to-mouth breathing is performed. The ratio of these two procedures is 30: 2, i.е. For 30 clicks, there are 2 breaths-exhalations. Thus constantly supervise, whether there was a patient pulse, testifying that his heart began to work. In this case, the resuscitation procedure as part of the first pre-hospital care for myocardial infarction is discontinued.

If the pulse does not appear, it is recommended to continue manipulation until the ambulance arrives, however, no more than 10 minutes, after which irreversible processes in the body begin, incompatible with life. Even if we bring people to their senses, there are no guarantees that during the resuscitation there has not been a critical change in the work of the brain, nervous system and other important organs and systems.

Indicators of the fact that a person returns to life, in addition to the appearance of a pulse on the carotid artery, is considered a discoloration of the skin from pale to pink and the appearance of pupillary responses to light.

[1], [2], [3], [4], [5]

Algorithm of first aid actions for myocardial infarction

Once again, we will briefly go through the scheme of first aid in case of myocardial infarction, which everyone needs to know in order to save a person's life, if necessary, when they are close at a difficult moment.

So, when you see a person with obvious signs of a heart attack on the street or if you suspect a heart attack, you should not turn aside and pass by, but try to provide feasible first aid, which consists of several important points:

• Calling an ambulance on the phone "103" (number is free from any phone). Be sure to tell the dispatcher about the suspected infarction, if possible, give information about the patient with his words or documents.
• For the meeting of "ambulance" we will involve one more person from the side or a relative, so as not to be distracted from rendering first aid.
• A person with a heart attack is placed back on a hard, level surface (on the street it can be a bench, in warm weather, the floor will also fit in the absence of suitable surfaces). Under the man's neck and shoulders, we put a homemade roller, lifting the upper part of the trunk. We tilt the patient's head back.
• If the person is unconscious, but breathes, we put him not on his back, but on his side to prevent asphyxiation.
• We take all measures to ensure that the patient has good access to oxygen (ask to part out curious, unbutton buttons on clothing in the neck and chest, untie the necktie). If the patient is in the room, you need to try to open all the windows in the room or turn on the air conditioner for cooling. In hot weather, you can slightly moisturize the face, lips and chest of the patient with cool water.
• If a person is restless and displays motor activity, ask other people to help keep him in place in a lying or half-sitting position.
• In the absence of signs of life, we turn to resuscitative measures (pericardial stroke, indirect cardiac massage in combination with artificial respiration), but it must be understood that if the patient has no consciousness, breathing and pulse, the chances of salvation are virtually zero.

The provision of first aid in case of a heart attack before the arrival of an ambulance includes medical therapy that helps to reduce the intensity of symptoms and delay the onset of unfortunate consequences:

• "Nitroglycerine". It is a cardiac drug that reduces the intensity of heart pain and improves blood circulation somewhat. The tablet is placed under the tongue. You can give 3 tablets with an interval of 15 minutes.
• "Aspirin". A popular anticoagulant that reduces blood viscosity and enhances blood flow. Effective in myocardial infarction dose is 300-325 g. They are given once.
• "Analgin" or any of the NSAIDs allowed for heart disease. Will help reduce the intensity of pain. Usually a single dose is 1-2 tablets.
• Soothing means (tablets and tincture of valerian, tincture or infusion of motherwort, "Barbovan", "Corvalol", "Drops of Zeleniena", etc. Drugs). Are shown in connection with that at a myocardial infarction as a specific symptom the fear of death is observed. Such a measure also helps unnecessarily troubled patients.

The question of where it is urgent to take the above drugs, usually does not arise, because most people with myocardial infarction are already permanent cardiologist patients, so they constantly carry the necessary medicines with them.

But even if a person did not know about his illness, one can always find a passerby nearby who has a mini-kit with him, because "cores" we have not so few as we would like. In extreme cases, you can ask someone to go to the nearest pharmacy. If the heart attack happened in the workplace, in the store, in the office, there must always be an emergency aid kit with the necessary medicines.

If you study the first aid scheme for myocardial infarction, it turns out that there is really nothing complicated in it, but these simple manipulations can help save a person's life.

[6], [7], [8], [9]

First aid for a heart attack at home

So far, we have talked about situations in which the reader could act as a rescuer of someone else's life. But after all, no one is insured against myocardial infarction, and any of us sooner or later can experience all of its horrors. Our food and lifestyle leave much to be desired, we actually earn the disease ourselves, and therefore we must learn how to effectively help ourselves if necessary, if there is no one nearby who could help.

Let's talk about situations when a heart attack finds a man at home. Well, if there are close friends or relatives who cause "emergency room", meet her, give medicines and carry out all the necessary manipulations to save their dear person. Alas, this is not always the case. An elderly person can be lonely, which means that there is usually no one to help him. And there are situations that at the right time, none of the loved ones is simply not at home, and the patient has to rely only on himself.

Of course, you can always turn to neighbors for help, but where is the guarantee that they will be in place. It's the most reliable way to learn to count not on someone, but on yourself.

If the heart attack has found you at home alone, the main thing is to try not to panic. Immediately need to call an ambulance (and whenever possible call your family) to your address, taking care that the doctors of the "ambulance" can enter the room even if you lose consciousness and can not open the door. It is necessary to leave the lock on the entrance doors of the apartment and, if possible, the door (the locked doors to the entrance and the absence of the intercom can significantly delay the moment of rendering medical assistance).

Next you need to open the windows and either use the air conditioner, loosen the gates of clothes, drink the necessary medicines, which we wrote about in the previous paragraph. After this, it is most reasonable to lie on the elastic surface, placing a pillow or a twisted blanket under your head, throw your head back and wait for the doctors to arrive. Active movements in this state can only do much harm.

As for the home medicine chest, there must always be a stock of necessary medicines: cardiac drugs, analgesics, sedatives, etc. In addition, the first aid kit should be in a place from where it can be easily obtained if necessary.

During walks on the street, trips to work and back, trips to shops and other establishments, the most necessary medicines needed to provide first aid to oneself, relatives or even strangers are desirable to have with you (in a bag, in a pocket, in a cosmetic bag and so on .). Places they do not take much, but to save life and health may well.

[10], [11], [12], [13]

Briefly on the treatment of myocardial infarction

Treatment of acute myocardial infarction is carried out in a hospital under the supervision of medical staff. At the same time, both medical methods and non-drug therapy are used.

As an ambulance for acute myocardial infarction use:

• "Nitroglycerin" in the form of tablets, capsules or solution for intravenous administration,
• thrombolytics ("Streptokinase", "Urokinase", "Alteplase"),
• anticoagulants ("Aspirin", "Heparin"),
• beta-blockers (Metoprolol, Atenopol,
• antiarrhythmic drugs (mainly "lidocaine"),
• analgesics ("Morphine" plus the neuroleptic "Droperidol", "Promedol"),
• ACE inhibitors ("Captopril", "Lizinopril", "Ramipril").

Less often appoint:

• antagonists of calcium ("Diltiazem", "Verapamil"),
• Magnesium preparations (if necessary).

In severe cases, when it is not possible to dilate blood vessels medically and reconstruct the blood flow, they resort to transgeneric percutaneous coronary angioplasty. With extensive infarctions, surgical treatment with aortocoronary shunting, intracoronary stenting, transluminal balloon angioplasty, etc. Is indicated.

Treatment of myocardial infarction and prevention of its repeated variants implies a diet, lifestyle changes, moderate physical activity (first under the supervision of a doctor).

The use of all the above treatment methods allows 80% of patients to return to normal life after a while, but does not save them from subsequent medication, which will last the rest of their lives.

[14], [15], [16], [17], [18], [19]

Prevention of myocardial infarction

Everything in our life happens for the first time. If these are pleasant moments, we long for their repetition, and if painful, then we want to forget about them forever. Of course, someone who has experienced a heart attack does not want to go through pain again. But where it is thin, there and it is torn, therefore at non-observance of care it is possible to call on itself a repeated infarction (and even not one).

Judging by the high mortality of myocardial infarction, this condition is easier to prevent than treat. To begin with, you need to reconsider your lifestyle and diet. Abandonment of bad habits, physical activity, walking outdoors, weight control and restriction of eating high cholesterol foods have already helped many people prevent the development of cardiovascular pathologies, among which is atherosclerosis of vessels and coronary heart disease, which are the most frequent causes of myocardial infarction.

If you can not avoid heart problems, you should strictly follow the doctor's recommendations for their treatment. The doctor prescribes preparations from the group of statins that prevent the formation of atherosclerotic plaques on the walls of the vessels, do not ignore this appointment just because these medications are not cardiac. If the patient has high blood pressure, it is necessary to take drugs that help reduce it (ACE inhibitors).

It is necessary to fight and with increased viscosity of the blood, taking anticoagulants and thrombolytics, preventing the formation of blood clots inside the vessels. If there is an increased heart rate and nervousness, beta-blockers will help. And, of course, do not forget about the diet.

All of the above measures will help prevent and repeated myocardial infarctions, which usually occur much heavier than the first.

First aid for myocardial infarction is urgent measures that help to save life and health of a sick person. But if you take care of your health in time and take preventive measures, such help may never be needed. And we can only wish our readers health and longevity.