First aid in an attack of acute myocardial infarction

Many people are familiar with such a dangerous condition as myocardial infarction. Some have heard about it firsthand, some have had to endure this disease, and others have even been lucky enough to take part in saving someone's life, because it is first aid for myocardial infarction that often determines the further course of events. Whether a person will be able to help himself or there will be a person nearby who will do everything to save him, and the patient will have a real chance to return to normal life. Otherwise, you may not even wait for the ambulance to arrive or simply not get to the hospital.

What is myocardial infarction?

Don't think that myocardial infarction is a special kind of life-threatening pathology that develops out of nowhere. In fact, this condition is an acute consequence of ischemic heart disease, in which the blood supply to the heart muscle is disrupted.

Circulatory problems in themselves are not fatal. Yes, they slow down the supply of oxygen and nutrients to the heart, which significantly complicates the work of the most important organ of living beings. However, if you fight this condition by taking antiplatelet agents, beta blockers, antiarrhythmic drugs, drugs and products containing heart-healthy Omega-3 fatty acids as prescribed by your doctor, you can live a completely happy life.

It is important to understand that in the vast majority of cases, coronary circulation disorders are caused by such a pathology as atherosclerosis of blood vessels, when harmful cholesterol settles on the walls of blood vessels, reducing the lumen through which blood flows. The more cholesterol enters the body, the more severe the situation, because over time, cholesterol plaques on the walls of blood vessels become larger and larger, and at some point they 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 the associated ischemic heart disease, but as soon as the volume of blood entering the heart becomes too small or blood circulation in some area stops altogether, we are talking about the development of myocardial infarction.

Acute circulatory disorders can also be caused by vascular thrombosis, so in case of heart and vascular pathologies it is very important to monitor blood viscosity by taking anticoagulants that prevent blood clotting. Coagulated blood can form clots, which in their movement through the vessels can form a serious obstacle to blood flow at the site of narrowing of arteries and veins.

The severity of the condition during a heart attack depends on how severely the coronary circulation is disrupted. If a cholesterol plaque or thrombus completely blocks the blood flow, an acute condition develops. A person has 20 to 40 minutes left, after which the heart cells begin to die due to a critical lack of oxygen.

If there is not a blockage, but a strong narrowing of the vessels, due to which the blood flow has become very weak, and the heart has stopped receiving the oxygen it needs, a pre-infarction condition occurs, the symptom of which may only be pain behind the breastbone for a long time. The vagueness of symptoms or their absence become an obstacle to the timely diagnosis of a dangerous condition, which 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 can lead to death at any time.

The process of necrosis of heart cells is irreversible. There are no magic pills that can restore dead cells, so the affected area of the heart remains a weak spot, which can later cause repeated heart attacks.

According to statistics, myocardial infarction most often occurs in people over 65 years of age. At a younger age, such a diagnosis is mainly given to men. The probability of the 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 have suffered a myocardial infarction is significantly higher compared to the incidence rates among the white-skinned inhabitants of the planet.

Risk factors for the development of myocardial infarction include:

• bad habits, and in particular smoking,
• high blood pressure (hypertension),
• sedentary lifestyle (hypodynamia),
• overweight,
• high blood cholesterol levels, which contribute to the development of vascular atherosclerosis,
• a disorder of carbohydrate metabolism, manifested by an increase in blood sugar levels, which, in the absence of appropriate measures, leads to the development of diabetes.

Myocardial infarction is an irreversible process of death of heart cells, so it is easier to prevent it than to treat it and be exposed to a recurrence of a life-threatening condition for the rest of your life.

Symptoms of acute myocardial infarction

In order for first aid for myocardial infarction to be provided in a timely manner, it is imperative to know the symptoms that precede cardiac arrest due to oxygen starvation and the death of its cells. It is important to understand that here time goes by minutes and seconds, therefore, the sooner the patient is provided with effective assistance, the greater the chances of saving a person's life.

How to understand that a person has had a myocardial infarction? This question worries many, because this pathology can destroy even a young person, and strangers will not even suspect that he has heart disease.

We are used to thinking that coronary heart disease, atherosclerosis, hypertension and similar cardiovascular pathologies are diseases of old age that young people should not worry about. This is fundamentally wrong. Therefore, if the symptoms described below are observed in young people and middle-aged patients, you should not come up with a logical reason, but urgently provide emergency care before the doctors arrive.

So, what symptoms may indicate an acute myocardial infarction, requiring immediate measures to save the patient’s life:

• A strong, squeezing pain behind the breastbone that lasts more than 15 minutes (sometimes even for 2 hours). With myocardial infarction, the pain is felt not only in the heart area, but also tends to radiate to the interscapular region, neck, shoulder, or left arm, which is a bit confusing for someone who is not well-versed in medical matters.

This obligatory symptom of myocardial infarction, however, is also characteristic of such a pathology as angina pectoris. A distinctive feature of pain during a heart attack is that it cannot be completely relieved by a strong cardiac analgesic that increases 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 stop taking it.

• Paleness of the skin. You may notice that the face and other exposed parts of the human body acquire an unhealthy whitish or yellowish tint during a heart attack. This is understandable, because we are talking about a violation of the blood supply not only to the heart muscle, but also to the entire body. Therefore, such a symptom should definitely alert people from the outside. In parallel, such phenomena as dizziness, chills, difficulty breathing, especially with inhalation, nausea can be observed.
• Hyperhidrosis. During a myocardial infarction, cold sweat appears on the forehead, face and back of the patient, which, against the background of increased pallor, may indicate the possibility of fainting. In many cases, this is what happens. The patient may lose consciousness and come to several times for a short time, 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, and show physical activity that is inappropriate to the situation. Some of them even have auditory and visual hallucinations. A person may talk nonsense, try to get up and run somewhere, it is difficult to hold him in place, which is vital in such a situation.
• More than half of patients with myocardial infarction have obvious symptoms of arrhythmia and heart failure: difficulty breathing, shortness of breath, cough without expectoration (cardiac cough), heart rhythm disturbances detected by palpating the pulse. Blood pressure is not indicative of myocardial infarction: some patients have high blood pressure, while others have severe hypotension.
• Some patients may complain of rather strange pain symptoms. Some talk about an incomprehensible pain in the fingers, others complain of sudden pain in the teeth and jaw, and others complain of painful sensations in the abdomen.

All the above symptoms are the first obvious signs of a heart attack, which indicate necrotic changes inside the patient's body. First aid at the first signs of a heart attack consists not only of calling an ambulance, but also of caring for the patient until the ambulance arrives.

Atypical forms of myocardial infarction are especially dangerous, the symptoms of which are largely reminiscent of other pathologies that do not indicate heart problems. For example, the abdominal (gastralgic) form of infarction is characterized by symptoms of gastrointestinal disorders. In such patients, complaints are mainly limited to weakness, nausea, often accompanied by vomiting, severe pain in the epigastric region, bloating, and digestive disorders. In parallel with these symptoms, a drop in blood pressure and signs of tachocardia can be diagnosed.

The symptoms of the asthmatic form are generally similar to an attack of bronchial asthma. Patients may complain of difficulty breathing, sudden severe shortness of breath, a feeling of lack of air. They become restless and look for a body position that will make breathing easier. The patient's respiratory rate is 2-2.5 times higher than normal. Due to hypoxia, they clearly have pale skin, cyanosis of the lips, and profuse cold sweat. Congestion in the lungs leads to the fact that the patient's breathing becomes loud and gurgling, a cough appears with the release of reddish sputum.

There is no severe heart pain in this form, so the thought of a heart attack arises mainly only when medications that make breathing easier do not work. The danger of this condition is that in the absence of medical care, congestion occurs in the lungs, causing swelling of the organ, which is no less dangerous than the myocardial infarction itself.

Quite a rare, but the most insidious condition is considered to be a painless (silent) form of the known pathology. In this form, even the obligatory specific symptom - pain - is absent. Patients may talk about an incomprehensible strong weakness, decreased performance, intolerance to physical activity, deterioration of the general condition, which was not felt before.

An atypical variant of myocardial infarction can also be called angina pectoris, the symptoms of which are detected in 1 out of 10 patients diagnosed with infarction. Often, the only manifestation of this disease is pain behind the sternum in the heart area, which occurs during walking and active movements. Infarction in such patients is detected in most cases by chance, when they go to the clinic with complaints of heart pain, and the results of the electrocardiogram confirm myocardial damage.

It is clear that it is difficult for a non-specialist to diagnose myocardial infarction based on such unusual symptoms for this disease. The only thing that can be done in such a situation, if it does not yet seem critical, is to create peace for the patient and seek help from doctors by calling an ambulance.

First aid for suspected heart attack

As we can see, there are quite a few symptoms of a typical myocardial infarction, so that it would be possible to more or less accurately diagnose the pathology before the doctors arrive and provide first aid to the patient. It is clear that first of all, you need to take care of calling an ambulance or helping the patient get to the hospital as quickly as possible by stopping passing vehicles.

When calling an ambulance, you must specify that there is every suspicion of a myocardial infarction. In this case, a special team from cardiology or a resuscitation team usually leaves. If the patient is outside, you must indicate his exact location and wait for the car with the patient.

However, let us remember that in the case of a life-threatening pathology, which is myocardial infarction, time goes not by hours, but by minutes and seconds, which means that the patient may not even wait for the car without our help. It is necessary to urgently take all measures to save a person's life, which are available to anyone.

First, the person needs to be given a comfortable position. He needs to be comfortably seated or laid on his back, with something under his head so that the upper part of his body is noticeably raised above the lower part. The head needs to be thrown back a little, and the legs raised and bent at the knees. It is desirable that the surface on which the patient lies be flat and hard. This position of a patient with myocardial infarction allows for a reduction in the load on the heart and allows for the gain of precious time.

As already mentioned, a specific symptom of myocardial infarction is considered to be the fear of death, which causes incredible anxiety in patients, making it difficult to lay them down and make them stay in this position until the 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, "Valocordin", "Barboval", valerian and other drugs with a similar effect are used. Sometimes it is even necessary to use physical force to keep the patient from active movements that are dangerous for him in such a state.

Since a common symptom of myocardial infarction is difficulty breathing due to oxygen starvation, measures must be taken to facilitate oxygen access to the patient. If a crowd of curious people has gathered, they must be forced to part. And if a person has had a heart attack indoors, it is necessary to turn on the air conditioner or fan if possible, open the windows wide and not obstruct the air supply to the patient's bed.

It is necessary to try to free the patient's neck and chest from constricting clothing by unbuttoning buttons or untying laces on clothing.

To dilate blood vessels and relieve severe pain, which in itself can sometimes cause premature death, you can use "Nitroglycerin". The tablet must be placed under the patient's tongue, if necessary holding the lower jaw so that the medicine does not fall out of the mouth. The next tablet can be given to the patient no earlier than a quarter of an hour later. The analgesic effect of nitroglycerin can be enhanced with "Analgin" or other painkillers or NSAIDs.

But we know that relying only on Nitroglycerin and analgesics in the case of a myocardial infarction is not worth it. Additionally, it is recommended to give the patient Acetylsalicylic acid (a little more than half a tablet) or a 325 g tablet of Aspirin. This drug is a blood thinner and helps it move more easily through the vessels, preventing thrombus formation.

With the help of "Nitroglycerin" and "Aspirin" in most cases it is possible to improve blood circulation somewhat and slow down the process of necrosis of heart tissue. 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, it is necessary to carefully monitor the patient's condition until the ambulance arrives, checking the pulse, breathing, heartbeat. If possible, it is also necessary to check the blood pressure, which drops noticeably when the heart weakens.

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

The first thing to do is to perform a pericardial strike. This procedure, despite its apparent cruelty and the possibility of causing injury in the form of broken ribs, in many cases helps to restart the heart and save a person's life. The blow is delivered once to the sternum area closer to the heart. You need to hit with your fist quickly and quite hard.

If such a procedure has not brought any effect, it is time to start artificial respiration and indirect heart massage. Usually, children are taught these manipulations from school and college, but information without practice is quickly forgotten, and not everyone in a state of excitement is able to quickly orient themselves and carry out the necessary manipulations, which in fact do not present any particular difficulty.

Indications for cardiopulmonary resuscitation are the absence of 2 of 3 vital signs: breathing, pulse, consciousness. In the absence of all 3 signs of life, biological death occurs, and resuscitation measures are pointless.

To perform indirect cardiac massage, the hands are brought together, fingers crossed, and the palms are pressed rhythmically and quickly on the patient's chest in the area between the mammary glands. The frequency of pressing is approximately 2 times per second. The hands must not be taken off the chest during the massage to prevent displacement to the side.

The force of pressure should be such that the chest compression is at least 5 cm. Indirect cardiac massage can only be stopped for the duration of artificial respiration and checking the pulse in the carotid artery area.

In between direct cardiac massages, artificial respiration is performed using the mouth-to-mouth method. The ratio of these two procedures is 30:2, i.e. 30 compressions are followed by 2 inhalations and exhalations. At the same time, they constantly monitor whether the patient has developed a pulse, indicating that his heart has started to work. In this case, the resuscitation procedure as part of first aid for myocardial infarction is stopped.

If the pulse does not appear, it is recommended to continue the manipulations until the ambulance arrives, but not more than 10 minutes, after which irreversible processes in the body begin that are incompatible with life. Even if you bring the person to his senses, there is no guarantee that critical changes in the functioning of the brain, nervous system and other important organs and systems did not occur during resuscitation.

In addition to the appearance of a pulse in the carotid artery, signs that a person is returning to life include a change in skin color from pale to pink and the appearance of a reaction of the pupils to light.

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Algorithm of first aid actions for myocardial infarction

Let's once again briefly go over the first aid scheme for myocardial infarction, which everyone needs to know in order to save a person's life if necessary by being there in a difficult moment.

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

• Call an ambulance by dialing 103 (free from any phone). Be sure to tell the dispatcher about the suspected heart attack, and if possible, provide information about the patient from his words or documents.
• To meet the emergency services, we involve another person from the outside or a relative, so as not to be distracted from providing first aid.
• We lay the person having a heart attack on his back on a hard, flat surface (outside, this can be a bench; in warm weather, the floor will do if there are no suitable surfaces). We place a homemade bolster under the person's neck and shoulders, lifting the upper part of the body. We tilt the patient's head back.
• If a person is unconscious but breathing, we place him not on his back, but on his side to prevent asphyxia.
• We take all measures to ensure that the patient has good access to oxygen (we ask curious people to step aside, unbutton the buttons on the clothes in the neck and chest area, untie the tie). If the patient is indoors, we should try to open all the windows in the room or turn on the air conditioner for cooling. In hot weather, you can slightly moisten the patient's face, lips and chest with cool water.
• If the person is restless and active, ask other people to help hold him in place in a lying or semi-sitting position.
• If there are no signs of life, we proceed to resuscitation measures (pericardial shock, indirect cardiac massage in combination with artificial respiration), but we must understand that if the patient is unconscious, has no breathing or pulse, the chances of survival are virtually zero.

Providing first aid for a heart attack before the ambulance arrives includes drug therapy, which helps reduce the intensity of symptoms and delay the onset of tragic consequences:

• "Nitroglycerin". This is a cardiac drug that helps reduce the intensity of cardiac pain and improve blood circulation somewhat. The tablet is placed under the tongue. You can give 3 tablets at intervals of 15 minutes.
• "Aspirin". A popular anticoagulant that reduces blood viscosity and increases blood flow. The effective dose for myocardial infarction is 300-325 g. It is given once.
• "Analgin" or any NSAIDs approved for heart disease. Will help reduce the intensity of pain. Usually a single dose is 1-2 tablets.
• Sedatives (valerian tablets and tincture, motherwort tincture or infusion, "Barboval", "Corvalol", "Zelenien drops" and other drugs). They are indicated due to the fact that fear of death is observed as a specific symptom during myocardial infarction. Such a measure also helps overly anxious patients.

The question of where to urgently get the above-mentioned drugs usually does not arise, because most people with myocardial infarction are already regular patients of a cardiologist, so they always carry the necessary drugs with them.

But even if a person did not know about his illness, you can always find a passerby nearby who has a "mini-first aid kit" with him, because we have more "heart patients" than we would like. In extreme cases, you can ask someone to go to the nearest drugstore. If a heart attack occurs at work, in a store, in an office, there should always be a first aid kit with the necessary medications.

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

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First aid for heart attack at home

So far we have talked about situations in which the reader could act as a savior of someone else's life. But no one is 100% immune from myocardial infarction, and any of us can sooner or later experience all its horrors. Our diet and lifestyle leave much to be desired, we actually earn the disease ourselves, and therefore we must learn how to effectively help ourselves if there is no one nearby who could help.

Let's talk about situations when a heart attack catches a person at home. It's good if there are caring friends or relatives nearby who call an ambulance, meet it, give it medicine and carry out all the necessary manipulations to save their loved one. Unfortunately, this is not always the case. An elderly person may be alone, which means there is usually no one to help him. And there are situations when at the right moment none of the loved ones are home, and the patient has to rely only on himself.

Of course, you can always ask your neighbors for help, but where is the guarantee that they will be there? The most reliable thing is to learn to rely not on someone else, but on yourself.

If you have a heart attack and you are home alone, the main thing is to try not to panic. You should immediately call an ambulance (and, if possible, call your family) to your address, making sure that the emergency doctors can enter the premises even if you lose consciousness and cannot open the door. You should leave the lock on the front door of your apartment and, if possible, the entrance unlocked (locking doors to the entrance and the absence of an intercom can significantly delay the moment of providing medical assistance).

Next, you need to open the windows and/or use the air conditioner, loosen the collar of your clothes, take the necessary medications, which we wrote about in the previous paragraph. After this, it is best to lie down on an elastic surface, put a pillow or a rolled-up blanket under your head, throw your head back and wait for the doctors to arrive. Active movements in this state can only do harm.

As for the home medicine cabinet, it should always contain a supply of necessary medications: cardiac medications, analgesics, sedatives, etc. In addition, the medicine cabinet itself should be located in a place where it can be easily accessed if necessary.

When walking outside, traveling to and from work, going to shops and other establishments, it is advisable to have the most essential medicines needed to provide first aid to yourself, your family or even strangers with you (in your bag, pocket, cosmetic bag, etc.). They will not take up much space, but they can save your life and health.

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Briefly about the treatment of myocardial infarction

Treatment of acute myocardial infarction is carried out in a hospital setting under the supervision of medical personnel. Both drug methods and non-drug therapy are used.

As emergency medical care for acute myocardial infarction, the following is used:

• "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, Lisinopril, Ramipril).

Less commonly prescribed:

• calcium antagonists (Diltiazem, Verapamil),
• magnesium preparations (if necessary).

In severe cases, when medication fails to expand the vessels and restore blood flow, transluminal percutaneous coronary angioplasty is used. In case of extensive infarctions, surgical treatment is indicated using aortocoronary bypass, intracoronary stenting, transluminal balloon angioplasty, etc.

Treatment of myocardial infarction and prevention of its recurrence involves diet, lifestyle changes, moderate physical activity (initially 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 eliminate the need for subsequent medication, which will last for the rest of their lives.

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Prevention of myocardial infarction

Everything in our lives happens for the first time. If these are pleasant moments, we crave their repetition, and if painful, we want to forget about them forever. Someone who has survived a heart attack, of course, does not want to go through the pain again. But where it is thin, there it breaks, so if you are not careful, you can bring on yourself a second heart attack (and even more than one).

Judging by the high mortality rate of myocardial infarction, this condition is easier to prevent than to treat. First, you need to reconsider your lifestyle and diet. Giving up bad habits, physical activity, walking in the fresh air, weight control and limiting the consumption of foods high in bad cholesterol have already helped many people prevent the development of cardiovascular pathologies, among which it is worth highlighting atherosclerosis of blood vessels and ischemic heart disease, which are becoming the most common causes of myocardial infarction.

If heart problems cannot be avoided, it is necessary to strictly follow the doctor's recommendations for their treatment. The doctor prescribes drugs from the statin group, which prevent the formation of atherosclerotic plaques on the walls of blood vessels; this prescription should not be ignored just because these drugs are not cardiac. If the patient has high blood pressure, it is necessary to take drugs that help lower it (ACE inhibitors).

It is also necessary to combat increased blood viscosity by taking anticoagulants and thrombolytics, which prevent the formation of blood clots inside the vessels. If there is an increased heartbeat and nervousness, beta blockers will help. And, of course, do not forget about the diet.

All of the above measures will help prevent repeated myocardial infarctions, which are usually much more severe than the first ones.

First aid for myocardial infarction is an urgent measure that helps save the 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.