All about a heart attack: what it is, what it looks like and what to do

Symptoms and signs of a heart attack

The clinical symptoms of an approaching heart attack depend on the true cause of the worsening of the condition. Pain in the region of the heart or the left side of the chest is not always a sign of a heart attack, and can occur when the rhythm is disturbed (arrhythmias), a sharp increase in blood pressure or the development of a hypertensive crisis. Also, with the transition of a stable form of angina pectoris to an unstable one, in patients with ischemic disease on the background of stress, psychoemotional or physical excessive stress, hangover.

In most cases, the reason is the same - insufficient oxygen supply, reduced blood supply to the heart muscle, or blockage of a large vessel that feeds this tissue site. This condition arises against the background of a violation of fat metabolism and lipid deposition in the vascular walls, atherosclerotic lesions of the arteries and veins or acute thrombosis, blockage by a clot of blood elements. Unstable blood pressure, increased body weight and metabolic disorders, diabetes, smoking or alcohol abuse can be a provoking factor. Each condition has its own symptoms and manifestations.

How and how it manifests itself: typical type of patient

In medical practice, a heart attack is understood as an exacerbation of ischemic disease, a difficult period of unstable angina pectoris with the threat of a heart attack. This condition can occur suddenly, or develop gradually, as evidenced by precursor symptoms. The following manifestations and signs of a heart attack are characteristic:

1. Pain in the region of the heart, in the center or in the left half of the chest, varying degrees of severity and lasting more than 10 - 20 minutes. It can manifest itself as a feeling of constricting discomfort, bursting, burning or constriction, and increase in intensity.
2. Unpleasant sensations in the left side of the body, both in the face, jaw, neck and shoulder, and in the back, lower back and abdomen.
3. Difficulty breathing, feeling short of breath, inability to take a deep breath.
4. Abdominal discomfort, nausea, or vomiting.
5. General deterioration of health, the appearance of headache or dizziness, perspiration on the face, pale skin, chills.

Features of development in men and women

With unstable angina and preinfarction, atypical symptoms of a heart attack in men may develop. So, a sign of coronary syndrome is more often the abdominal variant, which is presented in the list below:

1. During the day or several hours, general discomfort in the epigastric and umbilical region (upper and middle abdomen) is disturbing. Heartburn or reflux (belching) of acidic stomach contents appears. Patients report nausea, flatulence.
2. Given these symptoms, a heart attack is often perceived as food poisoning, exacerbation of peptic ulcer disease, gastritis or pancreatitis.
3. In some cases, coronary syndrome develops with symptoms of an astatic attack, shortness of breath, wheezing, coughing, severe shortness of breath, and increasing respiratory distress.
4. Given the rapidly increasing risk of developing a heart attack and associated complications, the outcome in all cases depends on the speed of medical care. In this connection, if complaints appear, you should immediately consult a doctor.
5. In a hospital, a cardiogram of the heart is taken for each patient in the admission department; if signs of myocardial infarction are detected, help will be quickly provided and life saved.

Symptoms of a heart attack in women are more often combined with a neurological clinic:

1. Increasing general weakness for no reason or after adequate sleep. Or a few days before the attack, bad sleep worries.
2. Dizziness and blurred vision, unsteadiness when walking, cramping, tingling in the arms and legs, back and neck, constant fatigue, which can be mistakenly regarded as osteochondrosis or neuralgia.
3. Against the background of pain in the heart, unmotivated fear may occur with an attack of shortness of breath and noisy deep breathing.
4. Increasing heart pain is accompanied by palpitations, possibly the development of arrhythmias and paroxysms, frequent pulse and loud heartbeats in the chest and ears. Pain sensations often appear on the left side of the body, with irradiation to the lateral surface of the neck or jaw.
5. Women are more susceptible to a heart attack after the onset of menopause (menopause), with hormonal imbalances. An unstable form of angina pectoris can be provoked by stress or physical overwork.

Another atypical form of heart attack is painless, when the patient does not notice worsening, the appearance of symptoms of a dangerous approaching condition. It develops more often in women or men with diabetes, which is associated with a complication of metabolic endocrine disease - neuropathy (damage to nerve endings against the background of a chronic high glucose content, and its drops). In this case, progressive cardiac ischemia can only be detected on an electrocardiogram. If you do not see a doctor in a timely manner, there is a high risk of complications of a heart attack.

How does a heart attack happen?

With the development of a typical heart attack, the clinical picture looks like this:

1. More often after psychoemotional, physical, or less often at rest, pain appears in the chest, in the region of the heart on the left or in the left half of the body.
2. For more than 20 minutes, the painful sensations do not disappear, intensify, or increase in intensity.
3. Irradiation (migration) of pain to the left side of the body is possible.
4. There is a noticeable pallor of the skin of the face and hands, possibly blue lips, cold clammy sweat, chills.
5. A shortness of breath is accompanied by a feeling of shortness of breath. Patients often try to take a relieving posture - sitting, with their hands resting on a chair, leaning slightly downward for breathing.
6. With dizziness, there is a panic fear of fainting.
7. Atypical forms are accompanied by one of the previously indicated syndrome: abdominal (with manifestations from the digestive system), respiratory or neurological.
8. With a painless form, unmotivated weakness, progressive fatigue for no apparent reason, or after a provoking factor (worries, quarrels or physical work) can alert you. In patients with severe heart failure, an attack may develop in the morning in bed.

How do the pressure and pulse of the victim change?

A heart attack can develop against the background of high blood pressure (BP) (hypertension), and against the background of normal numbers, or low (with hypotension). In each clinical case, depending on the underlying cardiac and concomitant pathology, blood pressure and pulse parameters change.

The following are the options for the symptoms:

1. A typical form of exacerbation of unstable angina pectoris or a condition close to a heart attack is often accompanied by a decrease in pressure, hemodynamic disturbances against the background of ischemia of the heart muscle.
2. This is manifested by an increased heart rate, more than 60 - 80 beats per minute. HELL within 120 / 80-100 / 60 mm Hg (units). The acute phase of a heart attack may be indicated by a drop in pressure less than these figures, with compensatory arrhythmia against the background of cardiac ischemia, a sharp pallor and cold snap of the skin, perspiration, chills and tremors throughout the body.
3. A significant increase in blood pressure can provoke an attack. In this case, they speak of a hypertensive crisis complicated by a heart attack. Patients are worried about arrhythmia or tachycardia with a rapid pulse of more than 90 per minute, shortness of breath, headache or dizziness. The pressure rises to 180/100 - 200/120 mm Hg and more. The risk of cerebrovascular accident in the elderly is significantly increased.

Action tactics

If you suspect a heart attack is developing, you should act immediately. First of all, you need to provide peace to the patient, stop performing any load, take a position, half-sitting or reclining, which will facilitate breathing. You also need:

• open a window or ventilate the room;
• free the neck, throat and chest from tight items of clothing;
• breathe measuredly, taking deep, calm breaths in and out;
• when chest pain appears, take a nitroglycerin tablet by placing it under the tongue (not recommended at a pressure below 110/70 mm Hg;
• in case of pain syndrome for more than 7 - 10 minutes, its intensification and deterioration of the condition, call someone for help, call an ambulance brigade;
• with arrhythmias (rapid uneven pulse and heartbeat), washing with cold water, a compress on the face or forehead can help;
• in case of dizziness and a state close to loss of consciousness, it is necessary to raise the position of the legs, which will ensure better blood flow to the upper body;
• when vomiting or nausea occurs, do not lie down, in order to avoid aspiration (flooding) with vomit;
• while waiting for a doctor, you should not take other medications or attempt self-medication.

Emergency care algorithm

With a prolonged attack of angina pectoris with chest pain or atypical symptoms, lasting more than 5-15 minutes, a doctor's intervention is necessary, otherwise there is a high risk of developing an acute stage of a heart attack.

In case of a heart attack, an ambulance specialist or a doctor in the admission department of a hospital urgently provides the following measures:

1. If the pain syndrome persists, the patient is given one dose of Nitroglycerin, in a tablet, capsule or aerosol under the tongue. The drug is contraindicated in case of a sharp drop in blood pressure, hypotension or collapse.
2. Another necessary tool is Acetylsalicylic acid (Aspirin Cardio or an analogue) at a dosage of 325 - 300 mg.
3. In parallel, an electrocardiogram is taken to detect signs of myocardial ischemia (insufficient blood supply) to the heart site, to confirm or refute the diagnosis of unstable angina pectoris or heart attack. And an oxygen mask is put on to prevent hypoxia.
4. In case of a heart attack with severe chest pain, an intravenous anesthetic drug (Analgin 2.0 - 4.0 50% solution or Promedol, Morphine at a dosage of 1.0 - 2.0 ml 1%) can be administered to the patient.
5. With increased blood pressure, drugs are shown to lower blood pressure, Propranolol 10-30 mg per day, or Metoprolol 50 mg.

In a hospital setting, the issue of further treatment of the patient is being decided. If a heart attack is confirmed and an attack is detected in the first hour of an attack, a specialist may prescribe diagnostic coronary angiography or stenting at the cardiological center of vascular surgery. These minimally invasive surgical techniques are carried out in order to detect a clear area of ​​occlusion of the heart vessel, its expansion with a stent to restore patency, blood flow and nutrition of the heart muscle.

In the absence of signs of a heart attack and confirmation of unstable angina pectoris, inpatient treatment is required for a period of 10-14 days and subsequent prophylaxis to prevent complications.

Conclusions

Under a heart attack with characteristic symptoms of chest pain, shortness of breath, rapid rhythm or pulse, many pathological conditions can be hidden. Heart pain is not always indicative of a heart attack. The reason for the deterioration of well-being can be an exacerbation and transition of angina pectoris to an unstable form, vegetative vascular dystonia (VVD), malignant arrhythmia, thromboembolism or heart failure. In this connection, if characteristic signs and complaints occur, you should immediately consult a doctor, call an ambulance. This will minimize the risk of cardiac complications and save lives.