Features of the pulse in patients with and after a heart attack

Why is the pulse an important parameter in these patients?

For an objective assessment of the contractile function of the heart, instrumental methods are used, however, in everyday life, the simplest and most accessible option is the analysis of the pulse in the peripheral arteries. The pulse wave moves from the aorta to the distal parts of the lower extremities, which helps to assess the blood supply in different parts of the body.

Analyze the pulse by the following indicators:

• frequency;
• rhythm;
• amplitude (force);
• filling;
• voltage.

Myocardial infarction is accompanied by necrosis (death) parts of the muscle fibers of the heart and replacement with scar connective tissue, which is not capable of contraction. A decrease in the workable area of ​​an organ leads to changes in pulse rates in myocardial infarction. By their nature, the degree of compensation and reserve capacity of the heart are determined. Tracking the heart rate, it is easy to predict the amount of oxygen requirements of the body, which must be compared with the capabilities of the muscle.

For this reason, heart rate is one of the key parameters of the cardiovascular system before, during and after a heart attack: a similar indicator determines the quality and quantity of energy support for the myocardium.

Characteristics and properties of the heartbeat in a heart attack

The qualitative and quantitative indicators of the pulse in patients depend on the location and size of the lesion. The pulsation of the radial artery changes slightly with focal or subendocardial variants of lesions of the heart muscle. Transmural ("trans" - through, "murus" - wall) infarction is characterized by a significant violation of hemodynamics.

The main changes in the properties of blood circulation are realized by a decrease in quality (low ejection fraction) and an increase in quantitative indicators.

A low pulse with a heart attack is characterized by:

• small amplitude of the pulse wave;
• slow filling of the artery;
• insufficient tension of the vascular wall.

These changes occur due to a decrease in the contractile force of the myocardium, with the help of which the blood is "expelled" from the cavity of the left ventricle. The smaller the affected area, the higher the heart rate.

An accelerated heartbeat in myocardial infarction (tachycardia) is a compensatory reaction. The triggering of the mechanism is provided by a violation of the acid-base balance of the blood: a deficiency of oxygen and nutrients causes dysfunction of metabolic processes, as a result of which undeoxidized metabolites accumulate. Irritation of the chemoreceptors in the vascular wall activates the centers of the brain, increasing the rate of respiration, heart rate and blood pressure.

What is submaximal frequency?

During the rehabilitation period, cardiological patients are recommended non-intensive exercises (walking, jogging), which are characterized by a predominant load on the heart, improving hemodynamic parameters and restoring body functions.

When selecting the intensity of exercises in the process of rehabilitation, physiotherapy specialists use the interrelated indicators of submaximal heart rate and low aerobic power:

• low aerobic power determines the level of load at which less than 50% oxygen is consumed (in comparison with the maximum);
• the submaximal pulse characteristic expresses the heart rate, at which the regulatory systems are strained within the physiological norms, without disruption of compensation.

The value of the submaximal frequency of contractions in patients depends on the length of time after a heart attack, the condition of the patients, age and gender (the myocardium of young men without pathologies increases strength and endurance at rates of 170 beats per minute; for a 60-year-old woman, 3 months after a heart attack, this value is 90 -120 strokes).

How to fix the situation and achieve the required indicators?

A satisfactory pulse parameter after myocardial infarction is necessary to reduce the excessive load on damaged muscle fibers and create conditions for an adequate blood supply to organs and tissues. The compensatory reactions of the contraction of the vascular wall muscles and the rapid heartbeat ensure normal functioning with ideal recovery. However, concomitant pathology, irrational therapy, late or inadequate rehabilitation disrupt the process of recovery and adaptation of the heart to work in new conditions.

Based on this, the pulse is considered an important indicator of the recovery period. Corrects the frequency and strength of tissue blood filling with the help of a complex combination of drug and non-drug methods of therapy.

Taking medications

The heart rate after a heart attack changes in both directions. Tachycardia is a normal physiological reaction of the myocardium during the adaptation period. However, careful monitoring of pulse parameters is necessary, since exceeding the submaximal value develops a repeated ischemic attack.

To reduce the heart rate, the following drugs are used:

• beta-blockers: Bisoprolol, Metoprolol, Carvedilol;
• sodium channel blockers: Ritmonorm, Allapinin;
• cardiac glycosides: Digoxin, Korglikon;
• potassium channel blockers: "Kordaron", "Sadogeksal";
• sedatives: "Novo-Passit", valerian extract.

Bradycardia is a decreased heart rate during a heart attack, which indicates the development of decompensation of the functions of the cardiovascular system. The consequences of this condition are acute or chronic starvation of systems and organs, primarily the myocardium.

For medication correction of bradycardia, use:

• choline receptor blockers: "Atropine";
• beta-adrenomimetics: Izadrin, Isoprenaline;
• stimulants: "Caffeine-sodium benzoate", "Askofen", "Citramon" (not prescribed for long-term use);
• phytopreparations: Zelenin drops, hawthorn tincture.

The doctor prescribes medications after examining the patient.

Lifestyle correction

Non-drug methods determine 90% of the effectiveness of post-infarction rehabilitation of patients. Lifestyle modification eliminates rhythm disturbances by a complex effect on neurohumoral regulation.

Patients are advised to:

1. Get rid of bad habits - drinking and smoking. The nicotine in cigarettes raises blood pressure, putting additional stress on the heart.
2. Lose excess weight. An increase in the percentage of adipose tissue requires additional blood supply.
3. Eat wisely. The diet of cardiac patients contains a large amount of proteins (meat, fish, fermented milk products), complex carbohydrates (cereals, legumes, potatoes), vitamins and minerals (fresh and dried fruits, vegetables). Limit the use of salt, fatty and fried foods.Exclude coffee and strong tea. The daily human requirement for energy is 2500 kcal.
4. Physical activity - morning exercises, swimming, jogging increase the general tone of the muscles, and restore the functions of the heart faster.

Alertness symptoms and complications

Myocardial infarction in the first months of rehabilitation is accompanied by a pulse with a high frequency and low amplitude, which are caused by the presence of a defect in the muscle tissue of the heart. Heart rate monitoring is performed to prevent complications.

The pulse rate value characterizes the reaction of the cardiac conduction system to changes in the percentage of oxygen in the tissues. Pathological frequent heartbeat after a heart attack is accompanied by the following clinical symptoms:

• pain in the region of the heart;
• shortness of breath;
• cyanosis or flushing of the skin;
• peripheral edema;
• violation of consciousness.

Such conditions are caused by repeated ischemic attack, acute heart failure, or other reasons.

The defeat of a significant part of the myocardium is accompanied by an expansion of the heart cavity and disturbances in the rhythm of contractions. An increase in the volume of the chambers of an organ with hypokinesia is characterized by the development of thrombi (blood clots) in the area of ​​reduced contractile function. Atrial fibrillation contributes to their detachment from the walls of the heart and movement along the bloodstream. Stroke is one of the complications that occurs as a result of clogging of the arteries in the brain by a thrombus.

Conclusions

Changes in the qualitative and quantitative indicators of the pulse in patients who have suffered myocardial infarction is an important characteristic of the recovery process. Corrects rhythm disturbances in such patients with drugs in combination with lifestyle changes.

Responsible attitude of patients to health and regular monitoring of heart rate characteristics help to rehabilitate and diagnose possible complications in the early stages.