Emergency help for a heart attack. Emergency care for myocardial infarction: how to distinguish a heart attack from an angina attack and prevent cardiogenic shock? Caring for patients after a heart attack

Doctors mean acute clinical form coronary heart disease. This condition causes necrosis of entire areas of the middle layer of the organ, caused by weak or absent blood supply, which in turn can even lead to death.

Myocardial infarction is a direct result of obstruction of the vessels supplying the above-mentioned area and is caused in 9 out of 10 cases by atherosclerosis coronary arteries. A person with this problem, in the absence of proper qualified treatment, receives serious complications, and in some cases even death! Regardless clinical manifestations if you suspect a heart attack, you should immediately call an ambulance/emergency medical service, and before her arrival, try to provide the highest quality, prompt and qualified assistance to the victim.

The first signs of myocardial infarction

The warning signs of the onset of myocardial infarction are quite clear and allow the problem to be diagnosed in 70 percent of cases.

1. Severe chest pain . A very unpleasant feeling occurs unexpectedly, paroxysmally, while the pain syndrome can “give” between the shoulder blades, in left shoulder, part of the neck. Lasts from thirty minutes to two hours.
2. Paleness and profuse sweating. A person with myocardial infarction quickly turns pale and feels cold all over the body. sticky sweat.
3. Fainting and borderline states. Almost always, especially in the first phase of an attack, a person may faint several times. Less often, he develops an unreasonable feeling of fear, sometimes - unclear hallucinations of an audio and visual nature.
4. And . Almost half of the patients who survived myocardial infarction experienced clear signs heart failure, from shortness of breath and nonproductive cough to atrial fibrillation and short-term sudden cardiac arrest.
5. Low effectiveness of nitroglycerin. A person does not feel significant relief after taking nitroglycerin - drugs in this group that expand blood vessels, can only be used as an additional remedy, together with prescription narcotic analgesics, and only under certain conditions.

Emergency care before the ambulance arrives. What to do?

At the slightest suspicion of a myocardial infarction, you must call an ambulance, while concentrating as much as possible on providing first aid to the person, and if you are the patient, follow the recommendations below.

First aid for myocardial infarction. Algorithm of actions.

1. Place the person in a chair with a backrest or in a reclining position so that top part the torso was located as high as possible - thus reducing the load on the heart.
2. Calm the patient emotionally or with Valocordin to reduce the heart rate.
3. Unfasten clothes that are too tight and tight, loosen all knots, tie, scarf, especially if signs of imminent pain begin to appear.
4. Be sure to check your blood pressure and pulse rate - if they are normal, then you can give nitroglycerin/aminophylline (if there is a sharp decrease this procedure may lead to cardiac arrest).
5. Several aspirin tablets actively thin the blood - be sure to give them (if the person is not allergic) with a maximum dose of up to 300 milligrams. A faster effect of the drug is obtained by chewing it.
6. Has your heart stopped? Is breathing agonistic or absent? Does it take a long time for a person to regain consciousness? Cardiopulmonary resuscitation should be started immediately. If you do not have a defibrillator, carry out artificial respiration, indirect massage heart or, in extreme situations, a precordial short strong blow with a fist to the sternum. The basic scheme is 15 pumping movements, two inhalations/exhalations, one launch-impact, all this should be done for a maximum of 10 minutes.

Actions of a patient during a heart attack

1. If you suspect a myocardial infarction, immediately inform people nearby, if possible, call an ambulance yourself and inform your family about the situation.
2. Try to calm down and take a sitting/reclining position.
3. If you have medications with you, take aspirin, nitroglycerin (preferably aminophylline) and Corvalol.
4. Try not to move, report your symptoms to the arriving emergency team.

How important is first aid for a heart attack?

First aid for myocardial infarction can save a person from further complications, and in some cases - save lives! Timely and adequate actions taken in the first 30 minutes after the onset of an attack significantly increase the chance of a positive outcome general treatment, and also reduce the risks of irreversible changes in the cardiovascular system.

Possible complications of myocardial infarction

The above condition can lead to a number of complications, both in the early stages of the development and progression of myocardial infarction, and after its treatment in the hospital.

Potential Risks

1. Primary - shock, pulmonary edema, ventricular fibrillation, pericarditis, hypotension of various etiologies, myocardial rupture.
2. Secondary - cardiac aneurysms, thromboembolic complications, chronic heart failure, Dressler's syndrome.

The first heart attack always comes unexpectedly. Prevention this state usually aimed at preventing recurrent attacks with maximum control of the body.

Main negative factors, causing relapse problems are high blood pressure, atherosclerosis, carbohydrate disorders metabolic processes and high blood clotting. The main prevention in these cases is a carefully selected comprehensive drug therapy, preventing the appearance of fatty plaques, adding the necessary enzymes to the body, normalizing blood pressure, etc. At the same time, changing the dosage or introducing new medications without approval is strictly prohibited!

Most often the following scheme is prescribed:

1. Antithrombotic therapy with clopidogrel and aspirin.
2. Taking beta blockers (carvedilol, bisopropol) and statins.
3. Consumption of Omega-3 unsaturated fatty acids And .
4. Therapy with unfractionated heparin and ACE inhibitors.

Except medicines, important role in prevention, plays with a minimum of salt, semi-finished products, sausages, sausages and other products containing both cholesterol and milk fat (cheese, cottage cheese, butter, sour cream, milk). In addition, you will have to give up smoking and - an exception is made only for a glass of red wine.

As a supplement, the doctor prescribes physical therapy and moderate exercise in the form of cycling, dancing and swimming, as well as daily walking - everything in moderation and no more than 40 minutes several times a week.

Useful video

Myocardial infarction. Symptoms and what to do before the ambulance arrives

First aid for myocardial infarction

According to the World Health Organization, many patients die from a heart attack even after prehospital stage. Observations show that men die more often than women, and the reason is fatal outcome usually becomes sudden death. The frequency of such sad outcomes is not related to the month of the year, but depends on other factors: time of day (usually in the early night or morning hours), day of the week (usually on weekends).

According to some statistics, approximately half of the men and 1/3 of the women who died due to myocardial infarction did not know that they had some kind of pathology of the heart and blood vessels. And the main thing predisposing to the development of this acute condition and subsequent death, arterial hypertension becomes a factor.

Cardiologists say that the patient’s life depends on the quality and timeliness of pre-hospital and emergency care for myocardial infarction. And this means that everyone, especially patients with coronary heart disease, should know the first signs of this acute heart pathology and correct algorithm actions until the ambulance arrives.

The first signs of myocardial infarction

The onset of a myocardial infarction is signaled by the following symptoms:

• occurring suddenly or spasmodically strong pain behind the sternum, lasting more than half an hour (up to 2 hours);
• the pain is burning, tearing, stabbing in nature, usually occurs after physical activity (sometimes immediately after sleep) and does not become less pronounced even after a state of rest;
• the pain is not eliminated (as during an attack of angina) by taking Nitroglycerin and after taking the pill (and even a repeat dose), a person may feel only a slight decrease in pain;
• severe weakness (up to pre-fainting or fainting);
• nausea;
• pain sensations radiate to the left (sometimes to the right) arm, neck area, interscapular area, teeth, scapula, lower jaw;
• severe pallor;
• the appearance of cold and sticky sweat on the skin;
• pronounced anxiety and fear of death.

Approximately half of patients with myocardial infarction experience signs of heart failure: difficulty breathing, shortness of breath, nonproductive cough, arrhythmic pulse, atrial fibrillation, sudden short-term cardiac arrest.

Video: What are the symptoms of myocardial infarction?

In some patients, the heart attack occurs in atypical forms. The following symptoms may indicate the occurrence of such an attack:

• pain in the left hand or little finger of the left hand, in cervicothoracic region spinal column, lower neck or in lower jaw, shoulder blade;
• pain localized in the abdomen and dyspepsia;
• suffocation and shortness of breath;
• shortness of breath with severe weakness and rapid increase in edema;
• dizziness with nausea, darkening of the eyes and a sharp decrease in blood pressure;
• dizziness with confusion, speech disturbances, nausea, vomiting and paresis of the arms and legs;
• discomfort in the chest area (no pain) with excessive sweating and severe weakness.

In a number clinical cases a heart attack is represented by a combination of symptoms of several atypical forms (for example, cerebral and arrhythmic). Such manifestations of this life-threatening condition significantly complicate the detection of myocardial necrosis and aggravate the prognosis of the outcome of the emergency condition considered in this article.

Emergency care before the ambulance arrives. What to do?

If you suspect a myocardial infarction, you should immediately call an ambulance and provide the dispatcher with the following information:

• about suspected myocardial infarction;
• describe the symptoms observed in the victim;
• ask for a team of cardiologists and resuscitators to arrive.

Before the arrival of specialists, it is necessary to immediately begin carrying out emergency assistance measures:

1. Help the patient find a comfortable position: lay him on his back and place a cushion under the back of his head, or give him a semi-sitting position by placing a pillow or folded clothes, a blanket, etc. under his back.
2. Unfasten and remove clothing or accessories (scarf, belt, tie, etc.) that interfere with free breathing, and ensure maximum comfort temperature regime(for example, open a window in hot weather or cover with a blanket in cold weather).
3. Explain to the victim that he must remain still and remain emotionally calm. You need to talk to a person in the state of an attack of myocardial infarction in an even, firm and calm tone, and you should not make sudden movements that could frighten him. If the patient has manifestations of motor excitation, then let him take sedative(tincture of valerian, motherwort, Valocardin, etc.).
4. Measure blood pressure: if it is not higher than 130 mm Hg. Art., then give the patient a tablet of Nitroglycerin or another drug available under the tongue, active component which are organic nitrates (for example, Isoket, Nitrocor, Nitrogranulong, Izodinit in the form of sublingual tablets or spray). Before the doctors arrive readmission Nitroglycerin should be given 1-2 more times (that is, 2-3 tablets can be given in total). If after taking the first dose of this drug the victim has severe headache pulsating nature, then the subsequent dose should be halved. And if after taking Nitroglycerin there was a sharp decline blood pressure indicators, then repeated use of this nitrate-containing drug should be discontinued. When using Nitroglycerin analogues (for example, medicine in the form of Izoket spray), each dose should be 0.4 mg. Before injecting the product, the first dose should be released into the air, as it may not be complete. After this, the patient must take a deep breath and hold his breath, then an injection is performed, the mouth is closed, and breathing for 30 seconds should be carried out only through the nose.
5. To prevent blood clots, thin the blood and reduce the load on the heart muscle, give the patient up to 300 mg of crushed Aspirin.
6. You can put a mustard plaster on the area where the pain is localized. Constantly monitor it so that the skin does not burn.
7. Count the patient's pulse, and if he has no history bronchial asthma, and the heart rate does not exceed 70 beats per minute, then give him to take 25-50 mg of Anetolol or a dose of any other beta-blocker (for example, Bisopropol, Propranolol, Nebivolol, etc.). This measure will reduce the risk of arrhythmia and sudden death, will limit the area of ​​necrosis of cardiac muscle tissue, protect the myocardium from toxic effects and increase its tolerance to stress.

Sometimes during an attack of myocardial infarction the patient faints. The following measures can help him in such situations:

• lay the patient on his back and place a cushion under his shoulders;
• remove dental structures from the mouth (if present);
• tilt the victim's head back or turn him to one side if the patient begins to vomit;
• ensure prevention of aspiration of vomit.

Remember! If a patient with signs of myocardial infarction has stopped his heart and breathing, or breathing movements become intermittent (agonal), then you should immediately begin performing cardiopulmonary resuscitation measures - chest compressions and artificial respiration.

Before resuscitation begins, a precordial blow is performed - 2 strong and short blows are applied to the sternum area (at the border of the middle and lower third) from a height of 20 - 30 cm. After their execution, the pulse is immediately felt. If it does not appear, then further cardiopulmonary resuscitation(indirect cardiac massage and artificial respiration):

• pressing on the heart area with a frequency of 75 - 80 per minute;
• 2 breaths into the patient’s mouth after every 15 to 20 chest compressions.

The duration of such actions should be at least 10 minutes.

First aid for myocardial infarction. Algorithm of actions

Emergency care for a patient after the ambulance arrives is carried out in the following sequence:

1. Relief of acute pain with non-narcotic and narcotic analgesics(solutions of Analgin, Morphine hydrochloride, Omnopon, Promedol) in combination with a solution of Atropine sulfate. The drugs are administered intravenously for faster pain relief.
2. Carrying out an ECG.
3. If delivery of the patient to the intensive care unit is possible within the next 30 minutes, then the victim is immediately taken to the hospital.
4. If such rapid transportation of the patient turns out to be difficult, then drugs to restore coronary circulation (Tenecteplase, Alteplase, etc.) are administered on site.
5. The patient is transferred to the ambulance as gently as possible - a stretcher is used for this. During transportation, humidified oxygen is inhaled.

After the patient is delivered to the intensive care unit, neuroleptanalgesia is administered to ensure complete relief. pain syndrome. For this purpose the following are used medicines such as Talamonal or a combination of Droperidol and Fentanyl. If the desired analgesic effect is not achieved, the patient is injected into inhalation anesthesia, which is provided by a mixture of oxygen and nitrous oxide.

• organic nitrates: Sodium isosorbide, Nitroglycerin, Isoket or others;
• anticoagulants: Heparin, etc.;
• antiplatelet agents: Acetylsalicylic acid, Cardiomagnyl, etc.;
• beta-blockers: Propranolol, Inderal, Obzidan, Anaprilin;
• ACE inhibitors: Enalapril, Ramipril, etc.;
• sleeping pills and sedatives: Temazepam, Diazepam, Triazolam, etc.;
• antiarrhythmic drugs: Lidocaine, Amiadron, Novocainamide, etc.

The treatment plan is drawn up individually for each patient. If necessary, other medications may be added to it.

To restore coronary circulation to a patient with severe forms of heart attack, the following surgical operations can be performed:

• balloon angioplasty;
• coronary artery bypass grafting.

Actions of a patient during a heart attack

Patients with coronary artery disease who are at risk of developing a heart attack should know not only the first signs of this dangerous condition, but also the algorithm of actions at the onset of such an attack:

• remain calm and take a “reclining” or “sitting” position;
• inform others about the onset of an attack and the need to take medications;
• if possible, call an ambulance yourself, informing the dispatcher about the development of a heart attack;
• try to move as little as possible;
• if you have medications, take 2-3 crushed tablets of Aspirin, Valocardin and Nitroglycerin;
• Describe symptoms to ambulance workers.

Video: First aid for yourself during a heart attack

After admission to the intensive care unit, the patient must follow all the doctor’s recommendations regarding medication, gradual expansion of physical activity and diet.

How important is first aid for a heart attack?

All cardiologists are unanimous in the opinion that it is timely and high-quality first aid during a heart attack that largely determines the patient’s chances of survival and reduces the risk of complications and irreversible changes in the heart. cardiovascular system. The first actions to save such patients should begin in the first 30 minutes after the onset of the first symptoms, and the emergency team should be called if there is any suspicion of such an attack.

Possible complications of myocardial infarction

Experts divide the complications of a heart attack into early and late:

Type of complications of myocardial infarction	When do they arise?	Types of complications
Early	In the first hours or days (in the first 3-4 days) after an acute attack	rhythm and conduction disturbances (90%), up to ventricular fibrillation and complete AV block; sudden cardiac arrest; internal, external, immediate or slow-flowing cardiac ruptures; mitral regurgitation; acute failure of the organ's pumping function; early epistenocardial pericarditis.
Late	Occurs against the backdrop of expansion motor activity patient 14–21 days after an acute attack	post-infarction Dressler syndrome; chronic heart failure; parietal thromboendocarditis; anterior syndrome chest wall or shoulder syndrome.

Depending on the nature of the damage and disorders, complications of a heart attack are classified as follows:

Type of complications	Nature of damage and violations
Mechanical	rupture of the interventricular septum; rupture of the free wall of the left ventricle; rupture of the papillary muscle; left ventricular failure; dynamic obstruction of the left ventricular outflow tract; large left ventricular aneurysm; right ventricular failure; cardiogenic shock.
Electrical (or arrhythmic)	occur in almost 90% of patients and manifest different types arrhythmias.
Ischemic	enlargement of the infarct area; post-infarction angina; recurrent heart attack.
Thromboembolic	vascular thromboembolism great circle blood circulation; parietal thrombosis of the left ventricle.
Inflammatory	epistenocardiac (early) pericarditis; Dressler's syndrome.

The most severe complications of myocardial infarction include:

• recurrent or prolonged course;
• pulmonary edema;
• areactive or true cardiogenic shock;
• clinical death;
• acute right ventricular failure;
• atrioventricular block at any location of the necrosis zone;
• acute cardiac aneurysm;
• thrombosis and thromboembolism in various organs;
• circulatory failure II B and III degrees;
• ventricular paroxysmal tachycardia;
• gastrointestinal bleeding;
• a combination of two or more complications.

Potential Risks

In case of myocardial infarction, experts identify the following potential risks:

Prevention of heart attack

According to the observations of cardiologists, the first heart attack occurs unexpectedly! That is why the prevention of this health and life-threatening condition should be aimed at preventing the occurrence of heart and vascular diseases and repeated angina attacks.

The main reasons for the development of myocardial necrosis are the following factors:

• arterial hypertension;
• blood thickening;
• atherosclerosis;
• carbohydrate metabolism disorders.

In connection with the above risk factors, prevention of myocardial infarction consists in prescribing a comprehensive drug therapy and diets aimed at preventing atherosclerotic deposits in the lumen of the arteries and reducing blood pressure.

The choice of medications in such cases, their dosage and duration of use are always determined only by a doctor, who is guided by the data of laboratory and instrumental studies!

Typically, a preventive drug therapy plan includes the following:

• antiplatelet agents and anticoagulants;
• statins;
• beta blockers;
• Dietary supplements based on Omega-3 and vitamins;
• unfractionated heparin;
• ACE inhibitors.

A diet with a high risk of developing myocardial infarction should include a reduction in the amount of salt consumed, foods with high level cholesterol, milk and animal fats. Everyone at risk is recommended to quit smoking, drink alcoholic beverages (in consultation with a doctor, only a glass of red wine is allowed), and combat predisposition to stress and emotional overstrain.

Compliance with the doctor’s recommendations on physical activity is also important in the prevention of heart attacks. Such patients are shown:

• appointment of exercise therapy;
• moderate exercise (for example, dancing, race walking, cycling, etc.).

The desire to engage in any kind of sport should always be discussed with your doctor. Volume physical activity determined only individually!

Cardiovascular diseases have held strong leading positions in the list of deadly diseases for decades. dangerous illnesses, and it is myocardial infarction that is one of the most common reasons the occurrence of death. Experts have also noted a significant increase in the number of young patients with this dangerous disease. In this regard, each of us should know how to properly provide first aid in such a condition that is dangerous to health and life. Severe and prolonged pain in the heart area that is not relieved by taking Nitroglycerin, pallor, cold sweat, fear of death - all these manifestations should become a reason to call an ambulance and begin decisive and right actions aimed at saving the patient.

Timely pre-medical and emergency medical care during an attack of myocardial infarction in most cases is the key to the patient’s successful recovery. It is the absence of such activities that often becomes the cause of death even for young people who have encountered this acute cardiac pathology. Cardiologists recommend that all patients with coronary artery disease know the rules for providing first-aid care. It is also important to know what treatment the patient will be prescribed in the hospital in order to prepare for a conversation with the attending physician and ask him the necessary and important questions.

When is it necessary to start performing first aid?

The answer to this question is always clear – immediately. That is, already when the patient began to show the first signs of myocardial infarction. Its onset is signaled by the following typical symptoms:

• intense;
• irradiation of pain into left hand, shoulder blade, teeth or neck area;
• severe weakness;
• fear of death and severe anxiety;
• cold clammy sweat;
• nausea.

With atypical forms of heart attack, the patient may experience other symptoms:

• stomach ache;
• digestive disorders;
• vomit;
• dyspnea;
• suffocation, etc.

First aid in such situations should begin with calling an ambulance. When talking with the dispatcher of this service, you must:

• report the symptoms observed in the patient;
• express your assumption about the possibility of myocardial infarction;
• ask to send a team of cardiologists or resuscitators.

After this, you can begin to carry out those activities that can be performed outside the medical institution.

First aid

During the provision of first aid, the patient’s condition may be complicated by the following conditions:

• fainting;
• heart failure.

If fainting occurs, it is important to remain calm and ensure normal functioning. respiratory system. The patient must be given horizontal position, place a cushion under your shoulders and remove dentures (if any) from the mouth. The patient's head should be in a tilted position, and if there are signs of vomiting, it should be turned to the side.

In case of cardiac arrest, artificial respiration and chest compressions must be performed before the medical team arrives. Frequency of pressure on the midline chest(heart area) should be 75-80 per minute, and the frequency of air blowing into Airways(mouth or nose) - about 2 breaths every 30 chest compressions.

Emergency medical care and principles of hospital treatment

Urgent health care in case of myocardial infarction it begins with relief acute pain. For this purpose, various analgesics (Analgin) and narcotic drugs(Promedol, Morphine, Omnopon) in combination with Atropine and antihistamines(Diphenhydramine, Pipolfen, etc.). For a faster effect, painkillers are administered intravenously. Seduxen or Relanium is also used to eliminate the patient's anxiety.

Then, to assess the severity of the heart attack, the patient undergoes. If hospitalization is possible within half an hour, the patient is immediately transported to medical institution. If it is impossible to transport the patient to the hospital within 30 minutes, thrombolytics (Alteplase, Purolase, Tenecteplase) are administered to restore coronary blood flow.

A stretcher is used to transfer the patient to the ambulance, and during transportation to the intensive care unit, humidified oxygen is inhaled. All these measures are aimed at reducing the load on the heart muscle and preventing complications.

After arrival at the intensive care unit, to eliminate pain and agitation, the patient is given neuroleptanalgesia with Talamonal or a mixture of Fentanyl and Droperidol. In case of a prolonged angioedema attack, the patient can be given inhalation anesthesia using a gaseous mixture of nitrous oxide and oxygen.

Others may also be used to treat myocardial infarction. pharmacological preparations, because tactics drug treatment the patient depends on general condition the patient and the presence of other pathologies (diseases of the kidneys, blood vessels, liver, etc.).

Also for the treatment of myocardial infarction modern medicine uses various instrumental highly effective techniques to restore coronary blood flow:

• balloon angioplasty;
• coronary artery bypass grafting.

Such surgical techniques allow patients with severe forms myocardial infarction avoid serious complications and prevent high risk mortality from this cardiac pathology.

Motor activity of a patient with myocardial infarction

All patients with myocardial infarction are advised to limit their physical activity, since this regime promotes faster replacement of the infarction area with scar tissue. In the first days, the patient must observe strict bed rest, and from 2-3 days, in the absence of complications and signs of heart failure, his motor regimen begins to gradually expand. Initially, he is allowed to sit on a bedside chair 1-2 times a day and sit on it for about 15-30 minutes (the frequency and duration of these actions is determined by the doctor).

These days the patient can eat on his own. He also needs to be washed and cleaned, and he must use a bedpan to defecate (the use of a bedside toilet seat is permissible only with the permission of a doctor and only for patients with a stable heart rhythm).

Starting from 3-4 days, the patient is allowed to sit on a chair for about 30-60 minutes twice a day. In case of an uncomplicated heart attack, the patient is allowed to start walking between 3-5 days (this time is determined by the doctor). The time of such walking and the distances over which the patient moves increase gradually.

In an uncomplicated form of myocardial infarction, the patient is discharged from the hospital on days 7-12, and in complicated cases it can take place only after 3 weeks or more. In the future, the patient must undergo a course of rehabilitation, which can be performed in specialized institutions or at home. During this period the intensity and duration physical activity gradually increases depending on health indicators.

Nutrition of a patient with myocardial infarction

In the first week after myocardial infarction, the patient is recommended to have a low-calorie diet with limited salt, animal fats, liquids, foods with nitrogenous substances, excessively coarse fiber and cholesterol. The diet should include foods that are rich in lipotropic substances, vitamin C and potassium salts.

In the first 7-8 days, all dishes should be pureed. Food is taken in small portions 6-7 times a day.

The diet may include the following foods and dishes:

• wheat bread crackers;
• semolina, oatmeal, buckwheat and rice cereals;
• lean veal;
• low-fat varieties of fish;
• chicken meat;
• protein steam omelette;
• low-fat cheese;
• fermented milk drinks;
• butter;
• salad of fresh grated carrots and apples;
• vegetable soups;
• boiled beets and cauliflower;
• pureed fruit;
• compotes and fruit drinks;
• rosehip decoction;
• weak tea;

During this period, the following foods and dishes are prohibited:

• dough products (pancakes, donuts, cakes, pies);
• smoked and marinated dishes;
• pickles;
• fried foods;
• sausages;
• fatty dairy products;
• salty and spicy cheeses;
• caviar;
• fat meat;
• boiled and fried eggs;
• fish and mushroom broths;
• pasta;
• cooking fat;
• mushrooms;
• legumes;
• sorrel;
• turnip;
• grape;
• tomato juice;
• spices;
• chocolate;
• natural coffe.

2-3 weeks after a heart attack, the patient is recommended the same set of products and list of restrictions, but the food may no longer be pureed, prepared without adding salt and taken about 5 times a day. Subsequently, the patient's diet expands.

Remember! Myocardial infarction is a severe and dangerous pathology, which can cause many severe complications and even the death of the patient. Be sure to follow all the rules for providing first aid in the event of an attack of this acute condition, call in a timely manner ambulance and follow all doctor’s recommendations during hospital treatment.

Providing emergency care for suspected heart attack (myocardial infarction) - Ministry of Health of Ukraine

Myocardial infarction - all “heart patients” and even those who do not have diseases of the cardiovascular system are afraid of this diagnosis. For many, it sounds like a death sentence. Indeed, a patient may die if he is not provided timely emergency care for myocardial infarction. Irreversible processes in the heart develop quickly, so there are 20-40 minutes before it becomes completely late. Usually a person dies within an hour if he does not receive the necessary treatment.

If you help a patient in time - call an ambulance, and follow a clear algorithm of actions before its arrival, you can save the person’s life. Moreover, after treatment he will be able to return to a full life.

Acute myocardial infarction is the death of the heart muscle as a result of cessation of blood supply. When a large cholesterol plaque or a blood clot, it is blocked, and the blood does not fill the heart enough, respectively, to muscle tissue don't arrive nutrients and oxygen. The process of cell death begins.

If blood circulation is resumed at early stage By providing first aid for a heart attack, most of the heart muscle can be saved. After the course of treatment, heart function will be restored.

If you miss this moment and lead to necrosis, cardiac arrest will occur and the person will die.

The difficulty is that you won’t be able to stop the process on your own – you will need medical help. Therefore, you need to immediately call an ambulance, reporting that there is a suspicion of a heart attack. Before this, you need to stabilize the patient’s condition at home and prevent it from worsening.

How to distinguish a heart attack from a heart attack?

Heart disease has a high mortality rate for two main reasons:

• People underestimate the danger, and in the event of a heart attack they write off the symptoms as another heart attack;
• On the contrary, they panic at the slightest ailment, aggravating the condition and taking medications that are contraindicated.

Signs of a heart attack should not be confused with other diseases, especially heart disease or an asthma attack. Incorrect first aid can seriously worsen the patient's condition and significantly reduce the chances of survival. The myocardial infarction clinic looks like this:

• the pain in the heart does not stop or subside after taking nitroglycerin. This is the main criterion that will help to quickly “calculate” a heart attack;
• the pain is severe, covers the neck, jaw, stomach;
• in parallel, shortness of breath and a feeling of heartburn appear;
• the pulse quickens, the blood pressure rises or falls sharply;
• the patient feels chills, limbs become cold and numb. This occurs due to a strong slowdown in blood circulation.

If you notice these symptoms in yourself or someone loved one, you need to urgently call a medical team. First aid for myocardial infarction should begin from the first minutes of the attack.

How to help a person with a heart attack while waiting for doctors

The first thing to do is put aside panic. The clearer and more coordinated the actions, the greater the chances of saving a person’s life. The sequence is not complicated, but it is worth remembering, especially if among your loved ones there are people with chronic diseases hearts.

How to help another person

The first thing to do is to provide the patient with peace. It is not at all necessary to place it in a horizontal position, especially if it is difficult for a person to breathe; it is enough to sit it down or place it half-sitting. Remember that you have a maximum of 10 minutes to begin treatment for a myocardial infarction. What do we have to do:

• Unfasten the collar of your clothes and open the window to provide access to fresh air;
• Give the patient a nitroglycerin tablet. It won't relieve the pain, but it will help buy time. Remember that you can take the next tablet after 15 minutes, otherwise there is a risk of greatly reducing your blood pressure and slowing down your blood circulation even more.
• The pain of a heart attack is so severe that a person can lose consciousness and even die from painful shock. In this state, the patient begins to panic greatly, which causes additional vascular spasm. Therefore, after nitroglycerin, you can give him soothing drops - valocordin or corvalol.
• Provide nursing care– measure blood pressure and heart rate, give if necessary the right drug of those that a person takes regularly.
• You can take an aspirin tablet after chewing it - this will help reduce blood viscosity and improve vascular permeability.
• If the pain is severe, you can give an analgin tablet or a non-steroidal painkiller.

Try to remember all the medications that were given to the patient - doctors will need this information.

If a person loses consciousness, his heart stops

During a heart attack, the patient may “pass out” from pain or lack of oxygen. Emergency assistance for acute heart attack myocardium in this case begins with resuscitation measures:

• To start the heart, you need to sharply hit the patient in the chest on the left side. The stronger the blow, the more likely it is to start the heart. This alternative method when there is no defibrillator at hand.
• Indirect cardiac massage must be performed according to a clear pattern. After 15 pressures on the heart area, you need to breathe air into the person’s mouth, wait for the person to exhale spontaneously, and take another breath. Next - again 15 rhythmic pressures. Remember that such resuscitation assistance cannot be stopped until the ambulance arrives. Cardiac massage can be canceled if the person has regained consciousness and can breathe on his own. In this case, you need to give him nitroglycerin and aspirin.

How to help yourself if an attack occurs when you are alone

Unfortunately, most patients die from a heart attack because there were no people nearby who could help. If you observe the first symptoms of a myocardial infarction, you can provide first aid yourself and save your life. Immediately take a nitroglycerin tablet and call an ambulance, saying that you are alone. If you are indoors, try to slowly walk to the door and open it. Ring your neighbors' doorbell and call for help.

If there are no other people nearby, sit or lie down so that your head is slightly higher than your heart. Try to lean on the wall so you don't fall if you lose consciousness. If there is a first aid kit nearby, take aspirin and Valocordin. Try not to panic and not to disrupt your breathing rhythm - the more ventilation you have, the more time you have before the doctors arrive.

What not to do

First aid for myocardial infarction should be balanced and careful. You should not “stuff” a person with all the medications that come to hand, even if he takes them regularly. It is forbidden:

• Give medications to lower or increase blood pressure without checking its readings. Even if a person is chronically hypertensive or hypotensive, at the time of an attack the pressure may be completely unexpected.
• Place the patient so that the head is below the level of the heart. This can only be done if the pulse is very slow.
• Placing a heating pad on the heart area will only increase the pain and lead to loss of consciousness.

A heart attack develops acutely and can be fatal. Therefore, it is very important if you have characteristic symptoms pathology provide adequate first aid. What needs to be done to help with a heart attack before the medical team arrives? How are resuscitation and other emergency procedures performed? What are the prognosis after a heart attack? Let's try to answer these questions.

Myocardial infarction – acute manifestation heart disease known as ischemic disease. It develops against the background of atherosclerotic lesions coronary vessels. In this case, complete or partial blockage of the heart arteries occurs.

As a result, blood circulation and nutrition of the heart muscle are disrupted. This condition leads to spasm and necrosis (death) of heart cells and their replacement connective tissue. If the patient is not provided urgent help, he might die.

What signs indicate the development of a heart attack? First of all, you should pay attention to the following symptoms:

• The occurrence of acute pain in the heart area. It has specific characteristics:

  • appears abruptly;
  • has an intense paroxysmal character;
  • radiates to the left arm, shoulder blade, neck;
  • lasts from several minutes to several hours;
  • it cannot be removed with Nitroglycerin.
• Paleness and bluishness of the skin.
• Increased sweating.
• Feeling of suffocation, lack of air.
• The appearance of signs of heart failure. A heart attack is often accompanied by arrhythmia and tachycardia. At the same time, the heart beats strongly, the patient feels its beating throughout the body.
• Cloudiness and loss of consciousness. Also, during an attack, hallucinations, a feeling of panic and fear of death may appear.

With atypical manifestations, other signs may be added. For example, abdominal pain, attacks of nausea and vomiting, cough, dizziness and headache.

Most often, a heart attack occurs after the action of provoking factors. A heart attack can occur after physical overload, stress, emotional shock, overheating or hypothermia. It also develops as a result of alcohol or toxic (including drug) damage.

First aid

To help the patient and prevent death, you need to know a certain algorithm of actions. Whenever characteristic symptoms you should urgently call an ambulance. In this case, it is important to report the presence of signs of a heart attack and ask to send a resuscitation team.

What can be done before the doctors arrive? As a rule, first aid for a heart attack comes down to the following manipulations:

It is important to take such measures within the first minutes after a heart attack. This significantly increases the patient’s chances of surviving and avoiding negative consequences.

The most common complications that occur are:

• Primary. They develop immediately after a heart attack. It can be:

  • cardiogenic shock;
  • swelling of the lungs;
  • fibrillation (cessation of activity) of the ventricles;
  • pericarditis;
  • hypotension (sharp decrease in blood pressure);
  • rupture of the heart muscle. Such conditions lead to the death of the patient. This happens in more than half of the cases, even when the necessary revitalizing measures are carried out.

• Secondary. These are complications that lead to irreversible changes in cardiac activity. Among them:

  • thromboembolism;
  • aneurysm;
  • chronic heart failure.

After carrying out the necessary manipulations, you should tell the doctors what exactly you did, as well as what medications and in what quantity you gave the patient.

Resuscitation manipulations

Many people do not know what to do if there is emergency situation and the patient exhibits signs of cardiac arrest. In this case, resuscitation should be carried out:

In some cases, the patient's condition may be complicated by loss of consciousness. In this case, the following actions should be taken:

• lay the patient down, put a cushion under his head;
• remove all unnecessary objects from the mouth (for example, dentures);
• when there is a urge to vomit, the patient’s head should be turned to the side so that he does not choke on the vomit;
• try to bring the person to consciousness (let him smell ammonia, apply a wet towel to his face).

Under no circumstances should the patient be hit or shaken if he faints. This can lead to serious injuries, which will only make the situation worse.

Resuscitation is carried out in case of cardiac and respiratory arrest. If they are performed on time and correctly, the patient’s chances of survival are significantly increased.

Specialized emergency measures

In some cases, after the heart has been started, the patient requires specialized emergency care. Among these measures:

• artificial ventilation;
• use of artificial blood circulation machines;
• use of artificial respiration devices;
• electrical stimulation;
• intubation.

As a rule, special equipment for specialized procedures is located in medical institutions. Therefore, a patient with a heart attack must be urgently taken to the hospital.

Forecasts

A heart attack is a serious condition that often results in cardiac arrest and fatal. The prognosis for successful resuscitation and recovery of a person largely depends on the following factors:

If signs of a heart attack appear, you should immediately call a doctor. The sooner resuscitation is carried out, the higher the patient’s chances of surviving and avoiding dangerous complications.

A heart attack is a sudden interruption of oxygen supply to the heart muscle. As a result, necrosis of heart tissue occurs. It is important to do everything possible to prevent the patient from dying. There is a special algorithm of actions that should be performed before the doctors arrive. Its correct and timely implementation can save a human life.