Before the heart attacks, it sends out warnings of impending danger. However, we are not always able to use them.
Either we neglect them (there are so many things more important than our health), or we do not believe that something bad may happen to us. It is possible that the infarction is still treated as an elite phenomenon. It is said that it is the disease of directors, managers, senior staff ... It touches people completely devoted to their work, even the heroes. It is only when we get a heart attack that we realize that this is not a medal for hard work, but something completely different. When is the last bell ringing, alarming that we must change something in our lives?
Coronary heart disease often generates symptoms that predict the risk of heart attack.
However, coronary pain is weaker and shorter lasting than symptoms accompanying myocardial infarction. These are promising signs. For the first time, they are usually experienced with considerable effort. They cease with its completion.
Pathomechanism of infarction
The consequence of the detachment of the atherosclerotic plaque from the vessel wall is a cascade of chemical reactions triggering the so-called clotting factors. As a result of their action, one of the blood proteins turns into an enzyme (thrombin). This enzyme converts some blood proteins into strong fibrin strands (fibrin fibers). Threads of fibril are entangled with a "cork" from the lamina like a dense network. In a moment, numerous cells of blood fall into this network like in a trap and already in it - creating a growing, massive thrombus, which does not let the blood flow to the heart. Blocking the coronary artery thrombus and cutting off the inflow of blood to the heart muscle means infarction.
Notice the advanced form of coronary disease - unstable angina.
Symptoms that accompany it mean that there is a large stenosis in the coronary arteries that impedes the flow of oxygenated blood to the myocardium. An ischemic, hypoxic heart begins to choke and choke. Strong ischaemia and hypoxia of the myocardium impairs the contractility of the myocardium that presses blood, especially during physical exertion. The heart then demands an increased amount of oxygen and energy substances. When he does not receive an adequate portion of oxygenated blood - he indicates a state of deficiency with a sharp, numbing pain called angina.
Angina pain; also known as 'coronary pain'.
The warning that constantly warns against a heart attack is the angina pain. He reveals himself: indefinite pressure after the bridge; pain in the chest of pulling or piercing nature radiating to the shoulder or shoulders; sometimes pain in the stomach or neck area. Pain paralyzes the patient, forces fo immobility, raises irrational anxiety. Usually, the pain is short-lived and resolves itself, which is characteristic of a stable form of angina pectoris.
A serious sign of risk of myocardial infarction is angina pains during nighttime rest.
In the stable form of angina pectoris usually disappears after about 30 minutes. These ailments are easy to confuse with back pain, so remember that for heart pains it is typical for them to appear during exercise. They pass after taking a medicine tablet, which is nitroglycerin, which also distinguishes them from other ailments.
Angina pectoris - also referred to as chronic coronary disease - is initially stable
In this form, the disease is stable and mild, with not very frequent symptoms. Angina pains do not last longer than 10-15 minutes, they are rare; they do not occur during rest.In this form, angina pains usually occur only after significant stress or emotional stress. However, it is possible to exacerbate coronary heart disease - i.e. acute coronary insufficiency - unstable angina.
Angina is unstable - it is an exacerbation of chronic coronary heart disease called - acute coronary insufficiency
In acute coronary insufficiency, angina pains are much more frequent and longer than in chronic coronary insufficiency (longer than 10-15 minutes) also during resting. This means a deepening of the ischemic heart, which may be caused by the progression of atherosclerosis and the advancement of the stable course of coronary heart disease. Acute coronary insufficiency - a risk of heart attack
TRAILER CHOICES - ASK THE HEART AND BLOOD CIRCULATION
The examination of the heart and the diagnosis of coronary heart disease should be made as soon as possible after angina pains, which may herald a high risk of heart attack. The most important heart tests include:
Electrocardiogram - ECG
Stress test
scintigraphy
coronary angiography
Electrocardiogram
Called in a nutshell, EKG is a study that does not say much about the danger of a heart attack, but only about a heart attack that has ever passed (or ... is currently undergoing!).
Stress test
This is an ECG test with gradual loading of the subject under increasing effort. Then the oxygen demand increases, the narrowed vessels can not provide enough of it, the heart is not sufficiently supplied with blood. Retrosternal pains appear (angina pectoris) as well as characteristic changes in the ECG (lowering the S-T segment). Sometimes pains do not appear at all, which is referred to as "silent" ischaemia. You can sometimes observe other important symptoms: lack of accelerated pulse and raised blood pressure, which should appear during physical exertion.
scintigraphy
Examination of blood supply to the myocardium with very small amounts of radioactive substance. Vasodilation is manifested by impaired blood supply to specific areas, which is visible on the scintigraphy.
coronary angiography
The study is much more accurate. It is because a thin plastic catheter inserted into the mouths of the coronary arteries is injected with a contrast agent. The image recorded on the film tape allows you to observe the condition of vessels and assess the occurrence of strictures or occlusions. On this basis, decisions are made to treat changes in the vessels. In one in a thousand cases, this may lead to a heart attack. However, coronary angiography provides the most complete picture of vascular changes and should be performed when the patient's pain symptoms are not advanced. This way you can prevent a heart attack. Diagnosis of coronary heart disease
