Myocardial infarction can occur at any time due to rupture of an atherosclerotic (cholesterol) plaque, explained Anastasia Lebedeva. The formation of atherosclerotic plaques is a disease associated with metabolic disorders. The patient does not notice their growth and a number of external causes – infection or systemic inflammatory disease – can trigger the onset of an acute form of coronary heart disease (myocardial infarction).
“If a patient with a myocardial infarction is not helped as soon as possible, then within a few days death may occur with a probability of approximately 50%,” said Anastasia Lebedeva. — At the same time, mortality can be reduced by more than 5 times. To achieve this, emergency intracoronary intervention must be performed within the first 24 hours. Along with this, multicomponent antithrombotic treatment is carried out in intensive care units. Constant monitoring is carried out to ensure that ventricular arrhythmia does not develop, which very often leads to death.”
According to the expert, there is a certain scheme for routing patients with myocardial infarction, the so-called infarction network. Ideally, as little time as possible should pass from the onset of symptoms to the call and arrival of an ambulance.
For thrombolysis (the process of dissolving a blood clot under the influence of an enzyme introduced into the systemic bloodstream, which causes the destruction of the basis of the blood clot), 2 “call-needle” time intervals are taken into account, which should not exceed 90 minutes.
And the “door-needle”, which should not exceed 30 minutes. Once the patient arrives at the hospital, percutaneous coronary intervention (PCI) is performed.
Patients who have suffered a myocardial infarction remain at a high long-term risk of subsequent cardiovascular complications, said a senior researcher at the Russian Gerontological Research and Clinical Center. Alexander Rozanov. Approximately 50% of significant coronary events occur in patients previously discharged from the hospital with a diagnosis of coronary heart disease. Prevention of acute conditions of coronary heart disease, such as myocardial infarction, is extremely important. It reduces the risk of recurrence of acute conditions and improves patient prognoses. Main risk factors: poor diet, physical inactivity, tobacco smoking, excessive alcohol consumption, excess weight, hypertension.
“According to the INTERHEART study*, smoking accounts for 36% of the population risk of a first myocardial infarction. Moreover, the incidence of myocardial infarction is 6 times higher in women and three times higher in men who smoke more than a pack of cigarettes per day, compared with those who have never smoked. On the other hand, the risk of a second heart attack for those who quit smoking after the first heart attack is halved within a year, and after two years it becomes the same as for non-smokers,” emphasized Alexander Rozanov.
Anastasia Lebedeva noted that there are people who can quit smoking “once and for life.” But most people find it difficult to make such a decision. In such cases, drug or replacement therapy is used, and it is also possible to consider switching to alternative sources of nicotine, for example, to electronic tobacco heating systems, where there is no combustion process and does not emit cigarette smoke, which contains the main carcinogens and toxicants.
“The main thing is that these funds help the patient take the path of quitting smoking,” Professor Lebedeva emphasized. “You can’t just tell a patient to quit smoking.” He will listen and will not come again. The doctor must say: let’s look for ways, let’s find an alternative.”
Doctors also noted a special diet for coronary heart disease, which excludes the consumption of saturated trans fats, as a necessary prevention. You must follow this diet for life. Also, patients after a heart attack need to engage in physical activity for 30–60 minutes every day.
Partner material: PMI Science