Definition and causes
The heart consists of special cardiac muscle. Around the heart runs crane pulse arteries (coronary arteries) that supply the heart with oxygen and nutrients. If the oxygen supply from coronary arteries pulse is not strong enough, the heart muscle is not pumping properly, and the area of the arteriegrenen supplies, will die. This is called an acute myocardial infarction (AMI) or myocardial infarction. A Danish name, the heart attack.
Iltmanglen is often caused åreforsnævring (arteriosclerosis) in coronary arteries pulse. If there is a slight injury on the inside of åren, can be deposited in particular fat inside karvæggen. This leads to an unevenness that makes platelets clumps together to form a so-calledtricyclic. When the thick flank (trigger) will be sufficient, for the lack of oxygen-symptoms. Atherosclerosis begins in the small already in the teenage years, and can occur in all major arteries. It marks not before most of the tank is closed.
Before the artery completely sealed, there may be periods of heart spasms (angina). These are apparent in physical load (of major or minor character) and fades by itself or by consumption of nitroglycerin (kar-expanding) tablets. Infarction can also occur without prior heart spasms.
In rare instances, a myocardial infarction, for example. due to a breakaway trigger an artery from somewhere else in the body, which suddenly endowed opper a coronary artery. Such a blood clot called aembolism.
The following are predisposed to åreforsnævring reasons:
- Male(Males develop Infarcts around. Ten years earlier than women).
- For high cholesterol, Especially LDL cholesterol.
- Lack of exercise.
- High blood pressure.
- The trend for arteriosclerosis in the family.
See also Atherosclerosis and prevention.
Myocardial infarction is a very frequent disease, and in Denmark found around. 2500 per case. million population. About 30% of these are fatal.
Symptoms of coronary disease
A myocardial infarction occurs suddenly. There appears strong, sultry pain behind the sternum, and they can jet off to neck and shoulder, usually the left. There may also be pain from the jaw, back and abdominal region.
At around. half infarction after a physical or mental exertion. The pains disappear after cessation of load, nor by intake of nitroglycerin. The pains goods untreated many hours. Other symptoms that may prove:
- There may be symptoms of heart failure, especially in the elderly.
- Accompanying vomiting and nausea.
- The sickness is pale and obnoxious sweating.
- Intense fear.
- Dizziness and fainting.
- Rapid breathing.
In approximately 15% in occluded infarct seen no symptoms and the disease seen only in elektrokardiagram (ECG) over the heart. It seems especially in the elderly and in people with diabetes.
Precautions and diagnosis
Up to a certain age have any greater or lesser extent arteriosclerosis. In most progressing so without symptoms, and you die of other causes. However, it is very important to avoid as many of the above reasons operative as possible.
If you are not hereditary congested, there is very little risk of contracting disease åreforsnævring rewarding, if you are of normal weight, grows exercise, avoid stress and not smoking. Monday suffering from heart seizures, it is especially important to change his lifestyle on the points which are possible.
For new onset coronary disease is sometimes an important factor for survival. The sooner you come to a hospital, the better the prognosis. You must call 112 at the nascent strong pain in my chest. Avoid all unnecessary activity, and never even run at the hospital since fainting may occur. Make sure the sick are not alone, and keep him warm and relaxed as far as possible.
We must never panic, and even if the person had to go into shock or cardiac arrest a few, there is an opportunity to help, including the first (if you are trained).
Myocardial infarction diagnosed partly on the typical disease picture, by means of an ECG. In a blood test will be found elevated levels of so-called cardiac enzymes, and the signs of dead heart.
By ultrasound examination of the heart (echocardiography) looks directly at the heart structures, and poorly pumping tissue can be seen.
Treatment of coronary disease
In Denmark treated coronary disease at this time on special departments at the major hospitals in the country. Optimal treatment is rapid primary PCI (percutaneous coronar intervention), which through a plug in groin introduce a balloon that can break the throat and extend the tank (ballonudvidelse). Often you will enter a "stent, a metal grille that hold the artery open.
At hospitals that do not have the opportunity to perform this procedure will begin Monday called thrombolysis treatment by injection into a vein. The treatment dissolves blood clots and must commence within 6 hours of Anfal its start, the sooner the better. Transfer to the hospital with the possibility of PCI will happen as soon as possible.
On arrival at the hospital, the doctor begin receiving a medical treatment program up to help the sick until ballonudvidelse is possible. They are:
- Morphine, which helps against the pain while doing that we relax more and become less anxiety.
- Oxygen, so the heart gets a bigger ilttilbud. Breathing becomes calmer and oxygen seems relaxing.
- Hjertemagnyl makes the blood less able to solidify, so clots can not grow more. This must be taken daily for life.
- Nitroglycerin, expand coronary arteries so that more blood to the heart muscle. Veins also expanded, so the body's blood accumulates here, and there are not too much to heart, so it does not have to work so hard.
- Beta-blockers. Blocks adrenaline effect on the heart, so it does not turn as quickly and strongly. Given to anyone who does not have low blood pressure or low heart rate.
- Heparin. Blood thinners, which also stops the blood clot's growth. Administered by an injection into the abdomen.
- If there was heart failure, which dealt with the so-called ACE inhibitor that blocks a hormone that causes blood vessels to tighten. After years expands, the heart does not pump against so much opposition, and its work easier.
After successful treatment for myocardial infarction, most of the blood pressure-lowering treatment. Cholesterol lowering by diet and kolestorolsænkende medicine (called statins). As mentioned earlier, a lifestyle change an important prerequisite for the subsequent health.
The prognosis depends largely on the size of infarction (how much heart muscle, which is dead). The sooner there is ballonudvidelse, the better the prospects, and this reduces the risk of having another stroke.
The prognosis is good, if not occurring cardiac arrythmia, or pump failure, six hours after the pain disappeared. Monday survive the first month, is 70-80% chance of surviving the next five years.
Complications of coronary disease
There may be several complications of the disease, and many of them are associated with low survival. If the tissue destruction involving the electrical systems controlling heart contractions, it can give heart rhythm disturbances, which is a feared