Heartbreak - is compromising the integrity of the heart walls.Typically, a heart attack occurs during the first week of new-onset myocardial infarction.Heart attack, happened again, very rarely ends with a broken heart.This is due to the fact that resulting from the previous myocardial scar is resistant to lack of oxygen (ischemia, hypoxia).
patients at a young age are less prone to rupture of the heart, as opposed to the elderly.There are internal (in which there is a rupture of papillary muscle and interventricular septum), interior and exterior a heart attack, which can be divided into 3 types:
- the first type is characterize
- the second type is caused by rupture of the lysis.In this case, you can watch or at least a longer interval between coronary artery disease and cardiac tamponade.
- the third type is characterized by a heart in the center of acute aneurysm.It occurs at an early stage of coronary artery disease.
can also select the one-stage heart failure and slow-moving, leading to a gradual deterioration of the patient.
complete rupture of the heart is characterized by damage to apply to the full depth.Incomplete rupture accompanied by damage to the heart muscle is not the full depth, with the further development of the aneurysm.
rupture of the aorta of the heart is characterized by a bundle of layers of the aorta due to the fact that the blood flows between the walls.Also, there is often a gap heart valve as a result of an illness or injury.
cause of early heart attack is myocardial infarction.Regardless of gender, cardiac rupture can occur in anyone.However, we know that women are more prone to heart attack than men.Basically, there are breaks in the heart of primary incident myocardial infarction.Repeated occur rarely.This is due to the fact that individuals who have previously had a heart attack, formed fibrotic changes in the myocardium and collateral circulation, preventing rupture of the heart.
deep and extensive lesions occur when transmulyarnom myocardial infarction.Quite often transmulyarnye extensive destruction of the heart muscle leading to heart failure.
Heartbreak, resulting from the high blood pressure is controversial today.There are experts who deny that possibility.However, some argue that patients with hypertension, which is not reduced diastolichskoe blood pressure (the acute phase of myocardial infarction) are subject to a heart attack.
There is evidence indicating that a heart attack occurs in 58-100% of patients with high diastolic pressure.For this reason, myocardial needed medications that help to reduce blood pressure, thereby decreasing the load on the myocardium and an acceleration of the healing of heart muscle (formed scars).
In the case of mental and physical stress, disorders of strict bed rest, especially during the acute phase of myocardial infarction, as possible rupture of the heart.In the first week after a heart attack, when patients begin to walk, to overcome the steps, the load on the damaged heart begins to increase.It is proved that there are cases when there is a rupture of the heart during a conversation with relatives and even in his sleep.
In case of late term hospitalization for heart attack, which from the beginning has been more than 24 hours, can lead to a heart attack, even when transporting a patient.Also, when the later reception thromboembolic drugs which promote dissolution of the thrombus, a heart attack may occur.In case of early supplementation, coronary blood flow is restored quickly, so the death of a heart attack occurs in rare cases.
When receiving anti-inflammatory, and hormonal drugs the inhibition of scar formation in the damaged portion of the myocardium, resulting in the likelihood of a heart attack is very high.
Heartbreak fear can occur even in a fully healthy person.This is due to the fact that in an emergency pressure fear heart rate increases, and blood flow in the muscle is enhanced.It produces more adrenaline, and by having ventricular fibrillation does not allow them to pump blood, resulting in death.
gap aortic heart can only occur in the case where the inner elastic membrane is thinned, thereby forming a clearance, from which seeps blood.As a rule, separation walls fatal.
Break heart valve may result from chest trauma, or infectious endocarditis.Quite rarely occurs in the case of acute heart failure.
Heart attack symptoms
prescission The period can be observed an intense pain in the heart, radiating between the shoulder blades, which is not relieved by nitroglycerin and narcotic analgesics (morphine).
Symptom shock caused by cardiac tamponade, will increase rapidly (blood pressure falls, lost consciousness, weak pulse, cold clammy sweat appears).An electrocardiogram can be registered as follows: ST interval rises and deeper pathological tooth QS in at least 2 leads.It says the expansion of affected areas and coming heart failure.
Heartbreak clinically accompanied by a sharp reduction in high blood pressure in the vein, the vein swell.These changes indicate the development of nodal or sinus bradycardia.
rupture of the heart can be slow, and perhaps suddenly.Typically, it often occurs suddenly due to the fact that the cardiac tamponade is rapid blood flow ceases.The patient suddenly loses consciousness, cyanosis pronounced - the skin turns gray-blue color in the upper half of the body and face.Jugular vein swell neck is much thicker.Mild heart sounds are heard.Blood pressure and pulse disappear.After 1 minute breathing stops.An electrocardiogram is recorded wrong rhythm that goes into asystole (full cardiac arrest).
slow rupture can occur for a few days or hours.This is related to the magnitude of the gap through which blood will flow into the pericardium.This creates intense pain that is not relieved by narcotic analgesics and nitroglycerin.Pain, often repeatedly will weaken and themselves grow, then fade and so on.
Skin takes on a gray hue, and the patient is covered with sticky cold sweat.Presence of a weak pulse and arrhythmia.Also, the lower (diastolic) pressure is able to reach the ground, the upper (blood) will be quite low.If the gap stop (thrombi are formed), then it follows that the symptoms start to diminish, stabilize blood pressure.On the ECG changes can be registered identical to the sudden rupture of the heart.
Despite the slow development of heart failure, often death occurs.But in the case of time spent puncture pericardium and urgent surgical intervention, patients can survive.
At rupture of the interventricular septum myocardium suddenly appears intractable pain.Begins to develop cardiogenic shock, in which blood pressure drops sharply, there is a sticky cold sweat, the skin becomes bluish tint, lost consciousness.
In the case of breaking the partition between the ventricles, neck veins swell, the liver increased in size, with pressure on it causes pain, swelling further formed feet and legs.As a rule, it ends in death.
When papillary muscle rupture rapidly formed pulmonary edema.In this case, it is practically impossible to save the patient and the following symptoms occur:
- Sharply renewed intractable pain in the myocardium;
- Quickly developing shock (blood pressure drops sharply, lost consciousness, weak pulse first, and then completely disappears);
- Shortness of breath is strong, which gradually goes into an attack of breathlessness;
- Coughing up sputum (foam), pink.
At rupture of the aorta of the heart can be seen the following symptoms, depending on the location and type of fracture:
- With the defeat of the aorta, the pain occurs behind the breastbone or in the intercellular area.If ruptured intima, the boring pain, acute, unbearable;
- When you break the abdominal aorta pain occurs in the abdomen, and can irradirovat in the groin, back;
- If ruptured intima, it may increase the pressure (blood), which normalized without taking any drugs.
Common symptoms are: the absence of a pulse in the lower limbs, vomiting, hiccups, nausea, dizziness, weakness emerged sharply.
Heart attack treatment
In order to develop effective prevention heart attack, you need a differential approach to the treatment of heart attacks at every stage of the disease.The main role in the treatment plays an accurate and early diagnosis, timely elimination of the manifestations of coronary insufficiency.
should protect the patient from the conditions that promote intraventricular pressure in the presence of hypertensive disease.Also, accurate and timely diagnosis allows for successful surgical treatment.In such cases a pericardiocentesis and intravenous catheter.Surgical intervention should lead to the restoration of blood flow, eliminating the gap.
If necessary, the coronagraph can hold not only in special laboratories, but also in the operating room.In order to restore the function of the left ventricle using the mechanical circulatory support.Also from the pericardium using a needle to remove fluid buildup (pericardiocentesis).
In some cases, a successful surgery for an internal rupture of the heart.Close the ventricular septal defect, or a prosthetic mitral valve.Surgery can achieve better results, especially during the month after the acute period.However, not all patients can survive at this point, and for this reason prescribed individually different combinations of non-drug and drugs.
Spend as open heart surgery - the gap is sutured to the special lining.In a closed transaction patch installed.Also, prosthetic mitral valve, coronary artery bypass surgery is performed, the area of the aneurysm removed, remove the upper part of the heart to the place of rupture, and in some cases carry out transplants.
At moderate decompensation, appointed for the treatment of cardiac glycosides and diuretics.But this is not enough in severe left shunting of blood or significant mitral regurgitation.
To combat this phenomenon is used peripheral vasodilator agents.Thus, the resistance decreases and the ejection reduced regurgitation of blood by increasing cardiac output.For greater effect is necessary to select drugs that mainly affect the arterial part of the vascular bed (sodium nitroprusside, Phentolamine).
If severe hypertension occurs with complications, the peripheral vasodilators combined with a strong inotropic agent.However, if this therapy is not effective, then resorted to kontropulsatsii (circulatory support).
Treatment of external heart failure actually has no effect.