Health

Acute Myocardial Infarction: Symptoms, Causes, Treatment, and Prevention

  Acute myocardial infarction is the most common cardiovascular disease with the highest fatality rate. It is caused by acute blockage of the coronary arteries supplying the myocardium, resulting in myocardial cell ischemia and hypoxia. Even if the patient does not die from acute myocardial infarction, there is a high possibility of complications such as heart failure and arrhythmia in the future. Therefore, we should pay attention to the possible symptoms of acute myocardial infarction in daily life, identify them early, seek medical treatment as soon as possible, improve the cure rate of acute myocardial infarction, and improve the quality of life.
  The main manifestations of acute myocardial infarction:
  50% to 80% of patients have prodromal symptoms such as fatigue, chest discomfort, palpitations, shortness of breath, irritability, and angina pectoris a few days before the onset. The most prominent is new-onset angina pectoris or exacerbation of existing angina pectoris. Once an attack occurs, it often manifests as sudden and severe retrosternal or precordial compression pain. A small number of patients may experience throat tightness, mandibular and tooth pain, and pain in the left upper limb or under the xiphoid process. It lasts for more than half an hour, even up to several hours or days, and cannot be relieved by rest and taking nitroglycerin, and is often accompanied by irritability, sweating, fear or a sense of dying. However, there are also some patients who only show symptoms such as mild chest tightness, upper abdominal blockage and discomfort, nausea, and suffocation. Elderly patients with diabetes, occlusive cerebrovascular disease, or heart failure are prone to painless myocardial infarction, which is easy to miss diagnosis.
  The diagnostic criteria for clinical acute myocardial infarction must meet at least two of the following three criteria:
  (1) clinical history of ischemic chest pain; (2) dynamic evolution of electrocardiogram; (3) dynamic changes in the concentration of serum myocardial necrosis markers . In addition, the difference between acute myocardial infarction and angina pectoris needs to be recognized.
  CHEST PAIN CHARACTERISTICS
  Angina pectoris is mostly substernal compressive or suffocating pain, which often occurs due to labor, emotional agitation, and exposure to cold. The pain lasts for a short time, usually within 15 minutes. Oral emergency medicine can effectively relieve the pain. The pain of acute myocardial infarction can occur not only in the sternum, but also in the upper abdomen, and the pain is more severe, usually without obvious inducement, and the pain lasts for a few hours or 1 to 2 days. The efficacy of oral emergency medicine is poor or ineffective .
  Accompanying symptoms are different
  . Acute myocardial infarction may present with dyspnea, pulmonary edema and other manifestations. Arterial blood pressure often decreases, and even shock may occur, while angina pectoris usually has no such symptoms.
  Laboratory and electrocardiographic examination results are different.
  Acute myocardial infarction will show increased myocardial necrosis markers and characteristic changes in electrocardiogram, but angina pectoris usually does not have such changes.
  Coping methods for acute myocardial infarction Patients
  with myocardial infarction and their family members must master the “120” first aid method, that is, dial “120” when chest pain occurs, and strive for golden 120 minutes for myocardial infarction treatment. Since myocardial infarction often occurs suddenly, early detection and early treatment should be achieved.
  Treatment before admission
  (1) If there is a history of coronary heart disease and angina pectoris in the past, and the attack time is longer than 15-20 minutes, or there is no history of coronary heart disease, but it is confirmed as acute myocardial infarction by the electrocardiogram performed by the emergency personnel, 300 mg aspirin should be chewed immediately.
  (2) Put nitroglycerin under the tongue while sitting, or chew the medicine into pieces and put it under the tongue. If it doesn’t work, take another tablet every 5 minutes, and it can be used continuously for 3 times. If still ineffective, seek medical attention immediately. Nitroglycerin can increase brain pressure and intraocular pressure, and should be used with caution in patients with glaucomatous cerebral hemorrhage.
  Treatment after admission
  Reperfusion therapy is the most important treatment for acute ST-segment elevation myocardial infarction. Opening the occluded coronary artery and restoring blood flow within 12 hours of onset can reduce the size of myocardial infarction and reduce mortality. The sooner the coronary arteries are recanalized, the greater the benefit to the patient. In hospitals with emergency PCI conditions, if the first balloon dilation can be completed within 90 minutes after the patient arrives at the hospital, all patients with acute ST-segment elevation myocardial infarction within 12 hours of onset should be treated with direct PCI. The balloon is dilated to recanalize the coronary artery, and a stent is inserted if necessary. Therefore, patients with acute ST-segment elevation myocardial infarction should go to a hospital with PCI conditions as much as possible. If there is no condition for emergency PCI treatment, or the first balloon dilation cannot be completed within 90 minutes, and the patient has no contraindications for thrombolytic therapy, thrombolytic therapy should be performed. Commonly used thrombolytic agents include urokinase, streptokinase and recombinant human tissue plasminogen activator (rt-PA), etc., which are given intravenously. The major complication of thrombolytic therapy is hemorrhage, the most serious being intracerebral hemorrhage. After thrombolytic therapy, patients should still be transferred to a hospital with PCI conditions for further treatment.
  Prevention of acute myocardial infarction
  According to different preventive measures, acute myocardial infarction is divided into primary prevention and secondary prevention.
  Primary prevention refers to patients who have already had myocardial infarction, to prevent recurrence, or patients with diagnosed coronary heart disease, to prevent the development of myocardial infarction. First of all, it is necessary to improve the self-care awareness of patients, such as understanding the hazards and causes of myocardial infarction, and changing bad living habits and eating habits. In life, smoking cessation and alcohol restriction are the most basic requirements; in terms of diet structure, the intake of greasy food such as red meat should be reduced; in terms of daily life, avoid staying up late and cold stimulation. Maintain an appropriate amount of daily exercise, keep a balanced mind, and avoid large emotional fluctuations. Second, control high risk factors. Clinical studies have confirmed that there are many factors that can induce acute myocardial infarction, such as low activity, smoking and drinking, obesity, constipation, diabetes, hyperlipidemia, and hypertension.
  Secondary prevention refers to the treatment of diseases that can cause coronary heart disease to prevent the development of coronary heart disease. Follow the doctor’s advice and apply corresponding drugs, such as antiplatelet drugs, β-blockers, statin lipid-lowering drugs, angiotensin-converting enzyme inhibitors, etc., so that blood pressure, blood sugar, and blood lipids can reach the target.
  Treatment of Myocardial Infarction Recovery Period
  After myocardial infarction, most patients will choose interventional therapy, and the effect is better. It should be emphasized that after being discharged from the hospital during the recovery period, you still need to take medicines on time according to the doctor’s advice, including antiplatelet drugs, such as aspirin and clopidogrel; lipid-lowering drugs, such as statins; beta blockers, such as Betoprolol, and ACE – Class I drugs, etc. After taking the medicine for a period of time, many patients stop the medicine on their own for fear of various side effects, which may cause myocardial infarction again and aggravate the condition. In fact, the incidence of long-term side effects of drugs for the treatment of acute myocardial infarction is not high, and most patients can take them with confidence. In addition, patients need to be instructed to improve their lifestyle:
  (1) Low-salt, low-fat diet, eat more vegetables and fruits, and avoid overeating; (2) Quit smoking and limit alcohol.
  (3) Relieve psychological pressure and maintain an optimistic and peaceful mood.
  (4) Formulate personalized exercise prescriptions, mainly aerobic exercises such as walking, jogging, and swimming, emphasizing gradual progress, 3 to 5 times a week.
  (5) See a doctor at any time if you feel unwell.

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