Signs of myocardial infarction in women

Statistics. General information

Myocardial infarction is an acute condition that occurs when coronary heart disease occurs, accompanied by significant ischemia and death (necrosis) of a portion of the heart muscle. Before reaching a certain age, this condition often develops in male patients, but after 55 to 60 years it is equally likely to occur in both men and women. Why is this happening? The answer to this question lies in the fact that it is after this age limit in the body of women that the level of estrogen protecting the myocardium from negative influences significantly decreases. And it is these sex hormones that ensure the maintenance of cholesterol level at the required level and thereby protect coronary vessels from the formation of atherosclerotic plaques in them.

According to Valentina Petrenko, head of the social policy committee, 7 million people in Russia suffer from coronary heart disease, and the proportion of post-infarct patients is 2.5 million, which corresponds to 2% of the total Russian population. The development of a heart attack in 10-12% of clinical cases threatens the life of the patient, and such disappointing figures point to the need not only to improve Russian cardiology, but also to intensify educational work among the population. With such threatening death rates, one should know about what is myocardial infarction, how it manifests itself and how to give first aid to the patient should everyone.

Video: Myocardial infarction

Causes and predisposing factors

In almost 90% of cases, the cause of myocardial infarction is atherosclerosis, which provokes the plugging of coronary arteries with fragments of atherosclerotic plaques. Such a process in the bloodstream causes the cessation of blood flow to the myocardium and the cells of the heart muscle due to oxygen starvation die. As a result, a necrosis site is formed, which after 1 - 2 weeks overgrows the connective tissue, and the heart can no longer function normally.

In other cases, myocardial infarction is caused by the following conditions and diseases:

• coronary thrombosis;
• trauma to the heart;
• spasm of the coronary arteries;
• tumor.

Such predisposing factors can contribute to the onset of a heart attack:

• atherosclerosis;
• arterial hypertension;
• presence of a myocardial infarction in the anamnesis;
• smoking;
• obesity;
• hypo- and adynamia;
• diabetes;
• increased level of LDL ("bad" cholesterol);
• frequent stressful situations;
• disorders in the blood coagulation system;
• excessive physical or emotional stress;
• alcohol intake in large doses and chronic alcoholism;
• postmenopausal age in women.

Symptoms of a typical myocardial infarction

The characteristic signs of myocardial infarction are as follows:

• intense pain in the heart, shoulder or upper abdomen lasting more than 30 minutes and not being eliminated by taking nitroglycerin or other nitrate-containing or vasodilating agents;
• pains burning, squeezing, tearing or dagger character, which are not eliminated, as with angina, even at rest;
• giving back pain to the left (sometimes right) arm, elbow, wrist, neck, jaw, nape, interscapular area or scapula;
• fear of death, causing panic and severe anxiety;
• presence on the background of painful dizziness, marked pallor with acrocyanosis (cyanotic mucous membranes), cold sticky sweat, nausea and vomiting, fainting;
• difficulty breathing and shortness of breath (these manifestations are enhanced even with a minimal load, for example, after turning the body);
• violation of the rhythm of the pulse and its frequency;
• numbness of the hands;
• first increase, and then lowering blood pressure;
• increase in temperature to 38 ° C (sometimes).

It should be remembered that approximately 20% of cases of myocardial infarction occur in atypical form and such a course of this dangerous condition makes diagnosis much more difficult. That's why everyone should know about atypical symptoms of this life-threatening illness!

Atypical symptoms

Cardiologists distinguish 8 atypical variants of the pathology considered within the framework of this article. Atypical symptoms of myocardial infarction occur only in the acute period of this condition. In the future - in the subacute and postinfarction periods - the ailment proceeds with typical manifestations.

Asthmatic variant

With this development of a heart attack, there are signs resembling an asthma attack, and more often this condition develops against a background of previous heart attacks or present cardiosclerosis. In the asthmatic variant, cardialgia is completely absent or weakly expressed.

The attack of an infarct in such patients proceeds as follows:

• shortness of breath and choking shortness of breath;
• dry cough with discharge of foamy sputum;
• wheezing in the lungs;
• development of pulmonary edema;
• arrhythmia;
• lowering of blood pressure.

Gastralgic variant

With this version of the flow of myocardial infarction, pain occurs in the stomach or upper abdomen and resemble an attack of acute gastritis or pancreatitis. When palpation of the anterior abdominal wall, muscle tension is revealed and further studies are necessary to establish the correct diagnosis, which allows to exclude the pathology of the digestive organs.

Cerebrovascular variant

With the development of this atypical form of infarction, the patient has the following symptoms of cerebral circulation disorder:

• speech impairment;
• dizziness;
• obscuration of consciousness;
• paresis of limbs;
• nausea, vomiting, etc.

Arrhythmic variant

With such a course of the infarction, even after receiving the ECG data, diagnosis is difficult, since signs of arrhythmias (extrasystole, paroxysmal tachycardia or atrial fibrillation) and atrioventricular blockades of different intensity are revealed in them.

The collaptoid variant

This atypical variant of a heart attack is manifested by the following symptoms of cardiogenic shock:

• complete absence of painful sensations;
• dizziness;
• a sharp drop in blood pressure;
• darkening in the eyes;
• cold sticky sweat.

Swelling option

With this atypical form, the patient develops dyspnea, and swelling rapidly builds up. When examined, signs of hepatomegaly and ascites can be determined.

A painless variant

With such a course of heart attack, the patient complains of discomfort in the chest, severe weakness and sweating.Some patients do not even attach importance to the occurrence of these symptoms, and the infarction is transferred "on legs". In such cases, the course of this acute and life-threatening condition is only aggravated, and the ailment is more difficult to bear.

Peripheral version with atypical place of pain localization

In this atypical variant of a heart attack, painful sensations arise not behind the breastbone or in the heart, but in the left arm, the tip of the little finger, the scapula, the cervico-thoracic spine, neck or lower jaw. All other clinical manifestations remain typical: pulse arrhythmia, fear of death, sweating, weakness, etc.

First aid for a heart attack

Video: First aid for myocardial infarction

When the first signs of myocardial infarction appear, immediately call an ambulance, telling the dispatcher about the possible development of this dangerous condition, and begin providing first aid:

1. The patient should be placed in a horizontal position on the back or give a semi-sitting position.
2. Provide fresh air, an optimum temperature regime and remove clothing or accessories that interfere with free breathing or squeezing the body.
3. Try to convince the patient to observe emotional and motor peace. To do this, he should explain the possible consequences of non-compliance with this rule and try to talk with the victim in a calm, even and confident tone.
4. Give a tablet of Nitroglycerin or another nitrate-containing drug. Measure the pressure and if its values are not higher than 130 mm Hg. st., then do not repeat the drug. At a sufficiently high pressure, repeated Nitroglycerin tricks can be performed 2-3 times before the arrival of an ambulance brigade. Each dose in such cases should be given to the patient every 5 minutes. If, after the first pill, the patient has a violent throbbing headache, then subsequent doses of nitroglycerin should be reduced to ½ tablets. And if after the first dose of nitrate-containing drugs blood pressure indicators dropped sharply, subsequent techniques should be canceled.
5. Grind 2-3 tablets of Aspirin and give to take the patient.
6. If the patient can not calm down on his own, then give him a sedative (tincture of valerian, motherwort or Valocardin, Corvalol).
7. To count the pulse, and if its indices are not more than 70 beats per minute and the patient does not have a history of bronchial asthma, then give the victim one of the beta-blockers (Atenolol, Anaprilin, Propranolol, etc.).
8. If the symptomatology developing during an attack does not cause doubts and there is a certainty about the development of a heart attack, the patient can be given an Analgin tablet to relieve pain. In other cases, taking pain medication should be postponed until the doctor arrives.
9. On the heart area, you can put a yellow card and watch it, so that the skin does not have burns.
10. If a patient develops fainting or has a cardiac arrest, then the necessary resuscitation should be carried out. Do not forget to take care of the prevention of aspiration by vomit or tongue twisting: remove dentures, turn the head to the side, fix the tongue, inserting a suitable object between the teeth (for example, a pencil wrapped in tissue or gauze).
11. After the arrival of an ambulance, it is necessary to notify the doctor of all the symptoms and actions taken.

The first harbingers of a heart attack in women

According to the observations of cardiologists, in many women who suffered a myocardial infarction, about a few days or even a month before the onset of the attack, the following precursors of this life-threatening condition arose:

• sleep disorders (up to insomnia);
• nothing unreasonable anxiety;
• snoring or sleep apnea syndrome;
• frequent and nothing inexplicable fatigue (even after a full weekend or vacation);
• swelling of the feet and legs;
• digestion disorders for no apparent reason (the occurrence of such manifestations is explained by the fact that in women the diaphragm is located higher than in men, and the lower parts of the heart are located closer to the stomach and pain sensations are more often given to this organ);
• frequent headaches;
• arrhythmic pulse;
• sudden occurrence of previously absent dyspnea (this manifestation is the first sign of coronary insufficiency);
• uncomfortable sensations and fettering pulling pains in the chest, giving in the neck, arm, shoulder or upper back;
• bleeding gums;
• frequent urination at night.

Features of the infarction clinic in women

After the onset of an attack (that is, the most acute period), especially in women, the leading symptoms of myocardial infarction are pain in the sternum and shortness of breath. The emergence of these manifestations is always an indication for an immediate call of an ambulance!

Unusual symptoms of heart attack in women are due to the following anatomical and physiological features:

• heart rate in women usually reaches 90 beats per minute, and in men - up to 75 strokes;
• the size of the heart in women is less;
• in the body of women there are estrogens that maintain cholesterol levels within the norm and, in fact, prevent the development of atherosclerosis (the main cause of myocardial infarction).

The main differences in the clinical picture of myocardial infarction in women are as follows:

• many women tolerate pain more persistently, and there is often a mistaken belief that their pain is less pronounced than that of men;
• women are more likely to vomit during an attack;
• the nature of the pain syndrome in women is usually somewhat different: the pain is more often given to the left upper limb, neck or jaw, often accompanied by an unreasonable toothache, which gradually self-extinction;
• during an attack, women often feel pain in the back of the head;
• it is women who are more likely to get dizzy, pre-fainting or faint.

Sometimes cardiologist patients ask a question about the likelihood of an infarction during pregnancy. Theoretically, such acute conditions can occur during the gestation, but the risk of their development remains minimal, since during this period of life in the body of a woman the level of estrogens is maintained at a high level. The threat of developing this condition increases in pregnant women who previously took long oral contraceptives, which can negatively affect the blood vessels and blood coagulation system.

Consequences of a heart attack

Complications of myocardial infarction, both in women and men, can be different. Their severity largely depends on the state of health, the vastness of the defeat of the tissues of the heart muscle, the timeliness and correctness of the first aid.

Often after an attack, the patient develops early post-infarction complications, such as arrhythmias and heart failure, which can lead to pulmonary edema and death. The occurrence of these complications is explained by the fact that replacement of a part of the cardiac muscle with connective tissue and scar formation reduce the contractile ability of the myocardium. In more rare cases, the early consequences of a heart attack are: heart rupture, pericarditis, vascular thrombosis (up to ischemic stroke).

With extensive infarcts and voluminous scars, an aneurysm of the heart can be formed. This complication is dangerous for the patient's life, since an aneurysm can break and always creates favorable conditions for thrombosis. That's why such patients always need cardiosurgical treatment.

Long-term consequences of a heart attack include the following conditions:

• chronic heart failure;
• parietal thromboendocarditis;
• neurotrophic disorders;
• Dressler's syndrome (pleurisy, pericarditis, pneumonitis).

Rehabilitation after a heart attack

Restoration of patients after a heart attack has always been complex and aimed at minimizing the risks of repeated seizures and eliminating the consequences. The course of rehabilitation begins even during treatment in the hospital and is made individually for each. It can include the following activities:

1. Continuous use of medications. The patient can be prescribed such medicines: Aspirin and other antiplatelet agents or anticoagulants, beta-blockers, angiotensin inhibitors, hypolipidemic drugs, diuretics, etc.
2. Making adjustments to the motor activity. The motor mode after an attack is extended only by the recommendations of a doctor and does not tolerate the acceleration of events. The amount of physical activity is determined for each patient separately.
3. Rejection of bad habits.
4. Power correction. The diet should include products with a high level of vitamins and minerals, which are useful for the heart. The consumption of caffeine, animal fats, fried foods and salt is necessarily limited.
5. Minimizing fatigue and stressful situations.
6. Fighting obesity.
7. Obligatory dispensary observation at the cardiologist with carrying out Echo-KG, ECG, blood tests and tests with stress tests.
8. Sanatorium treatment: sleep in the open air, mineral and gas baths, massage, physiotherapy and exercise therapy.

Conclusion

Myocardial infarction in women can be manifested by several other symptoms and each of us should know about such possible differences, as the number of such patients grows from year to year. The principles of providing emergency care, treatment, rehabilitation and the possible consequences of this life-threatening condition remain almost the same for both sexes.