Signs of a microinfarct: correct diagnosis of the disease

Author Ольга Кияница

2018-05-16

Microinfarctions are most common in the elderly population, but they are often incorrectly or untimely diagnosed, which affects the further treatment tactics. Errors in diagnosis are mainly associated with nonspecific symptoms and the need for a histological examination, which is often performed posthumously.

Microinfarction (MI) is a microscopic lesion that causes cell death or tissue necrosis. It is a consequence of pathologies associated with small vessels, among which the most important is atherosclerosis and amyloid angiopathy.

A microinfarction can have a size of 0.2 to 2.9 mm, so it usually goes unnoticed in a clinical-radiological, for example structural MRI, study and is known as a "silent pathology".

Develop microinfarctions in various organs, but most often - the brain by the type of micro stroke and in the heart muscle, then they say about the cardiac microinfarction. If a person has a high probability of cerebrovascular disease, then the risk of dementia increases.

Video: Microinfarction

Clinical picture

A microinfarction can manifest itself in the form of an attack that is dangerous with an asymptomatic course. In this case, a person may feel at first sight an unfounded weakness, not related to the assessment of the general condition with the likelihood of developing a heart attack.

The first signs of a microinfarction

Usually the earliest signs are:

  • pain in the sternum;
  • numbness of hands or feet;
  • spread of pain in the neck, face, shoulder blade;
  • dizziness;
  • sweating;
  • trembling in the body;
  • feeling of fear.

Patients with any pain in the heart should be carefully examined, since the microinfarction is most often asymptomatic.

Pain

Painful sensations most often indicate a microinfarction. The localization and intensity of pain varies considerably and can be either weak or extremely pronounced. In some cases, there is a painless form of pathology.

Sharp, piercing pain, comparable to a knife wound, as accurately as possible indicate a microinfarction. Also, the pain can be pressing, burning, giving to different parts of the body, for example a scapula or epigastric region. Sometimes the pain is felt in the hands, legs, neck. Often, the face begins to ache, while the main pain sensations are localized in the area of the lower jaw.

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With pain in the heart, patients suffering from heart disease often take a tablet of nitroglycerin. If it turned out to be ineffective, then there is no doubt that a microinfarction occurred.

Cold sweat, severe weakness throughout the body are the main signs of the microinfarction. Later, these feelings are replaced by a sense of fear, panic, anxiety. Often determined by the fear of death, which in nature resembles a panic attack. With prolonged development of the disease, the temperature can rise, which will indicate necrotic processes in the region of the heart or other organ.

Traditionally, pain of any kind and intensity, lasting more than 20 minutes, is already an occasion for calling an ambulance and immediate treatment.

This is very rare among "conscious" citizens, so a micro-infarct is often carried on its feet. Even if the development of a microinfarction does not occur, similar symptoms already indicate a long-term angina that is considered "pre-infarction" in medicine.

Particular care must be taken to monitor people with a reduced pain threshold, as well as those who suffer from diabetes, because the disease also does not completely feel pain.

Psychological disorders

With a microinfarction, there is often a feeling of panic and fear. In most cases, the fear of death, despair, despair, inability to take any action is determined.

Physical signs of microinfarction

Physically, the patient may experience different discomfort sensations, starting with pain, burning or pressure in the chest and ending with shortness of breath. Often, the victims feel that the pain spreads from the heart to the sternum, is transmitted to the neck, hands, face. Sometimes the pain is localized in the area of the lower jaw. If such an attack lasts more than 20 minutes, irreversible damage to the heart tissue occurs.

Arterial pressure with a microinfarction

With a heart attack, blood pressure can be either normal or disturbed. On average, there is a decrease or increase in indicators by 20 units below or above the norm. It all depends on the type of microinfarction and the severity of clinical signs.

The main types of microinfarction

Microinfarction of the brain

The main cause - a sharp violation of blood circulation and oxygen starvation of brain tissue (GM), which is caused by damage to the blood vessels. This contributes to the lack of nutrients, the poisoning of metabolites. At various researches it is defined, that vessels are subject to morphological and functional infringements, an atherosclerotic lesion.

With a microinfarction of the brain, there is:

  • severe headache;
  • dizziness;
  • severe sweating;
  • noise in ears;
  • weakness and tremor in the hands and feet.

The consequence of the microinfarction of the GM can be a violation of sight, speech, sometimes there is a partial paresis. A person loses the ability to articulate his thought clearly, words are often misused, speech can be illegible and incomprehensible to others. Memory is also suddenly broken, a person loses the ability to navigate in space and time.

The nature of the pathology may depend on which part of the brain is affected. The most serious symptoms are observed with damage to the brain stem, since then there are violations that pose a threat to life (respiratory muscle paralysis, collapse, temperature reaction).

The basis of treatment is the principles of neuroprotection, in which therapy is aimed at restoring the impaired blood circulation of the brain and suppressing the local inflammatory process.

Myocardial microinfarction

This pathology is also known as the "cardiac microinfarction." Despite the fact that with a microinfarction only a small area of the heart muscle is damaged, the disease is serious and requires long-term treatment followed by rehabilitation.

Approximately 36% of deaths are from a microinfarction. The most susceptible to this disease are people aged 36 to 65 years.

MI can occur with symptoms in the form of pain behind the sternum and without any signs. If there is no treatment, relapses occur, or an extensive heart attack develops immediately. In some cases, sudden death occurs.

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Separately it is necessary to designate a microinfarction of the posterior wall of the left ventricle. It develops when the blood circulation is disturbed for more than 20-30 minutes. Often occurs as a result of deposition on the back wall of substances of protein nature (fibrins). The greatest risk for the development of this pathology occurs in citizens aged 45 to 50 years, because at this time deposits are formed on various internal organs. The main cause is an excess of cholesterol in the blood, which leads to blockage of blood vessels and impaired blood circulation.

Micro-infarct of the kidneys

The main cause of this disease is a sharp violation of blood circulation due to a thrombus, which clogs the lumen of the vessel. It manifests a sharp, cutting pain in the lumbar region. During treatment, drugs that lower blood pressure, vasodilators, are used. Also important are drugs that help maintain the balance of salt in the body. In addition, antibiotics are needed, since the necrotic process in the kidneys is accompanied by inflammation and infection. If this happens in the child, then hemodialysis is performed.

Microinfarction in women

Women much more often do not notice a heart attack than men. It is because of this that most of the female population suffers from the effects of a microinfarct carried on their legs. Women tend to write off the manifestations of the disease on an unstable emotional state, nervous overexertion, the effects of nervous breakdown or hormonal disorders. In view of this, if there is a relationship to the risk group for developing a heart attack, you need to pay close attention to your health.

The slightest pain and discomfort in the heart for a long time should be the reason for visiting a doctor, as they can point to a microinfarction.

In women, a heart attack is most often accompanied by a feeling of "freezing" and numbness of the fingers. This is due to a violation of blood circulation. Sometimes on the extremities the swelling due to developing edema is detected.Additionally, anxiety, fear, panic are determined. Sweating is markedly increased.

Anatomical and morphological features of the female body contribute to the occurrence of pain in the stomach. This is due to the higher location of the diaphragm in women than in men, which contributes to the spread of pain in the epigastric region. Permanent migraine in the background of high blood pressure may also be an indirect sign of MI.

Microinfarction in men

In the male part of the population, it is more difficult not to notice the microinfarction, because it is accompanied by severe pain in the heart area. In addition, sometimes chest pain extends to other internal organs.

In addition, symptoms can be identified, which are often taken for manifestations of colds:

  • general malaise;
  • headache;
  • pain in the joints;
  • weakness;
  • profuse sweating.

The attack time for a microinfarction can be 45 minutes or more.

Subjectively: in the region of the heart there is a sudden burning pain, most often on the left side; pain gives in the scapula, the left shoulder or the lower jaw; sometimes there is dizziness and even loss of consciousness.

Objectively: the nasolabial triangle takes a cyanotic hue, a tremor of the hands appears. Sometimes you can hear from a distance how a person is breathing heavily, which indicates the presence of dyspnea. There is also an asymptomatic course of the disease.

Microinfarction carried on the legs

The microinfarction, especially the asymptomatic, can develop imperceptibly. Very many patients learn about a previous seizure when going through electrocardiography, when the doctor determines the characteristic ECG-signs.

If the symptoms do develop, they are usually perceived for other diseases or malaise. Often there is a sharp pain in the heart, although it may be completely absent. Nausea, a feeling of pressure, a general malaise is often associated with mild poisoning, a gastrointestinal disorder, and not a microinfarction. The condition can stabilize by itself, or complications arise.

Microinfarction in a dream

Heart attacks often occur in a dream, while in the heart there is a sharp pain. After this, a person usually wakes up, feels numbness in the hands, legs, can not move for a long time. Further often there is a feeling of panic, fear, palpitations, a strong headache. There may be a feeling of lack of air, suffocation.

Accompany MI in a dream cold sweat, trembling, fear of death. In addition, the patient may have a dream in which he thinks that someone has struck him in the heart or made a shot in the heart. As a result, there is a lot of pain, because of which a person wakes up. Especially often this happens with angina pectoris, around 4-5 am.

Diagnosis of a microinfarction

To make the correct diagnosis, you need to contact a cardiologist who will prescribe the appropriate laboratory tests, instrumental examination.

The disease is very difficult to recognize. Sometimes even doctors can not immediately diagnose correctly, because these electrocardiograms can be very controversial. With a small MI cardiogram may not even indicate the presence of a microinfarction. In such cases, additional studies are carried out.

  • Lab tests

Be sure to perform a biochemical blood test, which shows an increase in the level of myoglobin. The activity of creatinine phosphokinase, lactate dehydrogenase and troponin also increases.

  • Instrumental diagnostics

For more information, an electrocardiogram, an echocardiogram, an MRI or a CT scan is performed. Holter monitoring is also prescribed in combination with electrocardiography.

Often used ultrasound of the heart, which allows you to determine myocardial contractility. On ultrasound, you can visualize an area in which the contractions are weakened or completely absent. This indicates a partial defeat of the heart tissue or complete necrosis. Depending on the size of the microinfarct, large foci of necrosis can be detected using a special imaging technique known as diffusion-weighted imaging. [1 - Smith, Eric E. MD, Julie A. Schneider, MD, Joanna M. Wardlaw, MD, and Steven M. Greenberg, MD. "Cerebral Microinfarcts: The Invisible Lesions." Lancet Neurology 11.3 (2012): 272-282. PMC. Web. 20 Mar. 2016]

  • Microinfarction on ECG

In most cases, changes in the electrocardiogram do not directly indicate a microinfarction. But they emphasize the ischemic processes in the cardiac tissue, which makes it possible to suspect MI and conduct additional research. The ECG can reflect a standard heart attack - in the form of the appearance of the Q wave, which intensively expands and sometimes deepens.

  • Differential diagnostics

The microinfarct differs from metabolic disorders, hypokalemia and pancreatitis. For this, potassium chloride is used, which is used by the patient. Before you drink a medicine, the patient is electrocardiogram. After the medication is taken, the ECG is repeated and the results are evaluated. The ST segment changes only if there is ischemia, which indicates a heart attack. In other cases, no violations are determined.

Video: Unusual symptoms of myocardial infarction


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