Life after myocardial infarction

Myocardial infarction (MI) is the death of a part of the heart muscle, because one or more of the coronary arteries were blocked by atherosclerotic plaques. As a result, the heart is less contracted, having a smaller number of capable cardiomyocytes. Health problems occur during physical exertion, because the body needs more oxygen, and its heart can not provide in full.

There is a so-called "tense dyspnea," which means that the body needs oxygen to carry out further activities. This is why patients whose heart is no longer able to meet oxygen needs are physically limited.

Inactivity leads to a further decrease in physical performance. The muscles and the cardiovascular system are losing power, and the situation is deteriorating. In order to get out of such a vicious circle, recommendations should be followed, both general, given to all the infarcted patients, and individual, defined in each case separately.

Video: Rehabilitation and way of life after myocardial infarction

Physical activity after myocardial infarction

Relation to rest and exercise after MI has significantly changed over the last hundred years in terms of rehabilitation of cardiac patients.

• In 1930, after a heart attack, strict bed rest was prescribed for two months.
• In 1956, a minor activity in the form of walking was recommended two weeks after myocardial infarction. This is not the most successful achievement, but progress.
• In the 1960s, various studies of cardiovascular changes were conducted during training. The first attempts to use the exercises as a therapeutic method began to be made.
• In the 1980s, studies have already appeared that show significant advantages in reducing risk factors, mortality and the frequency of relapse in patients who underwent a comprehensive exercise program.
• In the 90s, studies provide additional interesting facts, indicating a slow evolution of coronary disease, reducing stress and improving the quality of life against a background of physical stress.

Although there are dozens and hundreds of studies showing the effectiveness of efforts to reduce mortality, the frequency of relapse, improve the quality of life, many doctors (including cardiologists!) Prohibit exercise. Why? This is exactly the attitude that needs to be changed, as it does not fit with the advances in medical science. Indeed, rehabilitation with physical exercises must necessarily be carried out in specialized centers and adapted to each patient after a detailed examination. After these tests, the level of allowable load for a particular patient is established, while the heart and body do not suffer from a lack of oxygen.

Currently, there are many positive effects from an exercise rehabilitation program designed for patients with heart disease. Among them you can specify:

• decrease in heart rate and blood pressure;
• more efficient use of oxygen by muscles, including cardiac;
• improved blood supply to the heart;
• improvement of physical working capacity by 20-30%;
• reduction of inflammatory biomarkers (fibrinogen, C-reactive protein);
• decreased LDL cholesterol and triglycerides and platelet adhesion;
• 25% reduction in cardiovascular mortality and the risk of sudden death by 20%;
• regression of atheromatous lesions;
• the formation of new blood vessels;
• decrease in stress and depression.

Nutrition after myocardial infarction

Changing the power can make a big difference. Studies show that people who eat healthy food can halve their chance of developing a repeat heart attack compared to those who do not eat right.

You need to eat at least five servings of various fruits and vegetables every day. They are rich in vitamins and minerals.You can use them fresh, frozen or dried.

It is important to limit the amount of animal fat. You should try to avoid eating foods high in saturated fat. In particular, meat pies, sausages, butter, cream, hard cheese, cakes, cookies and products containing coconut or palm oil are not useful after IM. Eating foods high in unsaturated fat can help lower cholesterol. These include sea kale, fish of fatty varieties (such as herring, mackerel, sardines, salmon), avocados, nuts and sunflower seeds, rapeseed and olive oil.

Reducing salt intake also has a beneficial effect on health. Many products contain hidden salt. Reducing salt intake can reduce the risk of recurrence of a heart attack, as well as other cardiovascular diseases.

The Mediterranean diet is exactly what a patient who has undergone myocardial infarction needs, as it meets all the above nutrition requirements.

• It is believed that eating in the Mediterranean style is one of the best ways to reduce the risk of a heart attack. This type of diet includes, most often, poultry instead of red meat, a lot of whole-grain flour and bread, plenty of fruits, vegetables, olive oil and fish. Also, this food is rich in various types of oil.

The practice of healthy eating (described above) will help lower cholesterol. In addition, most people suffering from heart disease are recommended to take statin therapy. Statins help to reduce the amount of cholesterol contained in the liver.In general, the lower the level of this substance, the better.

Alcohol after myocardial infarction

Some studies show that drinking a small amount of alcohol can be beneficial to the heart. The exact dose is unknown, but it is clearly very small. Therefore the most correct decision is to give up alcohol altogether. However, in extreme cases, we can limit ourselves to the following recommendations:

• Men should drink no more than 14 units of alcohol per week, these units should be distributed throughout the week, with at least two days a week without alcohol at all.
• Women should drink no more than 10 units of alcohol per week, these units should be distributed throughout the week, with at least two days a week without alcohol.
• Pregnant women and women who are trying to get pregnant should not drink alcohol at all.

Units of alcohol (they are units) is a concept that was introduced in the UK in 1987. With their help indicate the amount of 100% ethanol in grams or milliliters with the account that 1 unit is 10 grams of pure alcohol.

Thus, one unit of alcohol is approximately 125 ml of strong beer, 25 ml of vodka or two-thirds of a small glass of wine.

Driving and flight after myocardial infarction

You should know that you can not drive a car, at least four weeks after a heart attack. Then, provided that there is a satisfactory recovery of health, short driving is allowed. However, if there is angina on the background of driving, you should stop driving, at least until the attacks are well controlled.

Concerning flights, the person usually affected by myocardial infarction can perform them two to three weeks after a heart attack, and then in the absence of complications. At the same time, the following positive dynamics should be noted:

• The patient returned to his usual daily activities.
• The general condition is stable.
• There are no symptoms of cardiovascular disease or they are well controlled.

As a rule, before departure, it is reasonable to consult your doctor, travel operator, airline and insurance company about the forthcoming trip.

Sexual activity after myocardial infarction

Some people are worried about the resumption of sex after a heart attack. For several weeks, that is, during the period of basic rehabilitation, it is best to abstain from intimacy. If there is a positive dynamics in the recovery of health, then the return to sexual relations should not cause any problems.

If sex causes pain in the heart or angina attacks, you must tell your doctor about it.

Some men find that they have problems with getting or maintaining an erection (erectile dysfunction) after a heart attack.These problems can be caused by emotional stress or medications, such as beta-blockers. However, impotence may also have other causes. You need to talk about this with your doctor, who will prescribe treatment if necessary. Various therapies (including medications) are now very effective in eliminating erectile dysfunction, so do not be afraid and hide.

Video: Sex after a heart attack

Stress, anxiety and relaxation

It is believed that stress can cause a heart attack. However, medical research has not confirmed this.

However, being in anxious condition, you can generally feel much worse. However, some people have unreasonable fears and wrong beliefs about heart attacks that can cause symptoms of anxiety.

Do not be afraid to talk to your doctor, especially if you have health problems. In addition, it is useful to learn to positively relax, which will improve overall health and control over the situation.

The way to relax

To relax, you can try to follow the steps below for 2-3 minutes. It is important to practice this every day until the exercise becomes natural, and it does not appear that it reduces anxiety. Then the reception can be done regularly in any stressful situation: slowly and deeply breathe through the nose and exhale through the mouth in a stable rhythm. It is important to try to make an exhalation twice as long as inhaling. For this, it may be useful to consider slowly "one, two" when breathing in, and "one, two, three, four", when an exhalation is done.

• Basically, you need to use the lower pectoral muscle (diaphragm) to breathe properly. The diaphragm is a large muscle located under the lungs. It pulls the lungs down, which allows them to expand their volume, resulting in more air penetrating inside. When a person begins to worry, he is inclined to forget to use this muscle and often uses the muscles of the upper part of the chest and shoulders. As a result, breathing becomes shallow. Thus, a person breathes faster and feels uneasy.
• You can check whether the diaphragm is used if you try to feel it just below the sternum in the upper abdomen. If you cough with a little, you can feel how the diaphragm pushes out your arm. If you hold your hand in this area, you can feel how it moves and how long it takes to exhale during breathing.
• You should try to relax the shoulders and muscles of the upper chest during breathing. With each breath, it is worth consciously trying to relax these muscles, especially until the diaphragm automatically participates in the breath.

Return to work

After a heart attack, most people can return to work within 2-3 months. However, this question requires a highly individual approach. For example, some patients who had a micro-infarction, and they feel good, return to work earlier.On the other hand, other patients with ongoing symptoms or complications, such as chest pain or heart failure, may need more time to do the previous work or move to a lighter type of activity.

Some people have misconceptions about work after a heart attack. For example, they may erroneously believe that work-related stress was the cause of their heart attack, and from that moment it is necessary to alleviate the situation.Nevertheless, increased activity is often preferable after myocardial infarction. Also in a number of cases it is believed that physical work should be excluded. Again, this is usually not the case, especially if you feel well. Indeed, physical exercises often have a beneficial effect on the heart. In addition to many people returning to work is an important part of restoring the quality of life.

Possible solutions:

• It is important to discuss with your doctor when you can return to work.
• It is necessary to organize a phased return to work, especially if the employer is loyal to this.
• You can start with an alternative half-day and gradually increase the load for 2-3 weeks.
• It is better to start with light or less difficult tasks.
• It is important to use additional periods of rest, especially if fatigue occurs.

Some people consider early retirement after a heart attack the best solution, since the future may be uncertain.Nevertheless, it is very important that the patient agrees to this for the right reasons, and not based on fear or wrong beliefs about his heart.

General Provisions

1. If you feel a pain in your chest after a heart attack, you need to tell your doctor about it. A similar manifestation can be caused by angina, which often occurs during training or while walking. Its appearance is associated with the narrowing of the coronary arteries.
2. If there is a feeling of heavy breathing, there is a strong feeling of fatigue than usual, or noticeably that your legs swell up, you need to tell your doctor. These symptoms can indicate heart failure, which is characterized by a decrease in contractile function of the myocardium.
3. Depression is quite common among patients who have had a heart attack. This condition is often exacerbated by unfounded fears. Therefore, again, you need to tell your doctor if there are any assumptions about the presence of depression. The treatment of this condition is now well developed and allows improving the quality of life.

Important to remember

1. Most people who have had a heart attack are completely restored.
2. In many cases, only a small part of the heart muscle is damaged. The rest of the myocardium remains undamaged and in many cases easily copes with the necessary work.
3. Most often, patients who underwent myocardial infarction, can return to the usual kind of activity and perform the work that was before the disease.
4. A heart attack often causes people to reconsider and change their diet and lifestyle. As a result, some patients after this become slimmer and healthier.
5. For some people, the main cause of disability after a heart attack is not the weakness of their heart, but unreasonable worries and concerns about their health. Therefore, one should learn to think positively and relax; and if necessary consult with your doctor if there are any problems.

Video: Rehabilitation and way of life after myocardial infarction