The infarction generally refers to myocardial infarction, the muscle of the heart. Nevertheless, a infarction can touch any vascularized organ of the body as soon as the arterial circulation which “nourishes” the cells of this organ is interrupted. Definition, causes, symptoms, good gestures … Zoom on the infarction.
Heart infarction occurs when a clot blocks a coronary artery. The only solution is to Unclog the artery as quickly as possible After the start of the symptoms. This rapid “reperfusion” decreases mortality and complications associated with myocardial infarction. In women, The infarction does not always manifest itself as in humans. The French Federation of cardiology recall that Almost half of women under the age of 60, victims of a myocardial infarction have not felt classic symptoms. People with high cardiovascular risk and those around them must have The reflex to compose 15 or 112 on a laptopwhen symptoms evocative of a heart attack occur.
What is a myocardial infarction?
Myocardial infarction (IDM), or “heart attack” in everyday language, is a death of the cells of heart Following a defect in vascularization and therefore of oxygenation of these cells. An IDM is due to thebrutal obstruction of a coronary artery by a clot (“thrombus”). The heart acts as a “pump”, within the body. He propels blood through the body and therefore plays an engine role in the blood circulation. During a myocardial infarction, One or more of the arteries vascularizing the heart (coronary arteries) clogs (nt). The blood no longer passes, and the area of the heart normally irrigated by this artery is then deprived of blood. If the artery is not quickly desoccluse, part of the fabric of Heart muscle “dies”. This leads to problems of contraction of the cardiac muscle (myocardium), manifesting itself by rhythm disorders, a heart failure, or even the cessation of the heart. The consequences of a myocardial infarction are more or less important According to the extent of the asphyxiated area and according to the speed of reperfusion. If the damage is very wide or immediately massive, the heart can stop beating because the muscle is no longer infused by blood. He can then occur a cardiac arrest.
At what age are we most at risk of infarction?
In France, the average age of occurrence of myocardial infarction is 61 years in men and 75 years in women. Its maximum incidence is in the decade of 60 – 69 years in men and 70 – 79 year olds in women.
What are the risk factors for a heart attack?
Several factors, called “risk factors for cardiovascular disease” are responsible for the development of the atheroma plate at the origin of obstruction. First of all, the non -modifiable factors:
- age,
- ethnicity,
- Sex,
- Family history.
Then the modifiable risk factors, which are mainly influenced by behavior:
- diabetes,
- dyslipidemia,
- high blood pressure,
- overweight and obesity,
- smoking,
- Psychosocial factors like stress.
What are the different types of infarction?
We distinguish myocardial infarction (touching the heart), brain infarction in the brain (also called “ischemic stroke”), mesenteric infarction in intestinal level, pulmonary infarction which concerns the lungs and the ‘Bone infarction which is a lesion in the bone tissue, the cause of which is an update of the artery which ensures its irrigation.
Symptoms: What does the pain of the infarction look like?
L’Appearance of chest pain represents the typical manifestation of myocardial infarction. This pain violent “takes” in the middle of the chestlike a vice or a crushing, often radiating in shouldersjaw, even even in the left arm. She appears suddenly. It does not disappear at rest. It causes the strange feeling of receiving a weight or bar in the chest. Its intensity varies from a minimal degree to the violent pain. It is accompanied by a impression of imminent death and does not give in to rest. Can also occur discomfort, nausea, dizziness or a loss of knowledge. A myocardial infarction can be very painful, but not always. Some infarction are even silent: Almost a quarter of myocardial infarction are not accompanied by typical signs. It also happens that an infarction is delayed, due to the occurrence of a complication.
Among the warning signs of a heart attack:
- thoracic oppression,
- difficulties in breathing,
- of the palpitations,
- digestive disorders,
- Persistent fatigue and shortness of breath.
What are the causes of myocardial infarction?
Those are Atheroma plates (atherosclerosis) which form inside the blood vessels of the heart (coronary arteries) which shrink their diameter and block the passage of blood. A break in these atheroma plates can also form and blood clot (thrombus) which blocks inside a coronary artery. In both cases, it is the complete obstruction of the latter which leads to suffering from the heart muscle.
Infarctus in women
In women, infarction does not always manifest itself as in men. The French Cardiology Federation recalls that Almost half of women under the age of 60, victims of a myocardial infarction have not felt classic symptomsnamely pain in the chest radiating the left arm and jaw. Women are rather affected by 3 atypical signs: the feeling of exhaustion, shortness of breath and nausea. Particular attention is necessary on the part of young women with at least one cardiovascular risk factor: tobacco, stress, sedentary lifestyle, high blood pressure, cholesterol, diabetes, etc. The women tend to underestimate their pain And to be in denial, which constitutes a real loss of luck, because women recover less easily from a heart attack. Their arteries are more difficult to revascularize, thinner and more fragile than those of men.
Heart crisis in young people
Unlike a widespread idea, the occurrence of a heart attack before the age of 45 occurs for half of cases in people with pre -existing cardiovascular risk factors and/or consumers of recreational drugs. For the other half, it is a coronary vasospasm, a spontaneous coronary dissection or an unmatched thrombophilia.
What examination makes it possible to make the diagnosis of infarction?
The electrocardiogram is the first examination carried out in emergency by the SAMU in the event of suspicion of myocardial infarction. If this one shows that an artery is completely obstructed, it is then a race once morest the clock which undertakes to descend it as quickly as possible (immediate transfer to make a coronarography most often followed by coronary angioplasty). If the artery is only partially obstructed, Medicines are administered and other examinations will be carried out in the service of intensive care cardiological to judge the time to carry out Coronarography. The earlier the treatment is started, the lower the extent of the infarction, the better and long -term prognosis.
It is in the first minutes that everything is played out.
What to do in the event of a heart attack?
As soon as the diagnosis of infarction is suspected, it is advisable to contact in emergency on 15 or 112. “This is a vital emergency. The earlier the care, the better the prognosis. It is in the first minutes that everything is played out“, Recalls Dr. Boulé. Thanks to a few responses, the Samu regulator will be able to assess the patient’s medical condition. A mobile team then comes on site to take care of the patient and drive him to the hospital close. An electrocardiogram carried out on site by first aid teams confirm the diagnosis. In the meantime, make as little effort as possible, lie down and Suit your legs to improve blood pressure And take your treatment (nitro derivative) if you already suffer from angina.
What is the treatment following a infarction?
Treatment following a myocardial infarction (following treatment in the acute phase which aims for revasculariation) begins with close control of cardiovascular risk factors:
- Stopping smoking,
- decrease in overweight,
- decrease in cholesterol,
- Strict balance of blood pressure or diabetes.
At the same time, drugs are systematic: Beta -blockers, aspirin, a statine To reduce the rate of bad cholesterol (“LDL-cholesterol”), an inhibitor of the conversion enzyme, and a nitré in spray derivative to take in the event of new symptoms: patient education is essential. Finally, following infarction, Heart rehabilitation is essential to re -educate the heart for effort.
Complications of a infarction
The complications of myocardial infarction are of 2 orders: those occurring at the time of the infarction and those occurring at a distance, consequences of cell death of part of the heart muscle. At the time of the infarction, the most serious risk is the death of the subject. At the same time, can occur Heart rhythm disorders, cardiogenic shock … Among the remote complications, we also find heart rate disorders, a risk of recurrence of the infarction, but above all Chronic heart failuremain complication causing the impact on the life of the individual.
In order to avoid making a new myocardial infarction, risk factors must be reduced:
- maintain a balanced diet,
- practice a sporting activity,
- NO SMOKING,
- avoid overweight,
- regularly take your medication,
- Respect regular medical follow -up.
“In the vast majority of cases, even if it is apparently a brutal event, the infarction reveals a fouling of the arteries of the heart (coronary arteries), which was made up very gradually over several years, under the ‘Influence of cardiovascular risk factors “explains Dr. Boulé before listing other risk factors: heredity, age, high blood pressure, sedentary lifestyle, too high cholesterol, etc.
What are the infarction figures in France?
We count approximately 120,000 myocardial infarction per year in France. Environ 10 % of victims die within an hour And the mortality rate at one year is 15 %. The prognosis has improved in the past 15 years: thanks to therapeutic progress, the SAMU intervention speed (provided you call it quickly) and the increased availability of operational interventional cardiology units 7 days a week and 24 hours a day, Mortality relating to 30 days fell by 68 %. “We observe that The proportion of women under the age of 60 victims of IDM is clearly increasing. In the French Fast -i register, it increased from 17% in 1995 to 29% in 2015. This is largely linked to the increase in risk factors in this population, especially smoking and obesity“, Details Stéphane Boulé, cardiologist specializing in the management of cardiac rhythm anomalies and member of the French Cardiology Federation.
Thank you to Dr Stéphane Boulé, cardiologist specializing in the management of cardiac rhythm anomalies and member of the French Cardiology Federation.
