Reduce the modifiable risk factors, recognize signals and act promptly: these are the three rules to survive the infarction. He speaks to Dr. Bruno Passaretti, an expert in Cardiology in Bergamo
When do you have a heart attack?
Infarction consists in the death of some heart cells that receive no more nourishment (blood and oxygen) due to the occlusion of coronary arteries. Coronary arteries surround the heart and are responsible for its nutrition. When one of these suppresses, due to the breakdown of atherosclerotic plaque that flows into the artery lumen causing occlusion, the heart cells begin to suffer and after about 6 hours die. The suffering of myocardial cells is called angina pectoris .
Re-opening of the artery before the death of such cells will prevent the infarction. In particular, if you can reopen the coronary within the first 90 minutes of occlusion, it is likely that no cell dies: this is why it is very important to intervene quickly and that the first hour after the onset of the anine is called Golden hour , golden hour. If, on the contrary, it occurs after 6 hours, it is likely that all the cells are dead and the reopening of the coronary will not produce any or nearly any benefit.
What are the risk factors of the infarct?
There are so many factors that increase the risk of heart attack: age, pollution, illnesses such as high blood pressure and diabetes, smoking, obesity and overweight, stress, sedentary and much more.
Some of these factors are not modifiable, such as age, sex (more men's risk, woman is more at risk after menopause), familiarity and pollution. Others, however, can be avoided. In particular, it is necessary to:
- Keep under control with appropriate disease therapies such as diabetes, hypercholesterolemia, hypertension and hyperuricaemia;
- Follow a rich diet of vegetable products such as fruits, vegetables, cereals, dried fruits and legumes (these especially essential as a source of protein), and low in animal fats (meats, cold meats, cheeses);
- Stop smoking;
- Slim if you are overweight or obese;
- Do more physical activity if you are sitting sedentary: half an hour or a day on alternate days (but not rarely) of moderate activity, such as a bare walk (maybe uphill), light racing, bicycle Or swimming. It must be an activity commensurate with the abilities and age of each; The concept of moderate activity is also being able to talk to who is standing (otherwise intense activity can be defined), but at the end of that activity you need to be tired.
Risk factors act synergistically and exponentially; Those with only one risk factor run a limited risk, but there are more risk factors and the greater the risk of having a heart attack.
On the one hand, prevention plays a key role, but it is equally important to know how to recognize the signs of the heart attack so that it can intervene in a timely manner.
The signals to recognize the infarction
The anginal pain, which if it persists can result in infarction, consists of a feeling of oppression or constriction, as if it had a weight or a vomit inside the chest. Often this symptom radiates to one or both arms, jaw, stomach or back, between the shoulder blades. Sometimes chest pain is not even present, so it is difficult to distinguish the heart from a malicious stomach or back pain. Sometimes the above disorder is associated with nausea, lack of breath, feeling stunned or fainting.
Infarction: The first rule is to call 112
When one of these disorders occurs, the first thing to do is call 112 and do not take personal initiatives. Ambulance staff often relieve the patient by starting effective treatment on site. It is also able to handle the most dangerous complications such as ventricular fibrillation, which causes cardiac arrest (fairly rare but fatal if you do not have trained personnel and equipment such as the defibrillator).
The ambulatory staff also performs an electrocardiogram and sends it to the nearest hospital, so that the cardiologist can inform the patient about the patient's situation. This way, when the patient arrives at the hospital, he will find the already equipped Emodynamic Room and staff ready to undergo a coronary artery , which is an examination that allows the coronary instinctively to reopen by interrupting that chain of events leading to cell death.
Treatment of infarction consists in inserting a balloon occluded in the occluded artery, which, inflated at the occlusion point, reopens the coronary by moving all the material that has blocked it against the walls and, therefore, in positioning a stent , A small metallic net that holds the coronary forcibly open.
Editor Karin Moscow