Heart attack is inherited. Why do young people's hearts stop?

A large heart attack poses a particular danger to human life. If during a normal heart attack blood circulation is disrupted only in a small part of the organ, then with an extensive form of the disease, almost the entire heart is deprived of nutrition, which leads to necrosis of cardiac tissue.

Classification of extensive infarction

Depending on the area of necrosis, extensive cardiac infarction is divided into infarction of the posterior wall and anterior wall. In case of an infarction of the posterior wall, the right coronary artery is blocked, and in case of an infarction of the anterior wall, the left artery is blocked.

The greater danger is an extensive infarction of the anterior wall.

Causes of extensive heart attack

This severe pathology is provoked by many negative factors. Basically, extensive myocardial infarction is caused by several reasons:

hereditary predisposition;
disturbances in the activity of the cardiovascular system (especially atherosclerosis);
kidney pathologies;
unhealthy diet;
sedentary lifestyle;
overweight;
frequent stress and mental trauma;
high blood pressure;
overwork;
diabetes mellitus;
smoking and alcohol abuse.

The above factors lead to the closure of one of the arteries that supplies blood to the heart tissues, as a result of which certain areas of the heart experience oxygen starvation and begin to die due to the accumulation of metabolic products in them. If the patient does not receive the necessary treatment within 24 hours, this will lead to complete tissue necrosis.

Symptoms

First of all, an extensive myocardial infarction manifests itself as a severe heart attack, making a person completely helpless. The patient becomes unable to speak, move, or carry out adequate thinking.

The attack is accompanied by unbearable pain in the left side of the body, which even nitroglycerin cannot relieve, intermittent breathing, shortness of breath, dizziness, pale skin, and the appearance of cold sweat. Painful shock and fainting may occur.

Stages

This pathology is characterized by a clear staged pattern of symptoms. An extensive cardiac infarction goes through 5 periods in its development:

The prodromal period or pre-infarction state (lasts from several hours to a month) is characterized by an increase in the frequency of angina attacks.
The most acute period (its duration is from half an hour to two hours) – there is the occurrence of burning pain, the appearance of cold sweat, a decrease in blood pressure, an increase or decrease in heart rate.
Acute period (duration from two to ten days) – an area of necrosis forms in the myocardium, pain decreases, heart rhythm disturbances and temperature rise.
Subacute period (lasts from four to five weeks) - formation of a scar at the site of necrosis, restoration of heart rhythm, disappearance of pain and normalization of pressure are observed.
The post-infarction period (takes from three to six months) - the density of tissue in the scar increases and adaptation to new operating conditions occurs.

When cardiac infarction is detected in men and women at the stage of the prodromal or acute period, it significantly improves the prognosis for the patient.

Complications of a major heart attack

Extensive myocardial infarction threatens with various complications: arrhythmia, heart failure, myocardial rupture, pericarditis, pleurisy, cardiogenic shock, venous occlusion, pulmonary edema, disturbances in the functioning of various organs, loss of voice, paralysis of the limbs, cardiac arrest and death.

Unfortunately, a serious danger is a massive heart attack, and death occurs very often. The number of deaths exceeds the number of cases of successful treatment.

Diagnosis of heart attack

At the first sign of suspicion of a massive heart attack, you should call an ambulance and hospitalize the patient. At the hospital, doctors will conduct diagnostics. The main method used for this purpose is an electrocardiogram of the heart.

Additionally, the patient is sent for an ultrasound examination of the heart, after which a photo of an extensive cardiac infarction clearly shows the emerging foci of necrosis. A study of the biochemical composition of the blood is also carried out.

Treatment and rehabilitation

Extensive myocardial infarction, the treatment of which must be carried out in a hospital, requires bed rest, complete psycho-emotional rest, a special diet and monitoring of the functioning of all body systems.

The patient is admitted to the intensive care unit. It is often necessary to perform artificial ventilation, cardiac defibrillation or electrical cardiac stimulation.

To cure a large heart attack, the drug method is mainly used. Patients are prescribed medications for:

resumption of blood flow to the affected area (aspirin, prasugrel, Plavix, ticlopedin, clopidogrel);
pain relief (nitroglycerin, analgesics);
getting rid of arrhythmia (lidocaine, amiodarone);
preventing blood clots (anticoagulants);
resorption of previously formed blood clots (thrombolytics).

If necessary, the doctor will prescribe surgery. Surgical intervention is performed by coronary artery angioplasty or coronary artery bypass grafting.

Despite significant advances in medicine that can cure extensive myocardial infarction, the prognosis is not entirely comforting. 40% of those who die do not even end up in hospital. Therefore, immediate hospitalization is extremely important, which significantly increases the chances of recovery. But even timely assistance does not guarantee success: 18-20% of patients die.

Rehabilitation period

After leaving the hospital, the patient remains under the supervision of the attending physician. During this period, it is advisable to purchase a ticket to a cardiological sanatorium and undergo rehabilitation after a heart attack.

To reduce the risk of a recurrent attack, which in most cases ends in death or paralysis, you should follow some rules: stop smoking and alcohol, avoid stress, maintain a special diet, engage in moderate exercise, take a daily walk in the fresh air and take medications recommended by your doctor.

Disease Prevention

To prevent a massive heart attack, you need to lead a healthy lifestyle: eat rationally, exercise, stop smoking, and limit your consumption of alcoholic beverages.

It is still believed that many factors are involved in the development of dilated cardiomyopathy (DCM), but the role of each of them separately in the development of the disease has not been reliably proven.

Viral DCPM.

Develops as a result of viral damage to the heart muscle (myocardium). In several studies, in more than half of the cases of cardiomyopathy, it was possible to identify signs of previous viral myocarditis and, probably, a disruption of the immune system as a result. However, this pattern was observed in only half of the patients, so other reasons deserve attention.

Hereditary DCM

A hereditary predisposition was noted in 20-25% of patients. The genes responsible for this predisposition have even been identified. However, it is possible that this predisposition is not entirely to cardiomyopathy, but to the development of myocarditis, and then, as a consequence, viral cardiomyopathy develops.

Toxic DCM

May occur in patients who have contact with hazardous industrial chemicals. Alcohol and, to a greater extent, beer, which contains cobalt chloride, also have a damaging effect on the myocardium.

Idiopathic DCM

Idiopathic (unidentified) form of the disease - in which it is not possible to determine the cause of the disease, but the patient has and continues to develop symptoms of the disease caused by changes in the heart muscle.

What will a heart ultrasound show?

Cardiac ultrasound is a painless, safe and highly informative diagnostic procedure used to identify diseases, heart defects, dystrophic and structural changes. This study can be prescribed to children and adults for diagnostic purposes or included in preventive examination programs for the purpose of early detection of heart pathologies.

Most often this examination method is called Echo-CG (echocardiography).

The procedure is performed on a special device - an echocardiograph, which is equipped with the following units:

emitter and receiver of ultrasonic waves;
signal interpretation block;
means of input and output of information;
electrocardiographic channel for ECG recording.

Computer programs are used for fast and synchronized processing of data obtained during the survey.

What can be detected with cardiac ultrasound?

Using ultrasound, the doctor can examine the structure of the heart, assess the size of its chambers and the condition of the valves.

Cardiac ultrasound is a simple, informative and widely available diagnostic method that allows you to identify many heart pathologies even in the early stages of development, when the patient does not yet have symptoms. The following patient complaints may be the reason for prescribing Echo-CG:

dyspnea;
frequent or periodic cardialgia;
swelling;
sensations of interruptions in the functioning of the heart and palpitations;
arterial hypertension, etc.

During the examination, the doctor can use a sensor to obtain the following data about the heart:

size of the heart chambers;
structure and integrity of the chambers of the heart;
the presence of blood clots and neoplasms in the chambers and walls of the heart;
the condition of the pericardium and the amount of fluid in the pericardial sac;
thickness of the walls of the heart chambers;
condition and diameter of the coronary vessels;
valve structure and functionality;
the state of the myocardium during contraction and relaxation;
direction of blood movement and its volume;
heart murmurs;
the presence of infectious lesions on the internal structures and valves of the heart.

Types of Echo-CG

Standard transthoracic cardiac ultrasound is the most common type of examination. It is performed using a sensor installed on the chest area and includes the following stages of the study:

I – using parasternal access, the left ventricular chamber, right ventricle, left atrium, aorta, interventricular septum, aortic valve, mitral valve and posterior wall of the left ventricle are examined;
II – using pairs of sternal access, the leaflets of the mitral and aortic valves, the valve and trunk of the pulmonary artery, the outflow tract of the right ventricle, the left ventricle, and papillary muscles are examined;
III - in the apical approach in the four-chamber position, the interventricular and interatrial septa, ventricles, atrioventricular valve and atria are examined, in the five-chamber position - the ascending aorta and the aortic valve, in the two-chamber position - the mitral valve, left ventricle and atrium.

Doppler echocardiography allows you to assess the movement of blood in the coronary vessels and heart. During its implementation, the doctor can:

measure the speed and determine the direction of blood movement;
assess the functioning of heart valves;
hear the sound of blood moving through the vessels and the sound of the beating heart.

Contrast Echo-CG is performed after introducing a radiopaque solution into the bloodstream, which allows the doctor to more clearly visualize the inner surface of the heart.

Stress Echo-CG is carried out using standard ultrasound and Doppler studies and, through the use of physical or pharmacological stress, allows you to identify areas of possible stenosis of the coronary arteries.

Transesophageal echocardiography is performed by inserting a probe through the esophagus or throat. This type of access allows the specialist to obtain ultra-precise images in moving mode. The following situations may be the reason for prescribing this type of ultrasound diagnostics:

risk of aortic aneurysm dissection;
suspicion of the formation of an abscess of valve rings, aortic root or paraprosthetic fistula;
the need to examine the condition of the mitral valve before or after upcoming surgical interventions;
risk of developing left atrial thrombosis;
signs of malfunction of the implanted valve.

This type of study can be performed after additional sedation of the patient.

Indications and contraindications

A doctor may prescribe an Echo-CG procedure to a patient if it is necessary to diagnose the condition of the heart and its vessels or to monitor the quality of treatment. Indications for prescription may be:

detected ECG changes;
heart murmurs;
complaints of chest pain, palpitations, shortness of breath, surges in blood pressure, etc.;
suspicions of myocardial infarction, heart defects, aortic aneurysm, inflammatory and tumor pathologies of the heart, cardiomyopathy, hydropericardium or heart failure;
rheumatism;
complicated course of sore throat, ARVI, influenza;
vegetative-vascular pathologies;
endocrinological diseases;
pregnancy;
thrombophlebitis and varicose veins (to eliminate the risk of pulmonary embolism, or pulmonary embolism).

Cardiac ultrasound is also performed for early detection of developmental abnormalities in the fetus. This procedure is not included in the standard list of examinations for pregnant women, but can be performed at 18-20 weeks of pregnancy if any abnormalities are detected during routine ultrasound screening. Also, echocardiography of the fetal heart may be recommended by a doctor in a number of other cases:

hereditary predisposition to congenital heart defects;
the pregnant woman has a history of rheumatoid arthritis, systemic lupus erythematosus, diabetes mellitus and epilepsy;
the pregnant woman's age is over 38 years;
signs of intrauterine growth restriction.

There are no contraindications for performing a standard ultrasound examination of the heart. Stress Echo-CG is contraindicated in the following cases:

increased susceptibility to thrombosis;
severe diseases of the respiratory system;
recent myocardial infarction (first month after the attack);
the presence of heart, liver or kidney failure.

How is cardiac ultrasound performed?

After standard echocardiography, if indicated, special stress tests may be performed on a treadmill or bicycle ergometer.

No special preparation is required to perform a standard Echo-CG. The patient should be sure to take with him the conclusions of previous studies: this way the doctor will be able to assess the effectiveness of treatment and the dynamics of the disease.

Before performing Echo-CG, the patient must calm down, undress to the waist and take a supine position. During the examination, the doctor asks you to turn on your left side. Also, when examining patients with large breasts, the specialist may ask the woman to lift her breasts.

As with ultrasound diagnostics of other organs, before the examination, a special gel is applied to the skin, which ensures high-quality impulse transmission from the sensor to the tissues being examined and back. As the main accesses for standard ultrasound scanning of the heart with a sensor, various points of the heart axes on the chest are used:

parasternal – in the zone of 3-4 intercostal spaces;
suprasternal - in the area of the jugular fossa (above the sternum);
apical – in the area of the apex beat;
subcostal - in the area of the xiphoid process.

When performing an ultrasound scan, the doctor follows a certain sequence:

Visualizes the valve apparatus of the heart.
Scans the partitions between the ventricles and atria, tracing their integrity in multi-projection and multi-position scanning, and analyzes the type of movement (akinesis, normokinesis, dyskinesia or hypokinesis).
Evaluates the relative position of the septum between the ventricles and valves.
Analyzes the characteristic features of the movement of valve leaflets.
Visualizes the size of the heart cavities and the thickness of their walls.
Determines the presence of chamber dilatation and the severity of cardiac muscle hypertrophy.
Performs Doppler and two-dimensional echocardiography to exclude pathological shunting of blood in the heart, valve regurgitation and stenosis.

When prescribing stress echo-CG, the doctor must take into account the patient’s health status, since he will need to carry out stress using physical or pharmacological methods. The study itself is carried out only under the supervision of an experienced specialist:

First, a standard echocardiogram is performed.
Special sensors are placed on the patient’s body that will record changes during physical or pharmacological stress.
The intensity of physical or pharmacological stress is determined individually (depending on the patient’s pulse and blood pressure). For tests using physical activity, various simulators can be used (bicycle ergometry or treadmill in a sitting or lying position), for pharmacological tests - intravenous administration of Dipyridamole (or Adenosine) and Dobutamine. Dipyridamole or Adenosine cause heart muscle stealing syndrome and arterial dilatation, and Dobutamine is used to increase myocardial oxygen demand.
When used as an exercise stress test, a sensor study is performed after completion of exercise, and when using pharmacological tests, a heart scan can be performed directly during drug administration.

When performing transesophageal echocardiography, transesophageal access is used. To prepare for the procedure of transesophageal ultrasound of the heart, the patient should refrain from eating and drinking 4-5 hours before the examination.

The research is performed in the following sequence:

Before inserting the endoscope, to reduce pain and discomfort, the patient is irrigated with an anesthetic solution in the oropharynx.
The patient is placed on his left side and an endoscope is inserted into the esophagus through the mouth.
Next, the doctor visualizes the structures of the heart using ultrasound waves, which are received and received through an endoscope.

The duration of a standard cardiac ultrasound takes no more than an hour, and a transesophageal ultrasound takes about 20 minutes. After this, the specialist fills out a protocol or research form in which he indicates the results and makes a conclusion about the exact or suspected diagnosis. Conclusion Echo-CG is given to the patient in paper or digital form. The final interpretation of the study data is performed by a cardiologist.

Normal Echo-CG indicators

The cardiac ultrasound protocol indicates many indicators and abbreviations that are understandable only to cardiologists or ultrasound diagnostic specialists. Also, different medical institutions may have different standards for maintaining the Echo-CG protocol. You can see the normal indicators in the table:

Table with normal indicators

Normal indicators are somewhat different in children and adults, men and women - remember this and entrust the analysis of heart ultrasound data to your treating cardiologist!

If deviations from the norm are detected, the doctor must explain to the patient the causes and possible risks of severe complications of the disease and prescribe the necessary course of treatment.

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Echocardiography in children Echocardiography is a non-invasive, painless and safe method for diagnosing heart diseases and major diseases, available in any hospital…

One in two men is at risk of sudden death from a heart attack, while one in three women are at risk.

Typically, coronary heart disease affects men 10 years earlier than women, with the most critical age being 40 years of age.

However, why are men so attracted to her?

Recently, the Lancet, one of the most prestigious medical journals, published a study conducted by the British University of Leicester. University scientists, examining the DNA of 3,233 men, discovered the following. Responsible for the genetic predisposition of the stronger sex to IHD is the Y chromosome, which determines male sex.

More specifically, those men who have a certain variation (polymorphism) of chromosome haplogroup 1 have a 50% increased chance of suffering from coronary heart disease - that is, from a myocardial infarction with complications or even sudden death.

Smoking, high cholesterol, hypertension and diabetes are the most well-known risk factors for heart disease. But when these factors are observed in a genetically problematic person, they sharply provoke bad genes - as a result of which coronary disease manifests itself much earlier. This explains the cases of myocardial infarction in men under 30 years of age who smoke 3-4 packs of cigarettes during the day.

The results of the British study are important from a practical point of view. If a man knows that he has the specified genetic anomaly, he can insure his health - paying attention to those preventive and therapeutic measures that can protect him from the occurrence of coronary artery disease.

The influence of heredity on the development and course of ischemic heart disease was especially clearly revealed during long-term observation of individual families. In this case it is established:

In families where there are patients with coronary artery disease, there is an unusually high frequency of heart and vascular diseases associated with atherosclerosis, often in several generations;
Among first-degree relatives, the incidence of this disease was significantly higher than among the rest of the population. If the prevalence of IHD among the population was 14.1%, then among brothers and sisters of patients with IHD it was 29%.
The incidence of IHD is especially high in families with unfavorable heredity on both parents;
Genetic factors that predetermine the development of coronary artery disease play a greater role in women than in men. The disease is more common (in approximately 50% of children) in families in which the mother died of this disease at a relatively young age.

The role of hereditary factors is evidenced by the higher incidence of coronary heart disease among identical twins compared to fraternal same-sex twin pairs.

In what ways is hereditary predisposition realized in the development of atherosclerosis and ischemic heart disease?

The undoubted role of genetic burden in the development of many risk factors for coronary artery disease, such as lipid metabolism disorders, arterial hypertension, diabetes mellitus, and obesity, has been proven. In some cases, hereditarily determined features of the anatomy of the coronary vessels, as well as structural changes in the arterial wall, can contribute to the development of coronary artery disease.

What practical conclusions arise from this information?

In order to protect people with unfavorable heredity for IHD from cardiovascular diseases, it is necessary first of all to cover them with medical examination.

The target of prevention should primarily be practically healthy family members of patients with severe forms of IHD that developed at a young age. It is very important when carrying out this procedure to eliminate as much as possible adverse risk factors from early childhood. The detection of coronary artery disease among close relatives should serve as a signal for an in-depth examination of all children, brothers and sisters and the initiation of activities for a primary prevention program for this dangerous disease.

Cardiovascular diseases can be inherited

in men, the likelihood of developing coronary heart disease increases by 55% if the mother has this disease, by 41% if the father has this disease; and also by 82% if this diagnosis was made to both parents.

In conclusion, it remains to add that the data obtained allowed the authors of the work to appeal to future parents to prevent heart disease in the interests of their future children. This applies especially to the fair sex, and regular physical exercise remains the most effective means of preventing heart problems.

Conditions for intrauterine development of heart disease

Is heart disease inherited? This issue has been studied by geneticists for decades.

The causes of cardiac anomalies have not yet been fully clarified, but there is already confirmed information that heart defects are largely determined by heredity, as well as the genetics of consanguineous marriages.

In many cases, heredity does not play a role.

The main causes of congenital heart defects:

Viral and infectious diseases of pregnant women, in particular rubella.
X-ray exposure.
Alcohol and drugs.

The causes of congenital heart abnormalities are classified as follows:

caused by environmental influences;
one of the components of a genetically determined syndrome;
abnormal chromosome set;
genetic type of inheritance, as a result of which an isolated defect is formed;
multifactorial causes.

Method for identifying hereditary pathologies

A geneticist works with the problem; laboratory, genealogical research methods and syndromic analysis of the family line help to identify the hereditary nature of the anomaly.

The most basic of these methods is geneological. Its essence is to identify similar cardiac anomalies in close and distant relatives, father and mother. To do this, a pedigree is compiled and a genetic analysis of the genus is carried out.

The collection of information begins with the patient himself (proband); brothers and sisters who have the same parents are called “sibs”.

The pedigree is displayed graphically using the required set of symbols.

A hereditary heart defect will occur several times in the pedigree, only in this case its nature is considered to be determined by heredity, and the unfavorable influence of external factors during the mother’s pregnancy is excluded.

After drawing up the diagram, the doctor determines the type of defect transmitted through the family line.

Congenital defects that have a hereditary cause

Isolated dogs with a healthy state of all organs and systems. The gene responsible for the disorder is Mkx2-5, chromosome 5d35. An abnormality of this gene can cause cardiac conduction disturbances and the development of a VSD defect.
Multiple developmental anomalies in which the heart defect is one part of the overall disorder.

So-called chromosomal defects, which are caused by a breakdown in a specific chromosome.
Polyploidies and aneuploidies are characterized by delayed cognitive development. In many cases, such children die immediately after birth or during the prenatal period.

To identify monogenic disorders, a genealogical method, molecular genetic or biochemical, is used. It is the biochemical method that is used to confirm Smith-Lemli-Opitz syndrome.

Chromosomal disorders

You can suspect a chromosomal defect in a child based on the following signs:

The presence of congenital anomalies of several organs.
Delayed mental, cognitive and speech development.
Hyperactivity, inappropriate behavior.
Anomalies in the structure of the face.
Low birth weight of the child, premature birth.

An important sign: several premature pregnancies in the mother, stillborn children, long-term treatment for infertility.

Identification of the above deficiencies should be a reason to seek advice from a geneticist.

The medical genetic center will identify genetic damage using a cytogenetic method, through analysis of the patient’s karyotype.

Major chromosomal abnormalities

Down syndrome

ASD;
atrioventricular defect;
hole in the atrial septum;
anomalous subclavian artery.

Numerous defects in Down syndrome are dangerous and lead to early death of children.

Patau syndrome

The cause is considered to be a problem chromosome 13; multiple heart defects lead to the death of newborns; such children rarely survive beyond six months.

Combination for Patau syndrome:

Non-union of the upper lip and palate;
limb deformity;
underdevelopment of the eyes;
specific ps;
disorders in the development of the genitourinary system.

Edwards syndrome

Changes in chromosome 18 lead to early mortality in children; none of these patients survive to one year.

Signs of chromosome 18 disorder:

prematurity of newborns;
change in the shape of the skull;
unclosed metopionic suture;
irregularly shaped ears;
deformed back of the head;
lack of nails;
numerous lesions of the heart, gastrointestinal tract, kidneys, and brain.

The most common PS: atrial septal defect; ventricular septal defect; anomalies of the right ventricle.

If Edwards syndrome is suspected, the mother carrying the child will most likely agree to terminate the pregnancy, since children born with such anomalies are not operated on; they are only entitled to polytherapy treatment.

Shereshevsky–Turner syndrome

This is a female syndrome associated with a violation in the sex chromosome set. Typical problems: absence of aortic valve; bicuspid aortic valve; coartation of blood vessels.

Symptoms during the newborn period:

abnormal heartbeat;
swelling of the limbs;
deformed chest.

As girls grow, noticeable growth retardation begins, associated with congenital heart defects. Girls are characterized by short stature, infantility, and amenorrhea.

S. Wolf-Hirschhorn

Congenital diseases of a high degree of danger lead to the death of children at an early age. Main symptoms:

deformed face shape;
wide beak-shaped nose;
nonunion of the palate and upper lip;
abnormal structure of the genital organs;
severe retardation in mental and physical development;
convulsions.

CPS of this chromosomal disorder:

valve abnormalities;
underdevelopment of the left, superior, vena cava;
arterial stenosis;
defects of the atrium and ventricles.

Wolf-Hirschhorn is characterized by abnormalities in the structure of the kidneys and brain.

Anomalies in the structure of the heart are amenable to surgical intervention, but the postoperative period is difficult, and a large percentage of children die.

This is associated with various disorders in the development of internal organs and neurological problems.

C. microdeletions 22q11.2.

For this change, ps serve as the main sign:

interrupted YES;
absence of pulmonary artery;
tetralogy of Fallot;
underdeveloped subclavicular artery;
hole in the interventricular septum.

This defect is detected at the molecular level.

underdevelopment of the thymus;
hypocalcemia;
nonunion of the upper palate.

With a sharp decrease in calcium levels, the child experiences seizures.

It is characterized by a deformed facial shape in newborns, mental retardation, and hypercalcemia.

The defects inherent in this disorder are: supravalvular narrowing of the aorta; peripheral narrowing of the pulmonary artery. Supravalvular thinning most often makes itself felt in the second half of a child’s life.

At birth, there are no physical signs and CHD is the only clinical symptom of the problem, so newborns diagnosed with aortic narrowing are necessarily referred to a geneticist.

Children from. Williams are at risk of sudden death during surgery under general anesthesia.

So are heart defects inherited? Geneticists claim that CHDs occur due to environmental and genetic factors at the same time.

The coincidence of maternal alcohol intoxication, environmental pollution, drug overdose and genetic predisposition will lead to the birth of a child with congenital heart disease.

Preventive measures to prevent these factors can reduce the likelihood of having a baby with a dog.

Planning

Even if there are no obvious genetic abnormalities in your family that people who are far from medicine are usually afraid of (schizophrenia, epilepsy, color blindness, hemophilia), it is worth compiling a medical pedigree of the family tree indicating all the diseases that can be remembered. By predicting a possible disease, you can prevent the disease.

Diseases of the cardiovascular system

Although coronary heart disease is not directly inherited, predisposing factors are inherited, such as disorders of cholesterol metabolism, pathology of hormonal status and vascular mechanisms responsible for reducing high blood pressure. Also, the cause of the development of hypertension may be the manifestation of hereditary kidney pathology.

Coronary heart disease, various forms of dilatation of the heart cavities, arrhythmia and heart failure are most often transmitted through the maternal line or through both parents. It is believed that if parents have developed heart disease, then the child runs the risk of inheriting the same pathologies in 25% of cases, and according to some experts - up to 50%. But don’t rush to despair - the other 50% depends on external reasons.

What to do: One good thing about most heart diseases is that there is always an opportunity to significantly reduce the risk of their occurrence. Let your child often be in the fresh air, move more, include more vitamin-rich foods in the family menu and remember that it is better to limit animal fats, like salt. In the future, you need to try to increase stress resistance using autogenic training, avoid alcohol, and take medications with caution, especially hormonal contraceptives and painkillers.

For a long time, the concept of “hereditary alcoholism” was denied, but now doctors have come to the conclusion that this disease can be transmitted from parent(s) to children. It is believed that as a result of prolonged alcohol abuse in the human body, irreversible disturbances of enzyme systems, as well as disorders of neurocerebral activity, occur. It is these disorders that are inherited; they are “to blame” for the fact that alcohol causes extremely positive emotions, people easily get used to it and/or have increased cravings. But here, too, the situation is quite manageable: if 50% of the risk depends on the presence of alcoholic parents, then the remaining 50% is the influence of the environment.

What to do: don’t be moved when the baby starts imitating adults (“clink glasses,” or show how dad opens a bottle), but immediately stop his actions. When the child gets older, it is necessary to conduct explanatory conversations with him, to get him interested in some kind of distracting activity - clubs, sports clubs, volunteering. Do not hide the harmful effects of alcoholism from your child and try to isolate him from those who abuse alcohol.

that there is a genetic disease in the family. Inherited - how

to roulette. My brother (cousin) began to progress after 35. Perhaps, if I had found out about this earlier, I would have thought 100 times about the children (I don’t want them to have such a fate).

The likelihood of inheriting this disease depends on whether the parents have type 1 or type 2 diabetes. If this is type 1 diabetes, then if one of the parents has such a diagnosis, only 5% of the offspring get sick; if both parents are sick, then the risk of getting sick is significantly higher - about 22%. In the case of type 2 diabetes, the risk of inheriting it is incomparably higher: if one of the parents is sick, then in almost 80% of cases the children get sick, and if both parents are sick, then the chances increase to almost 100%.

Find out which other relatives, in addition to those closest to you, suffered from this disease, at what age and under what conditions they were diagnosed. This could have happened completely by accident, or the disease made itself felt, and the person purposefully went to the doctor. Have there been any cases of so-called diabetic foot, coma, nephropathy?

What to do: monitor the baby’s weight, since obesity is one of the predisposing factors. Give as little sweets as possible, and it is better to replace them with fruits. Viral infections such as influenza, rubella, chicken pox, and epidemic hepatitis can “push” the development of the disease. Talk to your doctor; if possible, it is best to get vaccinated against viral infections. If not, then you need to try to harden the baby, give him food rich in vitamins, and spend a lot of time in the fresh air. It is necessary to ensure that the baby moves more.

Caries itself is not a hereditary disease, but the size, structure and composition of dental tissues, and the distance between them are passed on to children from their parents. The predisposition to this pathology, determined by genes, is also influenced by the composition of saliva and the structure of the jaws. According to the latest data, cases of increased susceptibility to caries reach 89% if both parents are sick.

What to do: if almost everyone in the family has toothache from time to time, then you should take your child to the dentist for the first time as early as 1 year. Milk teeth can and should be treated, otherwise inflammatory processes may appear, underdevelopment of tooth enamel, and the timing of the eruption of permanent teeth may be disrupted. Every six months, the baby must be shown to a pediatric dentist. If a child is at high risk of illness, doctors suggest not only constantly using antibacterial rinses, but also covering the teeth with fluoride varnish, and the frequency of the procedure depends on the condition of the oral cavity.

Are cardiovascular diseases inherited?

Are cardiovascular diseases inherited if they were on both the paternal and maternal lines? What needs to be done to prevent this process?

The results of a recent study conducted by a group of Swedish specialists from the Royal Institute in Stockholm suggest that the widespread statement about the ability of cardiovascular diseases to be inherited is completely true.

In the large-scale study discussed here, Stockholm experts made another attempt to verify the ability of diseases of the cardiovascular system to be inherited. For these purposes, the authors of the work analyzed data from more than 11 million (!) people since 1932, trying to identify the nuances of the ability of heart disease to be transmitted from parents to children.

As the Internet portal e-news.com.ua reports on its pages, based on the results of their work, the researchers came to the following conclusions:

in women, the likelihood of developing coronary heart disease increases by 43% if the mother has this disease, by 17% if the father has this disease, and also by 108% if this diagnosis was made to both parents;

in men, the likelihood of developing coronary heart disease increases by 55% if the mother has this disease, by 41% if the father has this disease; and also by 82% if this diagnosis was made to both parents. In conclusion, it remains to add that the data obtained allowed the authors of the work to appeal to future parents to prevent heart disease in the interests of their future children. This applies especially to the fair sex, and regular physical exercise remains the most effective means of preventing heart problems.

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WHAT DISEASES ARE TRANSMITTED BY INHERITANCE?

List of ailments "on the ladies' side"

Genetics have recently found out for sure: in 57% of cases, girls' periods begin at the same age as their mothers, with a difference of a maximum of three months. Previously, the key emphasis in determining the timing of the transformation of a girl into a girl, according to scientists, was the diet - in particular, the amount of meat consumed. But now priority is given to heredity.

What else do women get from their mothers? Is it possible to “predict” a woman’s health simply by looking at her mother’s chart? Researchers from different countries are answering these questions.

Genetic link: The risk of inheriting this nasty disease is 70 to 80 percent, says Dr. Kate Henry of New York University.

Reason: A specific gene that causes migraines was recently discovered. If it does not work properly, then environmental factors (noise, caffeine, etc.) can easily awaken the pain centers in the brain “responsible” for migraines.

What to do? Keep track of what exactly causes migraines in your case and, if possible, avoid these factors. Many migraine sufferers are known to be very sensitive to foods such as chocolate, coffee, cheese, citrus fruits and red wine. Hormones also play a role - rising or decreasing levels of estrogen and progesterone during the menstrual cycle cause migraines.

Genetic connection: 3 percent.

Reason: a mutating gene. Moreover, the risk of inheriting this terrible disease increases if a blood relative gets sick at a young age.

What to do? In some countries, women with a family history of cancer are offered genetic testing to identify mutated genes. Sometimes women in this case immediately choose to remove the mammary gland.

It must be remembered that the development of breast cancer is affected by taking hormonal medications and contraceptives, as well as smoking and alcohol. According to a study by British scientists, smoking is responsible for more than a quarter of all cancer deaths in Britain. Drinking alcohol, even lightly, increased the risk of cancer by 7 percent, according to researchers, reports The Daily Mail.

Genetic connection: up to 50 percent.

The reason: "The ease with which you develop muscle and improve fitness is hereditary," says Louise Sutton of the University of Leeds in Britain. “They often say that if you want to win an Olympic medal, choose your parents.”

What to do? 30 minutes of physical activity a day is the standard recommendation from doctors. Exercising 5 days a week will help maintain your physical condition and strengthen your muscles, but won't change you dramatically. To do this, you need to do something more serious than simple exercises at least three times a week: swimming, running, and so on.

Genetic connection: 10 percent.

Cause? Mental illnesses – depression, including – sometimes familial illnesses. Scientists have identified a gene that may play a role in the development of depression. It deprives the brain of serotonin, the happy hormone that regulates our mood.

What to do? Avoid chronic fatigue, stress and alcohol - factors that cause depression. But doctors reassure: even if you have the gene for depression, it is far from a fact that you will be at risk of depression.

Genetic connection: Only 4 percent of girls whose mothers were slim turned out to be overweight. But those whose mothers were overweight, and who later also became overweight - 41 percent. Scientists say that if the parents are obese, the risk of obesity in the child increases by 70 percent.

Reason: Again, the reason is a special gene, the presence of which in the body increases the risk of obesity by 30 percent. One of the studies in this area notes the interesting fact that obesity is inherited only from mother to daughter or from father to son. That is, if a father suffers from excess weight, this is unlikely to be passed on to his daughter.

What to do? Doctors blame not so much poor nutrition as an inactive lifestyle. TV and computer - this is what you should give up in the name of a slim figure.

Genetic connection: percent.

Reason: As many as four genes are responsible for this process. On average, menopause occurs at age 51, but some women (about one in twenty) experience it earlier—up to 46.

What to do? Unfortunately, nothing can stop this process. But there are many ways to make it easier on the body.

Genetic connection: 20 percent.

Reason: A study from Oxford University found that if a mother has had a heart attack, her daughter's risk of developing heart problems increases. The hereditary vascular disease affects the coronary artery in the heart and the cerebral artery in the brain. However, what exactly is the cause of heart disease - heredity or the environment - scientists cannot say for sure.

What to do? Taking care of yourself and leading a healthy lifestyle are banal, but always true advice. Minimize salty and fatty foods in your diet, drink less alcohol and, of course, do not smoke.

ECG - The first and main diagnostic method at the emergency stage is an electrocardiogram, which detects changes characteristic only of a heart attack; it can be used to determine the localization of the lesion and the period of the infarction. It is recommended to do a cardiogram for all the symptoms described above.

Coronary angiography method– an x-ray research method in which the coronary vascular system is contrasted through a probe, and blood flow through the vessels is observed under x-ray radiation. The method allows you to determine the patency of blood vessels and more accurately indicate the location of the lesion.

Computed coronary angiography method– often used for coronary artery disease to determine the degree of vasoconstriction, which indicates the likelihood of developing a heart attack. This method, unlike X-ray coronary angiography, is more expensive, but also more accurate. It is less common due to the lack of equipment and specialists who know the technique.

Laboratory diagnostics— During myocardial infarction, characteristic changes in blood composition and biochemical parameters occur, which are monitored throughout the treatment.

First aid and treatment of myocardial infarction

First aid for myocardial infarction

A person suspected of having a heart attack must be laid down and the airways freed from constricting clothing (tie, scarf). An experienced heart patient may have nitroglycerin preparations with him; you need to put 1 tablet under his tongue, or inject him if it is a spray (isoket). Nitroglycerin preparations should be given every 15 minutes until doctors arrive. It’s good if you have aspirin on hand, aspecard - drugs containing acetylsalicylic acid, they have an analgesic effect and prevent the formation of blood clots. If the heart and breathing stop, the patient needs to undergo artificial respiration and chest compressions until doctors arrive.

Attention:

Nitroglycerin preparations not only dilate the coronary vessels, they have the same effect on the vessels of the brain; if a person is in an upright position, a sudden outflow of blood and a sudden short-term (orthostatic collapse) are possible; the patient may be injured when falling. Nitroglycerin should be given to the patient in a lying or sitting position. Orthostatic collapse goes away on its own if you lay the person down and raise his legs in 1-2 minutes.

If the patient has heavy noisy bubbling breathing, he should not be put down, as this will aggravate the condition. Such a patient must be seated comfortably and securely.

First aid in an emergency room

Before arriving at the hospital, the patient continues to receive the necessary treatment in accordance with the leading symptoms:

give oxygen;
provide access to the vein;
they try to relieve the pain syndrome with non-narcotic or narcotic analgesics (droperidol, morphine hydrochloride), depending on the degree of its severity; if there is no effect, they can use inhalation anesthesia with nitrous oxide (resuscitation vehicles are equipped with portable anesthesia machines), or administer sodium oxybutyrate intravenously, this The drug, in addition to its hypnotic and analgesic effect, protects organs from oxygen starvation;
heparin is used to prevent the formation of blood clots and resorption of existing ones;
normalize blood pressure; if blood pressure is high, Lasix is administered; if blood pressure is low, prednisolone and hydrocortisone are administered;
To prevent or relieve arrhythmias, lidocaine is administered intravenously in saline solution.

Hospital treatment

In the acute period, treatment of a heart attack is based on the leading syndromes; the main task of the doctor is to stabilize the patient’s vital functions and limit the spread of the lesion. Maximum possible resumption of coronary circulation. Prevention of complications.

Pain relief is a simultaneous prevention of cardiogenic shock.

— If the pain persists, droperidol with fetanyl is re-administered after 30–40 minutes. These drugs have a side effect - respiratory depression.
- Therefore, you can replace them with a mixture of analgin with Relanium or 0.5% novocaine; a mixture of analgin, diphenhydramine and promedol in 20 ml of physiological solution. These mixtures may have vomiting as a side effect; for prevention, a 0.1% atropine solution is administered subcutaneously.
— If there is no effect, anesthesia with nitrous oxide.

In case of asthmatic variant with pulmonary edema

The patient needs to elevate his upper body as much as possible. Three times with an interval of 2-3 minutes, nitroglycerin (isoket) under the tongue. Inhalation of oxygen with alcohol is effective. While waiting for the doctor, in the absence of oxygen, you can hold a cloth generously moistened with alcohol or vodka near the patient’s face (without closing the airways!). For high or normal blood pressure, Lasix (furosemide) is injected intravenously in large doses. For hypotension, prednisolone is administered intravenously and rheopolyglucin is infused drip-wise.

For arrhythmias

Tachycardia (fast pulse) is stopped with isoptin solution. In the event of atrial fibrillation and flutter - novocainamide, unithiol. If there is no effect, electrodefibrillation is used. Bradycardia (rare pulse) - atropine is administered intravenously, izadrin 1 tablet under the tongue. If there is no effect, IV alupent and prednisolone.

One of the reasons for coronary circulation disorders is their blockage with blood clots.

They are combated with medication using fibrolytic therapy based on streptokinase and its analogues. Contraindications to such therapy are all types of bleeding. Therefore, during this treatment, the patient’s condition is strictly monitored and platelet levels and blood clotting time are monitored.

Surgery

After achieving a stable condition, restoration of normal heart rhythm, and other vital signs, surgical treatment is performed according to indications in order to restore the patency of the coronary vessels. The following interventions are currently being carried out:

Stenting is the introduction of a metal frame (wall) into the narrowed areas of the coronary vessel. During this operation, the chest is not opened; a special probe is inserted into the desired location through the femoral artery under the control of an X-ray machine.
CABG – coronary artery bypass grafting. The operation is performed on an open heart, its essence is that it creates an additional possibility of blood supply to the affected area by transplanting the patient’s own veins, creating additional paths for blood flow.

Indications for surgical treatment and the choice of type of intervention depend on the results of coronary angiography:

damage to two arteries out of three, or the degree of narrowing is more than 50%
presence of post-infarction

The patient’s physical activity is of great importance in the treatment of myocardial infarction. In the first period from 1 to 7 days, strict bed rest is recommended, in which, from the moment a stable condition is achieved, it is recommended to perform passive movements while lying in bed, and breathing exercises under the supervision of medical personnel. Further, as the condition improves, it is recommended to constantly expand physical activity daily by adding active movements (turning, sitting up in bed, eating independently, washing, etc.).

Myocardial infarction is a focus of necrosis of the heart muscle that develops against the background of an acute circulatory disorder in the coronary arteries. If we talk about myocardial lesions in general, infarction is the most common pathology. This condition is a direct indication for hospitalization of the patient in a specialized department, since without the provision of qualified medical care it can lead to death.

Considering the danger of pathology, it is better to prevent it than to treat it. That is why, if you suspect heart disease (IHD) or other disorders of the heart, it is important to immediately seek help from a specialist in order to prevent the formation of a disease such as myocardial infarction.

Causes

To understand what a heart attack is, it is extremely important to understand the reasons that cause it. One of the most important reasons against which this condition develops can be confidently called atherosclerosis. This is a disease whose pathogenetic basis is a violation of fat metabolism in the body.

Against the background of excess cholesterol and lipoproteins, they are deposited in the lumen of blood vessels with the formation of characteristic plaques. In case of blockage of the coronary arteries, a heart attack occurs. In more detail, there are three main components of atherosclerosis, which can cause circulatory disorders in the coronary arteries, namely:

Narrowing of the lumen of blood vessels as a result of the deposition of plaques on their walls. This also leads to a decrease in the elasticity of the vascular wall.
Vasospasm, which can occur due to severe stress. In the presence of plaques, this can lead to acute coronary circulatory disorders.
Separation of plaque from the vascular walls can cause arterial thrombosis and, worse, myocardial infarction (damage).

Thus, atherosclerosis is the main cause of myocardial infarction, which is a rather dangerous condition and must be corrected.

The risk of developing a disease such as a heart attack is significantly increased by the following factors:

Bad heredity. Pathologies of the cardiovascular system in close relatives play a role.
Poor nutrition and sedentary lifestyle. These factors lead to the formation of a condition such as obesity in a person.
Obesity. Excess fat leads to direct deposition of plaques on the walls of blood vessels.
Bad habits. Drinking alcohol and smoking lead to vasospasm.
Endocrine disorders. Patients with diabetes are more prone to changes in cardiac circulation. This is due to the negative effect of this disease on blood vessels.
A history of heart attacks.

Blood pressure disorders, manifested by persistent hypertension, and constant stress can also cause a heart attack.

Symptoms

The symptoms of myocardial infarction directly depend on its stage. During the damage stage, patients may not have any complaints, but some have unstable angina.

In the acute stage, the following manifestations are observed:

Severe pain in the heart area or behind the sternum. Irradiation is possible. The nature of the pain varies from person to person, but most often it is pressing. The severity of pain directly depends on the size of the lesion.
Sometimes there is no pain at all. In this case, the person turns pale, blood pressure rises greatly, and the heart rhythm is disturbed. Also, with this form, the formation of cardiac asthma or pulmonary edema is often observed.
At the end of the acute period, against the background of necrotic processes, there may be a significant increase in temperature, as well as an increase in hypertensive syndrome.

In the case of an erased course, manifestations are completely absent, and the presence of a problem can only be suspected when an ECG is performed. This is why it is so important to undergo preventive examinations from specialists.

It should be said about atypical forms of the acute period. In this case, the pain syndrome may be localized in the throat or fingers. Very often, such manifestations are typical for older people with concomitant cardiovascular pathologies. It is worth noting that an atypical course is possible only in the acute stage. Subsequently, the clinical picture of myocardial infarction in most patients is the same.

In the subacute period, with myocardial infarction, gradual improvement occurs, the manifestations of the disease gradually become easier, until they disappear completely. Subsequently, the condition normalizes. There are no symptoms.

First aid

Understanding what it is - the occurrence of myocardial infarction, it is important to realize that first aid plays an important role. So, if you suspect this condition, it is important to take the following steps:

Call an ambulance.
Try to calm the patient down.
Ensure free access of air (get rid of tight clothing, open the windows).
Place the patient in bed so that the upper half of the body is higher than the lower half.
Give a nitroglycerin tablet.
If you lose consciousness, begin performing cardiopulmonary resuscitation (CPR).

It is important to understand that the disease called myocardial infarction is a life-threatening condition. And the development of complications and even the life of the patient depends on the correctness of first aid, as well as the speed of initiation of medical measures.

Classification

Heart attacks are classified according to the following criteria:

Size of the lesion.
Depth of damage.
Changes in the cardiogram (ECG).
Localization.
Presence of complications.
Pain syndrome.

Also, the classification of myocardial infarction can be based on stages, of which four are distinguished: damage, acute, subacute, scarring.

Depending on the size of the affected area - small- and large-focal infarction. It is more favorable to involve a smaller area, since complications such as cardiac rupture or aneurysm are not observed. It is worth noting that, according to studies, more than 30% of people who have suffered a small-focal heart attack are characterized by transformation of the hearth into a large-focal one.

According to ECG abnormalities, two types of disease are also noted, depending on whether there is a pathological Q wave or not. In the first case, instead of a pathological wave, a QS complex may form. In the second case, the formation of a negative T wave is observed.

Considering how deep the lesion is located, the following types of disease are distinguished:

Subepicardial. The affected area is adjacent to the epicardium.
Subendocardial. The affected area is adjacent to the endocardium.
Intramural. An area of necrotic tissue is located inside the muscle.
Transmural. In this case, the muscle wall is affected to its entire thickness.

Depending on the consequences, uncomplicated and complicated types are distinguished. Another important point on which the type of heart attack depends is the localization of pain. There is a typical pain syndrome localized in the heart or behind the sternum. In addition, atypical forms are noted. In this case, the pain can radiate (give) to the shoulder blade, lower jaw, cervical spine, and abdomen.

Stages

The progression of myocardial infarction is usually rapid and cannot be predicted. Nevertheless, experts identify a number of stages that the disease goes through:

Damage. During this period, there is a direct disruption of blood circulation in the heart muscle. The duration of the stage can range from one hour to several days.
Spicy. The duration of the second stage is 14-21 days. During this period, the beginning of necrosis of some of the damaged fibers is noted. The rest, on the contrary, are being restored.
Subacute. The duration of this period varies from several months to a year. During this period, the final completion of the processes that began in the acute stage occurs, with a subsequent decrease in the ischemic zone.
Scarring. This stage can continue throughout the patient’s life. Necrotic areas are replaced by connective tissue. Also during this period, in order to compensate for myocardial function, hypertrophy of normally functioning tissue occurs.

The stages of myocardial infarction play a very important role in its diagnosis, since changes in the electrocardiogram depend on them.

Variants of the disease

Depending on the characteristic manifestations, there are several options possible for myocardial infarction, namely:

Anginous. It is characteristic that for myocardial infarction, it is the most common option. It is characterized by the presence of severe pain, which is not relieved by taking nitroglycerin. The pain may radiate to the left shoulder blade, arm or lower jaw.
Cerebrovascular. In this case, the pathology is characterized by manifestations of cerebral ischemia. The patient may complain of severe dizziness, nausea, severe headaches, and fainting. Neurological symptoms make it quite difficult to make a correct diagnosis. The only symptoms of myocardial infarction are characteristic changes on the ECG.
Abdominal. In this case, the localization of pain is atypical. The patient has severe pain in the epigastric region. Characterized by vomiting and heartburn. The abdomen is very swollen.
Asthmatic. Symptoms of respiratory failure come to the fore. Severe shortness of breath is expressed, a cough with foamy sputum may appear, which is a sign of left ventricular failure. The pain syndrome is either completely absent or appears before shortness of breath. This option is typical for older people who already have a history of a heart attack.
Arrhythmic. The main symptom is irregular heart rhythm. The pain syndrome is mild or completely absent. In the future, shortness of breath and a decrease in blood pressure may occur.
Erased. With this option, manifestations are completely absent. The patient does not make any complaints. The disease can be detected only after an ECG.

Given the abundance of options possible for this disease, its diagnosis is an extremely difficult task and is most often based on an ECG examination.

Diagnostics

For this disease, specialists use a number of diagnostic techniques:

Collection of medical history and complaints.
Study of the activity of specific enzymes.
General blood test data.
Echocardiography (EchoCG).
Coronary angiography.

In the medical history and life history, the doctor pays attention to the presence of concomitant pathologies of the cardiovascular system and heredity. When collecting complaints, you need to pay attention to the nature and localization of pain, as well as other manifestations characteristic of the atypical course of the pathology.

ECG is one of the most informative methods for diagnosing this pathology. When conducting this survey, the following points can be assessed:

Duration of the disease and its stage.
Localization.
Extent of damage.
Depth of damage.

At the stage of damage, a change in the ST segment is observed, which can occur in the form of several options, namely:

If the anterior wall of the left ventricle is damaged in the area of the endocardium, the location of the segment below the isoline is observed, in which the arc is directed downward.
If the anterior wall of the left ventricle is damaged in the area of the epicardium, the segment, on the contrary, is located above the isoline, and the arc is directed upward.

In the acute stage, the appearance of a pathological Q wave is noted. If the transmural variant occurs, the QS segment is formed. With other options, the formation of a QR segment is observed.

The subacute stage is characterized by normalization of the location of the ST segment, but the pathological Q wave remains, as well as negative T wave. In the cicatricial stage, the presence of a Q wave and the formation of compensatory myocardial hypertrophy may be noted.

To determine the exact location of the pathological process, it is important to evaluate in which leads the changes are determined. In the case of localization of the lesion in the anterior sections, signs are noted in the first, second and third chest leads, as well as in the first and second standard leads. There may be changes in lead AVL.

Lesions of the lateral wall almost never occur independently and are usually a continuation of damage to the posterior or anterior walls. In this case, changes are recorded in the third, fourth and fifth chest leads. Also, signs of damage must be present in the first and second standard. In case of posterior wall infarction, changes are observed in lead AVF.

A small focal infarction is characterized only by changes in the T wave and ST segment. Pathological teeth are not detected. The large-focal variant affects all leads and reveals the Q and R waves.

When conducting an ECG, the doctor may encounter certain difficulties. Most often this is due to the following characteristics of the patient:

The presence of scar changes causes difficulties in diagnosing new areas of damage.
Conduction disorders.
Aneurysm.

In addition to the ECG, a number of additional studies are required to complete the determination. A heart attack is characterized by an increase in myoglobin in the first few hours of the disease. Also in the first 10 hours there is an increase in an enzyme such as creatine phosphokinase. Its contents return to full normal only after 48 hours. Afterwards, to make a correct diagnosis, it is necessary to evaluate the amount of lactate dehydrogenase.

It is also worth noting that during myocardial infarction there is an increase in troponin-1 and troponin-T. A general blood test reveals the following changes:

Increase in ESR.
Leukocytosis.
Increase in AsAt and AlAt.

EchoCG may reveal impaired contractility of cardiac structures, as well as thinning of the walls of the ventricles. Carrying out coronary angiography is advisable only if occlusive lesions of the coronary arteries are suspected.

Complications

Complications of this disease can be divided into three main groups, which can be seen in the table.

According to the time of occurrence, late and early complications are distinguished. The later ones include the following:

Dressler's syndrome.
Endocarditis.
Chronic heart failure.
Innervation disorders.

In addition to classic complications, gastric ulcers and other acute gastrointestinal pathologies, mental disorders, and others may occur.

Treatment

The first thing to understand is that to achieve maximum effect, treatment must be started as quickly as possible. Initially, reperfusion therapy (thrombolysis, angioplasty) is necessary. The goals of treatment are:

Relief of pain syndrome. Initially, nitroglycerin is used sublingually for this purpose. If there is no effect, intravenous administration of this drug is possible. If this does not help, morphine is used to relieve pain. In order to enhance its effect, it is possible to use droperidol.
Restoring normal blood flow. The effect of the use of thrombolytics directly depends on how early therapeutic measures were started. The drug of choice is streptokinase. In addition to it, it is possible to use urokinase, as well as tissue plasminogen activator.
Additional treatment. Also used for heart attacks are aspirin, heparin, ACE inhibitors, antiarrhythmic drugs and magnesium sulfate.

In any case, therapy for myocardial infarction should be comprehensive and begin as quickly as possible. In the absence of adequate drug therapy, not only the early development of complications, but also death is possible.

If coronary artery disease is diagnosed, surgery may be necessary. Methods such as balloon angioplasty, stenting and bypass surgery are used.

Prevention

Considering the causes of myocardial infarction, one can easily understand that by following preventive measures, the risk of developing the disease is greatly reduced. For the purpose of prevention, the following rules must be observed:

Control your body weight. The main goal is to prevent obesity, since this factor is decisive in the formation of atherosclerosis - one of the main causes of myocardial infarction.
Dieting. Reducing salt intake, as well as reducing the intake of fats from food, can not only reduce the risk of obesity, but also normalize blood pressure.
Maintaining an active lifestyle. Adequate physical activity helps normalize metabolic processes, reduce body weight, and generally strengthen the body. If you have a history of a heart attack or other cardiovascular pathologies, you should consult your doctor about the amount of exercise.
Rejection of bad habits.
Cholesterol control.
Pressure control.
Measuring sugar levels.
Carrying out preventive examinations with a specialist.

Thus, given the etiology of myocardial infarction, we can say with confidence that prevention plays an important role. If you follow the above recommendations, the risk of developing the disease is reduced significantly.

American scientists have discovered that certain gene mutations increase the risk of heart attacks. 26 thousand people from 10 countries took part in the international study.

The project was initiated by US National Institutes of Health physician Christopher O'Donell. More than 10 years ago, he began studying the medical records of patients who had suffered a heart attack in young or middle age (women under 60 and men under 50). After a while, the head of the cardiology department of the Massachusetts Hospital joined the workSekar Kathiresan. In 2006, both scientists headed the Consortium for the Genetics of Myocardial Infarction.

According to WHO, myocardial infarction is one of the most dangerous family diseases, which can result in death. SekarKathiresan stated that the main cause of the disease lies in the appearance of mutations in certain genes. Replacing just one link - a nucleotide - in a chain of two DNA molecules can significantly increase the risk of a heart attack. Identifying such “genetic damage” was the goal of the stated study.

DNA samples were taken from 13 thousand cardiac patients and 13 thousand healthy people who made up the control group. Scientists conducted a series of comparative analyzes and discovered 9 genes with single nucleotide polymorphisms, the presence of which can lead to the development of heart disease. One of the mutations had already been described by O'Donell earlier - while studying the causes of atherosclerotic plaques.

According to researchers, if a patient inherited all 9 “wrong” genes from his parents, then his chances of sooner or later suffering a heart attack are 2 times greater than those of people with an unchanged genotype. However, a direct correlation between the number of copies of mutated genes and the risk of heart attack has not been established.

Scientists hope that the discovery will make it possible in the future to prevent heart disease as effectively as possible, taking into account the hereditary factor.