Infarct

Many people have heard or read that over 60,000 people attend each year Heart attacks die different ways. The heart attack is one of the most common causes of hospital stays in Germany and one of the most common causes of death. A large part of the population only thinks of the most famous word, heart attack, when they hear the word infarct. But what exactly is a heart attack, what causes it, and how do doctors treat it?

What is a heart attack?

Infarct is the death of the body's own tissue as a result of insufficient oxygen supply. This happens due to the lack of oxygen-rich blood in the affected tissue and the supplying blood vessels.

Just as with a lack of inflow, the infarction can also be triggered by the lack of an outflow of blood, since the accumulated amount of blood also prevents the new inflow. Heart attack is often understood by infarction. However, it is also possible to close an artery in the retina or the optic nerves of the eye. The drainage of blood through the veins of a tissue can also cause a heart attack.

Embolisms are also a frequently observed cause. These are particles of different composition washed into the blood. Such vascular occlusions can be fat, oxygen (trapped air bubbles) or blood clots. The body's own and foreign substances are possible.

Embolisms are always very problematic for the body and the affected tissue and, in severe cases, even have to be surgically removed in order to avoid further complications.

causes

First of all, a heart attack is due to a lack of blood flow. Blood supplies our body with nutrients and oxygen. If the oxygen arrives delayed or not at all at an organ or tissue association, tissue can die as a result. This can be the tissue of a muscle, a detoxification organ or an optic nerve.

Whenever a tissue dies completely due to a lack of oxygen, it is a heart attack. The bones, the brain, the spinal cord or the tissue of the lungs can also suffer from a heart attack. The best known is the heart muscle infarction. Vascular occlusions often precede the oxygen deficiency.

In this respect, a causal connection to vascular embolism, thrombosis and the general occlusion of supplying arteries can be established. Heart attacks as a result of infections are also known. Most of the time, however, it is disturbances in the outflow or in the inflow of oxygen-enriched blood that cause the infarction.

Typical or common forms

• Heart attack
• Brainstem infarction
• stroke
• Splenic infarction
• Mesenteric infarction
• Pulmonary infarction
• Eye attack (sudden vision loss)

Symptoms, ailments & signs

Depending on the area of ​​the body affected, a heart attack causes different symptoms. Typical of a heart attack are severe chest pain that often radiates to the left arm, upper abdomen or lower jaw and is usually associated with sweating, nausea, dizziness and fear of death.

In women, shortness of breath, a feeling of pressure in the chest and upper abdominal pain are often in the foreground, the characteristic chest pain is much less pronounced. Pulmonary infarction is characterized by sudden, severe pain in the area of ​​the ribs, which is accompanied by shortness of breath and difficulty breathing. Bloody sputum appears when coughing.

The doctor describes the symptoms caused by a splenic infarction as "acute abdomen": There is massive pain mainly in the left upper abdomen, which increases when you breathe in and often radiates to adjacent areas. Often there are also fever, nausea and vomiting. A mesenteric infarction manifests itself in the early stages as stabbing or cramp-like abdominal pain, which is often accompanied by nausea, vomiting and bloody diarrhea.

After a less painful phase of several hours, the symptoms intensify again, the massive intestinal damage can lead to circulatory failure. Symptoms of paralysis, impaired vision and language, impaired sensitivity, impaired vision and clouding of consciousness can be signs of a stroke;

Diagnosis & course

Anyone who has known problems with their heart or circulation is at risk for a heart attack. Permanent high blood pressure, problems with the sugar metabolism such as diabetes or above-average cholesterol levels are already frequent indications for the development of heart attacks in diagnostics.

Known methods for checking infarcts of affected organs are the EKG, measuring the currents in the heart muscle and its vessels, measuring blood pressure, blood and cholesterol levels, and computed tomography in the event of a suspected pulmonary infarction or measuring so-called infarct markers in the blood.

Infarct markers are substances in the blood that occur when blood clots break down and are therefore a clear indication that such are present. There are also nuclear medicine procedures such as MRI or lung scintigraphy, which help determine the blood flow and ventilation in the lungs in order to provide clues for any vascular occlusions.

Complications

Basically, the complications of an infarction depend on the type of infarction and the organ affected.After a heart attack, for example, cardiac arrhythmias, left heart failure, rupture of the papillary muscle or tendon thread (chorda tendinea) and rupture of the heart muscle (myocardial rupture) are possible complications. In addition, early pericaritis, an inflammation of the pericardium, can occur.

In the further course of the disease, complications such as late pericarditis and inflammation of the heart muscle and pericardium (perimyocarditis) are conceivable. In mitral regurgitation, a heart valve, namely the mitral valve, fails. A septic infarction can lead to blood poisoning (sepsis). This is potentially fatal and must therefore be treated properly.

Another complication of septic infarction is peritonitis. The fluid loss that accompanies peritonitis can cause further discomfort. If the pleura or pleura becomes inflamed (pleurisy), the affected person usually suffers from severe pain that increases and decreases with breathing. The patient usually feels ill and weak and has a fever.

In addition, an infarct aneurysm, in which a pouch forms in the wall of a blood vessel or the wall of the heart, can form after various types of heart attack. Thrombi can form in such a bulge, which can loosen and impede blood flow, possibly leading to another heart attack. It is also possible for large amounts of blood to sink into an aneurysm and thus become absent from the bloodstream.

When should you go to the doctor?

A heart attack must always be treated by a doctor. Anyone who keeps noticing symptoms such as chest pain or heart attack should consult their doctor and have this clarified. If the symptoms worsen or occur more frequently, this indicates a serious heart disease that can result in a heart attack. A doctor's visit is indicated at the latest if the symptoms affect the well-being or cause fears. Further warning signs that require immediate clarification are a decrease in physical performance or breathing difficulties.

People with heart disease should see a doctor immediately with unusual symptoms. If symptoms such as a stitch in the heart area, paralysis in the left arm or neck pain develop, the emergency doctor must be called. In the event of severe discomfort or even a heart attack, first aid measures must be provided until the emergency services arrive. If a heart disease has been diagnosed, a regular examination by the doctor is necessary. The right contact person is the family doctor or a cardiologist. In case of doubt, the emergency medical service can be contacted.

Treatment & Therapy

The therapy of heart attacks always promises success in most cases if it is started as soon as possible after the heart attack is noticed. However, a heart attack is not always recognized as such. In the so-called stroke - the cerebral infarction - the therapy is very extensive and can take months or years. Intensive inpatient treatment and possibly an operation are usually used to monitor blood values ​​and breathing.

The laboratory examines eliminated metabolic products for indications. Cholesterol-lowering agents help normalize blood values ​​and physiotherapy trains the brain to balance the function of dead tissue if possible. In the case of an eye infarction, the doctor will check for an arterial or venous eye infarction. He can try to open the closed vessel with a special massage.

The blood flow can be normalized by injecting blood flow enhancing agents. This is done through outpatient surgery on the eye after local anesthesia. Laser or cold therapy, if necessary, prevents the increase in intraocular pressure.

Outlook & forecast

A heart attack has an unfavorable prognosis. Without immediate intensive medical care, the condition is fatal. The prospect of survival is linked to the general state of health of the person affected, the possibility of first aid from people present and the intensity of the infarction.

The person concerned is subject to an emergency and in most cases is not in a position to initiate measures for self-help or to call a doctor immediately. Therefore, people in the immediate vicinity are challenged. The better they are trained to deal with emergency situations, the higher the chances of survival for those affected. If a rescue team is alerted immediately and first aid measures initiated immediately, the person affected has a good chance of surviving the condition. If intensive care is provided within an hour or two, the chances of survival increase.

Long-term consequences are to be expected with every suffered and survived infarction. Disorders of the musculoskeletal system, limitations in cognitive performance, functional disorders or paralysis can occur. Despite rehabilitation measures, targeted training and comprehensive medical care, some complaints remain lifelong. With a healthy lifestyle, a stable psyche and the cooperation of the patient, many symptoms can be alleviated. However, complete freedom from symptoms occurs only very rarely, even under favorable circumstances.

Aftercare

The heart attack is a serious illness for which consistent follow-up care is very important. The most important factor in follow-up care is the regular check-ups by the treating doctors such as cardiologists or internists, but also by the family doctor. A possibly implanted pacemaker must be checked as well as the structure and function of the heart muscle. This can be checked with EKG and ultrasound, as well as other imaging methods such as MRI and CT.

Restoring exercise capacity is also a factor in aftercare. For heart attack patients there are special cardiac sports groups with specially trained rehabilitation sports teachers. Those affected can also postpone their resilience themselves through well-dosed activities such as walking or cycling, although it is important to consult a doctor in order to avoid excessive demands.

A healthy lifestyle with a cholesterol- and calorie-conscious diet, sufficient amounts of water to drink and stress reduction as well as nicotine and alcohol avoidance also contribute to optimal aftercare of the infarct. Make sure you get enough sleep.

Anyone who has to deal with a heart attack from a psychological point of view can incorporate self-help groups into their personal aftercare. Going to the psychologist can also be helpful if the shock of the heart attack is deep in the affected person or if the fear of a relapse noticeably reduces the quality of life. Social distraction can also help in this regard.

prevention

Heart and circulatory problems are the most common sign of a heart attack risk. Therefore it is better not to smoke as a member of this risk group. Alcohol in moderation and a diet with fresh fruit and vegetables are good for you and keep you fit. Exercise in the fresh air and in nature also promotes the mobility of the veins and arteries.

The body likes to run regularly. Twice a week is the minimum exercise for a body that is supposed to stay healthy. In addition, drinking pure water is preferable to luxury foods. At least the proportion of water intake should far exceed that of coffee, alcohol or soft drinks. All of this is important for blood circulation, metabolism and vascular health.

You can do that yourself

A heart attack is a medical emergency regardless of which organ is affected. The patient or the first aiders must notify the emergency doctor immediately.

Heart attack is the most common. The best self-help measure with an impending heart attack is to correctly interpret the signs and see a doctor immediately. A heart attack is often announced by chest pain pulling into the left arm, feelings of tightness and pressure behind the breastbone. In particular, risk patients should not downplay such symptoms and consult a doctor immediately. The risk groups include in particular overweight people, smokers and people with high blood pressure. Avoiding these risk factors in combination with a healthy diet and getting enough exercise can help prevent heart attack.

If an acute heart attack is imminent, the patient should not lie down flat until the rescue team arrives, but rather sit in an armchair. This reduces the volume pressure in the chest and the heart is relieved. This effect can be reinforced by the so-called Hauffesche arm bath. The patient places the left arm or, if necessary, both arms in a basin with water, the temperature of which should be around 35 degrees Celsius. Then hotter water is slowly added until the temperature of the water rises to around 40 degrees Celsius. The bath increases the blood circulation in the arms, thus diverts blood from the chest to the extremities, and thus provides momentary relief for the heart.