Inpatient myocardial infarction treatment ⋆ Heart treatment

Half of people with a heart attack die before they get to the hospital. Many of these deaths could have been prevented by acting quickly and receiving treatment right away, especially during the first hour after chest pain.

Thus, what to do if your heart hurts, you probably already guessed – save your life, call, call an ambulance.

Women make up nearly half of all heart attack deaths. From cardiovascular diseases, 5 times more women aged 40 to 60 years die from breast cancer.

Diagnose a heart attack more quickly and accurately with new blood tests. It is important to get treatment quickly – at the first sign of a condition. These are conditions for the effectiveness of drugs and treatments.

Check the box next to the risk factors for heart disease that concern you:

  1. Smoking or daily exposure to second-hand smoke (at home or at work).
  2. Heart attack or coronary heart disease.
  3. Family history.
  4. Elevated lipids (more than 240 mg / dl. HDL or less than 35 mg / dl.).
  5. Abnormal heartbeat.
  6. High blood pressure.
  7. Birth control pills (combined with smoking).
  8. Overweight (per 100 kg or more).
  9. Postmenopausal (and non-replacement estrogen therapy).
  10. Sedentary lifestyle.
  • Pain, pressure, discomfort or constriction in the center of the chest.
  • Shortness of breath or shortness of breath.
  • Acute chest pain.
  • Radiated pain in the shoulder, neck, back, arm, or jaw.
  • Accelerated heartbeat.
  • Pain in the upper abdomen.
  • Nausea, vomiting, or digestive problems.
  • Sweating for no apparent reason.
  • Dizziness with weakness.
  • Sudden extreme fatigue.
  • Panic with a sense of doom.

About a third of women with a heart attack do not experience chest pain at all. 70% of women reported flu-like symptoms that lasted for two weeks until acute chest discomfort or severe shortness of breath.

Atrial fibrillation is a disease in which normal heart rhythm is disturbed. Normally, the heart contracts at regular intervals to effectively expel blood. The correct rhythm is set thanks to the sinus node, after which the atria and ventricles begin to contract in the same rhythm – sinus.

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Types of disease

There are several types of atrial dysfunction:

  • Paroxysmal atrial fibrillation is a more frequent form in which acute attacks are observed against a background of normal heart rhythm. Such episodes with timely assistance are stopped in a day, sometimes the attack goes away on its own.
  • The persistent type is characterized by a longer duration – 7-10 days and the attack cannot be stopped on its own. With this form, medication or even surgical treatment is necessary (when the disease is delayed for 5-7 months).
  • The constant form is called normal heart rhythm, alternating with arrhythmia. The duration of the disease is from 1 year to several years. Since it is impossible to completely restore the normal rhythm, this form is often cons >

According to the clinical course, atrial fibrillation can be overt and asymptomatic.

Symptoms of the disease

The main symptoms of atrial fibrillation:

  • weakness in the body, increased fatigue;
  • heart palpitations;
  • autonomic disorders (hyperhidrosis of the palms and feet, cystalgia, chills or fever, pain or short tingling in the sternum, pallor of the skin);
  • dyspnea;
  • dizziness, up to loss of consciousness;
  • pulse deficiency, which manifests itself in a mismatch in the number of pulse waves and strokes of the heart contractions;
  • panic attacks.

The danger of the disease is that the patient alone can not determine the symptoms of atrial fibrillation and treatment in this case will be delayed and not very effective. In the absence of timely diagnostic procedures, the disease becomes chronic, which is practically not subject to therapy.

Treatment of atrial fibrillation includes several basic methods. Below we will talk about the most popular.

Post-infarction diagnosis

Despite the discharge from the clinic, the patient will have to be observed by a cardiologist:

  • the first 30 days – 1 time in 7 days;
  • from 1 to 6 month – 1 time in 2 weeks;
  • from 6 to 12 months – 1 time per month;
  • from 1 to 2 years – 1 time in 3 months.

The doctor may need the results of examinations:

  • electrocardiography;
  • echocardiography;
  • blood and urine tests.

Based on their results, the doctor can adjust the treatment regimen. Other diagnostic methods are carried out according to individual indications.

Heart attack stages and resuscitation treatment

Immediately after an anginal (painful) attack, the patient is hospitalized in the intensive care unit (BRIT). There he is for about three days. After all urgent medical measures, he is transferred to the ward of the cardiology department.

The duration of the patient’s stay in the hospital depends on the presence or absence of complications and the general condition after myocardial infarction. The first 28 days after a sore throat are considered an acute period of myocardial infarction. It is highly desirable that patients be monitored during this period of time.

However, patients who are less than 70 years old, without concomitant complications and rhythm disturbances after a heart attack, with normal contractile ability of the left ventricle, can be discharged after 7-10 days. Provided that at least one of these conditions is not fulfilled, the patient remains on treatment until complete recovery. At the same time, the terms can be very different, depending on the severity of the complications that arose.

However, there has been a recent trend towards an earlier discharge from the hospital. This has become possible thanks to modern methods of treating myocardial infarction, primarily reperfusion therapy. So, with a successful reperfusion and the absence of complications, the patient can be discharged from the hospital for 5-7 days.

In the hospital, the patient not only receives the necessary treatment, but also consults on nutrition, physical activity, subsequent treatment and further lifestyle.

• Grade I – non-transmural myocardial infarction with no complications and angina attacks.

• Class II severity – a state of moderate severity. Transmural myocardial damage, with possible not very pronounced complications in the form of single extrasystoles, sinus tachycardia. Circulatory failure is not higher than I degree.

• Grade III severity is a serious condition, serious complications come to light: circulatory failure of the II — IV degrees, arrhythmias, crisis hypertension.

• Grade IV severity – an extremely serious condition, there are complications that increase the risk of sudden death (frequent ventricular extrasystoles, circulatory failure, grade IV, grade III arterial hypertension)

Sanatorium treatment is subject to patients with I – III severity class. They are sent during the first year after a heart attack to a local cardiological sanatorium. Sanatorium treatment includes physical activity in the form of walks in the fresh air, therapeutic exercises, and in patients with a low class of severity, even moderate short-term exercise in the gym is possible.

The duration of treatment is 21 days and includes a balance of stress, nutrition and rest, which contributes to a positive prognosis.

After a myocardial infarction, it is extremely important to undergo a cardiac rehabilitation course in a sanatorium. This will improve and consolidate the achieved results of treatment and return the patient to a full life. To sign up for a rehabilitation treatment program at the Barvikha sanatorium, call: 8 (495) 228-90-30, 8 (925) 642-52-86.

Surely there is at least one person in your environment who has had a myocardial infarction. In addition, you have repeatedly heard about other people, acquaintances and strangers, also affected by this disease. As you know, the consequences of the disease can be different. Someone returns to their previous lives, someone becomes disabled, and someone may even die. What does it depend on? From various factors, but mainly from the timeliness and quality of treatment.

Heart attack symptoms

In order to start treating a heart attack, you must first recognize it. This, like the treatment itself, is the task of doctors.

However, experts cannot find out for themselves that somewhere someone had a heart attack, and immediately rush to the rescue. The patient himself or his environment should suspect something was wrong. And to do this, you need to at least approximately know the symptoms of the disease.

Myocardial infarction may “look” completely different, but usually the clinical picture of the disease is quite typical. A person develops intense chest pain, usually provoked by some kind of exertion. They can be localized behind the sternum or in the left half of the chest, “give” to the left hand, neck, interscapular space.

The pains are very strong, they intensify with movements and are not relieved by nitroglycerin, which helps with angina attacks. If the pain persists for more than 20-30 minutes, this is likely to indicate a heart attack. The patient or someone near him should call an ambulance, and the sooner the better.

The speed of action is very important, because while the patient felt the first symptoms, a blood clot began to rapidly increase in one of his coronary arteries. It blocks the blood flow in the vessel and causes ischemia, and then death (necrosis) of some part of the myocardium. The more time passes, the more serious consequences this causes. 70% of all people who died from a heart attack die in the first 6 hours of the disease! Remember this.

To reduce the consequences of the disease, treatment can be started at home, before the doctors arrive. The patient should be allowed to chew half a tablet of aspirin and 2-3 times – a tablet of nitroglycerin under the tongue, provided that the patient’s blood pressure is not lower than 100/60 mm Hg.

Case from practice. Patient V., 46 years old. From the age of 30, he suffered from obesity and hypertension, but for this reason he was not examined or treated anywhere. About 5 years ago, he began to notice the appearance of chest pain during exertion, but also ignored it. A year ago, a man had a heart attack: once a man was very nervous at work, and when he came home, he developed severe pain in the left half of his chest.

After he was discharged from the hospital, he “tried” to live as before: he did not follow a diet, periodically forgot to take medicine. This led to the fact that two months later he was again in the hospital with signs of heart failure.

After making sure that his condition is dangerous, the patient became more responsible about his health. He completed a cardiac rehabilitation course at the Barvikha sanatorium. During this time, he lost 6 kg, his condition improved significantly. The man faithfully performed the recommended complexes of exercise therapy, quit smoking. Attending classes at thematic schools helped him understand how to behave so that he would not get worse again.

Having discharged from the sanatorium, the patient continued to follow the necessary recommendations. Now she feels fine, returned to work.

Heart attack diagnosis

As soon as an ambulance arrives to the patient, the doctors immediately evaluate his condition. If the patient has prolonged pain and no effect of nitrates, he is immediately taken to the hospital with a suspected heart attack. If possible, a person already has an ECG in place. With unambiguous changes in the cardiogram, the diagnosis of a heart attack is immediately confirmed.

Doctors begin treatment on the patient’s path to the hospital. If a person has not yet taken any drugs, he is given aspirin and anticoagulant drugs are administered intravenously (to stop the growth of a blood clot in the coronary artery). Nitrates and beta-blockers can also be used to expand vascular lumen and improve myocardial nutrition. Painkillers are also often used.

A person who was admitted to a hospital with acute myocardial infarction is taken to the intensive care unit, where there is all the necessary equipment and drugs for emergency care. The patient is quickly “connected” to the ECG apparatus to confirm a heart attack, evaluate the functioning of his heart and see the degree of myocardial damage. He also takes a blood test. If possible and depending on the severity of the patient’s condition, an ultrasound scan of the heart and coronary angiography are performed.

Simultaneously with the diagnosis, treatment is carried out.

The first thing to do is to eliminate the pain. Severe pain causes an increase in pressure, increased heart rate. This creates an increased load on the heart, which is unacceptable with a heart attack. In addition, pain can cause shock in a person, which can lead to his death. For pain relief, narcotic analgesics are most often used – morphine, promedol. Sometimes they need to be entered more than once.

If the patient was admitted in the first 3-6 hours from the onset of the disease, doctors may try to reduce the effects of a heart attack. The fact is that during this period of time, a so-called peri-infarction zone exists around the focus of a heart attack in the myocardium. In this area, the cells are in a state of critical ischemia, but if you quickly restore blood flow in the affected vessel, they can maintain their viability and not die.

With successful thrombolysis, after a few tens of minutes or hours on the patient’s ECG, the infarct zone is visually reduced: the focus of necrosis is limited, and pathological changes become less pronounced. Unfortunately, thrombolysis is possible only with the rapid admission of a person to the hospital.

With a heart attack, the patient’s blood is in a state of hypercoagulation: changes occur in it and in the vessels, contributing to increased thrombosis. This is an undesirable phenomenon, and it is actively fought with antiplatelet agents (aspirin, clopidogrel) and anticoagulants (heparin, enoxaparin). In patients who are treated with these drugs, the risk of thromboembolic complications is reduced several times.

  1. Urgent activities. They include diagnosis, elimination of pain.
  2. Early help. The beginning of reperfusion therapy, treatment of shock, arrhythmias, acute heart failure.
  3. Prevention of future complications.
  4. Risk assessment and monitoring the progress of existing pathologies.

Symptoms of the disease

Drug therapy after stenting

While at home, a person still has a long time to follow the drug therapy regimen compiled by a specialist:

  • Statins (“Atomax”, “Crestor”) are prescribed to reduce inflammation in the vessels and the concentration of bad cholesterol in the blood. The effect helps to prevent the formation of fatty plaques. It is necessary to take them against the background of a diet.
  • Antiplatelet agents (Aspirin, Aklotin) prevent blood coagulation by reducing its viscosity. Their intake significantly reduces the likelihood of blood clots.
  • Sartans (“Losartan”, “Valsartan”) and ACE inhibitors (“Captopril”, “Hinapril”) do not allow angiotensin II to exert their effect, due to which it is possible to stabilize blood pressure and heart rate
  • Nitrates (“Nitroglycerin”, “Nitrokor”) are used to quickly dilate blood vessels, relieve arterial hypertension and relieve pain. They reduce the load on the heart and improve its nutrition.
  • Beta-adrenoreceptor blockers (Anaprilin, Timolol) do not allow adrenaline to exert its effect on the heart muscle. With prolonged use, it is possible to reduce the frequency and severity of heartbeats, reduce blood pressure and reduce myocardial oxygen demand.
  • Pills rich in magnesium and potassium (“Orokomag”, “Magnestad”) are necessary to improve regulation of the heart, stabilize neuromuscular transmission and maintain normal vascular tone.

Immediately after the end of the procedure, the patient is taken to a postoperative ward, where medical personnel carefully monitor his condition. If vascular access was through the femoral artery, after surgery, the patient needs to lie in a horizontal position on his back with legs straight for 6-8 hours, and sometimes longer. This is associated with the risk of developing dangerous bleeding from the site of the puncture of the femoral artery.

There are special medical devices to reduce the length of the required horizontal stay in bed. They fill a hole in the vessel and reduce the chance of bleeding. When using them, you have to lie 2-3 hours.

To remove the contrast agent introduced into the body during stenting, the patient is recommended to drink as much water as possible (up to 10 glasses per day) if he does not have contraindications for this (such as severe heart failure).

If the patient has pain at the site of the puncture of the artery or in the chest area, the usual painkillers like paracetamol, ibuprofen or other drugs can help.

If stenting was performed according to planned indications, and not for the treatment of acute coronary syndrome (myocardial infarction, unstable angina), the patient is usually discharged home on the second day, giving detailed instructions for further recovery.

Medication after stenting is required, regardless of the reason for which it was performed. Most people take drugs that reduce the risk of thrombosis within a year of surgery. This is usually a combination of a low dose of aspirin and one of the following:

It is very important to follow all the doctor’s recommendations for taking these drugs. If you stop using them earlier, this can significantly increase the risk of myocardial infarction caused by stent thrombosis.

The duration of treatment with clopidogrel, prazogrel, or ticagrelor depends on the type of implanted stent, approximately one year. Most patients need low-dose aspirin for the rest of their lives.

Medication after discharge home

• Hypolipidemic therapy. It is aimed at reducing the “bad” cholesterol in the body and at reducing the development of atherosclerotic and cardiovascular risks. All patients, regardless of cholesterol level and in the absence of contraindications (advanced age, liver and kidney disease), are prescribed statins (for example, atorvastatin, rosuvastatin). It is necessary to take them constantly and in combination with a strict diet.

In the presence of contraindications or intolerance to any doses of statins, the use of ezetimibe can be considered.

Fibrates and nicotinic acid can also be used to lower cholesterol.

• Antiplatelet agents. They are used to reduce platelet and erythrocyte aggregation, reduce their ability to adhere and adhere to each other, which in turn reduces the “blood viscosity”.

– Acetylsalicylic acid (aspirin). It is used for a long time, more than a year after a heart attack. The daily dose of 75-100 mg 1 time per day. If the patient has contraindications for use (allergic reactions, hemorrhagic diathesis, peptic ulcer of the stomach and duodenal ulcer), then clopidogrel is prescribed at a dose of 12 mg once a day.

– Blockers of the P2Y12 adenosine diphosphate receptor (clopidogrel, ticagrelor, prasugrel). It is recommended to use in combination with aspirin, the so-called double antiplatelet therapy, with a low risk of bleeding. The maintenance recommended dose of clopidogrel is 75 mg 1 time per day, ticagrelor 90 mg 2 times a day, prasugrel 10 mg 1 time per day (with a weight of less than 60 kg 5 mg 1 time per day).

• Anticoagulants (Rivaroskaban). They are aimed at reducing the activity of the blood coagulation system and preventing thrombosis. Rivaroskaban at a dose of 2,5 mg 2 times a day are used in addition to antiplatelet agents, only at low risk of bleeding.

• Beta-blockers. They have a cardioprotective effect (protect the heart muscle from oxygen deficiency). Often prescribed to patients with left ventricular dysfunction and heart failure. They are used for a long time, up to three years.

• Blockers of the renin-angiotensin-aldosterone system (ramipril, perindopril). The drugs of this group are very effective for anterior heart attack and reduced contractile function of the left ventricle (ejection fraction of less than 40%). Reduce post-infarction remodeling of the left ventricle. Assigned to all patients after myocardial infarction in the absence of contraindications, are taken indefinitely.

• Angiotensin II receptor blockers (valasartan) It is used instead of renin-angiotensin-aldosterone system blockers or if they are intolerant.

• Aldosterone receptor blockers (eplerenone). Often prescribed to patients with myocardial infarction with signs of heart failure, ejection fraction of the left ventricle of less than 40% and in the absence of renal failure. The initial dose is 25 mg / day. With normal tolerance and the absence of hyperkalemia, increase to 50 mg / day.

What procedures in the hospital do the patient with myocardial infarction?

If your heart hurts, your doctor will need your electrocardiogram (ECG) and a blood test to confirm the attack. Even if the ECG is normal, other current studies are required. They allow you to diagnose a heart attack faster and more accurately than ever before. Emergency doctors are trained to diagnose heart attacks quickly and to prevent damage to the heart muscle, they will begin the procedure promptly.

An ambulance doctor may decide that you are not in danger and let you go home. Ask for the opinion of a cardiologist, it may be worth staying in the hospital overnight for follow-up.

When describing the symptoms, be clear, objective and patient, insist on the best heart care.

Note: If you have a heart attack, the chance of survival is to open the clogged artery quickly – within 90 minutes of the onset of symptoms. However, funds for performing angioplasty are not available in all hospitals. You need to find the nearest clinic with a catheterization laboratory. It is advisable to go to the heart surgery center and directly to the emergency department.

(For patients with a cholesterol level less than 4,5 mmol / l – prescribed by decision of the attending physician).

Additionally, drugs are prescribed for a heart attack in a hospital. But only if the condition of the patient requires this.

These are the following medical devices:

  • narcotic and non-narcotic analgesics (with severe pain);
  • ACE inhibitors (treatment of hypertension);
  • diuretics (in acute left ventricular failure, pulmonary edema);
  • antiarrhythmic drugs (with blockades and tachyarrhythmias);
  • long-term oral anticoagulants (in the presence of blood clots in the cavity of the left ventricle).

Patient care at home

The disease is considered life-threatening, therefore, the patient should receive full treatment in a hospital ward, where under the supervision of doctors he will be able to take the necessary medications and undergo surgery.

It is characterized by a two-week duration, when the heart muscle begins to recover gradually, but it is not yet able to take on a full load.

At this time, the person should be completely at rest, under the supervision of doctors and observe bed rest.

The slightest physical exertion is contraindicated for a person, so he is not even able to roll over in bed on his own.

During the acute period:

  • the patient is constantly measured in pulse and pressure;
  • feed and carry out hygienic procedures in bed;
  • all changes in the work of the body are reported to the attending physician.
  • during the acute period and during the rehabilitation period at home, most often there are problems with emptying due to the immobility of the patient;
  • stress is contraindicated for the patient, therefore, for the timely release of the intestines, the use of laxatives and painkillers is recommended;
  • therapy is carried out under the strict supervision of a physician;
  • sometimes the patient needs cleansing enemas.

Bed rest and its difficulties

  • a stationary state causes thrombosis in the lower extremities;
  • even a slight squeezing of a vein can lead to impaired blood flow and the formation of a blood clot;
  • starting from the second day, a pillow is placed under the patient’s knees so that the legs are in an elevated state;
  • preventive massage and special solutions / ointments will help prevent the formation of pressure sores on the skin;
  • at this time, the patient should be as much as possible protected from the outside world;
  • any emotional experiences, nervous shocks, loud noises, fear can lead to complications.

If the patient is an elderly person

  • older people need special care from the medical staff and relatives, who must ensure that drugs are taken on time;
  • the use by older people of drugs that were not prescribed by a doctor is strictly prohibited, their close people are responsible for this.

Myocardial infarction in diabetes is more severe and the likelihood of severe complications is high.

Symptoms of a thigh muscle infarction are indicated in this publication.

Is it allowed to go to the bathhouse after a heart attack and how it can be dangerous – the answers are here.

Secondary Prevention

The development of a heart attack indicates an aggravation of coronary disease. After an experienced attack, problems with pressure and rhythm of the heartbeat rapidly develop, against which signs of heart failure occur. In order to avoid the development of consequences, you will have to follow the rules of secondary prevention:

  • attend cardiac rehabilitation classes;
  • follow a strict diet;
  • follow the treatment regimen drawn up by the doctor;
  • control heart rate and pressure;
  • comply with the rules of a healthy lifestyle.

Despite the fact that the patient’s sick leave lasts several months, throughout the life of the patient it is recommended to follow certain recommendations that will help to avoid complications and secondary heart attack.

To do this, pick on the following tips:

  • follow a diet, not allowing yourself to overeat or eat harmful foods;
  • refuse alcohol in any form and quantity;
  • quit smoking;
  • have a full sleep (sleep at least 8 hours a day);
  • take frequent breaks in work, even if it is sedentary;
  • take medications prescribed by your doctor;
  • control blood pressure and prevent sudden jumps;
  • eliminate heavy physical exertion;
  • refuse coffee and energy, which are negatively displayed at the heart;
  • eliminate stress.

On average, a person needs to stay in the hospital after a heart attack for a month. At the same time, often the therapy after this course does not end, and the patient takes the drugs already at home.

The disease cannot be called an unpleasant episode in a person’s life; it becomes for people who have suffered it a trait behind which health problems begin. The most dangerous thing is that ischemia of the heart undergoes accelerated progress.

The first months after a heart attack become crucial for the life of the patient.

Health monitoring should be ongoing, its deterioration can lead to disability, re-infarction or death. At this time, it is necessary to make every effort to recover.

The attending physician helps the patient achieve a high quality of life if he:

  • follow a diet;
  • take medications in a timely manner;
  • independently monitor well-being and report it to the doctor;
  • lead a healthy lifestyle ;
  • engage in cardiac rehabilitation courses.

The first time after a heart attack is fraught with serious complications, which only specialists can prevent the development of

Forecast

The prognosis is based on the results of the examination and the condition of the patient. A small-focal form of a heart attack rarely leads to serious consequences with timely detection and treatment. Large lesions often cause complications. Without assistance in the first hours from the onset of the attack, the patient may die.

The speed and degree of recovery is affected by the effectiveness of the treatment regimen and lifestyle correction. If the patient will comply with all the recommendations of the attending physician, then the likelihood of the return of disability increases significantly.

After the manifestation of signs of myocardial infarction, the patient should call an ambulance. Doctors will take him to the intensive care unit for the necessary medical measures. In the hospital, a person will have to spend at least 2-3 weeks to get out of a serious condition and avoid possible consequences.

The prognosis after myocardial infarction is always serious. In the absence of complications, preserved contractility of the heart, the middle-aged patient has a favorable prognosis. It must be understood that an important condition for a favorable prognosis is lifestyle modification, the implementation of the doctor’s recommendations, and commitment to therapy.

It is worth noting that there was no significant difference in the prognosis for men and women after myocardial infarction.

Patients are often worried about how much they live after a heart attack. Life expectancy depends on the severity of a heart attack, on the effectiveness of reperfusion therapy and the presence of complications. With uncomplicated heart attack, life expectancy is high.

Over time, with treatment, heart function improves, this is due to the restoration of the so-called “sleeping myocardium”, which is manifested by a decrease in shortness of breath, a decrease in the severity of rhythm disturbances.

Doctor Chuguntseva M.A.

Food at the hospital

Restrictincrease
• Foods that are high in calories.
• Alcoholic drinks.
• Salt (not more than 5 g per day).
• Fatty foods, fast food.
• Vegetables and fruits (150-200 g each day, divided into several meals).
• Meat and fish of low-fat varieties.
• Dairy products (with a low percentage of fat).
• Bread (from coarse flour).
ViewProducts
Monounsaturated AcidsOlive and rapeseed oil, avocado, almonds, pistachios.
Polyunsaturated acidsVegetable oils (canola, soya, sunflower), fish and seafood, leafy vegetables and pumpkin, poppy and flax seeds.

Unsaturated fatty acids help lower bad cholesterol (high density) and increase good (low density). Their number in the diet of a person who has survived a heart attack should be 10 times greater than the limit acids. In total, it is allowed to consume no more than 100-150 g of fat per day.

About half of the calories a person should receive from carbohydrates. The remaining amount needs to be replenished by the absorption of proteins and fats. Simple carbohydrates (confectionery, processed cereals, sweet soda) should be excluded from the daily menu. You can replace them with complex carbohydrates containing a large amount of fiber (vegetables, fruits, cereals).

What and when can I eat after a heart attack? In the first week after a heart attack, patients should receive low-calorie foods with a restriction of salt, liquid and fat, rich in vitamin C, potassium salts and lipotropic substances. Food is taken in pureed form 5-7 times a day. The diet includes cereals (rice, oatmeal, buckwheat, multi-cereal), low-fat varieties of fish and meat, dairy products, low-fat cheese, steamed omelettes, vegetable soups, boiled vegetables, mashed fruits, fruit drinks, fruit drinks, tea, wheat crackers. Spicy, fried, salty, pickled foods, chocolate, grapes, and flour products are contraindicated.

After two to three weeks, the diet remains the same, but food can not be taken in a grated form. In the future, the list of products is expanded according to the lipid-lowering diet.

• high-calorie write; • salt, less than 5 g / day. The optimal intake of salt is 3g / day, • alcoholic beverages. In terms of pure alcohol, up to 20 g / day for men and 10 g / day for women.

• vegetables and fruits, about 200 g per day (2-3 servings), • whole grain cereals and bread from wholemeal flour, • fish. At least twice a week, one of which will be fatty fish (halibut, tuna, mackerel, herring, salmon), • lean meat, • low-fat dairy products.

Replace saturated and trans fats with monounsaturated and polyunsaturated fats of plant and marine origin. This means that it is necessary to exclude fried foods (trans fats), fast food (trans fats, saturated fatty acids) from vegetable fats from the diet, and increase the consumption of fish, including marine breeds.

In general, it is necessary to reduce the amount of fat by about 30% from previously received. Replacing saturated fats with monounsaturated fatty acids provides a positive effect on the level of “good” cholesterol (HDL), and polyunsaturated fatty acids provides a decrease in the level of “bad” cholesterol (LDL).

An increase in fish consumption 2 times a week reduces mortality from coronary heart disease by 36%, and overall mortality by 17%. The restriction of salt favorably affects one of the main risk factors for myocardial infarction, and arterial hypertension. It is proved that even with a short salt restriction, blood pressure decreases by 3,2 degrees in people with hypertension and 1.6 degrees in healthy people.

Carbohydrate intake is best reduced to 45% -55% of the total calorie intake. Simple carbohydrates are best replaced with complex carbohydrates, while using fiber-rich foods such as vegetables, fruits, nuts, cereals.

An individual diet for patients is made taking into account concomitant diseases of the heart, kidneys, and gastrointestinal tract.

  • All patients with heart disease need to supplement the diet with fresh fruits and vegetables, fiber (bran), vegetable oils. You must eat fish at least 2 times a week. The consumption of fish oil as a dietary supplement, as well as the intake of dietary supplements containing omega-polyunsaturated fatty acids is welcome. Such a diet helps to lower blood cholesterol and slow down atherosclerosis, which causes the development of various forms of coronary heart disease.
  • Patients with heart failure, some rhythm disturbances, as well as those who have had a heart attack, are especially important in the presence of products containing potassium in the diet. These include dried fruits, baked potatoes, bananas, other fresh fruits and vegetables.
  • If you are overweight, you must always strive to reduce it, since overweight is a factor that increases the risk of complications of cardiovascular diseases.
  • All cardiac patients need to strictly limit the intake of animal fats. It is necessary to significantly reduce the dietary content of fatty meats, fatty cheeses, sour cream, cream, fatty cottage cheese. It is advisable to exclude sausages, semi-finished products, lard, margarine. It is also recommended to refuse confectionery, sweets, sugar as much as possible. All of these products contribute to the accelerated development of atherosclerosis.
  • Patients with coronary heart disease and a tendency to increase blood pressure should not drink a lot of coffee and strong tea, as well as other caffeinated drinks (sports drinks, energy drinks).
  • It is important for patients with a transplanted biological heart valve to prevent overly active consumption of foods containing calcium (dairy products). Limiting it is not necessary, just do not “overeat”.
  • By agreement with the doctor and taking into account the patient’s condition, small amounts of sweet are sometimes allowed (30 g of easily digestible carbohydrates 1-2 times a day), up to 1-2 cups of natural weak coffee per day, small amounts of dry red wine (no more than 1 glass per day )

• Salt (not more than 5 g per day).

• Fatty foods, fast food.

• Meat and fish of low-fat varieties.

• Dairy products (with a low percentage of fat).

• Bread (from coarse flour).

Unsaturated fatty acids help lower bad cholesterol (high density) and increase good (low density). Their number in the diet of a person who has survived a heart attack should be 10 times greater than the limit acids. In total, it is allowed to consume no more than fat per day.

Detonic – a unique medicine that helps fight hypertension at all stages of its development.

Detonic for pressure normalization

The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.

Detonic not addictive and withdrawal syndrome, since all components of the product are natural.

Detailed information about Detonic is located on the manufacturer’s page www.detonicnd.com.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

Detonic