Myocardial Infarction Temperature ⋆ Heart Treatment

The patient’s body temperature on the 1st day of MI usually remains normal and rises on the 2nd, less often on the 3rd day. The temperature rises to 37 – 38 ° C and stays at this level for 3 – 7 days. In some cases of extensive heart damage, the duration of the temperature reaction can increase up to 10 days. Longer subfebrile condition indicates the addition of complications.

High temperature (39 ° C or more) is rare and usually occurs when a complication, such as pneumonia, is attached. In some cases, the temperature rises slowly, reaching a maximum in a few days, then gradually decreases and returns to normal. Less often, it immediately reaches its maximum value and then gradually decreases to normal.

The magnitude of the temperature increase and the duration of the fever to some extent depend on the vastness of the MI, but the reactivity of the organism plays a significant role in this. In young people, the temperature reaction is more pronounced. In elderly people, especially with small focal MI, it may be insignificant or absent. In patients with myocardial infarction complicated by cardiogenic shock, body temperature remains normal or even lowered.

The appearance of a temperature reaction after an anginal attack is an important diagnostic sign of MI and should always alert the doctor regarding the development of fresh focal changes in the myocardium. MI is very characterized by an increase in the number of white blood cells in the blood. It is observed several hours after the development of MI and lasts 3-7 days.

Longer leukocytosis indicates the presence of complications. Usually there is a moderate increase in the number of white blood cells in the blood – up to (10 – 12) * 10 9 / L. Very high leukocytosis (over 20 * 10 9 / l) is considered an unfavorable prognostic sign.

According to some authors, the severity of leukocytosis to a certain extent depends on the extent of myocardial damage. In approximately 10% of cases, leukocytosis may be normal throughout the entire period of the disease. The number of leukocytes in the blood increases mainly due to neutrophils, while a shift of the leukocyte formula to the left is noted.

“Myocardial infarction”, M.Ya. Ruda

In the pre-infarction state, blood supply is gradually disrupted, the body weakens and becomes vulnerable, easily perceiving infections. During this period, you can easily catch a cold. Difficult pulmonary ventilation also causes signs similar to the onset of a catarrhal viral infection. A slight throat tickle, the desire to clear one’s throat is very characteristic.

In the acute period of a heart attack, on average throughout the week, besides the main signs of heart failure with weakness and shortness of breath, there is a temperature of up to 38–39º. The inflammatory process in the infarction zone is aimed at isolating the dying tissues of the heart muscle from those areas that are not subject to destruction.

Resorption, necrotic syndrome is required for the onset of a heart attack, it is he who distinguishes myocardial infarction from an attack of angina pectoris or asthma. The tissues of the affected areas of the heart muscle begin to decay, and the decomposition products are actively absorbed by the body. This provokes a febrile state, an increase in the number of leukocytes.

Among leukocytes, neutrophil cells (a type of white blood cells) predominate, which absorb tissue decomposition products, causing the body’s reaction to inflammation. In laboratory diagnostics, a blood test confirms a shift in the peripheral blood to the left. The erythrocyte sedimentation rate is accelerated, blood enzymes become active. Outwardly, this is expressed in an increase in the patient’s body temperature, on average, up to 38.5º.

Usually a febrile state is recorded in such cases on the second day of reactive changes. How much the temperature rises, and how much will remain, depends on many factors. For example, how large the dying area is and is deeply affected, what is the reaction of the body to this process, etc.

When necrosis advances, it captures the myocardium from the inside. The process reaches the inner lining of the heart – the endocardium, its inflammation develops. If further deposition of blood clots – blood clots – occurs on the walls of the cardiac cavities – this is parietal thromboendocarditis. It gives a prolonged increase in the temperature of the patient.

The same temperature reaction is noted with fibrinous pericarditis as a complication of myocardial infarction. The temperature rises due to necrobiotic processes in the heart muscle. Initially, it is provoked by leukocytosis, and then often keeps parallel to it. Exudative (effusion) pericarditis in complicated myocardial infarction causes inflammation of the pericardial leaves.

When a sharp drop in heart tones occurs, the mass of blood necessary for normal circulation is greatly reduced. Arterial and venous pressure decreases because the flow of venous blood to the heart is reduced. There is oxygen starvation of the brain, which causes difficulties in the functioning of the whole organism. This is a heart collapse in which the temperature is normal or even below normal.

In severe processes of the development of the disease, leukocyte production may slow down until leukopenia, when their number drops sharply or gradually. This is often found in patients over 60, in women more often than men. In this case, the effect of the so-called scissors arises – ESR indices increase sharply, the body reacts with fever with temperature. The reasons for this:

  • Infectious damage to the heart and valves.
  • Softening the muscle tissue of the heart – myomalacia.
  • Anemia
  • Perifocal inflammation – ins >

The temperature reaction to the inflammatory process is very individual, but there are general symptoms characteristic of it:

  • On the first day of myocardial infarction, the temperature rises rarely or towards the end of the day. However, there are some patients in whom this occurs immediately after a pain attack. Although the process of decay of the myocardial fibers and absorption of its toxic waste has not yet begun. According to doctors, this is due to the neuro-reflex reaction of the body.
  • On 2 or 3 days, 90% of patients have a temperature increase to 38º, although there are cases of subfebrile preservation – 37.1–37.9º.
  • The level of elevated temperature lasts up to 6–10 days, inclusive.
  • The process of myocardial inflammation is expressed by a small (up to 38º) increase in temperature on the 3rd day of myocardial infarction. The temperature returns to normal after 4 days.
  • Extensive damage to the heart tissue causes a manifestation of high temperature for two weeks.
  • If the fever persists for longer than 14 days, then myocardial infarction has turned into a complicated form.

When the patient’s body temperature rises to 39–40º, as a rule, another serious illness that complicates the situation is added to myocardial infarction. It can be pneumonia or pyelonephritis.

Sometimes a fever progresses slowly. The maximum growth in these cases is observed only after a few days. The process of its reduction and normalization is also gradually going on.

The degree of temperature reaction is affected by the age of the patient. The young body reacts with greater force, so the temperature rises more. In elderly and elderly patients, the temperature may not rise much, or even be normal. Another temperature indicates that myocardial infarction is represented by a small focal species or is complicated by the insufficiency of the functioning of the left ventricle of the heart to an extreme degree. With cardiogenic shock, the temperature decreases due to a decrease in myocardial contractile activity and a lack of blood supply.

After 2 months, sometimes later, it happens a few years after a heart attack, when even the scarring process has reached full completion, a second heart attack occurs. Most often, in the one-year period after an attack, it develops in males, the elderly. The provoking factors are hypertension, especially crisis, chronic coronary heart disease. And the effect is exerted by how long the period between the initial and second seizures lasted, how much myocardial destruction.

Repeated heart attack sometimes develops atypically and is difficult to diagnose with an electrocardiogram. However, the course of the disease is severe: with heart failure in acute, and then chronic, arrhythmias. There is a high probability of death. Therefore, if the decoding of the ECG and the comparison of the diagnostics of its previous version with the subsequent one did not bring results, then other indicators are analyzed.

Severe development of myocardial infarction affects the production of white blood cells. This can lead to leukopenia (the percentage of leukocyte production decreases sharply). Such processes are observed in elderly patients. The erythrocyte sedimentation rate increases, which leads to a febrile state.

The reasons for these changes are as follows:

  • infectious processes with damage to the heart and arteries;
  • decreased tone of the heart muscle;
  • anemia;
  • tissue inflammation and their destruction.

After a course of therapy, the patient should undergo rehabilitation. Then do physical exercises at home. Be sure to daily measure body temperature so that hyperthermia does not occur again. It is also necessary to adhere to the following recommendations that cardiologists give to their patients:

  • correct daily routine;
  • proper nutrition without overeating;
  • avoidance of conflicts and stressful situations;
  • full sleep for at least 8 hours;
  • exclude addictions (tobacco smoking, alcohol abuse, etc.).

Can the temperature increase with myocardial infarction?

An increase in body temperature is one of the main signs by which a patient can determine myocardial infarction. Primary seizures in 80 percent of people are accompanied by fever. The increase occurs after a few minutes or within three days.

Hyperthermia in myocardial infarction is a protective reaction of the body to anginal pain (squeezing). Therefore, any cardiologist will immediately determine that tissue damage occurs in the myocardium. At the same time, the level of leukocytes surpasses the norm. In some cases, granular leukocytes of eosinophils can decrease significantly. This leads to intoxication of the body, as a result of which the body temperature also rises.

What body temperature can be with myocardial infarction:

  1. Based on the neuro-reflex reactions of each organism, body temperature on the first day of a heart attack can occur in different ways for everyone. In one patient, it rises immediately after an attack of pain, in another – only after a few hours, in the third – it does not rise at all.
  2. On the 2nd and 3rd day, the patient’s body temperature ranges from 37,1 to 38 degrees.
  3. The rest of the days (for another week) the temperature stably stays up to 38 degrees. In some patients, it gradually decreases after 4 days.
  4. At high temperature for 2 weeks, we can talk about a complicated form of MI.
  5. If the body temperature reaches 40 degrees, this indicates the presence of a complication – a disease that aggravates the situation. Most often these are lesions of the lungs and kidneys.
  6. In old age, the temperature may not rise at all, but rather decrease. This is due to age-related changes in which blood circulation slows down, therefore, all other processes.
  7. In some cases, the temperature rises sharply and also drops.

Temperature at other stages of the disease

Preinfarction condition. The patient feels a general malaise, a slight increase in temperature. It is more like a cold. A hoarse cough and sore throat appear. An elevated temperature can last for several months. If you do not consult a specialist in time, this can lead to circulatory disorders, oxygen starvation of the brain and an extensive attack of a heart attack.

The acute period of the course of the disease. Body temperature rises to 39 degrees, in rare cases – up to 40 degrees. The temperature lasts about 7 days. Shortness of breath, mild condition, chest pain appears. Some patients confuse this condition with SARS or bronchitis.

The course of the disease is dangerous because the risk of repeated attacks increases. In these cases, the process of isolation of dying cells of the heart muscle from non-destroyed tissues occurs. The number of leukocytes increases. Neutrophils absorb decayed tissues, which is accompanied by complex inflammatory processes. Fever progresses, depending on the number of affected areas and the severity of the disease.

Subacute period. In the subacute stage, hyperthermia lasts from 37 degrees to 38 degrees. There is a temperature due to the spread of decay products after decomposition of tissues into the bloodstream. Cells of the immune system react to this – protecting the body, phagocytosis of toxins is provided. Chemical processes take place in organs, due to which heat transfer decreases, but production increases. In simple words, by increasing body temperature, the body gets rid of toxic deposits and dead elements.

Recurrent myocardial infarction. The minimum period for relapse is 12 months. With a repeated heart attack, the body reacts to an attack more sensitively, therefore, body temperature can also rise to critical levels.

In the subacute period, the patient’s condition usually becomes much better, the pain goes away, the body temperature becomes normal.

The protracted course of a recurring form of myocardial infarction is characterized by re-infection. It occurs due to the fact that the process of disintegration of muscle tissue is incomplete and the scar is formed slowly.

One option may be re-arrhythmic or asthmatic infection. This causes a temperature reaction even two, two and a half months after the initial attack of a heart attack. This type of heart attack is characteristic of senile patients with severe coronary atherosclerosis. Necrosis in this case affects not only the areas that underwent the first attack of a heart attack, but also healthy muscle fibers located in the heart attack region. This can be with a large-focal or small-focal form of a heart attack.

It also draws attention to the state of collateral blood supply through the lateral vessels. With this form, patients complain of typical pain, fever, and blood tests show all the characteristic changes in white blood cells, enzymes and ESR.

Long-term forms of myocardial infarction can occur with a peripheral temperature increase (an increase in the temperature of the skin receptors, subcutaneous adipose tissue, internal organs, the surface of the muscles of the skeleton, etc.).

What is the danger?

By itself, an increase in body temperature, if the indicators do not exceed critical standards, is not dangerous. On the contrary, the body is cleansed in this way, and this makes it possible for doctors to trace the chain of inflammatory processes in the myocardium.

It is quite another thing when the temperature is over 39 degrees. In this case, the development of complications is likely. Therefore, it is important to get rid of hyperthermia in a timely manner.

If hyperthermia lasts more than 3 days, this leads to the following consequences:

  1. The coagulability of the blood fluid increases, which provokes the formation of blood clots, the nutrition of the brain and heart stops, and oxygen starvation occurs. And this further exacerbates the situation with a heart attack. Feature – with improper blood coagulation, disseminated intravascular coagulation syndrome develops, which leads to death.
  2. Metabolism is accelerated, as a result of which the body uses all energy reserves (carbohydrates, etc.). Then there is a breakdown and exhaustion, against the background of which cerebral edema develops.
  3. The defeat of the central nervous system, since high temperatures weaken the functionality of the central nervous system. In this case, convulsions are observed, after which death may occur.

What to do if a temperature occurs during a heart attack: first aid

  1. The patient needs peace. It must be put in a horizontal position or in a sitting position.
  2. Call an ambulance.
  3. Give the necessary medicines to drink, making sure that the person is not allergic to certain components. The appearance of an allergic reaction can lead to serious consequences. This may be Aspirin, Paracetamol, as well as drugs intended for the heart (they should be prescribed by the attending physician before an attack of a heart attack).
  4. Measure blood pressure. Provide access to fresh air.
  5. Upon arrival of the ambulance, describe the symptoms that accompany the attack.

How temperature is associated with the diagnosis of myocardial infarction

An increase in the patient’s temperature as a reaction of the body to compressive (anginal) pain during an attack is an important symptomatic diagnostic indicator for a doctor. This shows that new foci of myocardial tissue damage develop in the patient’s body. This is confirmed by an increase in the number of leukocytes. The more there are, the worse the prognosis of the course of the disease due to the extent of the lesion.

Also in the very first days there is a strong decrease in one of the varieties of leukocytes – granular eosinophils, up to their complete absence – aneosinophilia. This is a reaction to the accumulation of decay products of toxins, which is also manifested by an increase in temperature. As you recover, your leukocyte counts are restored and the temperature decreases.

With a complicated stage of the disease, this process is delayed. An increase in temperature and ESR is absent in angina pectoris, the symptoms of which are very similar to signs of a heart attack. Therefore, these two signs are characteristic for its diagnosis. An increase in the functionality of the enzyme — myoglobin creatine phosphokinase in the heart muscle — is already evident 2–4 hours after the onset of the attack.

Indications of the activity of transaminases (liver cell enzymes), which remain at this level for up to a week, change. All this externally can be expressed by the temperature reaction of the patient’s body. Observation of these processes allows us to draw conclusions about how the myocardium is restored.

Sometimes, especially in women and with diabetes, myocardial infarction can be asymptomatic. This is an atypical form. However, a symptom of its transfer becomes a temperature of up to 39º, which rises one day after a heart attack. This is again due to intoxication of the body with tissue decomposition products. Therefore, the temperature gives reason to think that perhaps an atypical manifestation of a heart attack has occurred.

Traditional treatment

If body temperature reaches 39 degrees, it is necessary to take antipyretic medicines. The temperature up to 37,5 degrees can not be brought down, because during the examination it will be difficult to find the focus of the disease.

To reduce the temperature suitable:

Folk remedies and tips

To eliminate an unpleasant symptom, you can use such folk recipes:

  1. Berry tea from fever. You will need cranberries, raspberries, strawberries. Pour the washed collection into the container. Pour boiling water for 20 minutes. Strain and drink in a warm form with the addition of 1 tablespoon of honey. It is advisable to drink the broth at night. It has an antipyretic property.
  2. A decoction based on dry raw materials. In a glass container, pour 2 tablespoons of chamomile flowers, wild rose, dry strawberry and raspberry leaves. Pour in hot water. Insist no more than 1 hour. Strain. Before each use, warm up to a warm state.
  3. Berry puree. Grate fresh cranberries and viburnum on a fine grater. Add 2 tablespoons of sugar or honey. Take a quarter of an hour before meals. Drink with a decoction of chamomile.
  4. Dried fruits compote. In an enameled pan pour 1 tsp of dried apricots, raisins and prunes. Pour in water and put on low heat for 40 minutes. Insist 20 minutes. During this time, the compote will become warm. Drink at any time of the day.
  5. A remedy for temperature based on a lemon. Squeeze lemon juice, add 1 tsp. honey and pour exclusively warm water. Lemon is rich in vitamin C, but in contact with boiling water, the process of decay occurs. And such a tool does not bring any effect.
  6. Acetic compress. Vinegar is a powerful cure for fever. Suitable apple or table.

Dilute 1 tbsp. l product in 1 liter of warm water. Put the patient on the bed and remove their outer clothing. Pre-moistened with a rag or towel in the solution rub your feet and hands. The lower limbs must be rubbed from the thighs to the fingers. Hands – from the shoulder. The chest and clavicles are also treated. Wet a handkerchief and put the patient on his forehead. Change the dressing every 5 minutes.

Measure your body temperature every 30 minutes. If it falls off slowly, wet your socks (preferably cotton) and put it on the patient. Take off your socks after 40 minutes. Remember that if a person has cool legs, it is advisable not to do a compress, since this can cause cramping.

  1. Alcohol rubbing. Dilute alcohol or vodka in a ratio of 1: 1. Moisten natural tissue and rub elbow surfaces, wrists and armpits.
  2. Potato compresses. Peel and rinse raw potatoes. Grate and add 1 teaspoon of vinegar. Wrap in a gauze bandage or bandage and attach to the temples and forehead. Stand for 20 minutes. If the temperature does not drop, repeat the compress every 30-40 minutes.
  3. Onion compresses. Grind the peeled onions in a porridge-like state, and add vinegar (1 teaspoon). Wrap in gauze and put on your forehead. In order not to cause a tear reaction, put tampons or a handkerchief moistened with cold water on your eyes. Onion porridge can also be used on the feet.

Fever during thrombolytic therapy

The cause of heart muscle infarction is most often a blockage or narrowing of blood vessels. They, affected by atherosclerotic plaques with thrombus formation, are not able to distill blood. Therefore, thrombolytic therapy is immediately used to treat myocardial infarction. Held in the first hour of the onset of the disease, the so-called golden one, it helps save most of the heart tissue from dying. The blood flow is restored, the patient is recovering faster.

However, such drugs as Fibrinolysin with Heparin, Plasmin – plasminogen activated by the enzyme trypsin (a drug based on human plasma) are endogenous, have an external form of application. They improve the condition very slowly, while causing an increase in the temperature of the patient. Therefore, to eliminate side effects, they are used together with activators such as streptokinase, injected directly into the coronary vessel.

Temperature for complicated heart attack

If a heart muscle infarction passes with a complication in the form of pulmonary edema, then most often this is due to blockage of blood vessels and the formation of blood clots on the walls of the right ventricle of the heart. With insufficient function of the left ventricle, this can occur due to stagnation of blood of the pulmonary circulation, which caused thrombosis of the vessels of the lungs.

Diagnosis is based on the examination of the patient and his description of his well-being. As a rule, this is chest pain, interruptions in heartbeat, shortness of breath, fever above 38º and bloody sputum when coughing.

An increase in temperature is possible during the rehabilitation period of scar formation with complications in the form of ischemic cardiopathy and pericarditis. The pains are similar to the acute course of a heart attack and are associated with the respiratory process. Often they depend on the position of the patient’s body.

Postinfarction inflammation of the pericardium – the outer membrane of the heart – causes leukocytosis and is manifested by an increase in body temperature.

Quite often, after an attack, an allergic post-infarction syndrome occurs, named after the doctor who described it. Dressler’s syndrome is an inflammation of the tissues of the heart and lungs. It is manifested by pleurisy (damage to the membrane covering the walls of the chest and lungs), pneumonia, pericardial inflammation, arthritis of the shoulder joints (mostly on the left). All these processes, as a rule, cause a temperature reaction of the body.

A similar reaction of the body is autoimmune, that is, immune cells perceive the tissues and organs of their own body as foreign and direct their forces to fight them.

Such a syndrome often occurs from the second to the sixth week from an attack of myocardial infarction. It can be expressed as one of the listed complications, or in the aggregate:

  • Inflammation of the heart membrane – the pericardium – in this case manifests itself in a lighter form, nevertheless causing a subfebrile temperature within 38º. Pain and temperature go away after a few days.
  • Pleurisy complements the picture of the disease with increasing pain in breathing, localized in the chest area, with a slight increase in temperature.
  • Autoimmune pneumonia is expressed by shortness of breath and a temperature reaction.
  • Damage to the inner (synovial) membranes of the joints is manifested by pain and subfebrile condition.

The combination complicates the course of myocardial infarction and gives a long-term increased temperature background.

There are low-symptom manifestations of Dressler syndrome, which are diagnosed only by a change in the biochemical composition of the blood and an increase in temperature for a long time. They can be found in connection with severe and persistent pain in the joints (arthralgia).

The reason for this condition in the syndrome is oxygen deficiency (hypoxia) of the heart muscle and other organs. Due to the fact that the cells of the muscle layer of the heart are damaged, antibodies are generated that attack the immune system, which later passes to the native cells, perceived as foreign. This situation often occurs with extensive myocardial infarction.

Also, the syndrome has an inflammatory-allergic nature of the occurrence, which can sometimes be manifested by isolated polyarthritis.

In treatment, to relieve inflammation and normalize the temperature, amidopyrine, aspirin (acetylsalicylic acid) are used, in severe cases – prednisone, cortisone (corticosteroid hormones).

The chronic form of a heart attack is manifested by periodic pressing pains and shortness of breath, very similar to those that occur at the very beginning of an attack of the disease. Such symptoms can occur for a week or more (up to 21 days). As soon as the pain begins, the temperature rises. The patient has a fever for several days, then the temperature drops, but soon a new surge occurs.

It so happens that the temperature appears subfebrile and remains at this level even when pain attacks pass. But then, if the pain returns, it leads to a temperature surge for at least 3 days. Such wave-like fever is very similar to the manifestations of septic, rheumatic endocarditis and may be caused by a similar complication. Then, when listening to heart sounds, the doctor discovers a characteristic systolic murmur – muscle or functional.

Myocardial infarction in any form, except for the stage of remission, proceeds as inflammation, which is confirmed by biochemical changes in the composition of the blood. Therefore, the body’s reaction to this is so universal – a change in body temperature. This implies a unified approach to prescribing drug treatment aimed not only at eliminating the consequences of heart muscle infarction, but also removing the inflammatory process as a whole.

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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.

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