Rehabilitation after a heart attack phased ration psychology

Myocardial infarction is a disease that can be avoided. This ailment develops for a long time and fatal completion can be prevented much earlier than when the cardiovascular system reaches an extreme degree of deterioration.

In fact, rehabilitation of patients with myocardial infarction continues for the rest of their lives.

It includes the following main steps:

  • with certain recommendations, operations are prescribed: balloon angioplasty, coronary stenting, etc. Intervention is necessary in order to prevent a recurrence of a heart attack or to eliminate the especially grave consequences of it;
  • restoration or achievement of the highest possible standard of living;
  • taking prescribed medications – it is a matter of maintenance therapy, therefore, it is impossible to refuse medications because there are no pains or attacks;
  • prevention of heart disease – also lasts the rest of your life;
  • lifestyle changes – that is, abandonment of unhealthy habits, changes in diet, rest and work, physical rehabilitation for myocardial infarction, and so on;
  • return to labor detail. At the same time, a return to the previous form of labor is not always possible, but it is quite possible to achieve success in your field.

Patient recovery begins immediately after the end of the critical phase of a heart attack.

From the very first days of hospitalization, medical personnel help the patient begin a fight that will allow him to regain his health and quality of life.

The rehabilitation period is conditionally divided into 3 stages:

  1. Stationary. It necessarily includes drug therapy, minimal physical activity and primary psychological support. The patient is in the hospital from 7 to 20 days. During this time, a person manages to restore minimal motor capabilities and gets acquainted with the nutrition program.
  2. Post-stationary. Now the patient must adapt to the new lifestyle as much as possible, change his eating habits, stabilize his psychological mood. Such rehabilitation is possible at home or in specialized sanatoriums, boarding houses. This period lasts from 6 to 12 months.
  3. Supporting. The duration of this rehabilitation period is not limited. A person should follow medical recommendations all his future life, which will allow him to reduce the risk of repeated heart attacks. An experienced heart attack requires the patient to adhere to proper nutrition and other principles of a healthy lifestyle, take prescribed medications and regularly undergo preventive examinations.

Each of these steps includes a set of measures (medication, a set of therapeutic exercises, diet) necessary for a relatively quick recovery.

During the stationary phase, they improve blood supply to the heart muscle, warn of the likelihood of complications, and determine the prognosis.

Stationary stage components.

Stage nameKeeping of
Bed rest
  • use of a bedside chair;
  • exercise therapy complex No. 1, consisting of breathing exercises, minimal physical activity of the legs, arms in the supine position. Duration of training – 10-15 minutes;
  • adoption of a sitting position (1-2 days), standing position (2-3 days);
  • initial conversation with the doctor. A person learns the danger of coronary heart disease complicated by a heart attack. Also, the doctor must emphasize that the outcome largely depends on the patient.
Ward mode
  • involves walking, activity exclusively inside the chamber;
  • exercise therapy complex No. 2, consisting of the easiest exercises. As the patient’s condition improves, their duration increases;
  • answers to patient’s exciting questions;
  • preparing the patient for future restrictions, justifying the need for each of them;
  • involvement of relatives in the rehabilitation process, explanation of the features of the recovery period.
Corridor Mode
  • the patient is allowed to leave the ward, use a shared shower, toilet;
  • the duration of the walk is increased gradually. The first, second walk should be short – no more than 50-60 meters. As the patient’s condition improves, the distance is increased to 200 m, and the number of passes from 2-3 to 5-6 times;
  • 2-3 days before discharge, climbing stairs is allowed. Between the rises, a break of 5-10 minutes is made;
  • severe patients begin to master the stairs from the descent: they rise one floor on the elevator, and then go down (no more than 1 floor);
  • complex exercise therapy №3.
Statement
  • discussion of a plan for further treatment;
  • recommendations for the near future;
  • appointment of the date of the first visit to the cardiologist.

Sexual life

In the first time (4-8 weeks) after a heart attack, it is recommended to lead a calm lifestyle. It is advisable for the patient to spend more time at home than to go around guests or get involved in parties. However, calm walks in the fresh air over rough terrain should be carried out daily.

After a heart attack, a restriction is imposed on the use of alcohol, although some doctors believe that a glass of quality red wine is quite acceptable from time to time. But smoking must be completely forgotten. If a person continues to smoke after a heart attack, then all measures taken to open the blood vessels will be completely ineffective.

You can have sex after a heart attack after 1,5 – 2 months after an acute attack. At the same time, a person should already normally tolerate an ascent by 2-3 flights of flights of stairs. It is extremely undesirable to use potency stimulants before having sex. But drugs that prevent an attack of angina, can even be recommended by a cardiologist before intimacy.

Before or after intimacy, it is not recommended to overeat, drink alcohol, coffee or smoke. All this increases the load on the heart. In addition, it should be controlled so that intimate life does not prevent the patient from getting enough sleep.

And also during sexual intercourse, a person should be psychologically comfortable, therefore, as a partner, you should choose a trusted person, do this in the usual conditions and in lightened poses.

It should be distinguished limitation in a certain kind of load from a complete rejection of the latter.

Myocardial infarction is not a sentence, after which a person must lead a plant lifestyle. On the contrary, damage to the heart muscle should be repaired, which automatically means a full life, and not limitation.

The intensity of some manifestations of life should be changed.

Recovery – the duration, intensity of the loads, the feature of nutrition, depends on the severity of the disease.

4 classes of patients are divided:

  • 1 functional class – these are patients who underwent small focal infarction without significant complications or even without them. Here, recovery from myocardial infarction is the simplest.
  • Grade 2 – this includes patients with moderate complications, or patients after a large focal heart attack, but with minimal consequences.
  • Grade 3 – these are patients with severe complications after a small focal heart attack, in particular, with angina pectoris up to 4-6 times a day.
  • Grade 4 – patients who have had a small focal heart attack with very serious consequences – up to clinical death, as well as patients with transmural myocardial infarction. This is the most difficult group of patients, the period of the rehabilitation period is very long.
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Physical exercise

The heart muscle is the same as everyone else and responds to stress and lack thereof, just like everyone else. With insufficient loads, the muscle atrophies, becomes weaker and faster damaged, with excessive loads it is injured. Here, as nowhere else important measure.

It is necessary to load the heart as early as possible and, of course, after consultation with the attending physician.

  • In the period after the attack, physical activity is prohibited. The patient can sit on the bed twice a day for no longer than 10 minutes and always under the supervision of medical staff. For patients of grades 1, 2, this period is 3-4 days, for 4 – at least a week. If the patient has a repeated heart attack or the condition is complicated by other diseases, the rehabilitation period is extended for another 2 days.
  • At the second stage, it is allowed to walk along the corridor, sit 3 times a day for 25 minutes. Avoid activities that require slopes – with a heart attack this is the heaviest load. Later it is allowed to do gymnastics while sitting – after examination and permission of the doctor, of course.
  • The third stage involves walking along the corridor – up to 200 m, full self-service, sitting position without time limits. This stage allows you to restore muscle faster.
  • At the fourth stage, walks are allowed – they are very convenient because the patient himself regulates their duration and intensity. At first, the distance is 600 m, then 1,5 km, and after a couple of days 2-3 km.
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This stage begins after the ECG data confirm the onset of scarring of the heart tissue. For different functional classes, this moment occurs at different times: for class 1 – on 18–20 days, for 2 – 16–7, for 3 – on 20–21. Recovery of patients of grade 4 depends on too many factors, it is impossible to indicate the recovery period here.

You should focus on walking not on a feeling of tiredness, but on more objective signs:

  • increased pressure serves as a signal to reduce the load;
  • increase in heart rate to 200. And, by the way, if after a walk the heart rate begins to fit into 100-120 beats, this indicates recovery;
  • shortness of breath – is not an indicator for asthma;
  • excessive sweating.

After successfully completing 4 steps, the patient may be discharged. At home, he is obliged to fulfill all the instructions of a cardiologist, including gradually increasing physical activity to the usual or developing physical activity if it was not characteristic of the patient.

Bad habits and life for a heart attack patient are simply incompatible.

  • Alcohol – even low-alcohol drinks, such as beer, are not allowed. Guilt is no exception, for patients there is some danger even grape juice.
  • Smoking is the most dangerous habit, since it is smoking that provokes vascular spasms and sclerosis.
  • Drugs – the negative consequences of taking them will negate the results of even the most successful operation.
  • A lot of weight – or rather, the habit of consuming fatty and floury foods. For the heart, every extra kilogram is a serious test of strength. Despite the rather complicated process of losing weight, people who have had a heart attack need to keep their weight normal.

According to available data, only 1% of patients suffer a second heart attack due to too active sexual activity. Therefore, there is no reason to suddenly give up personal life. However, to start having sex should be gradual.

The first tests are allowed to be made after short walks – at least 2-3 km, shortness of breath disappears.

Attempts are not always crowned with success: drugs used during rehabilitation inhibit sexual function in both men and women.

Poses are somewhat limited. The best position is on the right side. It is undesirable to use postures where a forward bend is required or possible.

Rehabilitation after myocardial infarction and a return to a full life are quite possible, but only with the exact fulfillment of a number of conditions:

  • mandatory monitoring of one’s own condition;
  • implementation of medical recommendations;
  • food restrictions;
  • quitting alcohol, smoking and drugs;
  • feasible physical activity.

Medication Therapy

The therapeutic approach after a heart attack is similar to that used for coronary heart disease. The goal of drug therapy is to improve the prognosis and quality of life of patients.

Of the conservative approaches to the early restoration of blood flow in a heart attack (affected) coronary artery, the most effective is the method of systemic thrombolytic therapy. First of all, they eliminate a blood clot (stenting) and stop the pain.

In the future, resort to the use of such drugs:

  • nitrates;
  • antiplatelet agents and anticoagulants;
  • in the absence of contraindications, beta-blockers are used;
  • ACE inhibitors, especially for patients with diabetes mellitus and / or left ventricular failure;
  • drugs that lower blood lipids.

Recovery from a heart attack, which continues after discharge from a medical institution, requires an individual prescription of drugs. For this, the presence of other somatic diseases, the causes of thrombosis and physiological features are taken into account. It can be antihypertensives that relieve stress on the heart or thin the blood.

Drug rehabilitation

The drugs that are prescribed almost always include drugs that prevent the formation of blood clots: aspirin, integrin, enoxaparin and so on. All of them belong to anticoagulants and reduce blood coagulation.

However, the treatment of the consequences of myocardial infarction is strictly individual. The doctor selects medications, evaluating not only the consequences of the disease, but also the severity of the injuries, the general condition of the patient, concomitant diseases, and so on.

Only one thing is common here: the appointment of a doctor must be carried out with all possible accuracy.

Exercises and exercise therapy

Elderly patients recover for a particularly long time. But they must make every effort to restore motor capabilities.

After extensive myocardial infarction, patients are shown bed rest for a long time, so the recovery program begins with the following actions:

  1. The physical activity of the patient begins with a smooth turning in bed from side to side.
  2. After a day, it is allowed to sit on the edge of the bed (no longer than 10 minutes) and relieve the need for a sitting position.
  3. In the future, the patient can sit daily, while gradually increasing the time spent in this position.
  4. The next stage is that the patient takes an upright position and moves slowly around the ward.
  5. After a week, a person can sit on the bed for an unlimited time and gradually master therapeutic gymnastics.

Over time, doctors will recommend the patient more dynamically move around the ward, as well as go out into the corridor and walk up the stairs. After discharge from the cardiology department, physiotherapy exercises are recommended for the patient. At first, classes take a quarter of an hour, but every week this time can be increased by 5 minutes and so gradually brought to an hour.

Popular exercises for the heart:

  1. The patient occupies a comfortable sitting position, while holding his legs together and lowering his arms along the torso. On inspiration, he raises one upper limb up, and on exhalation, he lowers it down. Then alternates the hand. For each limb, this exercise is repeated 5 times.
  2. The patient is still sitting. He spreads his arms to the sides so that the palms are facing up. It bends the limbs at the elbows and begins to make circular movements with them clockwise, and then counterclockwise. 5 times in each direction.
  3. The patient is standing, holding his legs together, and arms extended to the sides. On inspiration, he bends the left lower limb in the knee and draws it to the stomach or chest. On exhalation, he returns the leg to the floor, and spreads the upper limbs to the sides. Repeat the exercise up to 5 times alternately with both legs.
  4. The patient is standing, legs apart at shoulder width, and holds his hands at the waist. Gathering air into the chest, he leans to the side, and exhaling, returns to its original position. Repeat the exercise in each direction up to 5 times.
  5. The patient is still standing. He holds the lower extremities shoulder-width apart, and lowers the upper limbs along the torso. Gathering air into the chest, he takes aside the left arm and leg, hovering in this position for 2-3 seconds. Then he returns to the starting position and does the same with the right limbs. The exercise is repeated 3-5 times.

How many repetitions and which exercise therapy exercises to use should be decided only by the attending physician. And their correct implementation should show the instructor LFK.

It is important to remember that excessive diligence in gymnastics can lead to negative consequences.

Psychological rehabilitation

Psychological correction, which is part of a comprehensive rehabilitation, will help the patient recover soon after a heart attack.

It allows you to achieve the following:

  • get rid of panic attacks;
  • cope with a rapid breakdown and impaired sleep quality;
  • establish an intimate life;
  • accept your diagnosis without panic and clearly follow medical advice;
  • master relaxing techniques so as not to overload the cardiovascular system during stressful situations;
  • gain self-confidence;
  • learn to enjoy life;
  • completely reconsider your approach to life in order to protect yourself from relapse.

Survivors of a heart attack, as a rule, are recommended psychotherapy sessions with an experienced psychologist who will support and help transfer this problem.

Thanks to him, the patient can calmly accept his situation and understand that MI, like any serious disease, is not a sentence. This is very important, since a positive attitude significantly affects the quick recovery.

Rehabilitation after myocardial infarction in most cases does not do without taking into account psychological factors. Emotions and nervous overloads affect the state of the heart more than physical activity, and during the recovery period should be excluded or minimized.

This is not about ordinary emotional outbursts, but about pressure that was caused by prolonged stress. The help of psychologists in this matter is invaluable.

Within 3-4 months, the patient is often tormented by fear and excessive fears for his life. It is necessary to prevent panic attacks, explaining in detail to the patient the mechanism of the formation of symptoms and their course.

No less often, patients experience depression. It is caused by a sense of inferiority, fears for their future, for their ability to work, and so on. Despite the completely objective significance of these factors, it is necessary to separate in the patient’s mind the fears that are unfounded and real.

A person recovering after a myocardial infarction needs self-confidence and loved ones. Often a consultation the help of a psychologist is needed not only for the patient himself, but also for his relatives.

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Equally harmful are both a complete denial of what happened, and excessive custody, limiting physical and mental activity.

During rehabilitation at home, the relationship between loved ones and recovering, as a rule, is complicated: heart patients are characterized by suspiciousness, continuous anxiety, constant expectation of help from others, as well as envy and bitterness.

In this state of affairs, the help of a specialist is invaluable, since patients rarely listen to the opinions of their relatives and friends. In addition, the latter constitute the closest object of envy and irritation.

After the patient undergoes inpatient treatment after a myocardial infarction, along with the physical component, the psychological component is of great importance. There are various types of human response to the disease, from adequate to hypochondria. Also of great importance is the family and good family relationships in the period of adaptation of the patient to the implementation of life outside the hospital.

The relevance of the psychological component increases in the process of completing the rehabilitation phase, when the patient returns to the workplace and his social status is restored after myocardial infarction. With a successful and satisfactory mental adaptation, patients adequately assess their condition, follow the doctor’s recommendations and try to lead an active lifestyle.

The purpose of using psychotherapy in the treatment of myocardial infarction is the psychological adaptation of patients and orientation to an active lifestyle. Much attention must be paid to eliminating the stressful, psycho-emotional causes that led to the development of a heart attack. The rehabilitation program includes such components as psychoregulation based on disseminated hypnosis, heterotraining, ideomotor training, adaptive training, and training in auto-training and self-regulation techniques is also used.

From the side of the next of kin in relation to the patient who suffered a myocardial infarction, three main types of reactions were revealed. In most cases, the behavior of the next of kin is based on a feeling of fear for the patient’s condition, which contributes to his excessive custody, this is especially true in matters that relate to his physical activity.

Basically, such relatives are near the patient when he visits the clinic, on walks and limit his minimal physical activity. Sometimes, the patient’s family members experience the type of reaction to the illness of a loved one, when the behavior of relatives is expressed as a complete denial of the disease in the patient or the severity of the disease is reduced.

The “golden mean”, which is formed between the two types of reactions of the patient’s immediate environment to his disease, is the correct and adequate reaction of the family to the disease. Also, the relationship between husband and wife after one of them suffered an acute myocardial infarction becomes one of the most significant psychotherapeutic, and sometimes psychotraumatic, factors, so family psychotherapy will be an important condition.

A significant aspect is social rehabilitation. The patient after suffering a myocardial infarction is incapable for 4 months, then the patient is sent to VTEK. By this time, 50% of patients returns to their labor activity, i.e., disability is almost completely restored. If complications arise, then a disability group, most often II, is assigned for 6-12 months.

with small focal myocardial infarction, proceeding without complications, – about 2 months; with large focal (including transmural myocardial infarction) – 2-3 months; with small focal or large focal complicated myocardial infarction – 3-4 months. In case of recurrent myocardial infarction, severe rhythm and conduction disturbances, severe chronic coronary insufficiency, circulatory failure, patients with stage PB are sent to a medical rehabilitation expert commission, which either prolongs the sick leave for more than 4 months (if the prospect of restoration of working capacity is real), or recognizes the patient as incapable.

At the first functional class, patients are fully able-bodied, but are exempted from night shifts, additional work, business trips. Persons whose profession is inextricably linked with hard physical labor are transferred to another job. In the second functional class, patients are able-bodied, but only if their work is associated with light physical labor, non-intense physical stress.

Treatment of mental disorders in patients with myocardial infarction. In the first week of the disease, the development of acute psychosis is possible, which is due to intoxication with the decay products of the necrotic focus, hypoxemia, and cerebrovascular disorders. Typically, psychoses occur in the evening, occur with a sharp motor excitement, sleep disturbances, anxiety and fear develop in patients, often in these conditions visual hallucinations are detected.

Diet and proper nutrition

Efficient medical nutrition is of great importance in the complex of rehabilitation measures after myocardial infarction.

Diet therapy makes it possible to normalize or at least reduce the effects of atherogenic dyslipidoproteinemia, and, therefore, is effective as a primary prevention of recurrent myocardial infarction. The simultaneous use of lipid-lowering drugs with the start of diet therapy is recommended only when it is necessary to immediately reduce the plasma lipid level in people with genetically determined pronounced dyslipidemia and a high risk of developing coronary heart disease or pancreatitis (with high hypertriglyceridemia).

In 1987, a group of experts in the study of atherosclerosis formulated 7 “golden rules” of diet, compliance with which will help eliminate lipoprotein metabolism disorders:

  1. reduce fat intake;
  2. sharply reduce the use of foods containing saturated fatty acids (animal fats, butter, cream, eggs), as they contribute to hyperlipidemia;
  3. increase the intake of polyunsaturated fatty acids, which are found in the following foods: liquid vegetable oils, fish, poultry, seafood, polyunsaturated fatty acids reduce blood lipids;
  4. it is necessary to increase the intake of fiber and complex carbohydrates (vegetables and fruits);
  5. completely replace the butter with cooking oil during cooking;
  6. dramatically reduce cholesterol-rich foods;
  7. limit the amount of salt in food to 3-5 g per day.

These conditions correspond to diet No. 10, developed by the Institute of Nutrition RAMS.

Patients with myocardial infarction, who did not have the effect of diet No. 10 and fasting days, with concomitant chronic circulatory failure of patients with stage II and stage III, may be prescribed Carrel diet. This diet significantly relieves metabolism, increases diuresis, and reduces acidosis. In the diet, the content of sodium salts is sharply limited and the content of potassium is increased. On the 5-6th day, the therapeutic effect of the diet occurs.

1 and no more than 14: 1. The potassium content in the diet should be 5-7 g per day. This diet includes dried apricots, raisins, nuts, baked potatoes, cabbage, rose hips, oranges, tangerines, peaches, barley, oat, wheat cereals, gooseberries, prunes, black currants, veal, vegetable oil, nonfat milk and cottage cheese.

The Institute of Clinical Nutrition RAMS has developed four variants of potassium diet, differing in potassium content and chemical composition. The chemical composition of this diet is inferior, given this, it is prescribed for 3-5 days, starting with the first diet, as the patient’s condition improves, they are transferred to subsequent diets.

Patients must be constantly convinced of the importance of dieting, even if there is no appetite, food should be eaten.

Drinking mineral water has a beneficial effect on lipid metabolism.

Mineral waters have a choleretic effect and contribute to a decrease in blood cholesterol by 15% and triglycerides by 20% (L. E. Mikhno, K. D. Vabov, 1995).

Mostly recommended are sodium hydrogen carbonate, chloride, hydrocarbonate sulfate mixed cationic mineral waters. The most widely used mineral waters are Essentuki No. 4, No. 17, Borjomi, Smirnovskaya, Luzhanskaya, Arzni and others.

Mineral waters should be prescribed in small amounts three times a day (in the morning on an empty stomach, before lunch and dinner) after their preliminary degassing to patients with clinical manifestations of coronary heart disease. The maximum single dose is determined based on the patient’s body weight: 1 ml of mineral water is prescribed per 3,3 kg of body weight.

In the absence of concomitant diseases of the digestive system, mineral waters are prescribed to patients with IVS 30 minutes before meals, the water temperature is 36-37 ° C. The duration of the course of drinking treatment ranges from 3-4 to 5-6 weeks. A second course of treatment with mineral waters at the resort is recommended for patients with coronary heart disease after 9-12 months.

Cholesterol is a structural element of all cell membranes, a precursor to the synthesis of bile acids and steroid hormones. For these needs, the human body synthesizes its own endogenous cholesterol in sufficient quantities. With excessive intake of cholesterol from the outside, that is, with food, the feedback mechanism is violated, and the concentration of cholesterol in the blood increases significantly.

In the presented diet No. 10, a cholesterol content is limited to 300-200 mg and even 150 mg per day. Cholesterol enters the body with animal products. The following foods are rich in cholesterol: brains, kidneys, liver, egg yolk, butter, pork and mutton fat, fatty meat, etc.

It is calculated that, on average, every 100 mg of cholesterol consumed increases its blood content by 10 mg / dl. The patient needs to calculate the amount of cholesterol taken with food during the day, for this special tables have been developed. In some cases, in order to lower cholesterol, it is enough just to limit the patient’s intake of fatty foods. By abandoning bacon, sausage, butter and replacing these products with fish and light margarines, the patient can avoid a repeated myocardial infarction.

There is a direct correlation between the consumption of marine fish, fish fat rich in ω-3 polyunsaturated fatty acids, and reduced morbidity and mortality from coronary heart disease. This fact is due to the normalization of lipid metabolism, a decrease in platelet aggregation and blood viscosity in the treatment of marine fish fat.

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The fat of marine fish for the treatment of hyperlipidemia is obtained from carcasses of fish, in contrast to fish oil obtained from cod liver. A new food product “Ichteon food oil” was developed and in the form of a preparation – eikanol. Under the influence of edible ichtheon oil, the content of total cholesterol, cholesterol of low density and very low density lipoproteins, triglycerides decreases and cholesterol of high density anti-atherogenic lipoproteins increases.

When treating with eikanol, side effects are possible in the form of exacerbation of chronic diseases of the gastrointestinal tract (chronic gastritis, cholecystitis, gastric ulcer, duodenal ulcer, chronic pancreatitis). In this case, treatment must be discontinued. In the absence of eikanol and ichteon oil, the patient can get eicosopentaenoic acid by eating fish and other seafood.

The content of this substance in the daily diet should be 2-3 g. The content of eicosopentaenoic acid in grams per 100 g of food is the highest in horse mackerel – 1,44 g, in Ocean paste – 1,14 g, in herring – 0,90 g, in sardines – 0,86 g, in mackerel from 0,7 to 1,26 g. When conducting diet therapy, it is advisable to take into account the type of hyperlipoproteinemia.

Rehabilitation after a heart attack has not been complete without proper nutrition. In the acute period, in order to reduce the load on the heart muscle, the patient is substantially cut portions, and the diet consists mainly of mashed soup without salt and hot spices.

Further adhere to the principles of dietary nutrition according to Pevzner (table No. 10):

  • meals should be frequent (up to 5-6 times a day), but fractional;
  • the menu should be as balanced as possible;
  • salt is allowed no more than 5 g per day;
  • It is not recommended to drink more than 1,5 liters of water or other liquid per day;
  • the exception of products that provoke the development of atherosclerosis.
Prohibited ProductsFoods to eat
Fatty meats (pork, ducklings, goose)Dietary meat (chicken, turkey)
Fatty FishLow fat marine and river fish
Fresh bakeryStale bread, biscuit cookies
Cooking oil, butterSunflower or olive oil
Too salty cheeseLow fat fermented milk products
Smoked meats, pickles, canned foodSome types of sausages
Mushrooms, Beans, Radishes, RadishPotatoes, tomatoes
Sour sorrel, spinachUnsharp greens
Coarse grapes, grapesSmall-Bone Berries
Chocolate cakesCocoa-Free Sweets
Spicy or fatty saucesVegetable or sour cream sauces
Coffee, cocoa, strong black tea, sweet sodasFruit juices, rosehip broth, herbal infusions, chicory

The priority should be steaming, baking (without a carcinogenic crust), stewing.

It is not recommended to add salt during cooking, but you can slightly add salt to ready-made dishes. Pre-cooked pieces of meat or fish can be slightly fried until a light crust appears.

A rehabilitation plan for myocardial infarction necessarily includes a change in diet. And this applies to the period of stay in hospitals, and recovery at home.

  • In the first 2 days, the patient has no appetite. 6–8 times a day he is given low-brewed tea, a rosehip broth, diluted currant or orange juice. It is forbidden to drink cold.
  • Over the next week, the diet includes broths and concentrated juices. The total calorie content should reach 1100-1200 kcal.
  • A week later, the menu includes soups on vegetable broth – this is mandatory, semolina and buckwheat porridge, mashed cottage cheese and boiled fish. Freshly squeezed fruit and vegetable juices are welcome.
  • After 2-3 weeks, if no complications are observed, the caloric content of the daily diet rises to 1600 kcal. The menu contains mashed potatoes, boiled cauliflower, kefir, milk sauces, butter as part of dishes.
  • After a month, calorie intake is 2000 kcal per day. The menu includes boiled meat and fish, a variety of vegetables and fruits, cereals, stale wheat bread. Butter is allowed, but not more than 10 g. Fatty and spicy foods should be avoided. It is strictly forbidden chilled food and drinks – below 15 C.

Dispensary observation

Heart attack is a difficult test for the heart. Complications can appear after a considerable time, therefore, for those who have had a heart attack, a periodic visit to the doctor is mandatory.

  • For the rest of his life, the patient needs to measure pulse and pressure daily.
  • In the first six months, a cardiologist must be visited at least 2 times a month, the next six months – once a month. Then, with a favorable course of events, a visit to the doctor is made 4 times a year. A cardiologist must conduct an ECG.
  • A heart attack survivor must visit the functional diagnostics room 2 times a year to undergo bicycle ergometry.
  • Twice a year, a general blood test should be performed to monitor the concentration of platelets, red blood cells and white blood cells, as well as a biochemical one to determine cholesterol levels.
  • 3 times a year, the coagulation system is examined.
  • 2 times a year, those who have had a heart attack should visit a psychotherapist. According to statistics, 60–80% of patients have a personality change. To prevent such consequences, specialist help is needed.

About spa treatment

During the first year after a heart attack, the patient is shown to stay in specialized cardiological sanatoriums.

Cardiac rehabilitation after myocardial infarction should be carried out in the climatic zone where the patient lives. A sharp change in climatic conditions is fraught with serious complications. Although in some cases, a cardiologist may decide that his patient after a heart attack should undergo rehabilitation in boarding houses by the sea.

The length of stay in the sanatorium usually lasts up to a month.

Medical rehabilitation usually includes the following:

  • taking cardiological medications;
  • classes in therapeutic gymnastics (30-45 minutes);
  • walking 2-3 times a day;
  • games with a sports bias;
  • compulsory walking on the flight of stairs;
  • sleep in the fresh air;
  • massage treatments;
  • taking mineral or gas baths;
  • cultural and recreational activities.

If sanatorium-resort rehabilitation is thought out competently, then all this will help a person to return to an active lifestyle quite smoothly, and eventually to return to working capacity.

Work and disability

This issue is always resolved individually.

If labor detail is not associated with excitement, does not require excessive workload, and professional or career growth does not depend on staying at work for more than 8–9 hours, then the patient can return to his former team and continue to work at his workplace.

If any of the listed factors is present, it is necessary to take it into account and transfer to another position, where such loads will be excluded.

In case of complications after a heart attack or with a high risk of relapse, it is recommended to abandon permanent labor detail.

In the most severe cases, disability takes shape.

After discharge from the cardiology department, all patients who have survived a heart attack are given a sick leave in their hands, which indicates temporary disability.

Depending on the type of heart attack, its period may vary: from 60 days to 5 months.

In the future, in order to assign a disability to a patient, it will be necessary to undergo a medical and social expert commission (MSEC), which consists of a consultation of doctors of various specializations.

To assign a patient to a particular disability group, the degree of cardiac impairment and the severity of heart failure are carefully evaluated. And also takes into account how much the patient’s body responds adequately to the treatment and whether it was necessary to resort to surgical intervention.

The following professions are contraindicated for any patients observed by a cardiologist about heart failure or a heart attack experienced:

  • aviation, drivers (responsibility for the lives of others);
  • industrial mountaineering or other work at height;
  • electrotechnological staff;
  • professions associated with prolonged stay on legs;
  • work in extreme conditions or in hazardous work (inhalation of toxins, poisons);
  • work schedule longer than 8 hours or work at night.

If before the attack the patient was engaged in one of the listed types of activities, then he is sent to undergo MSEC regardless of the severity of the pathological process affecting the myocardium.

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