Pressure In Myocardial Infarction: Increases Or Decreases, The Norm

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

What is the pressure with a heart attack?

The content of the article:

What is the pressure during a heart attack and what does it depend on
Why does the pressure rise and fall during a heart attack
How myocardial infarction develops
Myocardial infarction symptoms
First aid for myocardial infarction
Prevention
Video

Heart attack pressure is an important diagnostic criterion. However, it is impossible to give an unambiguous answer to the question of what pressure and pulse during a heart attack, without taking into account the phase of the disease and the initial, i.e., the patient's pressure preceding the attack.

Myocardial infarction is the formation of a necrosis focus in the area of the heart muscle, the development of which is associated with a relative or absolute insufficiency of coronary blood flow. It is a very serious, life-threatening disease. Up to 50 years of age, a heart attack affects men several times more often, and at an older age, it can happen with the same frequency in both men and women.

High blood pressure is a risk factor for heart attack

His prognosis to a large extent depends on the timeliness of the medical care provided. Therefore, each person is required to know the first signs of myocardial infarction, including whether there can be normal blood pressure (blood pressure) with a given cardiovascular pathology.

What is the pressure during a heart attack and what does it depend on

Hypertension, that is, a pathological condition in which the patient often or constantly has arterial hypertension, is a risk factor for the development of myocardial infarction. A particular danger is a sharp drop in significantly increased blood pressure (for example, during a hypertensive crisis). However, during myocardial infarction, pressure fluctuations are also observed in patients who have not previously suffered from arterial hypertension.

At the beginning of an acute heart attack, blood pressure usually rises, but after 20-30 minutes it drops and sometimes very strongly, up to the development of vascular collapse and cardiogenic shock.

Why does the pressure rise and fall during a heart attack

High blood pressure is one of the most frequent causative factors underlying the disturbance of blood flow in the coronary artery system. But even if the patient did not have arterial hypertension, high blood pressure is characteristic of the onset of a heart attack and persists in the first minutes after a heart attack. This is due to significant irritation of pain receptors, the release of so-called stress hormones (adrenaline, norepinephrine) into the blood, which have a vasopressor, i.e., pressure-increasing effect.

However, the high blood pressure begins to decrease rather quickly. This is due to the fact that as a result of the formed focus of necrosis, the contractility of the heart muscle is disturbed to one degree or another and cardiac output decreases. In turn, due to a decrease in cardiac output, a whole group of endogenous substances enters the patient's bloodstream:

myocardial depressing factor;
lactic acid;
leukotrienes;
cytokines;
thromboxane;
bradykinin;
histamine.

These substances further reduce the contractile function of the heart, which becomes the main cause of the development of cardiogenic shock - a formidable complication of myocardial infarction. Its main features:

arterial hypotension (systolic blood pressure equal to or less than 80 mm Hg. Art.);
decrease in pulse pressure to 20 mm Hg. Art. and less;
frequent pulse of weak filling;
lethargy up to complete loss of consciousness;
violation of peripheral blood circulation (pallor and / or marbling of the skin, decreased skin temperature, acrocyanosis);
oligoanuria (decrease in urine output to 20 ml / h or less).

It should be understood that high or low blood pressure alone is not a sign of myocardial infarction. Also, labile pressure (BP "jumps") cannot be considered as a symptom of this disease.

A significant drop in blood pressure during a heart attack in women and men is an unfavorable prognostic sign and indicates an extensive focus of necrosis, the development of cardiogenic shock.

How myocardial infarction develops

Myocardial infarction is one of the most severe acute forms of coronary heart disease (CHD).

In the vast majority of cases, the immediate cause of myocardial infarction is atherosclerosis of the coronary arteries - the vessels through which blood flows to the heart muscle. With atherosclerosis, lipid metabolism is disturbed in the patient's body. This leads to the deposition of cholesterol on the walls of the arteries in the form of plaques. Gradually, cholesterol deposits are saturated with calcium salts and increase, creating an obstacle to blood flow. In addition, platelets attach to the surface of atherosclerotic plaques, leading to the gradual formation of blood clots.

Atherosclerosis is a systemic disease, that is, it affects all blood vessels. However, different people have different vessels to a greater or lesser extent. Myocardial infarction is usually preceded by atherosclerosis of the coronary vessels, and stroke is usually preceded by atherosclerotic lesions of the cerebral vessels.

Due to high levels of catecholamines that increase blood pressure, myocardial infarction often occurs in the morning

Normally, blood pressure in adults (men and women) should not exceed 140/90 mm. rt. pillar. With a sharp and significant increase in it, a spasm of blood vessels occurs and the blood flow through them significantly worsens. And if the lumen is blocked by an atherosclerotic plaque, then the blood flow can completely stop. As a result, the portion of the heart muscle supplied by this vessel ceases to receive nutrients and oxygen along with the blood. Clinically, this is manifested by the appearance in the patient of an acute attack of pain in the retrosternal region, i.e., an attack of angina pectoris. If, within 30 minutes from its onset, coronary blood flow is not restored, irreversible processes begin in the affected area of the myocardium, leading to its necrosis.

In addition to arterial hypertension, factors that increase the risk of myocardial infarction are:

hypercholesterolemia;
diabetes;
gout;
hypodynamia;
smoking;
hereditary predisposition;
elderly age.

Myocardial infarction symptoms

Myocardial infarction often occurs in the morning. This is due to the fact that at this time there is an increase in the secretion of catecholamines (hormones of the adrenal cortex), which increase blood pressure. The patient suddenly has unbearable pressing pain in the left side of the chest or in the chest region, lasting more than 25-30 minutes and not relieved by taking nitroglycerin. The pain can radiate to the left arm, throat, lower jaw, back, or epigastric region. Anxiety, anxiety and fear of death are characteristic signs of the disease.

Myocardial infarction is often accompanied by the development of shortness of breath, profuse sweating, and a sharp pallor of the skin. In almost all cases, certain violations of the heart rhythm are noted (bradycardia, extrasystole, tachycardia), some of which are described by patients as an attack of a strong heartbeat.

First aid for myocardial infarction

If a person suddenly has severe pain in the heart, he should immediately be given first aid. The algorithm of actions in this situation is as follows:

call an ambulance team;
put the patient to bed (with a loss of consciousness, turning his head to one side);
give him a nitroglycerin tablet under the tongue if the pain persists and the systolic blood pressure exceeds 100 mm Hg. Art., then after 15-20 minutes you can give the medicine again;
provide an influx of fresh air (open a window, unfasten the collar);
try to calm the patient;
before the arrival of doctors, to monitor the basic vital functions (pulse rate, respiration);
in the event of clinical death, immediately proceed to resuscitation measures (indirect heart massage, artificial respiration using the mouth-to-mouth method), which should be carried out either until the patient's breathing and heart rate are restored, or before an ambulance arrives and a doctor is diagnosed with biological death.

According to medical statistics, about 10% of patients with myocardial infarction die at the pre-hospital stage. At the same time, first aid provided correctly can save a person's life.

Patients at risk for cardiovascular disease need to monitor blood pressure

Prevention

Myocardial infarction is a very serious disease, after which it is no longer possible to recover completely, since part of the heart function is irretrievably lost with the death of a portion of the muscle. Therefore, it is very important to try to prevent its occurrence.

In fact, prevention of cardiovascular disease is quite simple and consists in maintaining a healthy lifestyle. This concept includes a number of measures.

Rejection of bad habits. It has long been proven and there is no doubt that alcohol and nicotine have a negative effect on the condition of the heart and blood vessels and impair their functions.
Proper nutrition. The diet should limit the content of fat (especially animal origin) and light carbohydrates. Adequate fruits and vegetables should be consumed daily. Properly organized nutrition allows you to normalize metabolism, therefore, reduces the risk of developing atherosclerosis, type II diabetes, obesity.
Blood pressure monitoring. If the patient suffers from arterial hypertension, it is necessary to regularly measure the level of pressure, carefully take antihypertensive drugs prescribed by a therapist or cardiologist. In addition, fatty, spicy, spicy and salty foods should be completely excluded from the diet, or at least drastically limited.
Fight against hypodynamia. This includes daily walks, morning exercises, physical therapy classes.
Full rest. Both physical and psycho-emotional overload should be avoided. A good night's sleep is very important. An annual wellness holiday in a sanatorium or dispensary is recommended.