Rehabilitation of patients with myocardial infarction
Myocardial infarction is one of the most dangerous diseases of the heart. And it is equally important are measures to rescue, and rehabilitation after suffering a seizure.
Myocardial infarction - a disease that rigidly divides human life into "before" and "after". And even in the case when forecasts are favorable and the effects of the disease minimized, you need to understand that a favorable outcome has become a reality, it is necessary to radically revise the way of life.
The main stages of rehabilitation
Myocardial infarction - a disease which can be avoided. This disease develops for a long time and prevent the fatal completion much earlier than when the cardiovascular system reaches a state of extreme deterioration.
According to statistical data of death done no more than 10-12% of the seizures. This means that even with such a serious disease, the survival rate is very high and recovery is more than possible, although it will take a lot of time.
In fact, rehabilitation of patients with myocardial infarction continues for the rest of my life.
It includes the following main stages:
- if specific recommendations are assigned to operations: angioplastica balloon, coronary stenting, etc. The intervention is necessary in order to prevent the recurrence of a heart attack or to eliminate the severe consequences of it;
- the restoration or achievement of the highest possible standard of living.
- appointment medicines it comes to maintenance therapy and therefore to refuse drugs, because there is no pain and seizures;
- prevention of heart disease - continues the rest of your life;
- a lifestyle change - that is, the rejection of unhealthy habits, change in diet, rest and work, physical rehabilitation, myocardial infarction and so on;
- the return to labor detail. A return to the previous form of work is not always possible, however, to achieve success in his field, but it is possible.
The lifestyle change
It is necessary to distinguish restriction in certain kinds of loads of the complete rejection of the latter.
Myocardial infarction is not a death sentence, after which the person must maintain plant life. On the contrary, the damage to the heart muscle to be restored, which automatically means a full life, and not limitation.
Should be changed the intensity of some manifestations of life.
Recovery - durationthe intensity of the loads, a feature of the power depends on the degree of severity of the disease.
Share class 4 patients:
- Functional class 1 - patients who have had small focal infarction without significant complications or no. Here the restoration after myocardial infarction very simple.
- Class 2 - these include patients with complications of moderate severity, or in patients after large-focal myocardial infarction, but with minimal impact.
- Class 3 - patients with severe complications after a small infarction, in particular, with strokes up to 4-6 times per day.
- Class 4 - patients who have had a small heart attack with very heavy consequences - up to clinical death, as well as patients with transmural myocardial infarction. This is the most difficult group of patients, the duration of rehabilitation period is very large.
Cardiac muscle is the same as all the others, and reacts to loads and the lack of it, as well as everyone else. In low loads, the muscle atrophies, it becomes weaker and faster damaged when excessive loads are damaged. Here, as nowhere else important measure.
Load the heart must as soon as possible and, of course, after consultation with the attending physician.
- In the period after a bout of physical activity is prohibited. Sick maybe two times a day to sit on the bed no longer than 10 minutes and always under the supervision of medical personnel. For patients 1, 2 this class period is 3-4 days, for 4 - at least a week. If the patient is a repeat heart attack or as complicated with other diseases, the rehabilitation period is extended for another 2 days.
- The second stage is allowed in the corridor, sit 3 times a day for 25 minutes. You should avoid activities that require bending - when a heart attack is the heaviest load. Later allowed to do exercises sitting - after examination and doctor's permission, of course.
- The third stage involves walking along the corridor up to 200 m, complete self-service, the sitting position without time limits. This stage allows for faster muscle recovery.
- The fourth stage of the permitted Hiking is very convenient because the patient controls their duration and intensity. Initially, the distance is 600 m, then 1.5 km and 2-3 km.
This stage begins once the ECG data confirm the beginning of scarring of cardiac tissue. For different functional classes, this moment comes at different times: for class 1 18 - 20 day 2 - 16- 7 for 3 - 20-21. The recovery of patients 4 class depends on too many factors, to indicate the recovery period impossible.
style="font-size: medium;">to Navigate when walking need not fatigue, but on a more objective signs:
- the increase in pressure serves as a signal to reduce the load;
- increase heart rate to 200. And, by the way, if after walking, the heart rate starts to stay within 100-120 beats, it indicates the recovery;
- shortness of breath is not increased with asthma;
- excessive sweating.
Contraindications for patients after myocardial infarction, diabetes mellitus, cardiac aneurysm or aorta, disturbances in the blood flow to the brain and so on. In this case, the patient is assigned to an individual mode.
After successfully overcoming the 4 stages the patient may be discharged. At home he is obliged to fulfill all the requirements of the cardiologist, including gradually increase physical activity to the usual or to develop physical activity, to the patient if she was not peculiar.
The agents that are assigned almost always include drugs that prevent blood clots: aspirin, integrilin, enoxaparin and so on. They are all blood thinners and reduce blood clotting.
However, treatment of consequences of myocardial infarction on an individual basis. The doctor selects the medication, assessing not only the consequences of the disease, but the severity of the damage, General condition of the patient, accompanying diseases and so on.
The total here is only one: the physician must perform with the utmost precision.
Rehabilitation after myocardial infarction in most cases is not complete without taking into account psychological factors. Emotions and sensory overload impact on the condition of the heart is stronger than the physical exercise and the recovery period should be eliminated or minimized.
We are not talking about normal emotional outbursts, but the pressure that was caused by prolonged stress. The help of psychologists in this issue is invaluable.
Within 3 to 4 months the patient is often tormented by fear and excessive fears for his life. It is necessary to prevent panic attacks, the patient explaining in detail the mechanism of formation of the symptoms and their course.
It is important to give the patient to understand that excessive rest and lack of adequate loads will affect the state of the heart so bad as the immediate return to the previous way of life.
Often patients have depression. It is caused by a feeling of inferiority, fears for their future, for the disabled and so on. Despite the objective importance of these factors, it is necessary to separate in consciousness the patient's fears are groundless.
Recovering after myocardial infarction, the confidence ones. Often the advice a psychologist is necessary not only to the patient but also his family.
Equally harmful as denying the incident, and overprotection, limiting physical and mental activity.
When rehabilitation in the home the relationship between close and recovering, as a rule, complicated: for heart patients inherent suspiciousness, continuous anxiety, constant expectation of assistance from others, and jealousy and anger.
In this situation the help of a specialist is invaluable, as to the opinion of the relatives and friends of patients are listened to very rarely. In addition, the past and make up the closest object of envy and irritation.
The rehabilitation plan myocardial infarction includes changes in the diet. This applies both to the period of stay in the hospital and recovery at home.
- In the first 2 days the patient's appetite absent. 6-8 times a day give him slobozhany tea, broth hips, diluted currant or orange juice. It is forbidden to drink cold.
- Over the next weeks the diet include broths, and juice concentrates. Total caloric needs to reach 1100-1200 calories.
- After a week on the menu include soups in vegetable stock is optional, semolina and buckwheat, grated cheese and boiled fish. Welcome fruit and vegetable juices, freshly squeezed.
- After 2-3 weeks, if no complications are observed, calorie daily ration is increased to 1600 kcal. The menu has mashed potatoes, boiled cauliflower, yogurt, dairy sauces, butter in the ingredients.
- A month later, the caloric intake is 2000 kcal per day. The menu includes boiled meat and fish, varied vegetables and fruit, cereal, stale white bread. Butter is allowed, but not more than 10 g of Oily and spicy food should be avoided. It is strictly prohibited chilled food and beverages - less than +15 C.
Not worth it to continue to move away from the principles of healthy eating. Greasy fried meat, smoked meat and spicy dishes provokes spasms, which reflects badly on the state of the heart. In addition, they act as a source of "bad" cholesterol.
A mandatory element of the diet is to limit the amount of salt - not more than 5 g per day. Restrictions on water depend on the degree of severity of the disease: you need to consult a doctor.
Heart attack - an ordeal for the heart. Complications can occur after considerable time, soafter myocardial infarction, it is obligatory periodic visits to the doctor.
- All subsequent life of the patient it is necessary to measure pulse and blood pressure daily.
- In the first six months of a cardiologist need to visit at least 2 times a month, the next six months to once a month. Then, with a favorable course of events, the visit to the doctor do 4 times a year. Cardiologist he spends ECG.
- 2 times a year after myocardial infarction should visit the office of functional diagnostics, to pass veloergometry.
- 2 times a year you need to carry out a General analysis of blood - concentration of platelets, erythrocytes, and leukocytes, as well as biochemical for the determination of cholesterol.
- 3 times a year, investigated the coagulation system.
- 2 times a year had a heart attack need to see a therapist. According to the statistics in 60-80% of patients have a personality change. To prevent such consequences, professional help is needed.
Struggle with bad habits
Bad habits and life for suffered a heart attack patient simply incompatible.
- Alcohol is not allowed even low-alcohol drinks, such as beer. Wine is no exception, the patients present a low risk even grape juice.
- Smoking is the most dangerous habit, as Smoking triggers vasospasms and multiple sclerosis.
- Drugs negative effects their admission would negate the results of even the most successful operation.
- A lot of weight - and, more accurately, the habit to consume fat and flour dishes. For the heart of every extra kilogram is a serious test of strength. Despite the difficult process of losing weight, suffered a heart attack, people need to keep their weight normal.
The lack of physical activity also applies to bad habits. Movement stimulates development of muscle tissue, including heart.
Employment or disability
This question is always solved individually.
If the work detail is not related to anxiety, does not require excessive workload, and professional or career does not depend on the stay at work longer than 8-9 hours, then the patient can return to his former team and continue to work in the workplace.
If any of the listed factors is present, it is necessary to take into account and move to another position where such loads are excluded.
Complications after a heart attack or at high risk of relapse it is recommended to give up permanent employment detail.
In the most severe cases is issued a disability.
According to available data only 1% of patients carries a second heart attack due to a too active sex life. So suddenly to abandon his personal life there's just no reason. However, to start having sex gradually.
The first test shall be permitted after at walks - at least 2-3 km, shortness of breath disappears.
Not always attempts are successful: of the drugs used in rehabilitation, depress sexual function in both men and women.
To fully restore the much-needed patience and kindness, and on the part of both partners.
Poses are somewhat limited. Considered the best position on the right side. Do not want to use poses where required or possible tilt forward.
Rehabilitation after myocardial infarction and return to normal life is quite possible, but only under the strict adherence of the following conditions:
- mandatory monitoring of their own condition;
- implementation of medical recommendations;
- food restrictions;
- avoiding alcohol, Smoking and drugs;
- feasible physical activity.