Myocardial infarction: consequences and risks

Myocardial infarction is the most prevalent cardiological pathology today, especially in the countries around us, and is related to a disease that affects the coronary arteries, known as arteriosclerosis. Atherosclerosis obstructs the coronary arteries and this generates a lack of blood flow in them. If this flow deficit is acute and abrupt, a heart attack occurs and a part of the heart may stop contracting properly.

Atherosclerosis, the disease that causes a heart attack, is due to the presence of various risk factors, as there is usually no single, specific cause. Among them are smoking, high cholesterol, hypertension, diabetes, sedentary life, etc. This causes chronic damage to the arteries and ends up affecting the heart.

Consequences of a myocardial infarction

When a heart attack occurs, the most immediate consequence is a high risk of sudden death due to arrhythmia. One in 3 people do not reach the hospital and die a sudden out-of-hospital death. Therefore, when a heart attack occurs, urgent catheterization must be performed to unblock the acute occlusion of the coronary artery in order to save the patient’s life. On the other hand, with the intention of avoiding these sudden deaths, many entities and scientific societies are promoting the installation of defibrillators in certain public areas. The intention is precisely to avoid this sudden death associated with infarction.

Once the patient arrives at the hospital, in-hospital mortality is normally low. This is especially true with stents, which are used to open the coronary arteries, and with the treatment administered after discharge. The problem is that a patient who has had a heart attack becomes chronically ill, requiring treatment and care throughout his or her life.

The care is basically to control the risk factors that led to this entity and to gain self-confidence, facilitating the patient’s return to physical or sporting activities and to work. In fact, this is why cardiac rehabilitation units are being set up in both public and private hospitals.

Cardiac rehabilitation units aim to help the patient return to a better working or personal life, improving their physical conditions. These units are responsible for:

  • Providing confidence to the patient in performing physical activity, slimming down and picking up an exercise routine.
  • Helping to quit smoking in those cases of smokers.
  • To provide psychological support for patients who are distrustful, because infarction, especially in young people, generates a lot of uncertainty about their future.
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Cardiac rehabilitation units are made up of multidisciplinary teams that aim to help correct risk factors, to establish another lifestyle that is heart-healthy, providing information on the medications to be taken, blood pressure targets to be achieved, bad cholesterol targets, adequate heart rate and adequate weight, among others.

Most patients who have had a myocardial infarction, if they take their medication and take care of themselves, will be able to lead a practically normal life. Only a few, who are those who have been left with a very important cardiac deterioration, require more complex interventions later on. But most of them will be able to lead a normal life. The problem is that, as they usually stay well and symptom-free, they become relaxed in their care. Therefore, the aim is to keep the pressure on them so that they do not relax.

What are the risks of myocardial infarction?

The main problem with myocardial infarction is that it is large in size and therefore the pumping capacity of the heart is greatly affected. This pump capacity is measured by the ejection fraction, which is the percentage of blood that the heart is able to expel with each beat.

Most heart attacks do not affect the pumping capacity of the heart, but approximately 10% of them have a very impaired ejection fraction. This generates a risk of death and the development of heart failure, which sometimes makes it necessary to consider therapies other than pharmacological treatment.

Sometimes it is necessary to implant certain devices, such as special pacemakers or defibrillators or even some of them end in a heart transplant, because the cardiac damage that has been generated has been very important. However, these are less frequent cases, rare, not the most common.

The normality after a heart attack is that people can lead a normal life, returning to work and leading a normal social and family life, but this requires a commitment to care on the part of the patient, maintained over time. Cardiologists and their primary care physicians, we are here to help them.