Myocardial infarction is a disease resulting from a clot in a coronary artery. As a result, oxygen starvation of the heart muscle occurs, in the absence of prompt medical care, some of the cells may die, scar tissue forms in their place. The cardiac muscle, which has undergone dramatic changes, loses its ability to function normally. The main treatment is in the hospital, after discharge the patient needs a long rehabilitation to avoid relapses that occur in 20-40% of cases.
Recovery steps
Rehabilitation after myocardial infarction consists of several stages, the purpose of which is to prevent heart attacks and complications, and resume normal life.
The main stages of the process:
- Drug treatment.
- Gradual increase in physical activity.
- Diet therapy.
- Psychological rehabilitation.
The doctor chooses the tactics of rehabilitation measures based on the general condition of the patient, age, and the causes of the pathology. The severe course of the disease is accompanied by complications - heart failure, arrhythmia or other changes in the work of the heart. In such cases, rehabilitation measures are carried out in specialized cardiology centers under the supervision of specialists.
Stages of the rehabilitation period
Depending on the severity of the lesion, the recovery period takes at least a year after the onset of myocardial infarction. Rehabilitation of a physical condition has the following stages:
- Stationary. The patient is in the intensive care unit with subsequent movement to the cardiology department. Medical measures are implemented until a satisfactory condition of the patient is achieved.
- Post-stationary - includes rehabilitation actions aimed at restoring the functions of the body. The implementation of the tasks takes place in specialized cardiocenters, day hospitals, at home. The end of the period is considered the possibility of a return to full-time work.
- Supportive - includes ongoing preventative measures. These include an annual visit to a cardiological clinic for a certain period of time to monitor the condition, the development of physical activity and supporting procedures.
Heart attack and vascular stenting
Myocardial infarction is often accompanied by a narrowing of one of the coronary arteries. To correct the situation, stenting of the vessel is performed. The surgeon introduces a special metal mesh tube (stent) into the affected blood line at the site of narrowing, which expands the lumen and allows the heart to function normally.
Operations are performed within a few hours after the attack, the longer the intervention is delayed, the more necrotic tissue forms on the myocardium. Rehabilitation after a heart attack and stenting takes a long time and requires more effort from the patient. After the hospital, the patient is recommended to go to a sanatorium or dispensary in order to continue recovery. The principles of rehabilitation are the same as for a heart attack without surgery, but returning to normal will take more than a year.
The first steps are in the hospital
Rehabilitation of patients after myocardial infarction, not burdened by complications, begins in a hospital. The doctor recommends starting exercise therapy on the 2nd or 3rd day after the patient’s admission. In severe forms of damage, dosed physical activity is prescribed after 7-8 days.
During the patient’s stay in the hospital, the aggravation that caused the attack is removed. The medical rehabilitation of a stationary stage myocardial infarction consists of the following steps:
- Within a few days, the patient was prescribed bed rest.
- On the 4th or 5th day, the patient can periodically take a sitting position, hang his legs from the bed.
- After a week, if the diagnosis of the condition allows, the patient is recommended to move next to the bed.
- After 2 weeks, with favorable dynamics, movement within the ward is necessary.
- At the beginning of the 3rd week, the patient, accompanied by medical staff or a physical therapy instructor, can move along the corridor wall and down the stairs to walk into the courtyard.
Principles of Physical Rehabilitation
The basic principle of restoration of physical functions is a gradual increase in the load on the muscles, respiratory apparatus and cardiovascular system. At each stage of increasing the load, pulse control is necessary, with an increase in indicators, the exercises stop and resume along with stabilization of the heart rhythm.
In the case of a favorable prognosis based on observations of the patient's condition, the patient is recommended to be hospitalized in a rehabilitation cardiocenter, where treatment will be carried out under the supervision of doctors. Also, a specialist can make individual appointments with a detailed description of actions and lifestyle, if he considers it possible to undergo a recovery period at home.
Physical activity
Physical rehabilitation of patients after myocardial infarction is a critical step towards recovery. The patient gets his first skills of gradual increase in efforts in a hospital under the supervision of doctors, in the future, the rate of increase in load should progress as the myocardial tissue is scarred. The bulk of recovery procedures are carried out at home or at a dispensary.
A standard recommendation for physical activity is to complete a set of exercises for 15 minutes with a further increase in class time and load.
Passion for exercises and unauthorized complication of the load can lead to another attack. A set of exercises is selected by the attending physician, based on indicators:
- Lack of dyspnea in a calm state.
- Lack of pain in the heart.
- Electrocardiogram reading (demonstrates a stable state).
Caution and perseverance
According to the observations of doctors, the most effective physical activity is walking on flat terrain. There are many exercise complexes developed, a specialist can recommend several options, the patient’s task is to strictly follow the algorithm to avoid another myocardial infarction.
Rehabilitation is considered successful if, after walks or exercise therapy, the patient’s pulse does not exceed 120 beats per minute, and after 10-14 days the frequency decreases to 90-100 units.
The recovery process is significantly accelerated by physiotherapeutic measures - massage, breathing exercises. The resumption of sexual life is recommended approximately 2 months after the attack, provided that the dynamics of the restoration of the functions of the cardiovascular system are positive and there are no objections from the attending physician.
Diet and its features
Rehabilitation after myocardial infarction involves making adjustments to the diet, sometimes patients seem to be radical, because many people need to change their eating habits and lose extra pounds. After the attack, diet food is prescribed, mainly consisting of small portions of mashed soups and other products. Salt and spices are either eliminated altogether or they are kept in a minimal amount.
Failure to comply with the recommended diet can cause complications or the next myocardial infarction. Rehabilitation includes changing the established menu according to the diet displayed in the principles of diet table No. 10I. The therapeutic diet is designed for different stages of pathology.
- The first diet is indicated for patients with an acute stage of the disease. Dishes are boiled or steamed. Spices and salt are excluded, food is rubbed, the patient eats in small portions up to 7 times a day. The volume of drinking fluid is limited - not more than 700 ml.
- The second diet is introduced with the onset of the second or third week after the attack. The principle of cooking remains the same, salt and spices are excluded. Food is served in crushed or mashed form no more than 6 times a day, the amount of fluid taken increases to 1 liter.
- The last type of diet is prescribed with the beginning of the process of scarring of the myocardial tissue (about three weeks after the attack). The principles of preparation and use of spices remain the same, the number of servings per day is limited to 5 meals. At the discretion of the doctor, no more than 4 grams of salt and an increase in the amount of drinking water to 1.1 liters are allowed.
Overweight and limitations
Rehabilitation after myocardial infarction at home is associated for patients with a large number of temptations, while the consumption of a rather impressive list of products should be significantly limited. Overweight people, in addition to observing nutritional rules, need to get rid of extra pounds, but do it gradually, no more than 3 kg per month.
Nutritional principles for successful weight loss after myocardial infarction:
- Reducing calories in food.
- Avoiding carbohydrate snacking to improve mood or seize problems.
- Leave in the diet only a small amount of animal fat.
- A complete rejection of spicy dishes and seasonings (sauces, spices, etc.) that stimulate appetite.
- Cut back on salt intake (up to 5 g).
- Limit fluid intake (up to 1.5 l).
- Meals should be taken no more than 5 times in very small portions (the reference volume is a palm folded by a boat).
Losing excess weight significantly improves cardiac activity, removes additional stress from the heart. Normalizing weight and improving overall tone through exercise significantly reduce the risk of relapse.
Drug treatment
In the hospital, the patient receives a full range of measures to stop myocardial infarction. Rehabilitation at home involves taking medications strictly as prescribed by a doctor.
In the post-infarction period, the patient is prescribed the following groups of funds to achieve such goals:
- To reduce blood viscosity.
- For the prevention of atherosclerosis.
- Stimulants of metabolic processes.
- Antioxidants.
- For the treatment of angina pectoris, arrhythmias and other diseases that served as provocateurs of heart attack.
The list of required drugs, dosage regimen, dosage is prescribed individually, depending on the diagnostic indicators. In addition, the patient may be prescribed a course intake of multivitamins, fortifying drugs. Before discharge from the hospital, you need to find out about analogues of prescribed medications, side effects and the possibility of replacing medications.
Psychological rehabilitation
Anxiety often accompanies patients with heart disease. The stages of rehabilitation of patients with myocardial infarction include mandatory psychological assistance. Depression and anxiety develop in approximately 20% of people who have had an attack. A negative state of mind causes damage to the recovery of the body - reduces the overall tone, causes fatigue and indifference. This situation worsens the quality of life and can cause a relapse.
All patients with myocardial infarction are prescribed a visit to a psychologist individually or as part of support groups. Doctors also prescribe a course of antidepressants, recommend unhurried walks, positive emotions with a calm background.
Relapse prevention
If the first heart attack could not be prevented, then each patient can avoid a recurrence of the disease.
To prevent the condition, it is enough to observe a set of measures:
- The developed system of moderate physical activity (exercises are performed daily).
- Refusal of bad habits (alcohol, tobacco smoking, etc.).
- Exclusion of light carbohydrates from the diet (sweets, cakes, refined foods, etc.).
- Significant reduction in the number of cups of coffee and tea drunk.
- Careful attitude to the nervous system (avoidance of stress and intense unrest).
In the post-infarction period, the patient must constantly take a number of medications, which is also included in the complex of preventive measures.