Myocardial infarction is a focus of ischemic necrosis of the heart muscle, the cause of which is an acute violation of coronary circulation.
What causes it? What are the consequences for the body? Give or not disability? Myocardial infarction, unfortunately, is a common problem, but because now we should pay a little more attention to this topic.
Briefly about the condition
Most often, this problem affects men aged 35 to 60 years. A heart attack occurs in women, but less often, and then - older than 50 years. Because up to this point their vessels are physiologically protected from atherosclerosis by sex hormones (estrogens in particular).
But after 55-60 years, the incidence among representatives of both sexes is equalized. Unfortunately, mortality is high - it is about 30-35%, according to modern statistics. About 15-20% of sudden deaths are caused precisely by myocardial infarction. "Do they give or not disability in this condition?" - a logical question, given such information. But more on that later.
You can save a person and his health. But then emergency assistance is needed as much as possible, because a violation of the myocardial blood supply lasting 15-20 minutes leads to the development of irreversible changes in the heart muscle and further disruption of its activity.
Due to acute ischemia, most of the functional muscle cells die, that is, necrosis occurs with further replacement by connective tissue.
Periods and symptoms
So, what is it - myocardial infarction, clearly. But how does this condition develop? It is customary to distinguish several periods.
The first is prodromal. He is preinfarction. It is characterized by an increase and intensification of angina attacks, can last from several hours to weeks. Symptoms: angina progresses unstable. But in 43%, a heart attack occurs suddenly.
The second is the sharpest. The development of ischemia and the subsequent appearance of necrosis takes from 20 minutes to 2 hours. Symptoms: the patient is struck by intense pain - it occurs in the chest, and can radiate to the collarbone, ear, neck, shoulder, teeth, interscapular area.
The nature of the sensations can be anything - sharp, compressive, oppressive, bursting, burning. The pain lasts from 30 minutes, but can drag on for hours, sometimes even for a day. Stop it with nitroglycerin does not work. In parallel, a person feels weakness mixed with excitement, as well as a sense of fear and shortness of breath.
Also, the second period is characterized by blanching of the skin, the appearance of cold, sticky sweat, anxiety and acrocyanosis. The pressure rises, but then decreases sharply or moderately.
The third is sharp. From the second period to the enzymatic melting of tissue already covered with necrosis, it takes from two days to two weeks. Symptoms: the pain disappears. But a fever develops, which can last from 3-5 days to 10 days. Signs of heart failure and hypotension also increase.
The fourth is subacute. It lasts from the 4th to the 8th week. Scars begin to form, granulation tissue develops. Symptoms: the condition improves, the temperature returns to normal. Systolic murmurs and tachycardia also disappear.
The fifth is post-infarction. The scar ripens, and the myocardium adapts to new conditions in which it has to function. Physical data are normalized, the listed clinical manifestations disappear completely.
Classification
Briefly should be studied and forms of myocardial infarction. It can be small focal and large focal - it depends on how large the lesion is. Symptoms vary. A small focal condition is not fraught with rupture of the heart and aneurysms. And it is less often complicated by thromboembolism, ventricular fibrillation and insufficiency.
Here are some criteria that can determine the form of myocardial infarction:
- Depth of defeat.
- Changes recorded on the ECG.
- Topography data.
- Multiplicity of occurrence.
- The appearance and development of complications.
- The presence of pain and its localization.
- The period and dynamics of development.
It is important to make a reservation that there are also atypical forms. They are characterized by the localization of pain in the fingers of the left hand, throat, left scapula, in the lower jaw, even in the cervical-ore spine.
There are forms that are not accompanied by any sensations. Symptoms in such cases are suffocation, coughing, swelling, collapse, dizziness, arrhythmias, and clouding.
These are very non-standard symptoms. Myocardial infarction in women and men of a similar form can occur if the patient suffers from circulatory failure, cardiosclerosis, or he has already survived one attack.
But atypicality is characteristic only for the most acute period. When it passes, then the state becomes common in such cases.
It should also be noted that the erased course of a heart attack may well proceed without pain. Often it can only be detected on an ECG.
Complications
It was described above about the symptoms that manifest myocardial infarction in women and men. Now we need to discuss the complications.
Often they occur already in the first hours and even days. In the next three days, the following conditions may appear:
- Extrasystole.
- Atrial fibrillation.
- Intraventricular block.
- Paroxysmal or sinus tachycardia.
- Ventricular fibrillation, capable of passing into fibrillation, which is fraught with the death of the patient.
The following complications can also overcome the patient:
- Pulmonary edema.
- Stagnant wheezing.
- Cardiac asthma.
- Cardiogenic shock.
- Decreased systolic pressure.
- Impaired consciousness.
- Reduced diuresis.
- Cyanosis.
- Cardiac tamponade, characterized by hemorrhage in the pericardial cavity.
- Pulmonary embolism.
- Insufficiency of scar tissue, fraught with bulging and further development of acute aneurysm.
- Parietal thromboendocarditis.
- Embolism of the vessels of the brain, lungs and kidneys.
- Postinfarction syndrome.
- Pleurisy.
- Arthralgia.
- Pericarditis.
- Eosinophilia.
And these are just some of the complications that myocardial infarction in the elderly entails. Everything is individual here, so the condition can be supplemented with other unpleasant phenomena.
Give or not disability?
Myocardial infarction is a serious condition, after which it is difficult for people, especially the elderly, to return to normal life. In addition to health effects, material problems arise. Therefore, for the first time, employed citizens receive benefits, the basis for which are sick leave.
In general, the authorities in this case have several mechanisms for helping citizens. Pension is the most common. However, in order to receive it, you must first go through a medical commission that will confirm the disease and confirm the fact that a person really has the right to receive it.
Give or not disability? Myocardial infarction is fraught with serious consequences, so yes - it’s possible to formalize a group. However, it will have to be constantly confirmed.
The term for which it is drawn up is strictly regulated by certain standards. When it comes to an end (and, therefore, the right to receive a pension, too), the patient must again go to the clinic for a second thorough examination.
Commission passage
Experts evaluate the following factors:
- The degree of damage to the heart walls.
- The level of complications.
- How weak is the ability to perform production tasks at work.
- The presence of physical and emotional stress.
After evaluating the results, the ITU commission decides on how long to free the patient from work. He is assigned a group and transferred to light work.
The process does not end there. First, a person is extended sick leave for up to four months. The ITU Commission then re-conducts the survey. If the condition is the same, the sick leave is extended for another year. And only after it is assigned a disability group.
The passage of a collegial medical examination, in which doctors of various specialties participate, is necessary. Because only by its results it is possible to determine the degree of restoration of the patient’s health.
What factors determine the group?
Talking about what it is - myocardial infarction and how to register disability with it, you need to answer this question.
It is possible to determine the group only after doctors have found answers to the following questions:
- Is a person able to carry out work operations?
- To what extent can it be loaded?
- How does his body react to ordinary, familiar movements?
- What kind of professional qualities does employment require in the position in which he is currently located?
After that, doctors study the degree of recovery of the patient. This process requires the study of the following indicators:
- The nature of the heart attack.
- The severity and severity of complications.
- Characterization of heart failure and medical history.
- How the body responds to the prescribed treatment, and whether it is effective at all.
When answering a question regarding how to register disability after myocardial infarction, it is necessary to make a reservation that a person may be denied this. This happens in the following cases:
- The degree of heart attack experienced by a person is small.
- His heart is contracting normally.
- No complications.
- The muscle has the ability to work.
- A person works in light, harmless working conditions.
The decision is made collectively, since the MES includes physicians of various directions. All specialists from the sides of their specialties determine the state of health of a patient who claims to be disabled.
Characteristics and features of groups
This topic also needs to be addressed. In myocardial infarction, a disability group, whatever it is, is assigned under certain conditions. There are three of them.
The first is claimed if any work is contraindicated to a person. He needs to observe a strict bed rest, undergo a long rehabilitation, and in the end undergo resort health support in one of the recommended sanatoriums.
Such citizens are treated in the cardiology department. They have to be observed for years by sanatorium specialists for the purpose of prevention.
If health is stabilized, the patient can be transferred to the second group. But this is only after passing through all stages of recovery. The transfer must also be approved by the commission.
The second group is prescribed if a person is working in a position involving emotional stress and physical exertion. He will have to change such a job to a new, calmer one, but it often turns out to be not so highly paid. Therefore, the pension received under the allowance is useful, given that the medicines necessary for recovery are worth a lot of money.
In what cases is a disability group 3 prescribed for a disease? In those when patients successfully undergo a rehabilitation period. But, nevertheless, they need time to return to a normal lifestyle, without exhausting themselves with excessive overloads. As a rule, these are patients who have undergone ischemia and stenting of the heart (or the installation of a stent or scaffold on it during the operation).
Rehabilitation
Having discussed the specifics of getting disability after myocardial infarction, you can go on to this topic. Restoring health is a very important process. And, of course, there are many restrictions after myocardial infarction.
Sitting on the bed, legs dangling, is allowed only for 4-5 days. A week after a seizure, it is allowed to take the first steps. After two - slowly walk around the ward, if the doctor permits. You can enter the corridor only from the third week of your stay in the hospital.
At this time, there is always a medical worker or someone from relatives next to the patient to monitor his condition, measure blood pressure and heart rate.
If rehabilitation is successful, the person is transferred to a suburban cardiological sanatorium. There, the patient will engage in physical therapy under the supervision of specialists, as well as take metered walks, eat diet and take medication.
Sanatorium treatment
It must be completed before disability after myocardial infarction. This is a classic therapy regimen: heart attack - hospital - sanatorium. Then either the design of the group, or a return to work.
The purpose of the patient’s stay in the sanatorium after myocardial infarction is to develop healthy eating habits and normal physical activity. If he establishes a lifestyle with the help of specialists, this will help him prevent repeated ischemic attacks.
In general, the benefits of spa treatment can be distinguished in such a list:
- The condition of the patient is always monitored by qualified cardiologists.
- During treatment, those physiotherapeutic methods are used that have already proved their effectiveness more than once.
- Comprehensive examinations are regularly conducted.
- Treatment is carried out using innovative equipment.
- The patient is individually developed dietary nutrition, taking into account the underlying disease, as well as all the attendant ones, if any.
- The correct daily routine is being compiled.
- The patient is in nature.
- An individual load regime is compiled.
- There is an entertainment program that helps to improve the psychological state of the patient.
Directly on the heart muscle is affected in order to achieve the following goals:
- Improving coronary blood flow.
- Converting muscle into a quiet, economical mode of operation.
- Saturation of myocardial cells with oxygen.
- Restoring the nervous regulation of vascular tone.
Another most important task is to reduce the patient’s stressful state, as well as return to him confidence in recovery. Upon completion of treatment, he will be able to switch from enhanced drug therapy to sparing.
The result of pastime in the sanatorium is the expansion of the motor regime and the strengthening of the body's defenses. To achieve the latter goal, by the way, the patient takes sun and air baths, makes dousing and contrasting procedures, swims in the pool.
If the sanatorium is located on the seashore, then rubbing with sea water, swimming and morning walks are mandatory.
What is included in the package of treatment measures? Typically, the list is as follows:
- Accommodation in a comfortable room.
- Five or six times specialized food.
- 24-hour medical care.
- Regular examination by a cardiologist. At first - every day, then once every 3-5 days is enough.
- Classes at school healthy lifestyle.
- Consultation with a rehabilitologist, nutritionist, neuropathologist, endocrinologist, physiotherapist, psychotherapist, as well as other narrow-profile physicians.
- Diagnostics, including ultrasound, ECG (normal and monitored), stress tests, blood tests, pulse oximetry, etc.
- Physiotherapy exercises - both ordinary and on cardiovascular equipment.
- A visit to the pool and taking classes in breathing exercises.
The list of procedures can be much wider. It often includes oxygen and carbon dioxide baths, circular showers, inhalations, reflexology, massages, mineral water and medicinal teas, etc. It all depends on what resort the person goes to.
Since the state allocates funds from the regional budget, a ticket is usually issued to a nearby resort institution. And this is the optimal solution - a climate change can provoke a relapse.
Sanatorium treatment lasts from 18 to 24 days. You can get a referral to it at the polyclinic at the place of residence by providing an extract from the medical history that is issued in the hospital. Then the patient passes a commission, which gives a recommendation regarding the type and duration of the course.