Home Diseases Heart attack (myocardial infarction): warning signs, causes, therapy

Heart attack (myocardial infarction): warning signs, causes, therapy

by Josephine Andrews
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A heart attack (myocardial infarction) occurs when a blood vessel in the heart muscle (coronary artery) occludes. The muscle is then cut off from the oxygen supply and can no longer do its work. A heart attack can be life threatening! It is therefore important to recognize the symptoms of a heart attack as early as possible. Here you can read everything you need to know about warning signals, causes and treatment options and first aid in the event of a heart attack.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

I22 I21 I23

Heart attack: brief overview

  • Typical symptoms: severe pain in the left chest area/behind the breastbone, shortness of breath, feeling of anxiety/anxiety; Attention, the symptoms in women can be different (dizziness, vomiting) than in men!
  • First aid: Call an ambulance, calm the sick person, raise the upper body, loosen tight clothing (tie, collar, etc.), if you are unconscious and not breathing , immediately revive!
  • Risk factors: high blood pressure , high cholesterol, obesity , little exercise, diabetes, smoking
  • Cause: Usually a blood clot that blocks a coronary artery
  • Examinations: ECG , heart ultrasound , blood tests, heart catheter examination
  • Treatment options: widening of the narrowed heart vessel (balloon dilatation) and installation of a vascular support ( stent ) as part of a PTCA, medicinal dissolution of the blood clot (lysis therapy), other medication, bypass surgery
  • Prevention: healthy lifestyle, regular exercise, healthy body weight

Heart attack: symptoms

In the event of a heart attack, there is no time to lose. The earlier it is recognized and treated, the better the chances of survival. That’s why you should dial the emergency number (Tel. 112) at the slightest suspicion and the first symptoms of a myocardial infarction – even at night or at the weekend!

In order to be able to react quickly, you have to know the heart attack symptoms in men and women. But beware: the typical signs do not always appear. Also, heart attack symptoms in a woman are often different from those in a man.

This is how you can recognize a heart attack

The classic sign of a heart attack (“heart attack”) is sudden severe pain in the chest , in the front left chest area or behind the breastbone. The pain can be aching, stabbing or burning. According to the German Heart Foundation, they last for at least five minutes. Sometimes they also radiate to other regions of the body. Pain in the arm (especially on the left), in the upper abdomen, in the back, in the shoulder or in the jaw can also be a warning sign of a heart attack.

Other typical heart attack symptoms are:

  • A feeling of anxiety or tightness: those affected often describe this strong feeling of constriction as “as if an elephant were standing on my chest”.
  • Feeling of fear up to fear of death: The strong fear is often accompanied by cold sweat, a pale complexion and cold skin .
  • Sudden severe shortness of breath, loss of consciousness or severe dizziness: These non-specific symptoms can have many causes, including a heart attack. They occur more often in women.
  • Nausea and vomiting: These symptoms, which occur in many diseases, are also possible signs of a heart attack, especially in women. This is especially true if those affected have not experienced such symptoms to this extent before.

The signs of a heart attack also depend on which coronary artery is affected. For example, occlusions in the right coronary artery often lead to a so-called posterior wall infarction. They are more likely to cause upper abdominal discomfort . If, on the other hand, the left coronary artery is blocked, an anterior wall infarction results. Here the pain is more localized in the chest area .

Typical signs of a heart attack
The symptoms shown indicate a heart attack. Sudden, severe chest pain is a typical sign of a heart attack. But be careful: Not everyone who suffers a heart attack has the typical symptoms!

In some cases, a heart attack is painless. Such a “silent infarction” occurs particularly often in patients with diabetes mellitus (sugar diabetes) and in older people.

Deviant heart attack symptoms in women

The symptoms of a heart attack described above do not always appear. Women often have a different set of symptoms. While the majority of affected men feel the classic chest pains, this only occurs in about a third of women. In addition, patients often report a feeling of pressure or tightness in the chest instead of severe chest pain .

In addition, non-specific complaints are much more often signs of a heart attack in women. These include shortness of breath, nausea and vomiting , and upper abdominal discomfort .

Such complaints are often not immediately identified as heart attack symptoms and are not taken seriously. That is why women with a heart attack come to the hospital on average an hour later than affected men (calculated from the time the first signs of a heart attack appear). However, rapid medical care is essential for survival.

Heart attack: harbingers

Many heart attacks occur “out of the blue.” There was previously no evidence that the occlusion of a coronary artery was imminent.

In the other cases signs announce the heart attack. Many patients have been suffering from coronary artery disease (CHD) for decades (unnoticed). The coronary arteries become increasingly narrow due to “calcification” (arteriosclerosis). This increasingly impairs the blood flow to the heart muscle. This can be recognized, for example, by the fact that chest pain and/or shortness of breath occur during physical exertion or mental excitement. After the end of the stress, the symptoms disappear again within minutes.

Doctors speak of ” chest tightness ” ( angina pectoris ). It can develop into a heart attack at any time. This is especially true when the duration and intensity of angina pectoris attacks increase. Particular caution is also required if the chest pain and/or shortness of breath occur even with the slightest exertion or even at rest. These are then serious harbingers of an impending heart attack. In such cases, call the emergency doctor immediately!

Heart attack: causes and risk factors

A heart attack is usually caused by a blood clot blocking a coronary artery . The coronary arteries are the vessels that supply the heart muscle with blood and oxygen. In most cases, the affected artery is already narrowed beforehand, due to deposits (plaques) on the inner wall. These consist of fats and lime. Such hardening of the arteries (arteriosclerosis) in the area of ​​the coronary arteries is called coronary heart disease (CHD).

The plaques can crack and rupture. Platelets (thrombocytes) then immediately accumulate to close the cracks. In the process, messenger substances are released that attract more blood platelets – a blood clot (thrombus) forms. If this clot completely blocks the affected vessel, a heart attack occurs: the section of heart muscle that is primarily supplied by this coronary artery no longer gets enough oxygen. It can then die within a few hours. In the worst case, the patient dies from the heart attack ( acute cardiac death ).

That’s what happens with a heart attack
During a heart attack, constricted coronary arteries become blocked due to deposits on the vascular wall. They often also become clogged with a blood clot. The affected coronary artery can no longer supply the heart muscle with sufficient blood and oxygen. In order to prevent the heart muscle from dying, it is necessary to intervene as quickly as possible.

Coronary heart disease is the main cause of myocardial infarction. Only very rarely are there other causes of a heart attack, for example cramps (spasms) of the coronary arteries.

risk factors for heart attack

Although certain factors are not direct causes of a heart attack, they do increase the risk of a heart attack. These include above all those risk factors that promote the above-described deposits on the inner wall of the coronary arteries (arteriosclerosis).

Some of these risk factors cannot be influenced. These include, for example, older age and male gender. But there are other risk factors that you can do something about, such as obesity and a high-fat diet. In general, the more of the risk factors listed below a person has, the higher their risk of a heart attack.

Male gender: The sex hormones apparently have an influence on the risk of heart attack. Because women before the menopause have a lower risk of heart attack than men; they are then better protected by the female sex hormones such as estrogens.

Genetic predisposition: Cardiovascular diseases are more common in some families – the genes seem to play a role in the development of a heart attack. So the risk of having a heart attack is hereditary to some extent.

Older age: The degree of hardening of the arteries increases with age. This also increases the risk of a heart attack.

Diet: High-fat and energy-dense foods lead to obesity and high cholesterol levels. Both promote hardening of the arteries and thus coronary heart disease – the most common cause of heart attacks.

Overweight: It is generally unhealthy if you weigh too many pounds. This is even more true if the excess weight is concentrated on the abdomen (instead of the hips or thighs): Belly fat produces hormones and messenger substances that, among other things, increase the risk of cardiovascular diseases such as coronary heart disease and heart attacks.

Lack of exercise: Sufficient exercise has many positive effects on health. One of them: Regular physical activity prevents hardening of the arteries and coronary heart disease by lowering blood pressure and improving cholesterol levels. These protective effects do not apply to muffles when moving.

Smoking: Substances from tobacco smoke promote the formation of unstable plaques that can break open easily. In addition, the blood vessels, including the coronary arteries, constrict every time you smoke a cigarette. Most patients who have a heart attack before the age of 55 are smokers.

High blood pressure: Constantly elevated blood pressure levels directly damage the inner walls of the vessels. This promotes deposits on the walls (arteriosclerosis) and thus coronary heart disease.

Elevated cholesterol levels: High LDL levels and low HDL levels also promote plaque formation.

Diabetes mellitus: In diabetes, the blood sugar level is abnormally high. In the long run, this damages the blood vessels – a risk factor for arteriosclerosis and coronary heart disease.

It is disputed whether an elevated level of the protein building block (amino acid) homocysteine ​​also represents a heart attack risk factor.

Heart attack: treatment

Heart Attack: First Aid

This is how you should provide first aid in the event of a heart attack :

  • If you have the slightest suspicion of a heart attack, call the emergency doctor (Tel. 112)!
  • Position the patient with their upper body elevated, for example by leaning them against a wall.
  • Open tight clothing, such as a collar and tie.
  • Calm the patient down and ask them to breathe calmly and deeply.
  • Do not leave the patient alone!

If the patient becomes unconscious, no breathing is recognizable or no pulse can be felt, there is cardiac arrest. Then you must act quickly and revive (resuscitate) the patient: Do the cardiac massage or – if you are experienced in it – alternately cardiac massage and mouth-to-mouth resuscitation (alternately press 30 times and ventilate twice). Continue CPR until emergency services arrive or the patient is breathing on their own.

Heart attack: What does the emergency doctor do?

The emergency doctor or paramedic will immediately check the patient’s most important parameters such as level of consciousness, pulse and breathing. It also connects the patient to an ECG or monitor to monitor heart rate, heart rhythm, oxygen saturation and blood pressure. The ECG is very important for the accurate diagnosis of a heart attack. It can thus be determined whether it is a so-called heart attack with ST segment elevation (ST elevation myocardial infarction, STEMI) or a heart attack without ST segment elevation (non-ST segment elevation myocardial infarction, NSTEMI). This distinction is important for the choice of immediate therapy (see below).

The patient is supplied with oxygen via a nasal tube if the oxygen saturation is too low or in the event of shortness of breath or acute cardiac insufficiency.

Access is also placed through a vein to give the patient the medication they need quickly . For example, diazepam for severe anxiety and morphine for pain. Also important are active ingredients (such as acetylsalicylic acid) that prevent the blood clot in the coronary artery from becoming even larger or further clots from forming.

The emergency doctor also administers nitrates to the patient, usually in the form of a mouth spray. These widen the blood vessels, lowering the heart’s need for oxygen and reducing pain. However, nitrates do not improve the heart attack prognosis.

If cardiac arrest occurs during transport to the hospital, the emergency doctor or paramedic will immediately start resuscitation with a defibrillator .

More heart attack therapy

Further treatment for a heart attack depends largely on whether it is an ST-elevation myocardial infarction (STEMI) or a non-ST-elevation myocardial infarction (NSTEMI) (see below: “Heart attack: investigations and diagnosis”):

  • STEMI : The treatment of first choice for these patients is acute PTCA . This means that the constricted heart vessel is widened by a balloon (balloon dilatation) and kept open by inserting a stent. If necessary, lysis therapy is also carried out for STEMI (administration of medication that dissolves the blood clot in the heart vessel). Under certain circumstances, a bypass operation may be necessary in the further course.
  • NSTEMI : The benefit of immediate balloon dilatation (acute PTCA) is not proven here. Lysis therapy is also not indicated. Instead, those affected receive medication immediately after the diagnosis , for example against (further) clot formation (such as acetylsalicylic acid). In addition, a cardiac catheter examination can be useful to determine the extent of damage to the heart muscle. It should be performed within two to 72 hours, depending on the patient’s risk profile. Further therapeutic measures depend on the result of the examination (e.g. further drug treatment, balloon dilatation and stent installation, bypass surgery).

The various treatment options for heart attacks are described in more detail below.

Heart attack therapy: acute PTCA

In the case of a myocardial infarction with ST segment elevation (STEMI) , the therapy of first choice is a so-called acute PTCA (percutaneous transluminal coronary angioplasty ). A cardiac catheter is immediately inserted to expand the blocked artery with the help of a balloon. This is called balloon dilation . After that, a stent is often implanted in the event of a heart attack: This is a small metal vessel support that is intended to keep the vessel open. Stents coated with an anticoagulant drug are often used. It prevents a blood clot from forming again at this point.

In most cases, an acute PTCA can reopen the blocked blood vessel after a heart attack. For this purpose, it should be carried out within 60 to 90 minutes after the onset of pain.

However, such an intervention is not readily available for all STEMI patients because not every clinic has cardiac catheter spaces. Therefore, if a heart attack patient cannot be transported within 120 minutes to a hospital where acute PTCA is possible, they should instead receive lysis therapy (see below) within 30 minutes. He should then be transferred to a cardiology center for an acute PTCA within the next three to 24 hours.

Heart attack therapy: lysis therapy

Lysis therapy (thrombolytic therapy) is an option for patients with an ST segment elevation myocardial infarction (STEMI) . The blood clot that caused the heart attack is dissolved with medication ( lysis ). To do this, the doctor injects medication into a vein that either breaks down the thrombus directly or activates the body’s own breakdown enzymes (plasminogen), which in turn dissolve the blood clot.

The chance that the coronary artery can be reopened is greatest shortly after the heart attack. Sometimes the emergency doctor starts the lysis therapy even before the patient arrives at the hospital.

The lysis can be carried out up to a maximum of twelve hours after a heart attack. After that, the blood clot is no longer properly dissolved, and the side effects of the treatment predominate.

Side effects: The lysis drugs administered after a heart attack severely inhibit the body’s own blood clotting – not only in the heart, but in the entire body. Serious bleeding can therefore occur as a complication. Previously undetected sources of bleeding such as stomach ulcers or vascular malformations (aneurysms) can be activated, i.e. begin to bleed. One of the most serious side effects is bleeding in the brain .

Heart attack therapy: medication

In the case of a heart attack, the doctor usually also prescribes medication for the patient. Some of these must be taken permanently. Which active ingredients are prescribed to the patient and how long they have to take them depends on the individual risk profile. Common medications used in heart attack patients are:

  • Acetylsalicylic acid (ASA) : The active ingredient ASA is a so-called platelet aggregation inhibitor. That is, it prevents platelets from aggregating. In the event of an acute heart attack, this prevents the blood clot in the affected coronary artery from enlarging (or forming new clots). Even the emergency doctor injects the patient with ASA because early treatment improves the prognosis.
  • other antiplatelet drugs : Some heart attack patients also receive clopidogrel, prasugrel , or other antiplatelet drugs.
  • Beta blockers : They lower blood pressure, slow the heartbeat , and relieve strain on the heart. If they are administered early, the size of the heart attack can be reduced and life-threatening cardiac arrhythmias ( ventricular fibrillation ) can be prevented. Even the emergency doctor can administer beta blockers to the patient.
  • ACE inhibitors : These drugs dilate blood vessels, lower blood pressure, and relieve strain on the heart. They reduce the risk of death in heart attack patients.
  • Cholesterol -lowering drugs : So-called statins lower elevated levels of the “bad” LDL cholesterol. This reduces the risk of another heart attack.

Non-ST segment elevation myocardial infarction (NSTEMI) is generally treated with medication immediately after diagnosis. Patients receive platelet aggregation inhibitors (such as acetylsalicylic acid, prasugrel), anticoagulants (such as fondaparinux) and drugs to reduce blood flow (beta blockers). Drug therapy is sometimes sufficient for NSTEMI. However, other therapeutic measures may also be necessary (such as balloon dilatation or bypass surgery).

Heart attack therapy: bypass surgery

In some heart attack patients, the coronary arteries have changed so much that a bypass operation is necessary: ​​Under general anesthesia, the surgeon first removes an artery from the patient’s chest wall or a superficial vein in the leg. He then uses this to bridge the constriction of the coronary artery.

Heart attack: examinations and diagnosis

The urgent suspicion of a heart attack arises from the patient’s complaints. But the signs are not always clear. Therefore, various investigations are necessary. They help to confirm the diagnosis of a heart attack and to rule out other diseases that can trigger similar symptoms (chest pain, etc.). These include, for example, inflammation of the pericardium (pericarditis), a tear in the large artery (aortic dissection) or a pulmonary embolism .

ECG

Electrocardiography (ECG) is the most important examination method when a heart attack is suspected. Electrodes are placed on the patient’s chest. These record the electrical excitation in the heart muscle. Characteristic changes in this cardiac electrical activity indicate the size and location of the infarction. Important for therapy planning is the distinction between a heart attack with and without ST segment elevation:

  • ST segment elevation heart attack (STEMI): In this type of heart attack, a specific portion of the ECG waveform (the ST segment) is elevated in an arc. The infarction affects the entire heart wall (transmural myocardial infarction).
  • Non-ST elevation myocardial infarction (NSTEMI or non-STEMI): In this inner wall infarction (non-transmural infarction), the ST segment is not elevated on the ECG. Sometimes the ECG is even completely unremarkable despite typical heart attack symptoms. The diagnosis of a heart attack can only be made if certain “heart enzymes” can be detected in the blood (see below: “Blood test”).

In addition, an ECG can also be used to detect heart attacks that do not cause any symptoms (silent or silent heart attacks). Cardiac arrhythmias can also be seen on the ECG. These are by far the most common complication of a recent heart attack.

The ECG also helps to distinguish an acute myocardial infarction from a heart attack that occurred some time ago.

Some infarctions do not show up on the ECG immediately after they occur, but only become visible a few hours later. Therefore, if a myocardial infarction is suspected, several ECG examinations are carried out a few hours apart.

Heart ultrasound (echocardiography)

If the ECG does not show any typical changes, although the symptoms indicate a heart attack, a heart ultrasound through the chest may help. The technical term for this examination is “transthoracic echocardiography “. The doctor can detect disturbances in the wall movement of the heart muscle. Because if the blood flow is interrupted by the infarction, the heart section concerned no longer moves normally.

blood test

The heart muscle cells that die during a heart attack release certain enzymes . In the event of a heart attack, their concentration in the blood is increased. These proteins, also known as biomarkers, include troponin T , troponin I , myoglobin and creatine kinase (CK-MB) . However, with the classic tests used for this purpose, the concentration of the enzymes in the blood increases measurably about three hours after the heart attack at the earliest. Newer, much more refined methods can speed up the diagnosis.

cardiac catheter

A heart catheter examination shows which coronary artery is blocked and whether other vessels are constricted. The function of the heart muscle and heart valves can also be assessed with the help of this examination.

As part of the heart catheter examination, the doctor inserts a narrow, flexible plastic tube into the leg artery (A. femoralis) and pushes it against the blood flow to the heart. Coronary angiography is usually carried out as part of the examination , i.e. a contrast agent is injected through the catheter so that the coronary arteries can be displayed in the X-ray image.

During the heart catheter examination, the blocked coronary artery can also be reopened immediately: the doctor inserts a small balloon through the catheter. It is filled with liquid at the site of the vascular occlusion, causing it to widen the constriction ( balloon dilatation or PTCA: see above). The doctor then usually inserts a small metal framework into the vessel as a stent to keep it open.

exercise after a heart attack

A heart attack reduces the patient’s cardiac output and thus his strength and endurance. Everyday tasks quickly become a physical strain: the heart muscle tissue that died during the infarction is scarred. Therefore, the rest of the tissue has to do the pumping work on its own. Slow, continuous training strengthens the sick heart again. Sport is therefore an important component of therapy after a heart attack.

But physical activity also has a positive effect on other bodily functions. she

  • improves the oxygen supply to the body
  • lowers blood pressure
  • regulates blood sugar and blood lipid levels
  • counteracts inflammatory processes
  • promotes healthy body weight
  • reduces unnecessary fat deposits
  • reduces stress hormones

Note: Training after a heart attack should only take place after prior consultation with the doctor treating you. Participation in a heart sports group is recommended.

Studies have shown that exercise not only helps to prevent a heart attack in advance. The training also has a positive influence after a heart attack. Those who become or remain active after a heart attack significantly increase their chances of survival. This is the result of a Swedish study with more than 22,000 heart attack patients.

Start of training after the heart attack

After a heart attack (STEMI and NSTEMI), scientific studies recommend starting training early – as early as seven days after the heart attack. This early mobilization supports the healing process and helps the patient to find his way back to everyday life more quickly.

After an operation to expand the coronary arteries (percutaneous transluminal coronary angioplasty, PTCA), the patient can start an individual sports program on the fourth day after the operation. However, this only applies to operations without complications. However, the training should only take place under medical or therapeutic supervision.

After a bypass operation, the affected person can begin early mobilization just 24 to 48 hours later. In the first few weeks after the bypass , however, restrictions are to be expected. The training should start with gentle exercises. Support, tensile and compressive loads should be avoided for at least six weeks. Pressure on the chest is also not advisable in the first few weeks after the procedure. There should be no jerky movements. If the procedure was minimally invasive, this period of time may be shorter.

How often to train

Patients should exercise at least twice a week shortly after the heart attack – regardless of the severity of the heart attack. It is important that the patients begin the training cautiously at first. Gradually increase the intensity and duration of the workout.

Cardiac patients should do moderate cardio training for 30 minutes four to five times a week.

Appropriate sport after a heart attack

Endurance sports are particularly suitable for training the cardiovascular system and optimally supporting recovery after a heart attack. But strength training and exercises for mobilization and mobility are also building blocks of heart sports.

Moderate endurance training

Suitable sports after a heart attack are the so-called endurance sports. They are the focus of heart sports because they improve the heart-lung function and help to carry out higher loads without discomfort.

According to the recommendation of the German Society for the Prevention and Rehabilitation of Cardiovascular Diseases, heart patients should do at least 30 minutes of moderate endurance training four to five times a week.

After a heart attack, walking briskly for ten minutes a day at about 5 km/h is enough to improve your health. Alternatively, if the pace is too high, those affected can go for a slow 15 to 20 minute walk.

Suitable endurance training after a heart attack is, for example:

  • (quick) walk
  • Walk on a soft mat/sand
  • walking
  • Nordic walking
  • cross country skiing
  • (Step) aerobics
  • Cycling or bicycle ergometer
  • rowing
  • Climbing stairs (e.g. on the stepper)

It is important that heart patients choose short stress phases of five to a maximum of ten minutes at the beginning. The load duration is then slowly increased over time

jogging after heart attack

Walking, running, walking, and jogging are the easiest ways to improve circulation after a heart attack. However, it is important to keep an eye on the training intensity. The attending doctor determines the performance and stress capacity of the heart in advance with a stress ECG . On this basis, he recommends the individual training effort to the patient.

Note: The target training zone for cardiac patients is 40 to 85% VO2max. VO2max describes the maximum amount of oxygen that can be absorbed by the body during maximum exertion. Heart rate should be between 60 and 90 percent during endurance training.

Heart attack patients should initially avoid competitions. Participation in competitive sports should only take place in consultation with the doctor treating you.

Cycling after a heart attack

Cycling after a heart attack or ergometer training is particularly suitable for overweight patients or people with orthopedic complaints. The person concerned does not have to carry the body weight themselves. That protects the joints. The ergometer has the additional advantage that the patient can measure his or her pulse during exercise . This allows him to optimally control the training intensity.

Strength training for cardiac patients

Strength exercises promote muscle building and strength. Muscle mass consumes more energy at rest than fat and helps in the fight against excess pounds. When carried out conscientiously under professional guidance, strength exercises do not pose an above-average risk for heart patients.

In order to avoid blood pressure peaks, it is important to avoid forced breathing during exertion. In addition, the athlete should make sure to relax the muscles as completely as possible between repetitions.

Gentle exercises for heart patients to build muscle in the upper body include:

  • Chest strengthening: Sit up straight in a chair and press your hands together in front of your chest. Hold the tension for a few seconds. Then let go and relax. Repeat multiple times.
  • Shoulder Strengthening: Sit up straight in a chair and clasp your hands in front of your chest. The left hand pulls to the left, the right hand to the right. Hold the pull for a few seconds, then relax completely.
  • Arm Strengthening: Stand an arm’s length in front of a wall and place your hands on the wall at about shoulder height. Bend your arms and do “push-ups” while standing. Ten to 15 repetitions. The intensity increases as you get further away from the wall.

You train your legs particularly gently with these exercises:

  • Abductor (extensor) strengthening: Sit upright in a chair with your hands on your outer thighs, as close to your knees as possible. Now press with your hands on the outside of your legs, your legs will push against your hands. Hold the pressure for a few seconds and then relax.
  • Adductor (flexor) strengthening: Sit upright in a chair with your hands between your knees. Push outwards with your hands, your legs working against your hands. Hold the tension for a few seconds and then relax completely.

When doing any strengthening exercise, be sure to breathe relaxed.

cardiac sports groups

After a heart attack, participation in a heart sports group is recommended. The patients train together with other sufferers under professional supervision. All exercises are adapted to the needs of cardiac patients.

Light circuit training is often used in cardiac sports groups. The participants complete eight different stations, for example. Depending on the selected exercises, this promotes endurance, strength, mobility and coordination at the same time. One minute of exertion is followed by a 45-second rest. The athletes then rotate to the next station. Depending on individual fitness, there are one or two rounds.

Various playful approaches are also carried out in heart sports groups. For example badminton, exercises with the Theraband or ball sports exercises are integrated into the training.

Heart attack: disease course and prognosis

Two possible complications in particular are decisive for the acute prognosis after an acute myocardial infarction – cardiac arrhythmias (especially ventricular fibrillation) and pump failure of the heart muscle (cardiogenic shock ). Patients can die from such complications.

The long-term prognosis after an acute heart attack depends, among other things, on the answers to the following questions:

  • Does the patient develop cardiac insufficiency (see below: Consequences)?
  • Can the risk factors for another heart attack (high blood pressure, high cholesterol, etc.) be reduced or eliminated entirely?
  • How consistently does the patient maintain a healthy lifestyle? These include, for example, regular exercise, a heart-healthy diet, not smoking, reducing excess weight and avoiding stress and tension.
  • Does the disease of the coronary arteries (hardening of the arteries) progress?

Statistically, five to ten percent of heart attack patients die of sudden cardiac death within the next two years after being discharged from the hospital. Patients over the age of 75 are particularly at risk.

Heart attack: follow-up treatment

Follow-up treatment is very important for the prognosis of a heart attack. Already in the first days after the myocardial infarction, the patients start with physiotherapy and breathing exercises . Physical activity gets the circulation going again and prevents further vascular occlusions.

A few weeks after a heart attack, patients can begin cardiovascular exercise . But this is far from competitive sports! Recommended sports include hiking , light jogging, cycling and swimming . Those affected should discuss an individual training program with their doctor. You can also join a heart sports group : training together with other heart patients can be a lot of fun and also motivate you.

Most heart attack patients spend some time in a rehabilitation facility after being discharged from the hospital . There they learn how to change their lives in such a way that the risk of another heart attack is reduced.

As mentioned above, risk factors for a (repeated) heart attack such as high blood pressure, high cholesterol, obesity or diabetes mellitus should be reduced as far as possible. This includes the patients adhering to the therapy prescribed by the doctor, for example taking the antihypertensive medication conscientiously. Regular check-ups with your doctor are also important. In this way, any problems can be identified early and countermeasures can be taken in good time.

Heart attack: Consequences

For many sufferers, a heart attack has life-changing consequences. These include, on the one hand, short-term consequences such as cardiac arrhythmias . They can take the form of atrial fibrillation or life-threatening ventricular fibrillation.

Long-term consequences are also possible after a heart attack. Some patients get depression , for example . Chronic cardiac insufficiency ( cardiac insufficiency) can also develop: the myocardial tissue that died as a result of the infarction is replaced by scar tissue that impairs cardiac function.

Rehabilitation treatment and a healthy lifestyle help to prevent such complications and consequences of a heart attack. You can read more about this in the article Heart attack – Consequences .

Heart attack: prevention

You can prevent a heart attack by reducing the risk factors for atherosclerosis as much as possible. That means:

  • Don’t smoke: If you don’t smoke cigarettes etc., you can significantly reduce your risk of heart attack. At the same time, the risk of other complications such as a stroke is reduced.
  • Healthy diet : The Mediterranean diet is considered heart-healthy diet. It consists of lots of fresh fruit and vegetables and little fat. Instead of animal fats (butter, cream, etc.), vegetable fats and oils (olive, rapeseed, linseed oil, etc.) are preferably used.
  • Reduce excess weight: Even a few pounds less have a positive effect on your health. A healthy body weight can prevent heart attacks and other diseases (strokes, etc.).
  • Lots of exercise: Be physically active on a regular basis. This is not about high-performance sport: Even a daily half-hour walk is better than no sport at all and reduces the risk of a heart attack. Exercise in everyday life (such as climbing stairs, shopping by bike, etc.) also contributes to this.
  • Treat risk diseases: Underlying diseases such as diabetes, high blood pressure or high cholesterol levels should be treated optimally. This includes not only the regular use of the prescribed medication. With a healthy lifestyle (exercise, healthy nutrition, etc.), every patient can also contribute a lot to the success of the therapy.
  • Avoid stress: Try to avoid prolonged stress at work and in your private life as much as possible. In this way, you can demonstrably reduce the risk of a heart attack.

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