VERIFIED CONTENTConsultation: lek. Maciej Grymuza, a graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań.

Pre-infarction condition - such diagnosis does not really exist. So why do we hear about it often, also from doctors? What does the term "pre-infarction condition" really mean? What is it basically and how close is it to a serious heart attack? Should we be concerned about this diagnosis and can pre-infarcts be treated?

Diagnosis"pre-infarction"does not exist, but doctors use this term frequently. This is justified because the exact explanation of the course and various forms of ischemic heart disease is quite difficult, at the same time the term shows very vividly what causes the ailments and what the consequences of the patient's current condition may be. A proper medical diagnosis corresponding to this term is angina.

Pre-attack state - what does it mean?

The course and causes of myocardial infarction have already been described on our website, but it is worth recalling some important aspects. Coronary heart disease is a disease of the coronary arteries, these are vessels that supply oxygen and nutrients to the heart muscle.

In the course of this disease, cholesterol is deposited in the walls of the vessels, their lumen gradually narrows, and, consequently, their leakage, and thus the blood supply to the heart is reduced. How quickly this process progresses determines what symptoms will occur - if the vessel is closed completely and very rapidly, we are dealing with a heart attack.

However, when atherosclerosis progresses gradually, it will not cause symptoms initially, but over time, when the narrowing will increase and the blood flow will be significantly reduced but preserved, we are dealing with the "pre-infarct state", i.e. angina.

Pre-infarction - symptoms

Symptoms of pre-infarction are primarily chest pain radiating to the shoulders, neck, jaw or back, it has the character of crushing, burning or pressure, less frequent:

  • shortness of breath,
  • faster fatigue,
  • nausea,
  • stomach ache.

The occurrence of angina is characteristicsymptoms during exercise, this is because less blood flows through the narrowed arteries.

Its amount is enough to nourish the heart during quiet work, but in effort, however, when the demand for energy and oxygen is greater, the vessels are not able to enlarge their diameter to increase the flow and cover the demand.

This results in ailments, so it is easy to predict that these symptoms will usually disappear when you stop exercising or after taking nitroglycerin under the tongue - a drug that dilates blood vessels.

Pain can also appear under stress, after going out cold or after a heavy meal, i.e. when the heart is forced to do more work and needs more energy.

Note! It should be remembered that any chest pain requires a medical consultation as soon as possible, and ignoring it can be very dangerous. It is not worth trying to "wait out" such pain, because it may be too late to save the heart, and only a doctor can distinguish a heart attack from a pre-infarct state!

Pre-infarction and myocardial infarction

The symptoms of myocardial infarction and the pre-infarction state are almost identical, but their dynamics differ. In a heart attack, the flow through the coronary vessels is completely and permanently blocked, this causes cell necrosis and the release of troponins, the so-called markers of a heart attack.

Pain or shortness of breath do not go away with nitroglycerin or when you stop exercising. Quite often, also in the pre-infarction state, symptoms remain constant, then to differentiate whether it is a heart attack, it is necessary to determine troponins and perform an EKG.

If the markers are normal and the ECG traces do not show signs of recent ischemia, the infarction is excluded and the diagnosis is unstable angina.

Therefore, it is not possible to differentiate this state from a heart attack only by observation or by any "home methods", in each case it is necessary to see a doctor and perform tests.

Another, less characteristic difference is the intensity of pain - in a heart attack it is much stronger than in angina and sometimes it is accompanied by anxiety.

Does the pre-infarct state need to be treated?

The pre-infarction condition is a kind of warning.Its occurrence is a sign that the coronary arteries are developing atherosclerosis that needs to be treated before permanent ischemic changes and heart attacks occur.

Cholesterol deposits present in the vessel, which, if they build up or become damaged, which can happen at any time, will cause the artery to close and result in a heart attack. So the situation is serious and cannot bedisregard.

Proper treatment is necessary, first of all, it is necessary to change the lifestyle and food, i.e. more physical effort, and less in the diet:

  • s alt,
  • animal fats,
  • sweets,

and more:

  • vegetables,
  • fruit,
  • lean meat,
  • fish that are a source of essential fatty acids.

Pre-infarct condition - what treatment can be undertaken?

With angina, see your GP. However, if the pain continues despite the disappearance of the factor that could cause it, or it worsens over time, this indicates a serious condition - it may be a sign of a heart attack. Then you should call the ambulance as soon as possible and check your condition in hospital conditions.

In the case of angina, your GP should identify risk factors for a heart attack, including:

  • male gender,
  • relatives suffering from ischemic heart disease at a young age,
  • smoking,
  • hypertension,
  • diabetes,
  • incorrect lipid profile,

and implement adequate treatment.

It includes drugs that lower cholesterol levels (so-called statins) and acetylsalicylic acid, and in the case of comorbidities, the treatment of these conditions, especially hypertension, diabetes and thyroid diseases.

After the first episode of angina, it is also often recommended to spray nitroglycerin under the tongue in case of pain. However, it should be remembered that if the pain persists after using it, you should call an ambulance, because it may be a heart attack.

Invasive treatment, i.e. clearing the coronary vessels with stenting, is rarely used in the case of angina, although coronary angiography is not infrequently performed.

It allows you to see the lumen of the arteries supplying the heart to make sure that all vessels are clear and that the flow in them is adequate. In the case of high severity of atherosclerosis, immediate treatment and implantation of a stent into the diseased vessel is possible, as well as if the symptoms of angina cannot be controlled with pharmacological treatment.

Treatment of a heart attack is a bit more complicated and requires very quick action, it is discussed in detail in the article on this disease.

Category:

Cardiology