<<
>>

the Aetiology and abundance of a primary and repeated heart attack of a myocardium

Heart refers to to the bodies most sensitive to an ischemia. The heart attack of a myocardium (IT) is omertvenie (heart attack) of a section of a muscle of heart (myocardium) as a result of acute misfit of a warm blood-groove to requirements of heart.

In development by IT the basic role is played by three interconnected processes: rupture of an atherosclerotic plaque (AB), stratification of a blood blob (blood clot) on AB and a vascular spasm. Sharp lifting arterial pressures (slip-ring motor), stress and (or) palpitation acceleration reinforce a blood-groove and the spasm of warm vessels becomes possible. Force from which blood treads out on walls of vessels repeatedly increases, passing on them. If AB does not stand this hydrodynamic blow, it is broken off, thus blood reacts coagulability increase that leads to blood clot formation in a place of rupture AB and to a spasm of the knocked vessel. There is an occlusion of a vessel and all section of a muscle of heart which krovesnabzhalsja the suffered vessel, perishes [5, 55, 68, 94].

In the absence of effective kollateralnogo blood circulations in case of a total occlusion of a large coronary artery in 15 minutes the  destruction kardiomiotsitov - muscular cages of heart begins, in 1 hour perishes about 50 % of cages in an ischemia zone, in 3 hours - 80 %, and in 6 hours - almost 100 %. The acute coronary syndrome calls an irreversible fault of an extensive section of a myocardium that leads to its infringement sokratitelnoj to function. Do not stand blow so-called astable "young" AB more often. Their composition includes a considerable quantity of tallows, and the kernel has the greatest trombogennyj potential. Vulnerability AB does not correlate with magnitude of a vessel,
With extent of its cotraction. It explains that fact, that in 65 % of cases IT vessel corking originates, when AB occupies no more than 50 % of a clearance of a vessel, in 20 % the cotraction makes 50-70 % and only in 15 % - more than 70 %. Therefore IT originates often suddenly, especially at young, without any symptoms - of harbingers. Now to distinguish astable AB from stable it is extremely inconvenient [68, 94, 106].

Process of healing (stabilisation) broken off AB consists in intergrowth of the formed glomeration by a connecting cloth. On a time this process occupies about two months. Throughout all this period in the majority (to 70 %) cases signs of instability AB remain.

There are three classifications by IT:

- On a clinical current - complicated and not complicated;

- On localisation - it is presented under names of walls left zheludochka - fast-head, back, lateral, peregorodochnyj and their combinations with involving of other departments of heart (for example, right zheludochka);

- On depth of defeat - it is presented on tooth Q which reflects extent nekrotizatsii a warm wall, discriminate - Q-positive (high tooth Q, defeat of a myocardium more than 50 %) and Q-negative (tooth Q is small or completely is absent, myocardium defeat superficial). Even the small Q-negative IT can bear in itself(himself) high risk of complications and a repeated heart attack [106, 130].

In difference from the forecast, the diagnosis is put by IT by three criteria, installed the CART: 1) a characteristic clinical picture; 2) characteristic changes on an electrocardiogram; 3) diagnosticheski significant changes of level of biochemical labels. In clinical practice to diagnose THEM, there is enough coincidence of two criteria from three [29, 40, 93, 106].

The basic results of epidemiological researches testify that IT meets at urban population is much more often, than at countrymen, and at men IT diagnosed in 50 % of cases, and for women - in 35 % [7, 28, 40, 93]. With the years disease considerably
Increases, so at men at the age of 20-24 years disease of IT makes 0,08 on 1000 persons, and at the age of 60-64 years - already 17,1 on 1000 persons, thus at 80-90 % of patients the heart attack debuts anginoznym an attack. For last decade the disease percent a coronary atherosclerosis at young men [25, 27, 55, 57, 68, 93] has considerably increased.

According to data of the State report on a state of health of the Russian Federation, in 2002г. It is registered more than 164 thousand diseases by an acute heart attack of a myocardium and more and 24 thousand repeated [22, 94, 101, 102]. Attracts attention that fact, that melkoochagovye repeated heart attacks are more often diagnosed for men, than at women and mainly at persons of advanced age, besides, at men repeated heart attacks happened in earlier age. Danger of a repeated heart attack consists that letalnost and frequency of complications, such as postinfarktnaja a stenocardia (38,1 %), an aneurysm left zheludochka (2,8 %), infringements of pace of heart (16 %), retsidivirujushchee a current (9,2 %) which develops in terms from 72 o'clock till 8 weeks (after development by IT and before the termination of processes of scarring) and in itself lead to THEM to acute or progressing warm insufficiency, to infringements of pace of heart and lethal outcomes, much above, than at primary to THEM. According to epidemiological researches survival rate after primary IT within seven years at men has made 69 %, at women - 53 %, and after PIM - 42 and 26 % accordingly [25, 88, 100, 101, 102, 134].

At every third patient, transferred IT, within a year develops repeated IT, thus within the next seven years the high risk of a lethal outcome [4, 94] remains. Proceeding from it, the question of timely diagnostic and prevention of a repeated heart attack is a vital topic in modern medicine.

1.2

<< | >>
Scientific source Kiselyov Alexey Viktorovich. HETEROGENEOUS QUALIFIERS With VIRTUAL STREAMS FOR INTELLECTUAL SYSTEMS of FORECASTING of the REPEATED HEART ATTACK of the MYOCARDIUM. The dissertation on competition of a scientific degree of a Cand.Tech.Sci. Kursk - 2019. 2019

Other medical related information the Aetiology and abundance of a primary and repeated heart attack of a myocardium:

  1. 5.1. The analysis of associations of polymorphisms of genes-candidates FCER2, ADRB2, TNFA, GSTM1, NOS2, NOS3и GSDMB c predisposition to a bronchial asthma, change of clinico-laboratory parametres at the Buryat and the Russian living in Transbaikalian edge
  2. the Analysis of interrelations of genes-candidates of predisposition to tobacco smoking THOIи CHRNA5у sick of a bronchial asthma and zdoyorovyh teenagers the Buryat and Russian
  3. 5.3. Modelling of intergene interactions at patients bronyohialnoj an asthma the Buryat and the Russian living in Transbaikalian edge
  4. modern representation about an aetiology and a pathogenesis of an acute stenosing laryngitis (croup) at children
  5. CHAPTER 4. RESULTS OF STUDYING OF THE MICROFLORA OF THE STOMATOPHARYNX AND THE INTESTINE BY MEANS OF THE BACTERIOLOGICAL METHOD OF RESEARCH WITH DEFINITION OF FACTORS OF PATHOGENICITY OF STAPHILOCOCCUSES AND DEGREES OF THE ENDOGENOUS INTOXICATION
  6. modern representations aboutan aetiology and a pathogenesis perinatalnoj encephalopathies
  7. 6.1. The Sanitary-and-hygienic characteristic of settlements of republic of Kareliya
  8. 6.2. The Sanitary-and-hygienic characteristic of settlements Komis of republic
  9. an aetiology and pathogenesis JUIA.
  10. an aetiology and a pathogenesis of disorders of an emiction.
  11. modern representations about an aetiology and a mucoviscidosis pathogenesis
  12. an aetiology and a pathogenesis of tumours and opuholepodobnyh diseases of soft tissues
  13. the purpose and statement of research problems
  14. the Etiology and a pathogenesis of a gangrene of the bottom extremities, the basic approaches to treatment
  15. the basic paradigms of interaction of the person and a trade in foreign and domestic psychology