acute myocardial infarction and ventricular fibrillation
Clinical Manifestations of Acute Myocardial Infarction:
- Prodromal Symptoms: Worsening and frequent pre-existing angina, accompanied by nausea, vomiting, profuse sweating, bradycardia, etc. Nitroglycerin is less effective, with fluctuations in blood pressure, severe arrhythmias, or heart failure.
- Pain: The earliest and most prominent symptom.
- Hypotension and Cardiogenic Shock
- Arrhythmias: Most patients experience arrhythmias, mostly occurring within the first 1-2 days, with the highest incidence within 24 hours. Ventricular arrhythmias are the most common. Ventricular fibrillation is a leading cause of death in the early stages of acute myocardial infarction, especially before hospital admission.
- Heart Failure: Primarily acute left heart failure, due to significantly weakened or uncoordinated myocardial contractility following myocardial infarction.
Atrial fibrillation (AFib) is a common arrhythmia that causes the upper chambers of the heart to beat irregularly and rapidly. Acute myocardial infarction, on the other hand, occurs when a coronary artery is suddenly completely blocked, leading to necrosis of the heart muscle due to inadequate blood supply. The co-occurrence of these two conditions in an elderly male can have dire consequences. This article aims to educate about AFib and acute myocardial infarction, their close relationship, and the importance of heart health awareness.
The elderly male patient, with a history of long-term AFib and hypertension, had a relatively fragile heart. During AFib, blood flow in the atria slows or even stagnates, making it easy for clots to form. These clots can dislodge and travel to various parts of the body, with the most dangerous scenario being the blockage of a coronary artery, leading to acute myocardial infarction. The patient was admitted to the hospital due to chest pain caused by a coronary artery blockage. Coronary angiography indicated a complete blockage of a coronary artery, suggesting a high probability of coronary thrombosis.
While preparing for stent placement, the patient experienced three cardiac arrests but was fortunately revived through defibrillation. These incidents highlight the risk of ventricular fibrillation in patients with acute myocardial infarction.
Prevention (acute myocardial infarction and ventricular fibrillation):
- Control underlying diseases: Hypertension, diabetes, and other underlying conditions are significant triggers for AFib and acute myocardial infarction. Managing these diseases can help reduce risk.
- Regular medication: Doctors often prescribe anticoagulants to prevent clot formation in AFib patients. It is crucial to follow the prescription strictly.
- Healthy lifestyle: Quitting smoking, limiting alcohol, balanced diet, regular exercise, and maintaining mental balance are vital for heart health.
Treatment (acute myocardial infarction and ventricular fibrillation):
- Emergency management of acute myocardial infarction: Immediate medical attention is required for symptoms like chest pain. Depending on the situation, thrombolytic therapy or emergency coronary intervention may be performed to restore coronary blood flow as quickly as possible.
- Treatment of AFib: Includes medication, electrical cardioversion, and radiofrequency ablation. For persistent AFib, radiofrequency ablation may be recommended to restore normal heart rhythm.
- Cardiac rehabilitation: Post-myocardial infarction cardiac rehabilitation is crucial, including medication, exercise rehabilitation, and psychological adjustment. A scientific rehabilitation plan can help patients gradually recover heart function and improve quality of life.
Conclusion (acute myocardial infarction and ventricular fibrillation):
Atrial fibrillation and acute myocardial infarction are significant threats to elderly heart health. Their co-occurrence is especially dangerous. Therefore, we must prioritize heart health, actively prevent and treat AFib and acute myocardial infarction, and maintain a strong and healthy heart rhythm. Additionally, we should encourage regular heart check-ups for the elderly to detect and treat heart issues promptly, ensuring a victorious battle for heart health.
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