Generality
The "fulminating infarction is a serious form of heart attack, which - following the obstruction of one of the two main coronary arteries - affects an" extended area of heart muscle tissue; hence a "high probability of sudden death of the affected person. .
Symptoms of fulminant heart attack arise suddenly and usually consist of: chest pain, lightheadedness, dizziness, sweating, shortness of breath, nausea, vomiting, overwhelming sense of anxiety, etc.
Given the speed with which it can lead to fatal complications for the patient, fulminant heart attack requires immediate diagnosis and treatment.
Brief anatomical review of the heart
The heart is an unequal organ, hollow and mainly of a muscular nature, located inside the rib cage, on the left center.
Including 4 cavities - the right atrium, the right ventricle, the left atrium and the left ventricle - the heart is the most important anatomical structure of the circulatory system. deals with distributing the oxygen-rich and nutrient-rich blood to the various organs and tissues of the human body, in order to keep them alive.
During its vital action, the heart also supplies itself with blood and the muscular component that constitutes it, called myocardium. The blood supply to the cardiac tissues depends on two important arterial vessels, certainly known to most and called coronary arteries or simply coronary arteries. One deputy to supply blood to the right half of the heart (right coronary artery) and one to supply blood to the heart. left half (left coronary artery), the two coronaries are divided into different arterial branches, which contribute to the blood supply of the entire cardiac structure.
Main blood vessels that come and go from the heart
- Hollow veins: they introduce non-oxygenated blood into the right atrium.
- Pulmonary arteries: they branch off from the right ventricle and carry non-oxygenated blood to the lungs
- Pulmonary veins: they enter the oxygenated blood into the lungs inside the left atrium.
- Aorta: departs from the left ventricle and carries oxygenated blood to the various organs and tissues of the human body.
What is the fulminating heart attack?
Fulminant infarction is a particular way of indicating a severe form of heart attack (or myocardial infarction), which affects a considerable part of the heart's muscle tissue and therefore has a high probability of causing sudden death of the affected person.
Readers are reminded that, in medicine, the death of a more or less large portion of cardiac muscle tissue is called myocardial infarction.
Curiosity: does the term heart attack always refer to the heart?
In the "common imagination, the word" heart attack "is associated with the heart, as if it were a pathology exclusive to this organ.
In reality, in the medical field, the term “heart attack” indicates the death of any tissue, due to the absence of local blood circulation.
So it shouldn't sound strange to hear about intestinal infarction, pulmonary infarction (or lung infarction), bone infarction and testicular infarction (or testicular infarction).
Causes
The fulminant infarction is the death of the myocardium resulting from the acute occlusion of a tract far upstream of the arterial vessel system that supplies the heart with oxygen and nourishment; in other words, it is myocardial infarction due to acute occlusion of one or both coronary arteries.
The occlusion of one or both coronary arteries represents, compared to the occlusion of the smaller coronary branches, a much more serious event in the consequences, as it depends on the death of an extended portion of myocardium and a greater risk of definitive interruption of the pumping activity of the heart (with clearly fatal outcomes for the patient).
Fortunately, according to the most reliable estimates, the episodes of fulminant heart attack are rarer than the episodes of myocardial infarction that depend on the occlusion of the smaller coronary branches.
Causes of fulminant heart attack
The most common cause of fulminant heart attack is the presence, within one or both coronary arteries, of an embolus, the size of which is such as to prevent blood flow.
The emboli that cause the episodes of fulminant infarction (and more generally of myocardial infarction) can result from the fragmentation of thrombi or atherosclerotic plaques (also called atheromas).
- Thrombi: thrombi are abnormal blood clots, anchored to a section of the inner wall of an arterial vessel; their dimensions can vary and they can hinder the flow of blood more or less markedly.
- Atherosclerotic plaques or atheromas: they are aggregates of lipid material (especially cholesterol), protein and fibrous, which form close to the internal wall of medium and large caliber arterial vessels and can be an obstacle to normal blood flow.
Embolic phenomena, however, are not the only causes of fulminant heart attack. The latter, in fact, can also depend on the so-called coronary spasm, ie the narrowing of a coronary artery due to the sudden contraction of the muscular component of a section of the vascular wall.
Various factors can trigger coronary spasms, including, mainly, the use of drugs such as cocaine, amphetamines and methamphetamines.
Risk factors
The risk factors for fulminant heart attack include:
- the risk factors of atherosclerosis, that is the phenomenon of hardening of the arteries of medium and large caliber, on which the formation of atheromas also depends;
- the use of drugs such as cocaine, amphetamines and methamphetamines.
Readers are reminded that the following are risk factors for atherosclerosis and, consequently, for heart attack fulminate:
- Cigarette smoke;
- L "hypertriglyceridemia (or high triglycerides);
- Overweight and obesity;
- Diabetes
- Hypertension;
- L "hypercholesterolemia;
- The sedentary lifestyle;
- A high-fat diet.
Symptoms and complications
Sudden onset, the symptoms that characterize fulminant heart attack generally consist of:
- Chest pain;
- Pain that from the chest tends to radiate to other parts of the body, such as arms (the left more than the right), jaw, neck, back and / or abdomen;
- Feeling dizzy and dizzy;
- Sweating;
- Shortness of breath;
- Nausea and vomit;
- Overwhelming sense of anxiety;
- Cough and wheezing.
Sometimes, it can happen that the "fulminating heart attack has such sudden consequences, that the patient does not have time to fully develop the aforementioned symptoms and directly faces complications with a potentially fatal outcome such as:
- Cardiac arrest;
- Severe heart failure;
- Cardiogenic shock;
- Breaking of the heart.
Why is fulminant heart attack highly fatal?
The fulminating infarction is a form of highly fatal heart attack, because the onset and evolution are sudden and the death of the myocardium, due to the occlusion of the coronary arteries, is so extensive that the probability of degeneration into fatal complications is very high.
Diagnosis
A serious condition such as "fulminating heart attack leaves no room for in-depth diagnostic investigations; indeed, wasting time on the latter" would further reduce the hopes of saving the patient's life.
Therefore, even for time requirements, in general, the diagnosis of fulminant heart attack is based exclusively on the objective examination, ie on the observation of the symptoms complained of by the patient.
What complicates the diagnosis?
The suddenness with which the fulminating heart attack arises and evolves is an obstacle to a timely diagnosis.
Add to this the fact that a timely diagnosis requires preparation which, in all probability, the very first rescuers of the victims of a fulminant heart attack do not have.
Therapy
As mentioned on other occasions, the hope of saving the life of the victims of a fulminant heart attack is small; however, in the most fortunate cases, a rigorously timely therapeutic intervention can be redeeming.
The treatment of fulminating infarction involves the same treatments that require myocardial infarction due to the occlusion of the coronary branches, namely:
- Recourse to coronary angioplasty, to free the occluded coronary or coronary arteries;
- Administration of drugs to dissolve any blood clots and prevent their formation (aspirin, thrombolytics, antiplatelet agents, anticoagulants, etc.);
- Administration of pain medications, to relieve chest pain, etc .;
- Administration of drugs designed to facilitate the activity of the heart, which in patients with fulminant heart attack is very weak. Among the aforementioned drugs, there are ACE inhibitors and beta-blockers.
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