Fortunately, not all myocardial infarctions are fatal. Survivors will require careful medical follow-up, since the severe damage to their heart can result in cardiomyopathy, a group of diseases affecting the heart muscle.
Cardiomyopathy is a disease of the heart muscle that impairs contraction, ultimately reducing the heart’s ability to pump blood.
There are three main types:
- The most common is dilated cardiomyopathy. The heart’s chambers become enlarged and the left ventricle dilates. It can no longer contract effectively and expel blood into the aorta as it should.
- A second type is hypertrophic cardiomyopathy. In this case, the left ventricle becomes too thick and can no longer function properly.
- Finally, there is restrictive cardiomyopathy. The heart stiffens and loses flexibility. This decreases its capacity to fill the chambers with blood.
Symptoms
The symptoms of cardiomyopathy after an infarction (heart attack) vary depending on the type of disease. Those affected may experience shortness of breath during physical activity or at rest in advanced stages, and unusual fatigue. Edema may also develop, causing swelling in the ankles or legs. Some people also experience palpitations and chest pain.
It is important to seek medical help as soon as the slightest symptom occurs.
Diagnosis
The first symptom is often chest pain. At the onset of the first symptoms, the patient should consult a primary care physician, who will make an initial diagnosis before recommending further examinations.
An electrocardiogram (ECG or EKG) is used to confirm the diagnosis and measure the presence of dilatation or stiffness in the heart chambers. A small device called a Holter monitor may also be used to record the patient’s heart rate for 24 hours.
A cardiac stress test may also be performed. This involves riding a bike or running on a treadmill while being monitored with an ECG.
Echocardiography can further refine the diagnosis in certain cases by analyzing the functioning of the heart and its structures.
Cardiac catheterization also helps identify narrowed blood vessels.
What is an electrocardiogram?
It is a test that records the heart’s electrical activity over a given period of time. It identifies the speed at which the heart is beating (heart rate), whether it is beating normally (heart rhythm) and the effectiveness of the heart muscle. An electrocardiogram is also called an ECG or EKG.
Treatment
After treatment during the acute phase, often involving in-patient care, various treatments will be introduced to prevent complications and decrease recurrences.
Medication is sometimes prescribed. This can include beta-blockers to slow down the heart rate, antihypertensives to reduce the workload on the heart, or diuretics to treat edema.
Anticoagulants can also be taken to prevent the formation of blood clots.
Medical devices are sometimes implanted. Examples include a pacemaker to treat bradycardia, and implantable cardioverter-defibrillators to prevent ventricular arrhythmias.
Surgery may also be necessary, such as coronary artery bypass surgery when revascularization is required.
If neither medication nor medical devices are effective, a heart transplant may be considered.
Rehabilitation
People who have had a heart attack are at a high risk of cardiomyopathy. Regular medical follow-up is therefore essential. However, this follow-up alone is not sufficient to prevent the onset of disease. This is the start of the cardiovascular rehabilitation period. The goal is to regain the body’s physical capacity, readapt the heart to exertion and restore the self-confidence undermined by the heart attack, while also changing long-term behaviors and adopting healthier habits.
Depending on the case, outpatient rehabilitation may be proposed. In this case, the patient lives at home but travels to a center two to three times a week for about one to three months for physical exercise, advice and medical follow-up.
In other cases, rehabilitation in a center is necessary. The program is either the same or more intensive and the medical follow-up will be more extensive.
In any case, patients will need to make changes to their habits and lifestyles. This may include giving up smoking or alcohol, losing weight, reducing cholesterol levels through dietary changes and exercising more regularly.Rehabilitation can also involve receiving psychological or social care. A life accident of this scale is no trivial matter. It can have long-term effects on mood and morale, which increases the risk of recurrence.
80,000
The number of myocardial infarctions that occur every year in France.
10%
According to France’s National Institute of Health and Medical Research, heart attacks are fatal within the hour in one in 10 patients
15%
The one-year mortality rate of a heart attack according to the National Institute of Health and Medical Research.
Reviewed and approved by Benjamin Bouyer, MD, Cardiologist at Bordeaux University Hospital (CHU)
