Generality
Fulminant infarction is a serious form of heart attack, which - following the obstruction of one of the two main coronaries - involves a large area of cardiac muscle tissue; hence a high probability of sudden death of the person affected.
Symptoms of fulminant infarction arise abruptly and usually consist of: chest pain, feeling of dizziness, dizziness, sweating, shortness of breath, nausea, vomiting, overwhelming sense of anxiety, etc.
Given the speed with which it can give rise to fatal complications for the patient, fulminant infarction requires immediate diagnosis and treatment.
Brief anatomical review of the heart
The heart is an unequal organ, hollow and predominantly of a muscular nature, which is placed inside the thoracic cage, on the left center.
Including as many as 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 ; in fact, through the extensive network of blood vessels, it deals with distributing 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 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 people and called coronary or simply coronary arteries. Deputies one to supply blood to the right half of the heart (right coronary artery) and one to supply blood to the left half (left coronary artery), the two coronaries are subdivided into different arterial branches, which contribute to the spraying of the whole cardiac structure.
Main blood vessels that arrive and depart from the heart
- Hollow veins : they introduce non-oxygenated blood into the right atrium.
- Pulmonary arteries : they depart from the right ventricle and carry non-oxygenated blood to the lungs
- Pulmonary veins : they introduce 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 fulminant heart attack?
Fulminant heart attack is a particular way of indicating a severe form of heart attack (or myocardial infarction ), which affects a considerable part of the heart muscle tissue and which 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 extensive portion of cardiac muscle tissue is called myocardial infarction.
Curiosity: Does the term infarct always refer to the heart?
In the common imagination, the word " infarct " is associated with the heart, as if it were an exclusive pathology of 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.
This is why it should not sound strange to hear about intestinal infarction, pulmonary infarction (or heart attack), infarct in the bone and testicular infarction (or testicular infarction).
Causes
The fulminant infarction is the death of the myocardium resulting from the acute occlusion of a tract very upstream of the system of arterial vessels that supplies the heart with oxygen and nourishment; in other words, it is the myocardial infarction due to the acute occlusion of one or both coronary arteries.
The occlusion of one or both coronary arteries represents, with respect to the occlusion of the smaller coronary branches, a much more serious event in the consequences, since the death of an extended portion of myocardium and a greater risk of definitive interruption depend on it. heart pumping activity (with clearly fatal outcomes for the patient).
Fortunately, according to the most reliable estimates, episodes of fulminant infarction are rarer than episodes of myocardial infarction that depend on the occlusion of the smaller coronary branches.
The causes of fulminant heart attack
The most common cause of fulminant infarction is the presence, inside one or both coronary arteries, of an embolus, whose dimensions are such as to prevent blood flow.
Emboli that cause episodes of fulminant infarction (and more generally of myocardial infarction) can derive from the fragmentation of thrombi or atherosclerotic plaques (also called atheromas).
- Thrombus: the thrombi are abnormal blood clots, anchored to a stretch of the inner wall of an arterial vessel; their size may vary and may more or less significantly prevent blood flow.
- Atherosclerotic or atheromic plaques: they are aggregates of lipidic material (especially cholesterol), protein and fibrous, which are formed close to the inner wall of arterial vessels of medium and large caliber and can be an obstacle to normal blood flow.
Embolic phenomena, however, are not the only causes of fulminant infarction. The latter, in fact, may 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.
Coronary spasms can be triggered by various factors, including, primarily, the intake of drugs such as cocaine, amphetamine and methamphetamine.
Risk factors
The risk factors of fulminant infarction include:
- the risk factors of atherosclerosis, that is the phenomenon of hardening of the arteries of medium and large caliber, from which also the formation of atheromas depends;
- the use of drugs such as cocaine, amphetamines and methamphetamine.
Readers are reminded that they are risk factors of atherosclerosis and, consequently, of heart attack:
- Cigarette smoke;
- Hypertriglyceridemia (or high triglycerides);
- Overweight and obesity;
- Diabetes
- Hypertension;
- Hypercholesterolemia;
- A sedentary lifestyle;
- A high fat diet.
Symptoms and complications
On sudden onset, the symptoms that characterize fulminant infarction 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;
- Sense of lightheadedness and dizziness;
- Sweating;
- Shortness of breath;
- Nausea and vomit;
- Sense of overwhelming anxiety;
- Cough and wheezing.
Sometimes, it can happen that the fulminant heart attack has such sudden consequences, that the patient does not have time to fully develop the aforementioned symptomatology and goes directly to complications with the potential fatal outcome as:
- Cardiac arrest;
- Severe heart failure;
- Cardiogenic shock;
- Heart break.
Why is lightning infarction highly fatal?
Fulminant heart attack is a highly fatal form of heart attack, because the onset and evolution are sudden and myocardial death, due to coronary occlusion, is so extensive that the probability of degeneration in fatal complications is very high .
Diagnosis
A serious condition such as fulminant infarction leaves no room for thorough diagnostic investigations; indeed, wasting time in the latter would further reduce the hopes of saving the patient's life.
Therefore, also for reasons of time, in general, the diagnosis of fulminant infarction is based exclusively on the objective examination, that is on the observation of the symptoms complained by the patient.
What complicates the diagnosis?
The suddenness with which the fulminant heart attack develops and evolves is an obstacle to a timely diagnosis.
Add to this the fact that a timely diagnosis requires a preparation which, very probably, the very first rescuers of victims of a fulminant heart attack do not have.
Therapy
As mentioned on other occasions, the hope of saving the lives of victims of fulminant heart attack is small; however, in the most fortunate cases, a rigorously timely therapeutic intervention can be salvific.
The treatment of fulminant infarction involves the same care that myocardial infarction requires due to the occlusion of the coronary branches, that is:
- Use of coronary angioplasty to free the occluded coronary artery;
- Administration of drugs designed to dissolve blood clots and prevent their formation (aspirin, thrombolytics, antiplatelet agents, anticoagulants, etc.);
- Administration of pain medications to mitigate chest pain, etc .;
- Administration of drugs designed to facilitate the activity of the heart, a heart that is very weak in patients with fulminant heart attacks. These drugs include ACE inhibitors and beta-blockers.
