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When a person after a heart attack is transferred from intensive care to a hospital ward, and then he is at home, relatives and the patient himself are at a loss.
What lifestyle is now leading the core? What loads are permissible for him now? Which diet to follow? What should I do if my heart catches again? Erkin Eldarovich Mirzoev, cardiologist of State Clinical Hospital No. 17 of Moscow, answers these and other questions.
Previously, it was believed that the most important thing for a person who suffered a heart attack is compliance with strict bed rest for 10 days after a heart attack. Only on the 11th day can he get up. The administration of physiological needs, feeding, dressing, skin care of the patient was allowed to be done only in bed.
Today, Russian cardiologists accepted international recommendations, according to which the patient begins physical therapy at the intensive care unit, and walks as soon as he is transferred to the ward.
The first exercises are gymnastics for the legs, thereby preparing the patient for walking. Modern doctors consider feasible movements a very important measure of rehabilitation. They will help restore physical activity in a person who has suffered a heart attack. But, of course, the number of permissible loads is determined by the doctor and depends on the degree of myocardial damage and the patient's condition.
The distance that a sick person walks should increase every day. After increasing the load, the doctor must do an ECG, measure the pressure and pulse of the patient. If the indicators differ from the norm, chest pain appears, it is difficult for the patient to breathe, the load will have to be reduced.
If recovery is favorable, the doctor will determine how much physical activity can be increased. Now it is possible to control its level independently by pulse, for the patient it is a marker of the permissible load. The doctor will tell you within what values the pulse may increase.
The patient’s diet will be determined by the doctor. Remember that a person after a heart attack should not eat spicy and smoked dishes, strong meat and fish broths, fried meat, animal fats, products that cause bloating (cabbage, brown bread, kvass).
Be sure to limit the salt. Instead, add lemon juice, spices, and herbs to your meal.
It is better if the patient’s nutrition is fractional – often in small portions, the last meal no later than 19.00.
The food should be light, the calorie content of the daily menu fits into 1400-1500 kcal. Vegetables and fruits rich in fiber are recommended, which will allow you to monitor the work of the intestines. It is very important to establish a chair, since it is hard for the patient to push. If necessary, you will have to do an enema.
Do not give the core a lot of liquid – no more than 1-1.5 liters. Be sure to monitor the water balance. If the amount of urine per day is less than 80% of the amount of fluid drunk, we can assume the development of edema. If more – the treatment is successful (edema is reduced). Has the patient developed swelling in the lower back and legs? Call a doctor right away.
Any experiences are dangerous now, so try to protect your relative from unpleasant news, he should not even communicate over the phone with friends who might upset him with something, they will make you worry.
Previously, doctors forbade the patient to even watch TV. Now there are no such stringencies, but, of course, at this time horror movies are not the best choice.
After a heart attack, acute attacks are possible – severe shortness of breath, asthma attacks with frequent and shallow breathing, most often occurring at night, so relatives should be near the person to come to his aid.
The first thing to do is to give the patient a semi-sitting position by placing pillows under the back. Ventilate the room or turn on the air conditioner. Try to reassure the patient.
You should be alert for a condition in which heart pain is accompanied by a drop in blood pressure, a weak pulse, pallor of the skin, blue lips, and the appearance of a cold sweat. Disruptions in the work of the heart, rapid non-rhythmic heartbeats are especially dangerous.
The pain behind the sternum should alert, it speaks of early post-infarction angina pectoris. Call an ambulance right there.
The likelihood of a repeated heart attack cannot be discarded. In order not to miss the deterioration, be sure to periodically measure blood pressure and heart rate.