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Ulrica Strömbäck
Ulrica Strömbäck, Lecturer in Nursing at Luleå University of Technology. Photo: Melina Granberg View original picture , opens in new tab/window

First and second myocardial infarction may differ

Published: 29 January 2019

People suffering from a myocardial infarction are more likely to be afflicted again. New research at Luleå University of Technology shows, among other things, that slightly more women than men change symptoms at the second heart attack, and that the patients feel more physically and mentally affected after the second one.

– Many patients reported that they felt anxious or even depressed after the second myocardial infarction. Depression in itself increases the risk to suffer again, so it is important to pay attention to these people in order to give them the right treatment in the care, says Ulrica Strömbäck, Lecturer in Nursing, who has a background as intensive care nurse.

Differences between women and men

First time myocardial infarction patients are relatively well represented in the research, but there are fewer studies on those who relapse. Ulrica Strömbäck has both processed data from the MONICA myocardial infarction register and interviewed patients, physiotherapists, nurses and cardiologists who work with secondary prevention and cardiac rehabilitation.

The data analyzed by Ulrica Strömbäck showed that the majority of the patients had chest pain for more than 20 minutes, both at the first and second myocardial infarction. But at the second myocardial infarction, there were more women than men who had atypical symptoms such as stomach pain, nausea, vomiting and pain radiating to the back.

– We found that about ten percent of the men and 16 percent of the women changed symptoms at the second myocardial infarction. I think it's important to inform the patients that there is a risk of recurrence and that the symptoms may change. In a second myocardial infarction, the consequences may be greater, as the risks of a heart muscle injury increase. Therefore, it is particularly important to as soon as possible after onset of symptoms seek medical care, says Ulrica Strömbäck.

Lasting change reduces the risk of a relapse

One of the project's studies also showed that women get their second myocardial infarction considerably closer to the first one than the men. More women also had the risk factors high blood pressure, diabetes and smoking. The results from the interviews after the second myocardial infarction showed that the patients wanted the secondary prevention and cardiac rehabilitation to be more individualised,

– The rehabilitation programs are the same whether the patient have a first or recurrent myocardial infarction. Perhaps a special group is needed for those who with recurrence. When medical tests are taken in aftercare, the patients' values ​​are often better in the beginning. It indicates that patients make an effort to change their lifestyle in the beginning. The disease requires much of the person affected, but I believe that person-centered care can be part of the solution, concludes Ulrica Strömbäck.