Frightening panic attacks: methods of relief

September 15, 2011

A heart attack is often confused with angina. There is also a “silent heart attack”, which is not accompanied by pain at all. How to recognize and - most importantly - prevent a heart attack?

A heart attack is the death of part of the heart muscle due to insufficient blood flow to it. This disease has other names: heart attack or coronary thrombosis. Most often, a heart attack develops in those who eat poorly, move little and cannot cope with stress. A heart attack usually occurs when one of the blood vessels supplying the heart muscle becomes blocked by a blood clot. If the clot is large enough, it can completely deprive the heart of blood supply. Also, a heart attack can be caused by a spasm of the artery that supplies the myocardium - the heart muscle. Most often, this spasm occurs under the influence of stress.

The heart works, the heart does not sleep

Heart... An organ surrounded by a romantic halo, awarded the attention of writers, musicians, poets... The heart is a unique symbol of love; we associate our feelings and emotions with it. If you descend from heaven to the “sinful” earth and briefly and prosaically define what a heart is, you will get something like this: “the heart is a strong muscular pump capable of pumping blood throughout the body to provide tissues with oxygen.” It would seem like just a pump, but what a pump! Able to work without sleep or rest for years, decades; capable, if necessary, of instantly changing the operating mode. And all this thanks to its amazing structure - muscle, valves, its own circulatory system, innervation and many ingenious mechanisms of regulation and compensation both inside and outside the heart.

How to remove MDPV from the body

“Salt” is swallowed, smoked, dissolved and injected intravenously or intramuscularly.

Drug intoxication develops within a few minutes, regardless of the method of use, and reaches its peak after approximately 1–1.5 hours. In general, the effect lasts up to 8 hours.

Soon a withdrawal syndrome develops, which the addict seeks to “relieve” with the next dose.

. It is almost impossible to cope with withdrawal symptoms at home. At first (approximately in the first day of giving up “salt”) the withdrawal symptoms are more or less tolerable, but then the addict’s well-being rapidly deteriorates. Complications (psychosis, cardiovascular and metabolic disorders) cannot be excluded.

Detox therapy must be carried out in a hospital setting

, where it is possible to organize round-the-clock medical supervision.
To remove MDPV from the body, the following drugs are used:

• infusion solutions
  that allow you to quickly cope with hypovolemia, electrolyte and acid-base imbalances;
• antioxidants to protect the vascular endothelium from compounds
  formed during lipid peroxidation;
• B vitamins
  , nicotinic and ascorbic acid: necessary for the normalization of the nervous system, the synthesis of coenzymes, and activation of peripheral blood flow;
• analgesics
  , antispasmodics, anticonvulsants;
• sedatives:
  they are used with caution due to the risk of overdose, but sedatives are necessary to restore proper sleep and prevent psychosis;
• nootropics
  to prevent acute cerebral hypoxia;
• antiarrhythmic and antihypertensive drugs.

This is not a complete list of medications used for detoxification..

Doctors constantly monitor the patient’s condition and, if necessary, adjust prescriptions.

The minimum length of stay for an addict in a hospital is 5–7 days.

But what to do then? Despite intensive detoxification therapy, the desire to take the dose persists, and it is almost impossible to restrain it after discharge from the clinic. Therefore, narcologists usually recommend immediately starting psychotherapy, extending the period of hospitalization, and leaving the drug treatment medical center for rehabilitation.

The heart is a “fiery motor”!

Normally, the heart is a strong muscular pump capable of pumping blood throughout the body to provide oxygen and nutrients to all organs and tissues of the body, as well as remove their waste products. Depending on whether we are resting or actively working, the body requires different amounts of nutrients. To meet the needs of the body, the frequency and strength of heart contractions, as well as the size of the lumen of blood vessels, can vary significantly. What happens when the heart stops sufficiently supplying tissues and organs with oxygen and nutrients? In this case, doctors diagnose heart failure (HF). The disease is usually chronic and the patient may live with it for many years before being diagnosed.

How to recognize the disease

Panic attacks, given the variety of its somatic symptoms, can masquerade as various organ diseases.

Most often, the patient feels like he is having a heart attack. Discomfort in the heart area is one of the most common phenomena among “alarmists”. They feel pain and tingling in the chest on the left side, palpitations. A pressing feeling appears, the heart seems to stop. But a regular ECG, echocardiography, ultrasound of the heart, 24-hour ECG and blood pressure monitoring can help rule out heart disease.

As for tachycardia, it is indeed present. But the reason for this is the activation of the sympathetic nervous system as a result of stress.

Another common condition that patients suspect is a stroke. Headaches, increased blood pressure, paresthesia in the form of tingling in the limbs, as well as changes in gait confuse him. The person gets very scared and even calls an ambulance.

The unrealistic fear that accompanies a patient with an attack separates him from reality. A person gets lost in space and does not perceive his surroundings. He fears that he will lose control of himself and do something unacceptable. He feels like he's going crazy. Because of this, such patients often fear that they are developing a mental disorder. Although mental problems can indeed appear. They are the result of a disorder.

Increased concern about one's health causes such a patient to develop hypochondria. He constantly visits all kinds of doctors, takes a whole bunch of tests. When specialists try to explain to him that the cause of his bodily discomfort is more psychological than physiological, they become irritated. And they go to another doctor in the hope that he will help them and get to the bottom of it.

Against the background of the disorder, depressive thoughts appear, since the person is really seriously concerned about his condition and does not know how to help himself.

Agoraphobia is a fear of open spaces or a specific place, literally “fear of the market square” can also become a complication of a panic attack. If the patient associates its occurrence with a certain place, then in the future he will avoid visiting it. A person may even be afraid to leave the house so as not to experience this painful feeling again.

Continuous, complicated attacks of PA can develop into panic disorder. To establish a diagnosis, the following criteria must be present:

• several severe attacks occur in a month;
• without a real threat;
• arises not only against the background of a predictable situation;
• non-anxious periods between attacks.

An important symptom of panic disorder is the constant anticipation of the next attack. In addition, the absence of the influence of psychostimulants (drugs, alcohol) is taken into account. Phobias and obsessive-compulsive disorder are excluded.

To confirm that the patient is really experiencing an attack of PA, and is not suffering from some real disease of the internal organs, the doctor is obliged to prescribe a series of examinations:

• ECG, ECG – monitoring; EEG;
• Ultrasound of the heart and other organs;
• radiography;
• CT, MRI;
• stomach examinations;
• blood test: CBC, liver tests, hormones:
• consultation of narrow specialists.

“Glitches”, “coughs”, “sneezes”... Who is to blame?

There are many reasons for the development of heart failure. Among them, the most important place is occupied by coronary heart disease or insufficient blood supply to the heart muscle. Ischemia, in turn, is caused by blockage of the heart vessels with fat-like substances. A heart attack can also cause heart failure because some of the heart tissue dies and becomes scarred. Arterial hypertension is another common cause of insufficiency. The heart requires much more effort to move blood through the spasmodic vessels, which results in an increase in its size, in particular the left ventricle. Later, weakness of the heart muscle or heart failure develops. Causes that influence the development of heart failure include cardiac arrhythmias (irregular contractions). A number of beats of more than 140 per minute is considered dangerous for the development of the disease, because At the same time, the processes of filling and ejection of blood by the heart are disrupted. Changes in the heart valves lead to disturbances in the filling of the heart with blood and can also cause the development of heart failure. The problem is usually caused by an internal infection (endocarditis) or a rheumatic disease. Risk factors for the development of diseases of the cardiovascular system, and, ultimately, heart failure, can also include excess weight, a sedentary lifestyle, alcohol and drug addiction, and hormonal disorders.

Why does a panic attack happen?

The reasons for this condition have not been fully elucidated. There are many prerequisites and provoking factors that can theoretically cause such a hypertrophied feeling of anxiety.

They are divided into biological, psychological and physiological.

Biological reasons include:

• hormonal changes during puberty, menopause, childbirth;
• beginning of sexual life;
• menstrual irregularities;
• heredity.

Panic attacks develop against the background of certain disorders:

• pheochromocytoma – hormonal tumor;
• psychosomatic disorders;
• phobias;
• depression;
• post-traumatic stress disorder;
• endocrine diseases;
• heart pathologies.

Among the psychological precursors of the condition are:

• acute stress - death of a loved one, divorce, any negative sudden situation;
• identification or opposition of oneself to any subject - the hero of a film, book, etc.;
• isolation from society;
• character traits;
• childhood experience.

As for character traits, most often panic attacks accompany women with a hysterical, demonstrative personality type. They constantly attract attention and crave recognition. Such women often have an extravagant appearance, are pretentious and very expressive. If they notice that they are not of interest to the “victim,” they very quickly switch to another object.

Men suffering from this disease exhibit traits called “health hypochondria.” They care very much about their appearance and strive to always look perfect.

Stress experienced in childhood also contributes to the development of attacks of fear already at a conscious age. One of the common causes is alcoholism in the family, which provokes situations of aggression. It could be a fight, a risk of murder. The situation becomes so acute that they have to flee home, often at night. In this case, fear is fixed, and in adulthood, in similar situations, it is repeated in such an impartial manner, intensified several times.

Another example is families where children grow up in conditions of emotional poverty and coldness. When parents or a parent (if we are talking about a single-parent family) are so passionate about themselves and their work that they simply don’t get around to the child. Or in the case when someone close to you suffers from a serious illness, everything revolves around the sick person, and they simply forget about the child.

Emotional coldness towards a child is present where too great demands are placed on him. At the same time, parents can keep the child under super control, but, at the same time, not show warmth and kindness towards him. Adults raised in such circumstances constantly seek approval and emotional support. Their stress resistance is significantly reduced.

The third model of family behavior is the opposite of the previous one and is based on overprotection of the child. At the same time, his parents are constantly worried about his condition, regarding any situation as potentially dangerous. They control literally all areas of their “blood” and try to accompany him everywhere. By doing this, they support the child’s infantilism, which leads to difficulties in social adaptation.

Constant conflicts in the family develop emotional lability in the child. The inability to influence the situation provokes confidence in one’s helplessness.

Any of the listed models lead to the fact that such a child grows into an adult who is emotionally unstable, insecure, and has difficulty interacting with society. This reduces his resistance to stress, exposing him to all sorts of mental disorders.

In addition to family conflicts, violence experienced in childhood, sexual or physical, contributes to the development of panic attack syndrome.

Physiological factors that provoke an attack include abuse of alcoholic beverages and psychostimulants, physical fatigue, weather changes, and excess solar radiation.

The incredibly talented actor Johnny Depp suffers from panic attacks. According to him, since childhood he has experienced anxiety in any non-standard situation. And the choice of his eccentric roles is nothing more than an attempt to hide his essence in front of millions of viewers.

Listen to your heart

Thus, heart failure is not an independent disease, but a stage of heart disease. Its severity and speed of development can vary and depend on the severity of the primary heart disease, the patient’s lifestyle, his age, concomitant diseases and, finally, on the quality of treatment. Heart failure is manifested by such symptoms as increased fatigue, swelling of the legs, shortness of breath, asthma attacks, causeless weight loss, etc. Any of these symptoms, especially taken individually, can occur in a variety of diseases. Therefore, the correct diagnosis is made, unfortunately, rarely and most often in the later stages of the disease. Thus, significant weight loss, which is typical for severe degrees of heart failure, is often mistaken for a sign of cancer. Or, for example, harmless swelling of the legs caused by stagnation of lymph gives rise to a diagnosis of “heart failure.” In my practice, there was a case when a patient with a severe form of heart failure was treated for several months for... constipation.

If a heart attack finds you alone

On September 8, First Aid Day is celebrated around the world, during which members of the Red Cross will talk about how to save a person’s life before the medical team arrives. But what if you have a heart attack and there is no one to help? In this material we will tell you how to recognize a heart attack and what actions should be taken to wait for the ambulance to arrive.

Unfortunately, heart attacks often occur when people are alone. This can happen at home or on the street, but regardless of the situation, the most important thing in this case is to receive qualified medical care on time. If the patient knows what to do with the first symptoms of a heart attack, he is able to independently save his life.

Is a heart attack instantaneous?

This is one of the popular misconceptions. However, in reality, a heart attack sometimes lasts for an hour, and sometimes longer. A mild heart attack may go unnoticed, but it is precisely such cases that carry the greatest danger.

How to recognize a heart attack?

Cardiologists identify a number of symptoms that should alert the patient:

• Sudden chest pain or discomfort (numbness, burning or tightness) is a common and concerning sign. Unpleasant sensations are localized in the center of the chest, appear for several minutes, and after a short break they repeat again;
• The pain may radiate to the back, left shoulder, jaw or stomach;
• Difficulty breathing, suffocation;
• Dizziness;
• Weakness and anxiety;
• Nausea, possibly vomiting;
• Sweating and cold sweat;
• Fast and irregular heartbeat

If these symptoms are present, the patient should call an ambulance without delay. This is especially true for young people who, due to their age, are skeptical about the possibility of a heart attack and are in no hurry to contact specialists.

I think I'm having a heart attack. What to do?

1) First, you must immediately call an ambulance (03 from a landline phone or 112 when calling from a mobile phone).

2) Take aspirin, chew the tablet for half a minute. This drug, which is in every medicine cabinet, blocks platelets - the main components that form blood clots. Taking aspirin will slow the formation of blood clots that block arteries during a heart attack. It is worth noting that coated tablets act slowly and may not be beneficial.

Do not take nitroglycerin! This can cause loss of consciousness and do more harm than good.

3) Do not drive. If you notice these symptoms, you should stop the car, because further movement may be dangerous and lead to an accident.

4) Calm, only calm. Don't be afraid or panic, this may make the problem worse. To relax, you can slowly count your pulse.

5) Don't cough forcibly. There is a widespread myth in the media that if you have a heart attack, you need to cough to wait for the ambulance to arrive. However, doctors are convinced that such self-help is a dangerous myth.

6) Don't eat. The presence of food in the stomach will complicate the doctors' actions. To quickly dissolve the aspirin, you can take a few sips of water, but if possible, you should refrain from drinking.

7) Before the doctors arrive, you should take a horizontal position. It is better to lie on the floor and raise your feet on the sofa.

Sad facts

Meanwhile, the prognosis for heart failure is unfavorable, if not fatal. When some primary symptoms of the disease (for example, pulmonary edema) appear, there is immediately a threat of death. These statistics are disappointing - within 3-5 years, 50% of patients die from heart failure, and after 9 years only 0.2% remain alive, of course, provided that the disease was not treated appropriately. Conventional drug treatment can only keep such patients alive in a state of severe disability with frequent hospitalizations. Of course, there is a radical way to help them - transplant a new heart. However, significant limitations for this intervention (age limit, high cost of surgery, lack of a sufficient number of donor hearts) make it unrealistic for the majority of heart failure sufferers. Now they have begun to talk about a new, promising method of restoring decrepit heart muscle, based on planting so-called “stem” cells. But, unfortunately, for practical use this is a matter of a rather distant future.

How to understand that a person is using MDPV: the main symptoms of addiction

Often, relatives find out that their loved one is using drugs already at stages II–III of addiction. But the disease can be recognized in the early stages, when it is much easier to remove MDPV from the body and cope with psychological dependence.

Narcologists recommend paying attention to the following signs:

• hyperhidrosis,
  and a rather unpleasant, specific “chemical” odor emanates from the body;
• change in behavior:
  a person becomes irritable, aggressive, thoughts of suicide, delusional ideas (usually delusions of persecution), panic attacks may appear;
• sleep disturbances
  , nightmares;
• lack of appetite
  , weight loss;
• rhinitis
  , conjunctivitis;
• grinding of teeth
  (the drug provokes a spasm of the chewing muscles).

Overdose symptoms

You should immediately consult a doctor to remove MDPV from the body if you have the following symptoms:

• critical tachycardia and hypertension;
• cyanosis (first of all, pallor with a bluish tint appears in the area of ​​the nasolabial triangle);
• increased temperature (sometimes it is hyperthermia that causes death);
• heavy sweating;
• convulsive syndrome;
• psychomotor agitation, hallucinosis;
• breathing disorders: shortness of breath, feeling of lack of air;
• deep fainting and coma.

An overdose can provoke a heart attack, ischemic or hemorrhagic stroke, acute respiratory failure (respiratory distress syndrome), critical metabolic disorders, and kidney dysfunction.

... and the other side of the coin

At the same time, in recent years, the development of medical science and pharmacology, in a successful combination with medical experience, has made it possible to achieve amazing success in the treatment of even the most severe forms of heart failure. Patients manage not only to save life, but also to regain its quality, an active lifestyle, and regain weight (and this after losing 20-30 kg!). Moreover, all treatment takes place on an outpatient basis, without hospital stay. Having worked for decades in a cardiac surgery center where there was a heart transplant department, I, along with other doctors, was a powerless witness to the death of patients after many months of fruitless waiting for donor hearts. How many of them could be saved thanks to today's knowledge, capabilities and experience!

Literature:

1. Asadullin A.R., Yuldashev V.L., Akhmetova E.A. Clinical case of methylenedioxypyrovalerone (MDPV) consumption polymorphism with a brief overview of the problem. - Medical Bulletin of the South of Russia, 2021. - No. 3.
2. Antsybarov A.V. New psychoactive substances: the end of drug evolution or the first step? - Medical Bulletin of Bashkortostan, 2017. - Volume 12, No. 4.
3. Mrykhin V.V. Psychiatric aspects of the use of designer drugs and new psychoactive substances. - Interactive Science, 2017. - No. 12.
4. Mrykhin V.V. Synthetic cathinones “bath salts”: mechanism of action, toxicological aspects, clinic, formation of addiction. - Interactive Science, 2021. - No. 17.

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More details

I will not hide that the treatment of such patients, in addition to experience, requires considerable effort and time from the doctor and great pedantry in carrying out the patient’s prescriptions. However, it would be too arrogant to attribute all the successes in the treatment of heart failure only to yourself, as the attending physician. The ability to quickly and accurately diagnose the underlying disease that caused heart failure has a huge role. In 50% of cases, this is coronary heart disease, the identification and treatment of which with coronary angiography and angioplasty greatly facilitates the subsequent correction of myocardial weakness. Equally important for successful treatment is the identification of the earliest, so-called “preclinical” (i.e., before the onset of complaints) forms of heart failure, which is only possible with the use of instrumental research methods: echocardiography, Holter monitoring, stress tests. The Center for Endosurgery and Lithotripsy has not only the most modern equipment, but also highly qualified specialists, which is necessary for the detection and timely treatment of heart failure. All these conditions help to successfully achieve the task of long-term preservation of active life in one of the most severe categories of patients with heart disease - patients with heart failure. But the reward is high: over the past 5 years, there has not been a single death among my 187 patients with heart failure!

Content:

1. MDPV: description.
2. How to understand that a person is using MDPV: the main symptoms of addiction: 2.1. Overdose symptoms.
3. How to remove MDPV from the body.

MDPV or methylenedioxypyrovalerone belongs to the class of synthetic cathinones.
In terms of the intensity of its narcotic effect, it surpasses the well-known Ritalin, a drug used primarily in the United States for the treatment of chronic fatigue syndrome and obesity. MDPV is not officially used in practical medicine; the compound is used in various types of clinical studies. However, in the early 2000s, the substance appeared on the illegal market and is widely in demand “thanks to” its pronounced narcotic effect. There is no specific antidote to the new psychostimulant, so in order to remove MDPV from the body, narcologists resort to standard detoxification methods. The drug is extremely toxic, sometimes even emergency resuscitation measures cannot save the patient’s life. Therefore, it is very important not to let the situation become critical and contact a narcologist at the first symptoms of addiction.