Myocardial infarction occurs when the artery supplying the heart is completely or partially blocked. In this case, necrosis develops and cardiac muscle cells die.
In men, the disease occurs 5 times more often than in women. In addition, according to statistics, women encounter this pathology on average 10 years later. Experts attribute this to the late onset of atherosclerosis in women, which is one of the causes of heart attacks. Atherosclerosis, in turn, develops more slowly due to the presence of estrogens - female hormones, as well as due to less addiction to smoking and drinking alcohol. However, as both men and women age, the risk of having a heart attack increases.
Risk factors
They are divided into two groups:
- Modifiable (they can be changed or reduced impact): smoking, arterial hypertension, physical inactivity, high cholesterol, consumption of foods high in animal fats and high calorie content, diabetes mellitus, stress, excess weight, menopause and postmenopause, increased homocysteine.
- Unchangeable: age, genetic predisposition, gender.
Etiological factors are also identified:
- Atherosclerosis of the coronary arteries and the appearance of blood clots in them.
- Non-atherosclerotic lesions of the coronary vessels. It occurs when the walls of the arteries become inflamed due to vascular injuries, congenital anomalies, blood clotting disorders, and vasospasm. As a result, blood flow decreases.
Benefit calculation
The benefit depends on the average daily earnings for the previous two years and length of service. If a person has worked for more than 8 years, for each day of illness he will be paid 100% of the average daily salary. Experience from 5 to 8 years makes it possible to receive 80% of the specified amount, and less than 5 years - 60% of average earnings.
If annual earnings exceed the base for calculating insurance premiums, the benefit is calculated based on the maximum amounts. Data for 2021 and 2020 are used to calculate compensation for the current year. — 865,000 and 912,000 rubles, respectively.
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If the employee had no income in the previous two years, his income is below the minimum wage or his length of service does not exceed 6 months, the temporary disability benefit is minimal and is calculated based on the established minimum wage (from 01/01/2021 - 12,792 rubles per month).
Symptoms of a heart attack
Depends on the stage of development of the pathology.
Pre-infarction period
- Cardiac symptoms of a heart attack: shortness of breath, pain, cardiac arrhythmia, palpitations.
- Non-cardiac symptoms: dizziness, sweating and weakness, lips and tissues under the nail plates turn blue.
The most acute period
- The main symptom is pain.
- The sensations are intense and pressing. Localized behind the sternum. They can spread throughout the chest or only on the left or right.
- Some feel burning pain - younger patients experience more severe pain, older patients experience it weaker. Smoothed sensations appear in those who suffer from diabetes.
- The skin is pale. Sweating, shortness of breath, increased heart rate, and arrhythmia may occur.
- The pain often radiates to the shoulder, shoulder blade, jaw, wrist, and ear on the left side.
- The pain syndrome can manifest itself in waves: increase, reach a peak, and decrease.
Acute period
At this stage, the final formation of a necrosis focus occurs. The pain disappears. If it is still felt, then the heart attack zone is still expanding. Other symptoms include low blood pressure and rapid pulse.
Atypical forms of myocardial infarction
There are also atypical forms of myocardial infarction. Their symptoms are often similar to those of other diseases, which makes it difficult to diagnose the pathology.
- Asthmatic. Pronounced symptoms include suffocation, coughing, cold sweat, and wheezing in the lungs. There is either no pain at all or it is mild.
- Abdominal. Signs: epigastric pain, nausea, vomiting, stool upset, a tense and painful abdomen. With this form, acute appendicitis is often suspected.
- Arrhythmic. Signs: heart rhythm and conduction disturbances, low blood pressure. Symptoms similar to those of cerebral ischemia also appear: dizziness, vision becomes dark, and the patient loses consciousness.
- Cerebrovascular. There are also symptoms similar to a condition when the brain does not receive enough oxygen: dizziness, fainting, weakness, blurred vision. There is almost no pain felt.
- Asymptomatic. It is usually discovered in older people during examinations associated with other diseases: diabetes mellitus and others. If signs of a heart attack occur, patients ignore them because the symptoms quickly pass. A heart attack is noticed accidentally during electrocardiography.
- Heart attack with atypical pain syndrome . Unpleasant sensations are felt in areas far from the heart: hand, shoulder blade, jaw. A false picture emerges; doctors suspect osteochondrosis or other diseases of the musculoskeletal system.
Grounds for extending sick leave
The main reason for extending sick leave is unrestored ability to work. If a person feels unwell or has post-infarction complications, then his release from work is extended.
Often, people who have suffered an attack are recommended to undergo rehabilitation in a sanatorium. Patients with grade 1-3 severity of the condition are usually referred to such institutions. In sanatorium conditions, physiotherapy, massage, and physical therapy are carried out.
All these procedures are aimed at restoring working capacity and maintaining health. Sanatorium treatment is also the basis for extending sick leave.
Exemption from work is given for the entire period of stay in such an institution. If a person who has had a heart attack requires invasive procedures, they cannot perform their job duties. In this case, the sick leave is extended. When extending a certificate of incapacity for work, the type of activity of a person also plays a big role.
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Diagnosis of heart attack
ECG plays a major role in the diagnosis of myocardial infarction. Electrocardiography is repeated several times, since in the first hours and even days the ECG manifestations of a heart attack are often not clearly expressed and appear later.
In addition to this study, the doctor prescribes:
- UAC. 5-6 hours after a heart attack, the number of leukocytes increases, and on the second day - ESR. Leukocytosis decreases after 7 days. If elevated levels persist, this indicates complications.
- Biochemical analysis of blood serum. A change in certain indicators will indicate the death of heart muscle cells.
- If the methods listed above are not informative (for example, due to the presence of concomitant diseases), selective coronary angiography is performed.
conclusions
Myocardial infarction is a dangerous emergency condition that requires emergency measures to save life. The earlier resuscitation measures are started, the greater the chances of a successful recovery.
During the first three to seven days, the patient is placed in the anesthesiology and intensive care unit, where there are all the necessary conditions for maintaining life and treating the early stages of a heart attack. Subsequently, the patient is transferred to a cardiology hospital. The timing of discharge from the intensive care unit depends on the specific situation. The duration of sick leave also varies according to the severity of each individual patient.
Recovery after a heart attack
Rehabilitation after a heart attack is a whole complex of measures. Moreover, for each patient they are developed individually, taking into account the characteristics of his health, as well as the speed and quality of medical care provided during a heart attack. Patients who have suffered a myocardial infarction need to be regularly monitored by a cardiologist, at least once a year, and strictly monitor blood pressure levels and cholesterol and blood sugar levels.
Physical rehabilitation
Increasing physical activity after a heart attack is one of the important points of rehabilitation. Unnecessarily prolonged bed rest can have a negative impact on health - lead to muscle weakness, the development of congestive pneumonia and increase the risk of thromboembolic complications. And this, in turn, affects the recovery time. In the hospital, after acute pain has been relieved, the severity of the heart attack is assessed and a rehabilitation program is offered. In the future, they judge by the dynamics and transfer the patient to the next stage of activity.
Long-term physical rehabilitation will help prevent recurrent myocardial infarction. At the same time, psychological support from family and friends, their care and the mood of the patient himself are also important. Therefore, during rehabilitation, psychological work is also carried out, which helps reduce stress and speed up recovery.
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Results
The algorithm for issuing BC is strictly regulated by the legislation of the Russian Federation. The minimum period of sick leave is determined by the attending physician. And the question of how long sick leave is given as long as possible is decided by a commission of doctors individually in each specific case.
Sources:
- Order of the Ministry of Health and Social Development of the Russian Federation dated September 1, 2020 No. 925n
- Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”
- Federal Law of December 29, 2006 N 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity”
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Minimum period
The minimum period of sick leave is not established in regulations. Legislators left this issue in the competence of doctors, who alone determine the period of rehabilitation of a sick employee based on his well-being.
A doctor can issue a document for at least one day of illness, but this rarely happens. According to unofficial practice, doctors open a certificate of incapacity for work for at least three calendar days. It does not matter in what conditions the treatment takes place: in a hospital, day hospital or outpatient.
In any case, how long the sick leave will last depends on the severity of the disease and the doctor’s decision. In this case, the period for which the disability form is issued is limited to the maximum values established by the Order.
Deadline for paying maternity benefits
Maternity benefits are paid from the Social Insurance Fund or the federal budget. If a woman expecting a child is officially employed, then she turns to her employer for benefits, but pays the money to the Social Insurance Fund. In this case, the payment period does not differ from the general rules for receiving compensation for sick days.
Material on the topic Rules for recording sick leave for external part-time workers Unemployed pregnant women apply for benefits to the social security authorities at their place of residence (stay or actual residence). Officials are given 10 days to review and assign a specific amount. Maternity leave must be issued directly no later than the 26th day of the month following the month of application and registration of the application with all the necessary documents.
The benefit is calculated based on average earnings. That is, a woman who provides sick leave for pregnancy and childbirth will receive 100% of the average earnings during the period of maternity leave. If an employee has worked for less than six months, her benefits will be calculated based on the minimum wage and regional coefficients (if applied). Unemployed expectant mothers will also be able to claim the minimum amount.
The benefit is paid in a total amount regardless of the number of days actually used by the pregnant woman before giving birth. The practice of not paying full maternity leave on the basis that a woman continued to work after 30 weeks of pregnancy is illegal.
Annual sick leave limit
Health is a factor that does not depend on anyone. Therefore, there are no quantitative restrictions on obtaining a certificate of incapacity for work. An employee may become ill again immediately after recovery. True, the constant illness of an employee or his children is fraught with the fact that he will spend all the paid sick days that he is given for the year. Then he will be sick and not attend work, but will not be able to receive disability benefits.
If the employee himself is sick, he will be paid for the entire period of incapacity for work. If he is disabled, then only 5 months of incapacity for work are paid during the year. There are also annual restrictions on sick leave for child care - 45 days for children from 7 to 15 years old, 90 days for children under 7 years old.
In addition, constant absence from work can damage your relationship with your employer. But if an employee does get sick, he should notify his superiors. The obligation to notify about illness is not legally established, but for absence without reason from the workplace for more than 4 hours, the employer can impose sanctions on the employee and fire him (Article 81 of the Labor Code of the Russian Federation).
Often, a sick employee does not go to the doctor, but informally asks the employer for time off. The law regulates only situations in which an employee officially receives sick leave. Other cases depend on the consent of the employer. The employee must take into account that unofficial release deprives him of sick pay from the Social Insurance Fund.
