Subepicardial ischemia begins to develop when there is an insufficient supply of oxygen and blood to the myocardium. Initially, a sick person may not notice strong changes in his body, since the manifestations will be periodic. As a rule, from the very beginning, the disease manifests itself in small attacks, which quickly pass. Spasms affect certain parts of the body, thus affecting parts of the heart, the epicardial and endocardial zones suffer in complex forms.
How to recognize subepicardial ischemia?
First of all, it must be clearly understood that myocardial ischemia is a violation of blood circulation in the heart muscle. It cannot be said that such a phenomenon occurs constantly, no, it is temporary, but it can cause the most deplorable consequences. Subepicardial myocardial ischemia occurs when insufficient amounts of blood enter the myocardium. This happens when the disease is in a late stage, so the affected area is large.
You can see the deviations after an ECG in the septal and apical department. Let's take a closer look at what subepicardial myocardial ischemia of the apical region might look like:
- This kind of ischemia is different in that the lesion in the area extends close to the electrode, which is connected during the ECG. The recovery process of the excited ventricle occurs from the endocardium to the epicardium.
- When an electrocardiogram is taken, this form of ischemia may appear as a negative T wave, which has an extended type due to the slow process of repolarization.
With the development of subepicardial myocardial ischemia in the lower wall, the restoration of the neural membrane of the ventricle occurs from the epicardium to the endocardium. In this case, the signs of heart pathology on the cardiogram will differ from the previous form, the scar will look like a positive T wave, which is mainly characterized by sharpness and expansion.
Why can the disease develop?
The main reason that can cause coronary disease is hidden in the presence of atherosclerosis or arterial hypertension in a person. When people have a he althy cardiovascular system, they are unlikely to experience ischemic attacks. If a person develops atherosclerosis, then plaques begin to appear in the vessels, due to which the lumen decreases, as a result of such changes, little oxygen enters the heart. With high blood pressure, plaques can rupture and their particleswill flake off, blocking the vessel completely. In this case, the blood flow in the damaged area stops, and myocardial cells cease to receive the necessary nutrition, as a result of which ischemia develops. Consider the main causes that can lead to cardiac ischemia:
- The disease appears in those people who lead a sedentary lifestyle and gain excess weight.
- People who already had relatives in the family with this disease may also suffer from this disease.
- Bad habits negatively affect the elasticity of blood vessels and the work of the heart in general.
- The reason may be hidden in constant stress and depression.
- If the body is subjected to frequent excessive physical exertion, subepicardial ischemia may also develop.
- Often the cause is hidden in acute infectious diseases and pathologies of the endocrine system.
It is worth paying attention to the fact that the likelihood of developing coronary disease increases with age. Most often at risk are men 45 years old, women 65 years old. To exclude the development of the disease, or rather, to prevent it at an early stage, doctors recommend undergoing an examination every year.
Symptoms
Myocardial ischemia can be accompanied by different symptoms, it all depends on what stage the pathology is at. Very often, the patient may not notice that he is sick until he gets to the hospital and undergoes a routine examination. Consider the main symptomsdiseases:
- There is pain in the chest area, which can be of a different nature and manifest itself with different intensity. Most often, people say that there is a burning and severe pain that radiates to the left side of the body.
- May experience shortness of breath even when the person is at rest.
- A sick person will feel weakness throughout the body.
- Sometimes nausea occurs.
- There is an unreasonable feeling of anxiety.
Symptoms may not last long, so people out of habit write off all signs of the disease as a simple ailment. But few people know that subepicardial ischemia of the anterior region may indicate an imminent heart attack, so you should immediately consult a doctor.
Diagnosis and treatment
To make an accurate diagnosis, doctors may prescribe different methods of examination of the body. First of all, blood and urine tests are prescribed, and an ECG is also required. After passing the ECG, it will immediately be clear whether the patient has heart problems or not. As a rule, treatment after the detection of a disease such as subepicardial myocardial ischemia of the anterior region is carried out in a complex. The specialist selects methods that will be aimed at eliminating all negative factors that can provoke the development of the disease.
During therapy, the patient must follow these rules:
- Completely abandon harmfulhabits.
- You should go on a diet prescribed by your doctor and monitor your blood cholesterol levels.
- Avoid stressful situations by all means and walk more in the fresh air.
- Try to avoid excessive physical activity.
Specialists may use medications as the main treatment, and in more complex cases, surgery is performed.
Medication treatment
To eliminate an attack of ischemia, doctors most often use "Nitroglycerin". People who suffer from low blood pressure should take these drugs with caution, as the drugs can lower blood pressure even further. Additionally, the doctor may prescribe funds that relate to adrenoblockers. Such drugs will help prevent vasoconstriction and normalize blood circulation. If a sick person has an arrhythmia, then antiarrhythmic drugs should be taken.
Experts recommend taking medications that help quickly restore metabolic processes in cells and adapt tissues to exist without a lot of oxygen.
Subepicardial ischemia may not be completely cured, but a person is quite capable of maintaining his body in a normal state if he takes statins every day. Such drugs help in the first place to lower blood cholesterol levels and prevent the development of atherosclerosis.
Surgical treatment
Surgery for ischemia cancarried out only in extreme cases, when other methods are useless. Thanks to modern cardiac surgery, the operation can completely restore blood circulation and improve the functioning of the heart muscle. Surgeons often only place a stent in a vessel during operations, which makes it possible to increase its lumen.
Naturally, a doctor can prescribe an operation only after a person has undergone a complete diagnosis.
How is the recovery period going?
If a person was treated after the discovery of a disease such as subepicardial ischemia, then the rehabilitation period should also be taken into account. The main goal of rehabilitation is to normalize the state of blood vessels and the heart, thus improving overall he alth and preparing the body for simple physical exertion.
The patient must comply with all the rules that were established for him during treatment. Be sure to give up bad habits and avoid stressful situations.
If it is necessary to increase physical activity, then this must be done very carefully and gradually. For this, a specialist can develop a special set of exercises.
Forecasts
Prognosis for myocardial ischemia may depend on many factors. Consider them in more detail:
- First of all, the degree of development of pathologies and where exactly the damage to the heart muscle is localized is taken into account.
- It is necessary to pay attention to age, since the condition directly depends on thisheart muscle.
- The patient should not have any other chronic diseases, as this may also affect the recovery period.
In all other cases, the patient needs to see a doctor and begin treatment, the outcome of which is likely to be favorable. It should be noted that treatment can be complicated with high blood pressure, diabetes, metabolic disorders.
Prevention
Regardless of what kind of disease a person has, subepicardial myocardial ischemia of the lower region or upper region, immediate treatment is required. Each person should lead an active lifestyle and play sports, it is important to ensure that the body does not have a strong physical impact, so you should learn to alternate work and rest. To improve the condition of your body, you should eat right and exclude foods that clog your arteries with cholesterol.
All people are recommended to be examined by a cardiologist at least once a year for preventive purposes.
