Diseases of the heart and blood vessels are in first place in the world in terms of frequency of occurrence. Almost every second person at least once during his life had complaints of discomfort in the heart area, a feeling of interruptions in his work, etc.
All this is due, for the most part, to malnutrition, non-compliance with the regime of work and rest, excessive physical exertion and exposure to stress. As a result, there is an overload of the heart muscles, as well as the walls of blood vessels, which leads to the development of circulatory disorders, myocardial infarction and coronary heart disease.
Features of the disease
Myocardial infarction is a rather serious disease, often leading to the death of the patient. It is based on the development of necrosis (death) of heart muscle cells - cardiomyocytes. If the patient was given emergency assistance in a timely manner and he survived, a recovery period begins, during which the affected muscle fibers are replaced by connective tissue. This phenomenon is called cardiosclerosis.
Depending on the localization of these changes, focal and atherosclerotic diffuse cardiosclerosis is detected, not many people know what it is.
The first variant of the pathology most often develops as a result of a myocardial infarction (connective tissue is formed precisely at the site of the ischemia zone that has arisen against the background of blockage of the blood vessels supplying the heart). Diffuse cardiosclerosis has a high prevalence and occupies almost the entire surface of the myocardium. It develops precisely due to the long-term effect of ischemia (lack of oxygen) on the heart.
However, in IHD (coronary heart disease), this deficiency develops slowly and is partially compensated, as a result of which such patients can live longer than with acute myocardial pathology.
Diffuse cardiosclerosis according to ICD 10 code is I25. It is coded as atherosclerotic heart disease.
This also includes coronary heart disease, the consequences of myocardial infarction (identified by ECG and ultrasound), as well as aneurysms of the heart and coronary arteries, ischemic cardiomyopathy. That is, in the ICD and IHD, and diffuse cardiosclerosis are practically in the same row.
Reasons
What are the main causes of diffuse cardiosclerosis, not everyone knows.
As mentioned above, a huge number of factors influence the heart. Among them, it is especially worth highlighting:
- Atherosclerosis of the heart and blood vessels. This is a disease that occurs in almost every person. Its appearance is associated with malnutrition, in particular, with increaseddietary intake of low-density lipoproteins. They play a decisive role in the development of atherosclerotic plaques - cholesterol deposits on the walls of blood vessels and the heart. As a result, the walls of blood vessels narrow, which leads to a lack of blood circulation (acute or chronic) in the heart muscle and, as a result, the development of cardiosclerosis.
- Excessive exercise. Unfortunately, few people take care of themselves, in particular, their activity and physical fitness. Because of this, many muscles of the human body, which include the myocardium, are not ready for physical activity, as a result of which they have to work “for wear”, which, in the end, leads to oxygen starvation.
- Stress. As they say, “all diseases are from the nerves”, and this expression has its share of truth. Against the background of excitement, a person has an increase in heart rate, blood pressure rises, which significantly increases the load on the heart. And if a patient has the above risk factors (atherosclerosis, unpreparedness for stress), most likely, against the background of stress, such a person risks “earning” a heart attack, which will lead to the development of cardiosclerosis in the future.
- Past endocardial diseases. Sometimes, against the background of inadequate treatment of a cold (tonsillitis, acute respiratory viral infections), cardiomyocytes may be damaged (as a result of an autoimmune attack on these cells), which is the main cause of the development of ischemic cardiomyopathy and diffuse cardiosclerosis.
- Hereditary anomalies and heart rhythm disturbances. This group of diseasesleads mainly to acute disorders of cardiac circulation. However, it is considered in conjunction with the above reasons.
What are the clinical manifestations of diffuse cardiosclerosis?
In the early stages, diffuse small-focal cardiosclerosis is completely asymptomatic and is most often an accidental finding during additional examination for another pathology.
The first symptoms of pathology may be a feeling of heaviness in the chest and shortness of breath after the usual load (for example, it became harder to climb to your floor or carry some kind of burden).
As diffuse small-focal cardiosclerosis develops, the heart gradually loses its ability to contract, as a result of this, blood stagnation occurs in the vessels of the body. Such a decrease in blood flow is manifested by the appearance of edema in the legs (more in the evening), shortness of breath and cough (with stagnation of blood in the vessels of the lungs). They may also be accompanied by pain in the right hypochondrium (due to stagnation of blood in the portal vein system and plethora of the liver).
Pain
The most common symptom of developing diffuse cardiosclerosis is pain. It is usually mild, aching in nature, appears and intensifies during physical exertion.
Over time, which is observed in the elderly, it becomes permanent. It can be either local (in the region of the heart) or spread along the back, to the left arm, face on the left, which often leads to misdiagnosis (such patientsturn to neurologists and treat osteochondrosis to no avail).
How can you determine the presence of cardiosclerosis?
Assuming diffuse cardiosclerosis, what it is and how to determine the pathology, not everyone knows.
First of all, the patient needs to take a biochemical blood test and determine the level of cholesterol, high and low density lipoproteins and triglycerides in it. All these substances, with their increase (with the exception of high-density lipoproteins), indicate the presence of atherosclerotic deposits on the vessels in the patient.
If possible, blood levels of creatine kinase and lactate dehydrogenase (MB-CPK and LDH), enzymes specific to cardiomyocytes, should also be measured. Their increase in the blood indicates damage to the heart cells (since these enzymes are inside the cell and appear when it is destroyed). The most informative is the troponin test (it also allows to differentiate acute myocardial infarction from coronary artery disease)
Other general clinical studies (general blood and urine tests) are not informative for this diagnosis.
Of the simplest instrumental examinations, electrocardiography comes first. It is on the ECG that you can notice the first signs of damage to the heart muscle (change in the amplitude of the teeth, an increase in the T wave, and more). An experienced doctor of functional diagnostics can detect the presence of focal and diffuse changes in the myocardium with an accurate indication of their localization.
It is also mandatory to conduct an ultrasound examination of the heart, which allows you to visualizeit and determine whether the changes detected on the cardiogram are focal or diffuse in nature (based on myocardial contractility, the activity of its valves and walls).
In some cases, the patient undergoes a transesophageal echocardiography. Its essence is the same as with conventional ECHO-KG, however, it allows you to more accurately determine all visible indicators.
It is definitely recommended to conduct an examination of the vessels of the neck and lower extremities (to clarify the diagnosis of diffuse cardiosclerosis, what it is, the doctor will explain according to the results of the examination, if the diagnosis is confirmed).
You can directly see the damage to the inner wall of the myocardium during endoscopic studies - coronary angiography or arteriography.
Among X-ray studies of the heart, thallium scintigraphy is informative (allows you to determine the possibility of accumulation of isotopically labeled substances by the myocardium).
Conventional chest X-ray allows you to indirectly judge the condition of the heart (based on its size, position, mediastinal condition). In cases of massive atherosclerotic lesions of the aorta, the diagnosis of cardiosclerosis can be made even on the basis of this image.
Additionally, the patient undergoes various functional tests (walking on a treadmill, bicycle) with simultaneous recording of myocardial and blood pressure indicators.
Treatment
What to do if a patient is diagnosed with coronary heart disease or diffuse cardiosclerosis (what it is, discussed above), not everyone knows.
BFirst of all, you should pay attention to your daily diet and, if possible, exclude fatty and spicy foods from it, as well as table s alt (which will provoke the development of atherosclerosis and arterial hypertension), or at least limit its use. Priority should be given to fish, vegetables and fruits, various broths and cereals.
In addition, you should bring minimal physical activity into your life, for example, morning exercises, start walking in the evenings. In a word, to refuse, as far as possible, from a sedentary lifestyle. Swimming, Nordic walking will be useful.
Drugs
From medicines, first of all, you should pay attention to drugs from the group of statins. These drugs help lower blood cholesterol levels, thereby preventing the development of atherosclerosis. These drugs include Atorvastatin, Lovastatin and others.
Another mandatory medicine for patients diagnosed with cardiosclerosis is Aspicard (ASA, cardiomagnyl, acetylsalicylic acid). It contributes to some blood thinning, which improves its rheological properties and reduces the risk of ischemic events in the myocardium.
It would be useful to use some metabolic drugs, such as Mildronate, vitamins of group B. These funds improve metabolic processes in the cells of the heart muscle, which improves its reparative properties and functional activity.
To reduce pain in the heart, you can use "Nitroglycerin", "Molsidomine" (or "Dilasid"), validol, Zelenin drops. These drugs act on the vessels of the heart, cause them to dilate and thereby improve blood circulation in them.
From cardioprotectors it is recommended to use "Thiotriazolin" or "Trizidine". Their main function is to improve the resistance of cardiomyocytes to stress and prevent the development of necrotic changes.
Other Therapies
From non-drug methods, climatotherapy and sanatorium-and-spa treatment help well. In some cases, if there is no decompensated arterial hypertension, a pressure chamber may help.
Among surgical treatments, stenting or coronary artery bypass grafting can help.
Forecast
What awaits those people who have been diagnosed with diffuse cardiosclerosis, ICD code 10 - I25, every patient needs to know.
First of all, it should be understood that the presence of coronary heart disease is an indicator of a person's vital activity, or rather, its relative passivity. If nothing is done, over time, the risk of developing myocardial infarction, stroke, stenotic lesions of peripheral vessels (brachiocephalic arteries, vessels of the lower extremities) will significantly increase. Adequate daily physical activity has been shown to reduce the risk of cardiovascular disease by 50%.%.
The development of these diseases significantly reduces the patient's activity, his interaction with society, leads to his disability, which affects not only the person himself and his relatives, but also the economy of the state as a whole (especially if young able-bodied people are sick). With the development of acute heart disease, a fatal outcome is possible. It is not uncommon for diffuse cardiosclerosis to be the cause of a patient's death.
Conclusion
It must be taken into account that if the disease is detected in time and all measures are taken to treat it, the prognosis is favorable. In addition to drug therapy, recommendations regarding diet and physical activity should be followed. A he althy lifestyle is recommended.
Regular exercise, proper nutrition, timely examination and access to doctors, adequate rehabilitation contribute to a favorable course of the disease and reduce the risk of patient disability. In any case, you should not ignore the first symptoms of the disease, but it is better to contact a specialist in a timely manner for a comprehensive examination.
