Coronary insufficiency is a pathological condition characterized by partial reduction or complete cessation of coronary blood flow. This condition is a manifestation of coronary heart disease.
Classified into the following groups:
- Acute coronary insufficiency.
- Chronic course of the disease.
The syndrome of coronary insufficiency is treated depending on the form. Both surgical methods and medical and folk remedies are used.
Reasons
The main cause of coronary insufficiency are spasms, atherosclerotic and thrombotic stenosis. An increased load on the myocardium can lead to the formation of an ailment. The load increases with the following factors:
- release of adrenaline into the blood (stress);
- anemia;
- high body temperature;
- infectious processes;
- hypertension.
Also, the cause of coronary insufficiency can be:
- heart disease;
- aortic aneurysm;
- heart contusion;
- heartbreak;
- pulmonary thromboembolismarteries;
- anaphylactic shock;
- pulmonary stenosis;
- impaired patency of the arteries (due to spasms, thrombosis, narrowing of the lumen of the arteries);
- intoxication as a result of alcohol or nicotine addiction (release of substances that cause coronospasm).
The reasons why coronary insufficiency occurs are a factor that activates a series of pathological mechanisms that can lead, among other things, to death.
Symptomatics
You should pay attention to the appearance of warning signs in time. Coronary insufficiency is a fairly common cause of death from heart disease. There is a fairly extensive list of symptoms indicating its presence.
- Perceptible pain around the heart, lasting for ten minutes.
- A peculiar "rigidity" of the body that occurs with increased physical exertion.
- Permanent pallor.
- High heart rate.
As a rule, the above signs are found in combination. It is also worth considering that there are a number of other signals. They are presented below.
- Shallow, slow breathing indicates illness.
- Nausea and vomiting. They are also harbingers of a pathological condition.
- Increased salivation. In other words, a lot of saliva is constantly secreted.
- Urine that is too light in color and is excreted in too much quantity.
These symptoms of coronary insufficiency clearly signal problems in the body. If they are found, you should immediately consult a doctor of the appropriate direction, since such a condition necessarily requires treatment.
Diagnosis
Diagnosis is carried out using several methods, they are able to cause symptoms by which this disease is detected. Here are some ways to diagnose:
- The most significant contribution to the recognition of coronary insufficiency is made by electrocardiography, it is carried out with dosed physical activity. ECG - signs of this disease, appear after the peak of physical exertion, and after 3-6 minutes, depression of the ST segment may begin. Another indirect sign of coronary insufficiency is the arrhythmia that occurred after physical exertion.
- They also carry out coronary angiography in order to assess the condition of the coronary arteries, as well as to accurately determine the areas of occlusive or stenotic lesions. This is an X-ray diagnostic technique that uses contrast agents.
- To determine the amount of electrolytes, glucose, lipoproteins, low and high density total cholesterol, T and I, laboratory diagnosis of coronary insufficiency is carried out. The detection of these signs means that a heart attack or a myocardial microinfarction has already occurred.
Sharp shape
The statistics of an unexpected death is very sad:every year there are more and more such deaths. The factor is heart failure. The heart muscle needs to “breathe” (supplied with oxygen) and eat (provide itself with microelements). This task is performed by the vessels.
The causes of acute coronary insufficiency are the same as the general ones. The arteries are located near the heart in the form of a crown, which is why the name came from - coronary or coronary. If the blood flow weakens due to external or internal vasoconstriction, the heart muscle feels a lack of nutrition and oxygen. This feeling in medical terms is called coronary insufficiency. If the disruption of work activity occurs gradually, then heart failure acquires a chronic deficit. Quickly (in a few hours or minutes) is acute coronary insufficiency. As a result, an oxidation product accumulates, which causes a malfunction in the working activity of the "motor", rupture of the vessel, tissue necrosis, cardiac arrest, death.
Basically, acute coronary insufficiency leads to coronary disease. It often develops in the form of such ailments as heart disease, trauma, cerebral edema, pancreatitis, bacterial endocarditis.
Chronic form
It should be borne in mind that the chronic form of pathology follows from the acute stage. In other words, if a person has acute coronary insufficiency, then after a certain period of time it will turn into chronic.
The condition is provoked by reduced blood flow to the myocardium. This, as a rule, is due either to atherosclerosis of the vessels, or some change in the propertiesblood. Also, we must not forget that this disease can be inherited.
There is a fairly extensive list of symptoms that signal coronary insufficiency. Thus, the possible presence of the disease can be judged if the patient has:
- Unreasonable shortness of breath.
- Frequent dry cough.
- Pressing pain in the myocardium.
It should be clarified that at the beginning of the disease, symptoms occur with increased physical exertion, but as the pathology develops, they manifest themselves at rest.
In addition to the above signals, coronary insufficiency can be indicated by:
- Nausea.
- Vomiting.
- Imperative urge - a constant desire to urinate.
Sudden death
Such a phenomenon as coronary insufficiency can lead to sudden death. There are a lot of such cases, even if the patient received medical care. This pathology is currently poorly understood, such a phenomenon requires more thorough research. It is known that this phenomenon is often found in older people, however, the development of pathology in people of 20 years of age is also possible.
Often there are such cases that people did not complain about their he alth, did not even visit a doctor, but they were diagnosed with coronary death. In this condition, a process occurs that blocks the normal coronary circulation, and this is fraught with a dangerous failure in the supply of oxygen to the heart muscles. The heart muscle is susceptible to shrinkageoxygen levels and tissues die within minutes due to lack of nutrition.
In many cases, sudden death in coronary insufficiency is associated with hypertension or with inflammatory processes that affect the muscles of the heart. The following factors provoke a lethal outcome:
- increased blood clotting;
- infectious diseases accompanied by sepsis;
- a state of overheating of the body;
- lack of potassium, magnesium;
- penetration of air bubbles into the coronary artery.
Medicated treatment
The main method of dealing with coronary insufficiency is drug treatment. The goal of therapy is to eliminate the cause of the disease and its symptoms. One of the objectives of such treatment is to restore the access of oxygen to the tissues of the heart. What drugs are prescribed for coronary insufficiency?
1. Emergency:
- Aspirin is a drug that can thin the blood and prevent blood clots. Facilitates the passage of blood through the vessels, even if they are narrowed.
- "Nitroglycerin" - supplies oxygen to the cells of the heart, thereby improving blood circulation. Used for sudden coronary insufficiency.
- "Clopidogrel" - affects the enzymatic system of platelets, changing their receptors and preventing formation.
- "Ticlopidine" - prevents platelets from sticking together, reducing blood viscosity, resulting in no formation ofblood clots.
2. Painkillers:
- "Droperidol" - blocks dopamine receptors in the brain.
- "Morphine" (analogous to "Fentanyl") - can cause mild arterial and venous dilatation. Is a narcotic opioid.
- "Promedol" - acts by relaxing the muscles, which leads to the elimination of spasms.
3. Thrombolytics:
Used to dissolve blood clots, most often drugs such as Tenecteplase, Streptokinase, Urokinase, Alteplase
Therapy is prescribed by the attending cardiologist, depending on the condition of the body.
Surgical treatment
When therapy in the treatment of coronary insufficiency no longer helps, surgical intervention is used, the purpose of which is to restore blood supply to the problem area of the vessel. There are 2 main types of surgical treatment of the disease:
- Bypass.
- Angioplasty.
When shunting, doctors create additional blood flow around the narrowed area in the vessel. For this, the patient's own vessels - veins or arteries - are most often used. This extra blood flow is called a shunt.
Angioplasty can be:
- balloon;
- laser.
In balloon angioplasty, a balloon is inserted into the narrowed part of the vessel, which expands the problemplot. During this operation, a small incision is made in the aorta, a tube with a balloon at the end is inserted, which advances to the site of narrowing of the vessel.
In laser treatment, instead of a tube, a quartz filament is inserted into the incision. It also advances to the point of constriction. After that, a laser is turned on, which affects cholesterol - the main problem of constriction in the vessels. The cholesterol plaque is destroyed and the lumen in the vessel becomes larger.
Efficiency of angioplasty reaches 95%. Therefore, this type of surgical treatment of coronary insufficiency is used more often.
Danger
Ischemic heart disease is often almost asymptomatic, progressing and leading to a number of complications, the most serious and irreversible of which is coronary death. Among the most common complications are:
- changes in the structure of the heart muscle;
- rupture of the heart wall;
- aortic aneurysm;
- pericarditis (inflammatory lesion of the pericardial sac);
- different types of arrhythmias;
- involuntary vasoconstriction;
- minor but dangerous changes in the anatomy of the heart.
In addition to the above, coronary insufficiency can also cause two extremely serious conditions: unstable angina and myocardial infarction.
There are three stages of the negative consequences of the disease:
- High risk of death. It is characterized by attacks of angina pectoris lasting more than 20 minutes, pulmonary edema with sputum secretions, low blood pressure,shortness of breath, darkening of the eyes, loss of consciousness.
- The average degree of threat of death is determined by angina attacks less than 20 minutes (manifested within the last couple of weeks, easily eliminated by resorption of "Nitroglycerin"), nocturnal attacks of chest pain, the age of the patient over 65 years.
- Low risk due to more frequent occurrence of angina attacks in the last two months, even after mild exercise, no new ECG changes compared to previous results.
Prevention
When entering the risk group for coronary insufficiency, it is necessary to adhere to a lifestyle aimed at preventing this condition. Criteria for entering a risk group:
- overweight;
- constant overwork, stress;
- high cholesterol;
- sedentary lifestyle;
- smoking.
Recommendations for disease prevention:
- Keep an active lifestyle: exercise regularly, swim in the pool, take slow walks. It is recommended to refuse to use the elevator and give preference to the stairs. It is impossible to increase the load sharply, it should happen gradually. If necessary, you can seek the advice of a cardiologist.
- Compliance with a he althy diet, the diet should be balanced. Shouldreduce the intake of foods rich in cholesterol and animal fats. It is worth making a choice in favor of vegetable oils, such as corn. It is also recommended to limit the consumption of sweet and flour products. Overeating should be avoided.
- Reducing stressful situations. You should try to worry as little as possible.
If you follow the above recommendations, the likelihood of coronary insufficiency will be minimized.
