Currently coronary heart disease is considered one of the most common pathologies worldwide. It is a consequence of the narrowing of the lumen of the coronary arteries, which are responsible for the blood supply to the most important organ. Over time, the number of atherosclerotic plaques on the walls of blood vessels increases, and the severity of symptoms of cardiac ischemia becomes brighter. Ignoring the disease can lead to complete blockage of blood vessels, the natural result of which is the death of a person.
Mechanism of development and forms of the disease
Ischemia of the heart occurs when there is an imbalance between the actual blood supply to the organ and its need for fluid connective tissue that delivers oxygen and nutrients.
In medical terminology, there are also other names for pathology: coronary disease and coronary sclerosis. This is due to the fact that cardiac ischemia is not one ailment, but a whole group of them. At the same time, all diseases that are included in it are characterized by impaired blood circulation in the arteries,whose task is to provide blood to a vital organ.
As a rule, the narrowing of the lumen of blood vessels occurs due to the deposition of atherosclerotic plaques on their walls, which appeared as a result of an increase in the level of “bad” cholesterol in the blood. The situation can be aggravated by the fact that a blood clot sometimes forms in the area of partial blockage, which completely blocks the blood flow. In this case, 2 scenarios are possible: either the artery independently restores its conducting function, or partial or complete tissue necrosis occurs.
Ischemia is a heart disease that includes both acute and chronic conditions, as a result of which the myocardium undergoes changes. In practice, they can also be considered as independent nosological units.
Currently, doctors use the following classification of forms of coronary disease:
- Sudden coronary death. Another name for it is primary cardiac arrest. This is an acute condition that develops in the shortest possible time (instantly or no later than 6 hours after the attack). With sudden coronary death, 2 scenarios are possible - successful resuscitation or death.
- Angina. It manifests itself in the form of an attack, which is a signal of the occurrence of oxygen starvation. Thus, one of the main signs of cardiac ischemia is angina pectoris. It can be stable, or voltage (subdivided into 4 functional classes, depending on the load that a person can endure),unstable (appears at rest, after a myocardial infarction or immediately before it), spontaneous (occurs due to a sudden spasm of the coronary arteries).
- Painless form. A third of all patients are not even aware of the presence of the disease, since they have no signs of cardiac ischemia at all.
- Myocardial infarction. This is an acute lesion of the heart, which is the result of blockage of one of the vessels with an atherosclerotic plaque. In this case, part of the muscle tissue dies. Myocardial infarction can be large- or small-focal.
- Irregular heart rhythm and conduction.
- Postinfarction cardiosclerosis. This is a condition characterized by the replacement of dead heart tissue with connective tissue. In this case, the functioning of the organ is disrupted.
- Heart failure. With this pathology, the muscle cannot fully provide other organs and systems with blood.
And now about what is dangerous ischemia of the heart. If the muscle does not receive enough oxygen and nutrients from the blood, its work is disrupted. As a result, the heart cannot fully perform its function, and all organs and systems are already involved in the pathological process.
Reasons
In 98% of cases coronary disease is a consequence of atherosclerosis of the coronary arteries. In this case, the lumen of the vessels of the heart can be blocked partially or completely. Blockage of the arteries by 75% already leads to angina pectoris, as the body begins to respond to a pronounced lack of oxygen. According to statistics, the mostthe left ventricle is susceptible to ischemia.
In rare cases, the disease occurs due to thromboembolism or spasm of the coronary vessels. But these conditions also develop, as a rule, against the background of already existing atherosclerosis.
There are many factors that significantly increase the risk of developing cardiac ischemia. The main ones are:
- high blood pressure;
- genetic predisposition;
- smoking;
- lack of exercise;
- high levels of "bad" cholesterol in the blood;
- alcohol abuse;
- diseases that cause an increase in blood clotting;
- physical and emotional overwork;
- improper organization of the working day, due to which there is practically no time left for a good rest;
- diabetes mellitus;
- overweight;
- often under stress;
- eating junk food.
In addition, the natural aging process of the body plays an important role. The older a person is, the higher the risk of developing coronary heart disease. According to statistics, middle-aged men are more likely to suffer from the disease.
Symptoms
Ischemic disease can be acute or develop very slowly over many years. Clinical manifestations depend on the specific form of pathology.
As a rule, the disease hasundulating nature, that is, calm periods during which the patient feels satisfactory, alternate with episodes of exacerbation.
Common symptoms of ischemia are as follows:
- Chest pain due to exercise or stress.
- Shortness of breath with any physical activity.
- Pain in the back, arm (usually left). Often there is discomfort in the lower jaw.
- Irregular heartbeat, rapid rhythm.
- Permanent feeling of weakness.
- Nausea.
- Short-term loss of consciousness.
- Dizziness.
- Excessive sweating.
- Swelling of the lower extremities.
Often, the above signs of cardiac ischemia do not occur simultaneously. As a rule, there is a predominance of certain symptoms in a certain form of the disease.
Before the occurrence of sudden cardiac arrest, a person feels pain behind the sternum, which has a paroxysmal character. In addition, he has sharp mood swings, there is a strong fear of death. Then the person loses consciousness, the breathing process stops, the skin turns pale, the pupils begin to expand, attempts to find his pulse are unsuccessful. In case of sudden coronary death, it is necessary to carry out resuscitation measures, the methodology for which everyone must know. According to statistics, the majority of deaths occur precisely at the pre-hospital stage.
Diagnosis
When warning signs appear, you should contact a cardiologist. At the initial appointment, he finds out what symptoms bother the patient, examines his skin for cyanosis, confirms or excludes the presence of edema of the lower extremities. In addition, using a phonendoscope, the doctor can detect heart murmurs and various abnormalities in the functioning of the organ. After collecting an anamnesis, the doctor gives a referral for examination.
The main methods for diagnosing coronary disease are:
- EchoCG. This method involves an ultrasound examination, during which the doctor receives information regarding the size of the heart and its condition. In some cases, echocardiography is performed after a small amount of physical activity, which makes it possible to detect ischemia with certainty.
- Functional tests with load. ECG sensors are installed on the patient's body, after which he is asked to perform any of the tests, for example, quickly walk, jump, climb stairs, etc. The method is informative enough to detect coronary disease at an early stage of development, but is not applicable to to patients who, for he alth reasons, cannot make active movements.
- Holter ECG. The method involves daily monitoring of the work of the heart muscle using a portable device that is attached to the patient's belt or shoulder. In addition to the readings of the device, the doctor must provide a diary of observations. In it, the patient must hourly note his activity and record changes in well-being.
- ChPEKG. The essence of the method lies in the fact that a special sensor is introduced into the esophagus, with the help of which the doctor is able to assess the state of the myocardium. The method is considered highly informative, since in the diagnostic process there are no interferences created by the skin, adipose tissue and chest.
- Coronary angiography. The method is based on the introduction of a reagent to the patient and subsequent contrasting of myocardial vessels. With its help, it is possible to assess the degree of violation of the patency of the arteries. As a rule, coronary angiography is used when it is necessary to make a decision regarding the advisability of surgical intervention.
In addition, the doctor prescribes a blood test, the results of which can also be used to judge circulatory disorders.
Conservative treatment
It includes several main steps:
- Taking medication.
- Therapeutic exercise.
- Physiotherapy treatments.
Only a cardiologist should decide how to treat ischemia of the heart in each case. Self-administration of drugs can only aggravate the situation and lead to sad consequences.
Generally, your doctor recommends taking the following remedies:
- "Nitroglycerin" and its derivatives. The action of the drugs is aimed at eliminating spasms and expanding the lumen of the coronary vessels. Due to this, the access of oxygen and nutrients to the heart with blood is restored.
- Drugs that reduce the rate of clottingblood. In the treatment of cardiac ischemia, it is necessary to reduce the risk of blood clots. Often, the doctor prescribes "Aspirin" for this purpose.
- Preparations that prevent the absorption of cholesterol, improve metabolism and promote the removal of lipids from the body.
- Vitamins P and E. In order to maximize the benefits of taking them, it is recommended to combine them with ascorbic acid.
Regardless of the severity of symptoms, treatment of ischemia of the heart must necessarily include exercise. At the initial stage of the development of the disease are shown: cycling, running, swimming. During the period of exacerbation, the load is prohibited.
In severe forms of the disease, the patient must regularly perform a set of therapeutic exercises. Classes are held exclusively in a hospital with an instructor and under the supervision of a cardiologist. All exercises are performed slowly and with a small amplitude. Before classes, during and after them, the patient's pulse is measured.
In the absence of contraindications for the treatment of cardiac ischemia, it is recommended to undergo a course of physiotherapy. The method is chosen by the doctor, taking into account the individual characteristics of the he alth of each patient.
The most effective are:
- healing baths;
- electrophoresis;
- plated collar;
- electrosleep.
Laser therapy is widely used in large cardiac centers.
In addition to the above, the patient needs to adjust the diet and minimize exposure to harmful factors.
Surgery
Currently, coronary artery bypass grafting is the most common surgical treatment for coronary artery disease. The decision to conduct it is made when conservative methods do not bring results.
The essence of coronary artery bypass grafting is that in the course of the operation workarounds are created. Through them, blood will flow to the heart, bypassing the vessels, the lumen of which is narrowed by atherosclerotic plaques. The goal of treatment is to improve the patient's condition and reduce the number of exacerbations that require urgent hospitalization.
Diet
With cardiac ischemia, the diet must be strictly observed. It is required to abandon products containing a large amount of animal fats. They contribute to an increase in the level of "bad" cholesterol in the blood, which significantly increases the risk of complications of coronary disease.
The following foods should be eaten as often as possible:
- nuts;
- cottage cheese;
- raisins;
- strawberry;
- honey;
- pumpkin;
- peas;
- eggplant;
- cranberries;
- seaweed;
- rosehip drinks.
Also, your doctor may recommend taking vitamin complexes.
Unconventional methods of dealing with the disease
Treatment of cardiac ischemia with folk remedies does not exclude the need to see a doctor when alarming symptoms appear. The use of any non-traditional methods must also be agreed with a specialist.
The most effective prescriptions for ischemia:
- Beat 2 egg whites with 2 tsp. sour cream and 1 tsp. honey. The resulting mixture should be taken on an empty stomach.
- Take 1 tbsp. l. crushed seeds or herbs of dill and pour 300 ml of boiling water. Let it brew for about an hour. Drink throughout the day in small portions.
- Chop 5 heads of garlic and mix it with the juice of 10 lemons and 1 liter of honey (preferably lime). Close the container tightly and put it in a cool place for 7 days. After this period, the mixture should be taken daily for 4 tbsp. l. At the same time, it is important to observe one condition - between the use of each spoon, it is necessary to maintain a minute pause.
Prevention
In order to reduce the likelihood of developing coronary disease, you need to reduce the number of harmful factors:
- quit alcohol and smoking;
- when obese, reduce body weight;
- keep active;
- follow the principles of proper nutrition;
- avoid stressful situations;
- correctly organize the working day;
- treat existing diseases in a timely manner.
Keeping a he althy lifestyle minimizes the risk of dangerous pathology.
In closing
The main cause of coronary disease is atherosclerosis. As a result of the narrowing of the lumen of the coronary arteries, the heart does not receive enoughoxygen and nutrients.
The disease can take several forms, each of which poses a serious threat to a person's life if warning signs are ignored.
Treatment of ischemia is carried out by several methods simultaneously. If conservative therapy fails, surgery is indicated. As a rule, in practice, the method of coronary artery bypass grafting is most often used.
