Ischemic heart disease (CHD) is a dangerous pathology caused by insufficient blood supply to the heart muscle. The disease can manifest itself in acute and chronic form. Often the lack of blood supply leads to death. Symptoms of the disease will depend on its form. The wording of the diagnosis of coronary artery disease will also differ.
Description of the pathological process
More than 50% of deaths in old age are due to coronary heart disease. Pathology is a serious problem of modern cardiology. To a greater extent, the disease affects men of working age (up to 65 years). The result of ischemia is often the patient's disability. The pathological process is based on an imbalance between the need of the heart muscle for blood supply and the actual flow of blood to the organ.
As a result of the disease, oxygen starvation occurs. All organs and systems of the patient suffer. Depending on the formulation of the diagnosis of IHD, the manifestations of the pathological process will also differ. Hereinclude both acute and chronic myocardial ischemia.
Causes of disease
In more than 90% of cases, the development of the disease is associated with atherosclerosis of the coronary arteries. The pathological process can develop with varying degrees of severity. With a slight narrowing of the lumen, symptoms may practically not appear. Complete vascular occlusion increases the risk of death. The diagnosis of "CHD: acute coronary syndrome" is the reason for the hospitalization of the patient.
Against the background of an already existing atherosclerotic lesion, elderly men and women often develop arterial thromboembolism. A spasm appears, which further aggravates the obstruction of the coronary vessels.
The risk of developing the disease increases with elevated levels of lipids in the patient's blood. Problems are faced by overweight people who eat fatty foods rich in cholesterol. Hyperlipidemia can develop in the stronger sex after 40 years. In women, pathology manifests itself most often with the onset of menopause.
Another negative factor provoking coronary heart disease is arterial hypertension. This pathology increases the risk of disorders of the cardiovascular system several times. At an early stage, the disease may not manifest itself. The patient does not feel increased pressure and continues to lead a normal life. Ischemic heart disease can be detected with a diagnosis of stage II hypertension, grade 2. It usually happensthis is when the patient gets to the medical facility by ambulance. The patient develops a hypertensive crisis.
Significantly increases the risk of coronary heart disease in men and women with bad habits. In men aged 35-50 years, the risk of death is significantly increased if more than 20 cigarettes are smoked per day. It is enough for women to smoke periodically to face unpleasant symptoms. Alcoholic patients experience heart disease much earlier.
Diabetes mellitus, sedentary lifestyle, malnutrition, constant stress can also provoke the development of coronary disease. The risk of developing a pathological process increases significantly when several negative factors are combined at once.
IHD classification
What does a diagnosis of coronary artery disease mean? This means that you need to pay special attention to your he alth, regularly visit a cardiologist for preventive examinations. The severity of ischemia, the rate of its development, the causes - all this will depend on the form of the pathological process.
Sudden coronary death is the most dangerous form of coronary disease. This is an unforeseen condition associated with a complete cessation of the blood supply to the heart muscle. Only in 20% of cases can the patient be successfully resuscitated.
The risk of death decreases with the formulation of the diagnosis "IHD: exertional angina". Attacks of ischemia periodically manifest themselves against the background of stress or excessivephysical activity. With timely medical care, the patient's condition improves. Angina pectoris is divided into three subgroups: stable, unstable and spontaneous.
Myocardial infarction is a type of coronary heart disease, often leading to death. The pathological process is associated with a sharp cessation of blood supply to the heart muscle. A heart attack can be small-focal or large-focal. If the patient's life was saved, postinfarction cardiosclerosis may develop in the future. What it is? This is a condition in which heart muscle cells are replaced by scar tissue.
Heart failure is another form of the pathological process. This is a syndrome that leads to a violation of the pumping function of the heart due to blockage of blood vessels. At an early stage, the disease may not manifest itself. Risk to life occurs with advanced heart failure.
Options for the formulation of the diagnosis of coronary artery disease
In the International Classification of Diseases, coronary artery disease is classified as class XI - diseases of the circulatory system. Allocate chronic ischemic heart disease and acute angina pectoris. Possible formulations of the diagnosis of coronary artery disease:
- atrial fibrillation;
- Coronary artery aneurysm;
- unstable angina;
- angina unrefined;
- heart aneurysm;
- Asymptomatic myocardial ischemia, etc.
In the medical records of patients, you can find other names for the pathological process. However, the international classifier is most often usedto formulate a diagnosis of coronary artery disease (an example can be seen above). This allows the specialist to quickly find their bearings if the patient is admitted for treatment from another country.
Symptomatics
How is coronary heart disease manifested? Symptoms and treatment will depend on the form of the pathological process. In general, the disease can have an undulating course with periods of remissions and exacerbations. A third of patients do not feel any signs of the pathological process at all and learn about their condition at the first heart attack or during a preventive examination. Ischemic heart disease can develop gradually. As the pathological process develops, its forms will also change.
Most often, the disease manifests itself against the background of excessive physical exertion or stress. Such unpleasant signs as shortness of breath, retrosternal pain, weakness of the limbs appear. Many patients complain of increased fatigue, dizziness. In some cases, it is possible to identify the disease after loss of consciousness. With the diagnosis of "IHD: paroxysmal atrial fibrillation", it is possible to identify the pathological process against the background of already developing heart failure. The patient develops severe shortness of breath, swelling of the lower and upper extremities develops.
Before a heart attack, patients may also experience psycho-emotional symptoms - panic attacks, fear of death. With a sudden coronary syndrome, the patient loses consciousness, breathing and pulse may be absent. The chances of a patient's life depend on correctly rendered first aid.
Diagnosis of disease
On the basis of individual signs alone, it is impossible to detect coronary heart disease. The diagnosis is made by a cardiologist in a hospital setting. Special instrumental techniques are used. The patient is sent for examination after characteristic complaints - rapid fatigue, swelling of the limbs, pain behind the sternum.
An important method of examination of any diseases of the cardiovascular system is an electrocardiogram (ECG). The device records the electrical work of the heart. If there are any deviations in the work of the myocardium, this will be immediately detected. By the names of the graph, it is possible to determine the localization of pathological changes in the heart muscle. With the help of an ECG, acute and chronic diseases can be detected. In some cases, a deeper study is prescribed - daily ECG monitoring. The technique makes it possible to identify abnormalities in the work of the heart that occur periodically.
An ultrasound of the heart is another technique available in many medical institutions. During the scanning of heart tissues, it is possible to determine the size of the organ, its pathological changes. In addition, the technique allows you to assess the state of the heart during physical or drug stress.
Laboratory and diagnostic tests are of great importance. The study allows you to identify a form of coronary heart disease. Symptoms and treatment will directly depend on the type of pathological process. The patient must have a blood test. The development of the disease will be indicated by an increase in the number of certainenzymes. The specialist will also study the level of lipids and cholesterol in the blood.
Treatment of disease
The choice of therapy method directly depends on the formulation of the diagnosis of coronary artery disease. However, there are basic guidelines that will be the same for all types of coronary heart disease. All methods of treatment are divided into drug and non-drug. Endovascular treatment is widely used. In the most difficult cases, specialists resort to surgical intervention.
Non-drug therapy primarily includes lifestyle changes. The patient needs to give up smoking and alcohol, adjust the diet, spend more time outdoors. Limitations will also depend on the formulation of the diagnosis. With valve insufficiency in IHD, the patient will have to give up excessive physical activity. Some patients have to change careers or retire early.
With coronary heart disease, special attention should be paid to nutrition. To limit the load on the heart muscle, it is necessary to reduce the intake of s alt and water. This will reduce the appearance of edema. A low-calorie diet will slow down the progression of atherosclerosis. It is recommended to refuse fats of animal origin completely. The diet for the patient is made taking into account the individual characteristics of his body.
Prolonging the life of a patient with coronary heart disease allowscomplex drug therapy. Adrenoblockers, antiarrhythmic drugs are prescribed. In hypertension, drugs that normalize blood pressure are additionally used. Diuretics can help reduce swelling. If drug therapy carried out in a hospital does not show good results, the patient is referred for a consultation with a cardiac surgeon.
To restore the normal blood supply to the damaged area, coronary artery bypass grafting is performed. A bypass vascular bed is created through which blood can fully flow to the heart muscle. Surgery can be performed on a beating heart or with cardiopulmonary bypass.
For minor lesions, minimally invasive techniques are used. Coronary angioplasty is a balloon expansion of a damaged vessel. The clearance necessary for normal blood supply to the heart is created.
Complications of coronary heart disease
Prevention of coronary artery disease is of great importance. Refusal of timely therapy can lead to serious complications that threaten the life of the patient. Myocardial infarction is one of the dangerous consequences, which leads to refusal to seek help. Due to blockage of the lumen of the vessels, the blood supply to the heart muscle is disrupted. In most cases, necrosis of the affected tissue develops. The following signs may indicate the development of a heart attack: severe chest pain that develops in a calm state, an increasing sense of fear, the usual painkillers do not improve the condition. With suchsymptoms, an ambulance should be called immediately.
It should be borne in mind that with myocardial infarction, uncharacteristic symptoms may also develop. Sometimes there are symptoms of an "acute abdomen" - bloating, nausea, diarrhea. Some patients develop asthmatic syndrome. The patient begins to choke for no apparent reason. At the same time, the patient has confusion of consciousness and speech.
Patients with diabetes often develop a heart attack without any symptoms. The only sign of a pathological process will be increased fatigue after work that was previously easy.
Heart failure is another dangerous complication of coronary disease. The contractility of the myocardium is sharply reduced. The patient is unable to perform simple activities. Even with slight physical exertion, shortness of breath appears. Acute heart failure is dangerous with pulmonary edema and death. In the chronic form of the disease, the full oxygen supply to the organs is disrupted.
Treatment prognosis
It is unfortunately impossible to completely cure coronary heart disease. However, with proper therapy and compliance with all the prescriptions of a specialist, the patient can live for many more years. Direct prognosis depends on the interaction of various factors. So, with a combination of hypertension and coronary artery disease, the chances of a full life are sharply reduced. Unfavorable factors also include overweight, diabetes.
Disease prevention
He althy lifestyle periodicpreventive examinations, timely seeking medical help for any unpleasant symptoms - the best prevention of coronary artery disease. Proper nutrition is of great importance. A balanced diet will reduce the likelihood of plaque buildup.
You will have to rethink your lifestyle if you have already been diagnosed with coronary heart disease. It is impossible to stop the development of the pathological process. However, timely treatment and the rejection of bad habits will significantly slow down the progression of the disease.
