Coronary heart disease today means a whole range of diseases. All of them are characterized by unstable blood flow in the arteries responsible for ensuring the work of the myocardium. Insufficient blood supply in this case may be caused by narrowing of the coronary vessels.
Such a pathology can manifest itself under the influence of both external and internal factors. How is ischemia determined on the ECG, is it possible to protect yourself from such a disease, and what does the course of treatment include? With these questions we will try to understand in this review.
Causes of occurrence
Ischemic heart disease can lead to disability and even death. According to the World He alth Organization, 7 million people die every year from this disease. Mortality by 2020 could double. At risk are men aged 40 to 62.
However, the risk of disease increases significantly when exposed to the following negative factors:
- Atherosclerosis is a disease that affects the arteries located in close proximity to the heart muscle. As a result, the walls of blood vessels become denser and lose their elasticity. The lumen can also narrow due to plaques formed by calcium and fat.
- Spasm of the coronary vessels - a similar ailment is due to the development of atherosclerosis, but it can form without it. May appear as a result of stress. Spasm has a negative effect on the functioning of the arteries. In hypertension, the heart has to contend with high pressure in the aorta. This can cut off circulation, cause angina and heart attack.
- Thrombosis. As a result of plaque breakdown, a blood clot can form in a coronary artery. Also, the vessel is blocked by a thrombus formed in another part of the circulatory system.
- Congenital and acquired defects.
Risk factors
Why does myocardial ischemia occur? On the ECG, the first signs of this disease can usually be seen after 40 years. Of great importance in this case is such a factor as heredity. If the parents suffered from coronary artery disease, then the children are likely to have a similar disease.
Negative factors also include:
- high blood cholesterol;
- fat metabolism disorders;
- obesity of any degree;
- diabetes;
- sedentary lifestyle;
- frequent disorders and personality traits;
- gender: coronary disease among menheart is more common;
- malnutrition.
Classification
What is she like? Specialists identify several forms of coronary heart disease:
- Primary cardiac arrest.
- Acute coronary insufficiency.
- Angina pectoris is a form of coronary artery disease characterized by squeezing and pressure discomfort.
Usually such manifestations are mainly localized behind the sternum. Painful sensations and discomfort can still be given to the left hand, epigastric region, jaw. Such a pathology usually develops as a result of physical activity. There are several forms: primary, progressive, vasospastic.
Consequences and complications
Ischemic heart disease in the absence of the required therapy can lead to the formation of progressive heart failure. The contractility of the muscles weakens. As a result, the heart stops providing the body with the required amount of blood. Patients with ischemic heart fatigue quickly and experience constant fatigue. If no measures are taken to treat the disease, then the case may end in disability or even death.
First signs
Of course, subendocardial ischemia is immediately noticeable on the ECG. But there are symptoms that will help to identify coronary insufficiency in the early stages, even without additional examinations. They can appear individually or in combination. Everybody is herelargely depends on the form of the disease. There is a direct relationship between the development of pain localized in the region of the heart and physical activity.
Also, discomfort can appear under adverse conditions and after a heavy meal. With IHD, patients usually experience pain of a pressing nature. It seems to a person that he feels a lack of air, heaviness builds up in his chest. The pain is usually localized along the left edge of the sternum. Unpleasant sensations can go to the arm, shoulder and shoulder blade. As a rule, attacks of pain last no more than 10 minutes. After taking nitrates, they gradually subside.
Other symptoms include:
- fainting;
- clouding of consciousness;
- dizziness;
- weakness;
- nausea;
- breathing;
- tachycardia;
- unstable work of the heart muscle;
- excessive sweating.
If the patient does not seek medical attention, swelling of the lower extremities will also be added to the symptoms listed above.
How to diagnose a disease?
Many believe that coronary artery disease can be determined by ECG. Signs of myocardial ischemia can also be established by conducting the following examinations:
- Collecting an anamnesis. For this purpose, the doctor should ask the patient in detail about the nature of pain, discomfort, and their localization. Also, the doctor will find out if the patient feels weak and has trouble breathing.
- Examination by a cardiologist. At this stage, the doctor should listen to the heartbeat forthe presence of wheezing and noises. Also, during the examination, the doctor measures the level of blood pressure.
- Complete blood count. Allows you to identify a possible cause of ischemia. Experts evaluate indicators such as triglyceride and cholesterol levels. This is especially important for assessing the risk of vascular atherosclerosis. Another important indicator is the level of troponins in the blood. When heart muscle cells are destroyed, specific enzymes are released into the bloodstream.
- Coagulogram. With coronary heart disease, blood clotting increases significantly.
- Electrocardiography. Allows you to identify the excess size of the left ventricle and other specific characteristics. The doctor will easily be able to determine the signs of ischemia on the ECG.
- ECG echo. With this type of examination, the structure and size of the organ are assessed, as well as the blood flow inside the heart, the operation of the valves and the degree of vascular lesions.
- Daily monitoring. With this method of examination, special equipment reads the electrocardiogram within 24-72 hours. Such a procedure allows you to objectively assess the patient's condition and accurately determine the causes of symptoms of coronary heart disease.
- X-ray. It is used to detect dilatation of the left ventricle. Such a pathology may be a consequence of aortic dissection. Also, this type of examination allows you to identify other complications.
What to do if cardiac ischemia was detected on the ECG? As a rule, to make an accurate diagnosis, the doctor uses a whole list of additional examinations. To theminclude stress testing, radiopaque examination, computed tomography, dopplerography, electrophysiological examination, etc.
Determination of coronary artery disease by ECG
What is it like? With the help of an ECG, the following forms of the disease can be detected:
- A silent form in which the person feels no pain.
- Angina characterized by significant pain in the sternum.
- Acute circulatory failure resulting from thrombosis.
- Pathology of myocardial contractions.
All these degrees of ischemia of the heart muscle can be determined using an ECG. This method is based on the principle of fixation of cardiac impulses.
How is the procedure done?
The electrocardiogram is a safe and accurate method for detecting myocardial ischemia. All necessary functioning parameters will be recorded within 10 minutes.
The procedure is carried out in the following order:
- The patient removes clothing from the chest and releases the area of the leg from the knee to the foot.
- The specialist conducting the examination lubricates the necessary areas with a special gel, fixes the electrodes.
- Data will be transmitted through the electrodes to the sensor.
- The device displays the transmitted information on paper in the form of graphs.
- Specialist deciphers the results.
What helps determine an ECG?
Electrocardiogram allows you to identify pathologies in the cardiac cycle. Also, with the help of such an examination, signs of myocardial infarction and pathological changes in the heart muscle can be determined. Thus, the ECG helps to know which area was most damaged. This type of examination is also used when symptoms come on paroxysmal.
Myocardial ischemia on ECG looks like this:
- T-wave polarity disturbances are negative and have an amplitude of over 6 mm. Due to the relaxation of the muscles, the teeth are symmetrical.
- Subepicardial ischemia on ECG is determined by T-wave inversion.
- With IHD, the QRS should not deviate from the normal value.
- Transmural ischemia on the ECG appears as a negative symmetrical wave. Only a qualified specialist can see this.
- Ischemia on the ECG may present as a flattened T-wave or biphasic.
Treatment
The entire course of therapy for coronary heart disease is based on several principles.
These include:
- Regular cardio training (walking, swimming, gymnastics). The amount and duration of training should be determined by the doctor.
- Special diet. A patient suffering from coronary heart disease should not eat s alty and fatty foods.
- Emotional peace.
Also, the patient's condition can be maintained through the use of pharmacological drugs.
Conclusion
Modern diagnostic equipmentallows early detection of coronary heart disease. Timely detection of the problem plays a decisive role in the success of treatment. However, it should be borne in mind that only a qualified cardiologist can correctly decipher the results of an electrocardiogram.
