Atherosclerotic cardiosclerosis is a diffuse development of connective scar tissue that occurs in the myocardium (the main muscle layer of the heart), which appears as a result of damage to the coronary arteries. The disease is serious, and every person suffering from it should be observed by a cardiologist. But its presence is not a sentence if symptoms are detected in time and treatment is started. However, the topic is important, so it is worth paying a little more attention to its consideration.
Pathogenesis
Atherosclerotic cardiosclerosis never forms on its own. It always occurs as a result of metabolic disorders and ischemia occurring in the myocardium (CHD). It is because of this that the slow development of dystrophy and atrophy begins, as a result of which muscle fibers die. Later, areas of necrosis and small scars form in their place. Due to the death of receptors, the sensitivity of myocardial tissues to oxygen decreases, and this causes further progression of coronary heart disease.
For atheroscleroticcardiosclerosis is characterized by a long course and diffuse spread. As it progresses, compensatory hypertrophy develops. Then there is dilatation of the left ventricle, the signs of heart failure become more and more obvious.
It is important to note that pathogenetic mechanisms differ. Therefore, cardiosclerosis is ischemic, postinfarction and mixed. If we talk about etiology, then there are myocardial, post-infarction, atherosclerotic and primary types.
Causes and course of the disease
Cardiosclerosis develops in all cases due to atherosclerotic lesions of the coronary vessels, through which the blood supply to the myocardium is carried out. The provoking factor is a violation of cholesterol metabolism. It is he who is accompanied by excessive deposition of fat-like substances in the inner lining of blood vessels.
How quickly atherosclerotic cardiosclerosis develops depends on three factors:
- Presence of arterial hypertension. Manifested by persistent high blood pressure from 140/90 mm Hg. Art. and above.
- Tendency to vasoconstriction. This is the name of the narrowing of the lumen of blood vessels, arteries in particular.
- Excess consumption of high-calorie, high-fat foods.
Under the influence of these factors, there is a violation of the permeability of the vascular wall. Subsequently, a plaque consisting of lipids is formed on the inner surface of the vessel. It is she who becomes an obstacle to blood flow,because it blocks the vascular bed.
If the lumen is closed by 70%, cardiomyocytes (myocardial cells) due to increasing oxygen starvation lose their ability to contract and conduct impulses. As a result, they rebuild and die. This is how a scar is formed.
Initial stage: symptoms
Atherosclerotic cardiosclerosis of the 1st degree is very often not expressed by any signs. The disease can make itself felt only after physical exertion. But in general, the following manifestations are characteristic of the clinical picture:
- Shortness of breath that occurs even after mild physical exertion. As the disease progresses, it begins to disturb the person even when walking.
- General malaise and feeling weak. Over time, these symptoms increase.
- Dizziness and headaches. This may be accompanied by tinnitus. Occurs due to oxygen starvation of brain tissue.
- Heartache with aching character. It may pass in a few minutes or last for hours.
- Angina. Sharp pains in the heart radiate to the left collarbone, arm and shoulder blade.
- Irregular heart rhythm. They can manifest themselves in atrial fibrillation, extrasystole and tachycardia. It is not uncommon for people with cardiosclerosis to have heart rates in excess of 120 beats per minute.
- Edematous syndrome in the feet and legs. As a rule, it makes itself felt in the evening. Also occurs due to circulatory failure.
Many people don't paydue attention to these manifestations, attributing everything to their excessive employment and increased fatigue. But it is not recommended to ignore the symptoms, because at the initial stage of the disease it is much easier to prevent the occurrence of dangerous complications.
Progressive form
Atherosclerotic cardiosclerosis of the 2nd degree is characterized by an increase in all of the above symptoms and the addition of other, more serious ones. In the future, the following manifestations make themselves felt:
- Congestion in the lungs. Symptoms include rapid breathing, pale skin, tachycardia, cold sweats, coughing up blood, fatigue, and discomfort when lying down.
- Increased size of the liver (hepatomegaly). But this is indicated by nausea, indigestion, an increase in the abdomen in volume, heartburn.
- Accumulation of fluid in the abdomen (ascites). A feeling of fullness and heaviness appears in the abdomen, and discomfort is also accompanied by belching, flatulence, swelling of the legs.
- Inflammation of the lung and parietal pleura (pleurisy). Manifested by chest pains and a painful cough.
Also, later on, atrioventricular and intraventricular blockade develops, peripheral edema appears, dizziness becomes frequent, and memory deteriorates significantly.
Diagnosis
Talking about the symptoms and causes of atherosclerotic cardiosclerosis, it is also worth discussing how this disease is diagnosed.
First of all, the doctor gets acquainted with the history of the disease. ATIn the vast majority of cases, people who have noticed symptoms of atherosclerotic cardiosclerosis have a history of arrhythmia, myocardial infarction, coronary artery disease, etc.
After that, the doctor examines the patient. And then sends it to the following procedures:
- EKG. Needed to detect heart failure, myocardial hypertrophy and the presence of scar tissue on it.
- Biochemical blood test. With its help, it is possible to detect beta-lipoproteins and high cholesterol levels in the blood.
- Echocardiogram. This procedure will reveal abnormalities in myocardial contractions.
- Veloergometry. This research method helps to identify the degree of myocardial muscle dysfunction and ventricular reserves.
But these are not all the procedures that a person may have to go through. Also, rhythmocardiography, coronography, MRI, polycardiography and ventriculography are often prescribed. Another person can be sent to diagnose atherosclerotic cardiosclerosis for ECG monitoring. And to clarify the presence of effusion, an ultrasound of the abdominal and pleural cavities and a chest x-ray are performed.
Medicated treatment
After confirming the diagnosis of atherosclerotic cardiosclerosis, a person is prescribed therapy. As a rule, a set of medications, the use of which is necessary to eliminate the symptoms of the disease and normalize well-being, is as follows:
- Cardiac glycosides: Korglikon and Digoxin. Improveblood supply, normalize the heartbeat and pressure, reduce the volume of circulating blood.
- Nitropreparations: Nitrosorbide and Sustak. Improve microcirculation, increase myocardial contractility and dilate blood vessels.
- Vasodilators: Molsidomin. It has a positive effect on the elasticity and strength of blood vessels.
- Calcium antagonists: Amlodipine. Reduces the frequency of contractions and dilates the arteries.
- Cytoprotectors: "Mildronate" and "Preductal". Improve myocardial contractility and metabolism, restore the function of cardiomyocytes.
- Potassium channel activators, such as Nicorandil. Reduce blood pressure, increase the elasticity of blood vessels and dilate them.
- Beta-blockers: Metoprolol and Atenolol. Normalize heart rhythm, reduce the frequency and strength of heart contractions, increase periods of myocardial relaxation.
- Antithrombotic drugs: Aspirin and Ticlopidin. They prevent the formation of blood clots and the adhesion of platelets.
- Statins: Atorvastatin and Lovastatin. They normalize the level of cholesterol in the blood and prevent the formation of new atherosclerotic plaques.
It should be noted that if a person has concomitant diseases and risk factors (arterial hypertension, for example, or diabetes mellitus), then the doctor prescribes medication that maintains blood glucose levels, as well as diuretics and antihypertensive drugs.
Alternative medicine
They are also worth mentioning. Possibilitytreatment of atherosclerotic cardiosclerosis with folk remedies must be discussed with your doctor, perhaps there is no need for it. But in general, the following recipes are most popular:
- Mix cumin fruits (1 tsp) and hawthorn root (1 tbsp), pour boiling water (300 ml), let it brew overnight. Strain in the morning. Drink throughout the day in equal portions for 5 receptions.
- Mix together lesser periwinkle leaves (1.5 tsp), white mistletoe herb (1.5 tsp), hawthorn flowers (1.5 tsp) and yarrow herb (1 tbsp. l.). Pour boiling water over one spoonful of the mixture (300 ml) and let it brew for 1 hour. Drink the resulting volume in 4 doses.
- Combine goose cinquefoil (30 g), fragrant rue (30 g), lily of the valley flowers (10 g) and lemon balm (20 g). Take 1 tbsp. l. collection and pour a glass of boiling water. Infuse for 1 hour, then strain. Drink three times a day before meals for 1 tbsp. l.
- Grind elecampane (300 g), put in a glass container and pour vodka (500 ml). For 14 days send to a cool place and strain. Drink three times a day, 30 grams, diluted in a small amount of water.
- Fruits of prickly hawthorn (30 pieces) pour a glass of boiling water. Let it brew. Berries can be suppressed for greater effect. Make this infusion daily.
- Buckwheat flowers (1 tablespoon) brew with boiling water (500 ml) and let it brew for 2 hours. Then strain. Drink 1/2 cup three times a day, always warm.
Also cope with atherosclerotic cardiosclerosis patients with rhythm disturbancethe use of red currant juice, a decoction of rowan bark, infusion on its fruits, as well as cranberries, blackberries and bird cherry in any form will help.
Surgery
It should be performed if a person diagnosed with atherosclerotic cardiosclerosis does not show any improvement after drug therapy.
Depending on the case, one of the following operations may be indicated:
- Coronary artery bypass grafting. The surgeon creates a path for additional blood supply through systems of prosthetic vessels (shunts). This helps restore blood flow and eliminate constriction.
- Closed vascular angioplasty. During this operation, the surgeon expands the area of stenosis with a plaque, which is performed by introducing a special balloon. It also helps to normalize blood circulation. And during the operation, the stenosis is eliminated.
- Stenting. The surgeon installs a special frame (stent) into the lumen of the narrowed vessels, thanks to which it is possible to eliminate the stenosis and normalize the blood flow.
- Removal of an aortic aneurysm. The specialist excised the defect or carried out its protrusion with shunting or prosthetics.
All of the above operations are aimed at eliminating oxygen starvation and obstacles to the normal blood supply to the heart.
Diet
Much has been said above about what atherosclerotic cardiosclerosis is. How to treat this disease is also clear, so now it’s worth a little attentiongive consideration to the principles of the diet. It must be observed without fail. With cardiosclerosis, the list of prohibited foods looks like this:
- Fried and cholesterol-rich food (fish, meat, sausage, lard).
- Some vegetables: radishes, onions, beans, parsley, peas, garlic.
- Alcohol.
- Energy and blood pressure drinks (strong tea, cocoa, coffee).
- S alt.
- Dairy products.
- Butter, animal fats, margarine, cream.
- Hard cheeses.
- Eggs.
- Everything is too sweet, spicy, spicy and s alty.
- Confectionery.
And here is a list of recommended foods:
- Fruits and berries: cherries, grapes, tangerines, bananas, apples, kiwi.
- Nuts, but in small quantities.
- Vegetables: potatoes, tomatoes, carrots.
- Grain and bran bread.
- Fat-free dairy products.
- Durum pasta.
- Rice and buckwheat with milk.
- Fresh juices from carrots, apples and oranges.
- Foods high in phosphorus and calcium.
Preference should be given to steamed and boiled food. Ginger, red pepper, horseradish and turmeric are recommended as seasonings - they can lower blood cholesterol levels.
You should also switch to fractional nutrition. There are 5-6 times a day with equal intervals between meals. But the last one should be 2-3 hours before bedtime.
Forecast
It is important to note that it is impossible to completely cure atherosclerotic cardiosclerosis. Death to people suffering from them is threatened, however, not always. And this is good news.
With moderate and mild myocardial damage (this is approximately 75% of cases), the condition of patients can be stabilized through the use of drugs. Many live to a ripe old age if they have regular check-ups with a cardiologist, drink prescribed medications, and follow a low-cholesterol diet.
If the patient turned to the doctor late, when extensive, pronounced changes have already occurred in the myocardium, then there will be complications of atherosclerotic cardiosclerosis. Death in such cases occurs in 80%. After surgery, in 90% of cases, the condition of patients improves significantly, and the symptoms smooth out.
No matter what degree the pathology is diagnosed in a person, he will have to be constantly observed, examined and treated by a specialist cardiologist. This is necessary to prevent disease progression and maintain quality of life.
