Normal work of the myocardium is provided by oxygen, which comes with blood through the coronary arteries. If they are damaged, delivery of the biological fluid worsens and ischemia develops. Without sufficient blood supply, muscle tissue weakens or atrophies.
Ischemic heart disease - causes
The pathology under consideration arises from atherosclerosis of coronary arteries of different degrees. The lumen of the blood vessel can be partially narrowed due to the cholesterol plaque or completely blocked. Against the background of a progressive atherosclerotic lesion, other causes of coronary heart disease (coronary heart disease) are added:
- spasm of coronary arteries;
- thromboembolism;
- cardiospasm;
- obstruction of the coronary vessels.
Ischemic heart disease - classification
The disease has acute and chronic course. Depending on its nature and severity of symptoms, there are such forms of ischemic heart disease:
- angina pectoris;
- myocardial infarction and postinfarction cardiosclerosis;
- sudden coronary death;
- painless or mute.
Ischemic heart disease - angina
The described type of pathology is divided into several subgroups in accordance with the factors provoking painful attacks. Chronic ischemic heart disease refers to stable angina (tension). They are differentiated into 4 functional classes in terms of severity (I-IV). Symptoms of this angina arise in response to emotional or physical stress.
Ischemic heart disease of an unstable kind happens:
- progressing;
- first emerged;
- early postoperative;
- postinfarction.
Other forms of angina pectoris:
- vasospastic;
- spontaneous;
- variant (stenocardia of Prinzmetal).
Often, painful attacks are complicated by arrhythmia. It is considered a condition equivalent to stable and spontaneous angina. Arrhythmia combines the clinical manifestations of left ventricular heart failure:
- dyspnea;
- asthma;
- swelling of the lung.
Ischemic heart disease - myocardial infarction
This type of disease can be large and small focal, depending on the extent of necrosis of muscle tissue. Acute ischemic heart disease or a heart attack requires immediate hospitalization, otherwise serious complications, including death, develop. One of the most common consequences of such an attack is cardiosclerosis (scarring of the myocardium). He is diagnosed approximately 2 months after the infarction.
IHD - sudden coronary death
Unforeseen condition, which is supposed to provoke electrical instability of the myocardium. If coronary heart disease has resulted in an instantaneous death or death within 6 hours after the attack, sudden coronary death is diagnosed. In other situations, the cause of the problem can serve other pathologies of the myocardium - infarction, cardiosclerosis or complicated angina pectoris.
Icy-free form of ischemic heart disease
This type of disease does not cause any symptoms and complaints are absent. It is more difficult to detect than the above variants of IHD, so the pathology slowly progresses and often provokes dangerous consequences. It is important to visit the cardiologist regularly for prevention. Hidden chronic ischemic disease is an insidious disease, which is accidentally detected even in young people. Without treatment, it can lead to sudden death.
Risk factors for coronary heart disease
There are circumstances predisposing to the appearance of the pathology in question. The development of ischemic heart disease is provoked by the following factors:
- genetics;
- elderly age;
- male;
- arterial hypertension ;
- diabetes;
- dyslipidemia;
- obesity;
- liver dysfunction;
- propensity to atherosclerosis.
Coronary heart disease is more common in people who have an unhealthy lifestyle. It occurs against the background:
- smoking;
- irrational nutrition;
- drinking alcohol;
- hypodynamia;
- non-observance of the working and rest regime.
Ischemic heart disease - symptoms
A typical clinical manifestation of the presented disease is a characteristic pain syndrome localized in the retrosternal region. The remaining signs of coronary heart disease are non-specific, so they are not always associated with the described ailment. With a painless form of pathology, complaints are completely absent, and the general human condition remains normal for a long time. Other symptoms of ischemic disease:
- shortness of breath, especially with physical exertion;
- weakness;
- a feeling of irregularities in the work of the heart, a violation of its rhythm;
- dizziness and nausea;
- swelling of the lower extremities;
- sweating;
- fainting or clouding of consciousness.
Pain in ischemic heart disease
The described pathology is accompanied by discomfort not only in the chest zone. Often ischemic disease causes pain syndrome in other parts of the body:
- hand, predominantly left;
- back;
- lower jaw;
- shoulder;
- scapula.
Unpleasant sensations can have any character (piercing, pulling or pressing). At first, the pain does not last long, for several seconds, and then it subside. Gradually, coronary heart disease progresses, and extensive areas of the myocardium are damaged. This leads to prolonged seizures, during which the symptom in question increases.
Diagnosis of coronary heart disease
At the reception, the cardiologist carefully collects an anamnesis. It is important to establish the nature and duration of the pain syndrome, its relation to physical exertion and the possibility of cupping with nitroglycerin preparations. During a physical examination, the doctor discovers the attendant signs of ischemic disease:
- the presence of edema;
- wet wheezing when breathing;
- crepitation (crunchy sound) in the lungs;
- increase in liver size (hepatomegaly).
The final diagnosis of "ischemic heart disease" is based on instrumental and laboratory methods of examination:
- standard or transesophageal electrocardiography;
- echocardiography ;
- blood tests for protein enzymes, sugar, cholesterol and other indicators;
- coronary angiography.
Ischemic heart disease - treatment
Therapy of this pathology depends on its severity and shape. The cardiologist individually selects ways how to treat ischemic heart disease, but there are general recommendations for all patients:
- Reduce the intensity of any physical activity. Gradually, they can be increased during the rehabilitation period.
- Bring the weight back to normal.
- Limit the intake of salt and water.
- Correct the menu. It is desirable to completely exclude products that contribute to the development of atherosclerosis - animal fats, smoked products, fried foods, pickles, desserts.
- Refuse from drinking and smoking.
To stop the symptoms of IHD and restore the work of the myocardium, a specialist is prescribed a course of drug treatment. If it in combination with general measures does not produce the expected therapeutic effect, surgical intervention is recommended:
- coronary artery bypass grafting (myocardial revascularization);
- balloon angioplasty;
- Stenting;
- bougie of coronary vessels (balloon dilatation).
Treatment of coronary heart disease - drugs
Conservative therapy is developed separately for each cardiologist patient, but there is a standard "ABC" scheme, which involves a combination of 3 groups of medicines:
- antiplatelet agents - Thrombopol, Aspirin, Clopidogrel, Acecardol;
- beta-blockers - Niperten, Egilok, Dilatrend, Concor;
- statins and fibrates - Simvastatin, Lovastatin, Atorvastatin, Fenofibrate.
In the presence of concomitant pathological signs, additional drugs are prescribed. Ischemic disease - treatment:
- anticoagulants - Heparin, Fenilin;
- nitrates - isosorbide mononitrate, Nitroglycerin ;
- diuretics - Lasix, Furosemide;
- lipid-lowering drugs - polikozanol, Nolipid;
- antiarrhythmic drugs - Amiodarone, Cordarone;
- inhibitors of the angiotensin-converting enzyme - Captopril , Enalapril;
- metabolic cytoprotectors - Mexicor, Coronater.
Ischemic disease - treatment with folk remedies
The use of alternative medicine methods is allowed only with the permission of the endocrinologist as symptomatic therapy. With their help, ischemic disease is eased - folk remedies reduce the increased pressure, accelerate the removal of excess fluid from the body and improve metabolism . Normalize the functions of the myocardium and prevent its necrosis, they can not.
Plant harvesting from ischemic heart disease
Ingredients:
- hawthorn flowers - 100 g;
- herb Leonurus - 100 g;
- chamomile color - 100 g;
- boiling water - 120-150 ml.
Preparation, use :
- Dry raw materials to grind and mix.
- A teaspoon of the collection should be poured with boiling water and covered.
- Insist a solution for 20 minutes.
- Strain the liquid.
- Drink the entire amount of medicine in the morning on an empty stomach.
- Continue therapy until persistent improvement in well-being.
Tincture for the heart
Ingredients:
- fresh garlic - 50 g;
- vodka - 120-140 ml.
Preparation, use :
- Grate garlic, do not squeeze juice.
- Pour gruel with vodka, stir.
- Insist means 72 hours.
- Three times a day, take 8 drops of medicine, adding them to a teaspoon of cool, clean water.
- The course of therapy is 7 days.
Decoction
Ingredients:- dry fruits of hawthorn - 20 g;
- water is 200-220 ml.
Preparation, use :
- Boil water, put berries in it.
- Boil the fruit for 2 minutes, turn off the fire.
- Insist the remedy under the lid or in the thermos for 2 hours.
- Strain the solution.
- Half an hour before each meal, drink 2 tablespoons. spoons of medicine.
What is dangerous ischemic heart disease?
The examined pathology is chronic and constantly progressing, causing irreversible damage to the myocardium and dangerous consequences. If ischemic heart disease develops, the complications can be as follows:
- cardiosclerosis ;
- insufficiency of energy metabolism;
- disorders of automatism, conduction and excitability of the myocardium;
- violation of systolic and diastolic muscular functions;
- deterioration of contractility of the left ventricle ("stunned myocardium").
Ischemic heart disease complicated in most cases leads to a steady decrease in the intensity of the coronary circulation. In combination with the listed morphofunctional changes and progressive atherosclerosis of the arteries, this results in chronic heart failure. This disease is often the cause of early death, especially men of adulthood.
Prophylaxis of coronary heart disease
To prevent the development of the described pathology, it is necessary to take measures to maintain circulation in the normal state and prevent atherosclerosis.
Prophylaxis of coronary heart disease:
- Adhere to the rules of healthy eating, preferring a diet low in animal fats and cholesterol.
- Abandon the use of alcohol and smoking.
- Regularly and moderately engage in physical activity.
- Observe the regime of the day, fully sleep.
- Maintain optimal weight.
- Avoid mental and emotional overload.
- Monitor blood pressure.
- Systematically consult a specialist for preventive examinations.
- Perform electrocardiography every year.
- Visit specialized sanatoria, resorts.