Ischemia, the symptoms of which are manifested not only by pain in the chest, is a disorder of the coronary circulation, which leads to insufficient blood supply to the myocardium, metabolic disorders and inadequate supply of oxygen to the heart muscle. Recently, a fairly common disease of the cardiovascular system, which leads to severe irreparable deterioration in health and even death. The risk group includes mainly men, women during the period, as well as after menopause, which, with a change in hormonal levels, brings with it a weakening of the body and provokes many diseases.

There are several forms of cardiac ischemia:

• The initial one is painless. There is a decrease in blood pressure, discomfort in the chest, shortness of breath.
• Primary arrest - characterized by cardiac arrest. In this case, without immediate professional help, it leads to death.
• Angina. There is a blockage of the coronary arteries with plaques that cause pain in the chest, arm, neck, and facial part.
• Heart attack. Termination of the full flow of blood to the heart.
• Heart failure or cardiosclerosis. Scarring of areas of the heart, violation of the shape of the valves.

If you do not seek medical help in a timely manner, serious complications are possible. At the first sign, you should immediately consult a doctor. The cardiovascular system is involved in the process of blood circulation of the whole organism, and the heart, as its independent organ, also needs blood supply. Coronary vessels or arteries feed the myocardium and heart muscle.

But there are reasons that lead to disruption of this process and the development of coronary disease:

• Atherosclerosis. The formation of cholesterol on the walls of blood vessels.
• Arterial hypertension. Due to the constant increase in blood pressure, there is an increase in the left ventricle and a violation of the full blood supply.
• Diabetes. It leads to the formation of cholesterol plaques, which impede blood circulation.
• Thrombosis. The mechanism of rapid blood clotting makes it impossible for it to enter the organs through the vessels.

These diseases often not only provoke ischemia, but are subsequently concomitant diseases. Much complicate the treatment and recovery of patients.

Provoke violations and improper functioning of the organs of the cardiovascular system can not only diseases, but also the characteristics of the body and the life of the person himself:

• Stress, nervous strain. They lead to constant arrhythmia, disruption of the supply of nutrients and oxygen to the organs.
• genetic predisposition. It is inherited along with the genetic code.
• Gender identity. In men, ischemia is more common.
• Excess weight. Exceeding normal body weight leads to an increase in the volume of blood that the heart must push out in one contraction. The tone of the walls gradually worsens, the load on the vessels increases.
• Having bad habits. Smoking provokes an excessive amount of carbon monoxide and a lack of oxygen in the blood.

Gradually and with age, the vessels lose their elasticity, so after 45-50 years there is a high probability that ischemia will appear. Symptoms in the stronger sex are more pronounced, as they are more vulnerable to ischemia. This is due not only to physiological characteristics. The reasons are difficult working conditions, bad habits and stressful situations.

An untimely visit to a doctor when there are complaints of coronary artery disease leads to coronary heart disease, which manifests itself in men with characteristic symptoms:

• severe pain in the chest;
• lack of air, shortness of breath;
• fainting, darkening in the eyes;
• dizziness and migraine;
• bouts of nausea;
• increased sweating;
• arrhythmias.

The prerequisites for the appearance of cardiac ischemia in this case are atherosclerosis, the formation of blood clots in the vessels, elevated cholesterol levels and spasms of the coronary vessels. All this contributes to a lack of nutrients in the body and disruption of the full process of blood circulation.

Signs of ischemia of the heart in women and children

Signs of cardiac ischemia in women are not as bright as in men, since for a long time only men were susceptible to cardiac ischemia. In women, this disease was observed quite rarely. Now it is considered age-related and manifests itself during menopause. Changes occurring in the body, lack of estrogen affects the work of the cardiovascular system in 20% of women.

Women still have individual signs of cardiac ischemia:

• bouts of acute sharp pain in the back;
• short angina - lasts no more than 15 minutes;
• dyspnea;
• indigestion;
• swelling of the extremities may appear in the evening;
• loss of consciousness or frequent dizziness.

In women, the cause for ischemia of the heart can be stress, hard mental work, age from 55 years. Then, as in men, the disease begins by the age of 40.

Diseases of the cardiovascular system affect even young children. There are several reasons for their occurrence. These include heredity, overwork during the educational process, congenital pathologies.

In a child, ischemia shows its characteristic symptoms:

• Pain, feeling of constriction of the chest. The duration reaches 30 minutes.
• Numbness and sharp pain in the left side of the face, arm and forearm.
• Lack of oxygen, shortness of breath, signs of suffocation.

In most cases, even the drug "Nitroglycerin" is not able to alleviate the condition. In childhood, mortality from coronary disease is much higher. Therefore, at the first even the slightest suspicion of a violation of the heart, it is urgently required to call an ambulance.

An ischemic attack usually begins after heavy physical exertion or a strong emotional shock. A person feels squeezing pain in the chest, there is profuse sweating.

In such cases, it is necessary to know exactly the rules of how to provide first aid for angina pectoris:

• immediately call an ambulance;
• it is convenient to put the patient on the bed, raising his head and loosening the belt and collar of the clothes;
• try to calm and distract;
• open windows, turn on a fan or air conditioner in the summer;
• pour warm water into a heating pad and place it at the feet of the patient.

You can also give the drug "Nitroglycerin", depending on the severity, you can give from 1 to 4 tablets. A person should put them under the tongue and dissolve.

It is impossible for angina pectoris to cause excitement, give unfamiliar drugs and force a person to move. Until the ambulance arrives, it is better to keep quiet and, in case of severe anxiety, apply valerian tincture.

The best way to avoid ischemia is to constantly monitor your health and undergo a medical examination. In the case when symptoms suddenly appear in the chest or left side of the body, contact a specialist.

The main measures for the prevention of coronary disease are simple daily rules that must be observed:

• Stick to a healthy nutritious diet. Control weight, avoid obesity.
• Move more and accustom the body to walks in the fresh air.
• Don't forget about physical activity.
• Get rid of bad habits.
• With a hereditary predisposition, spend more time visiting doctors.
• Take, on the advice of a specialist, drugs that strengthen the heart and blood vessels, for example, Entresto (you can read about the drug) or Kordanum medicine.

Many diseases are the result of the wrong way of life of the person himself. It is necessary to take into account environmental problems, which also play a large role in the deterioration of health. In every possible way avoid stressful situations and excessive loads.

Ischemic heart disease (CHD) is a real scourge of our time. They talk about it much less than about cancer or AIDS, but according to statistics, death from heart disease occupies a leading place in Russia, and in half of the cases the disease that led to death was coronary artery disease.

Causes, groups and risk factors

Ischemic heart disease is a blockage of the coronary artery, which leads to, that is, the necrosis of part of the heart muscle due to oxygen starvation. This can lead to:

• Smoking. Sudden death syndrome from heart disease occurs 5 times more often in those who smoke regularly. The reason for this is the effect of nicotine on blood vessels. It damages their tissues, narrows, provokes the development of atherosclerosis. Especially strong is the effect of nicotine on women. They have a degree of damage to the vessels of the heart from smoking 2 times more than men.
  

  23% of deaths from coronary artery disease are caused by the daily intake of a dose of nicotine and combustion products into the body.

• Excess weight. Obesity is a sign of lipid metabolism disorders. Fat cells enter the bloodstream and can cause thrombosis of the heart arteries, which leads to a heart attack. The danger arises when the overweight index exceeds 0.25. It is calculated by the formula: weight (kilogram) / height (meters) squared.
• Constant stress state. Nervous strain causes narrowing of the coronary vessels. If they already have cholesterol plaques, then this process can accelerate blockage.
• Sedentary lifestyle because it contributes to the development of obesity and atherosclerosis.

Particularly susceptible to coronary artery disease and are at risk:

• People with hereditary predisposition. Direct relatives who have had myocardial infarctions, or who have suffered from angina pectoris, are a warning about vascular problems inherent in this genotype.
• Men. Statistically confirmed that most often. The chances are equalized when a woman begins menopause.
• Dyslipidemics. These are people with elevated levels of cholesterol in the blood, an imbalance in its fractions, an increase in triglycerides and low-density lipoproteins (LDL). The norm of cholesterol is 5 mmol / liter, triglycerides - no higher than 1.7 mmol / liter, LDL - 3 mmol / liter for those who have not had a myocardial infarction and no more than 1.8 mmol / liter for those who have already suffered so clear manifestation of IBS.
• Diabetics. Diabetes mellitus at least 2 times increases the risk of developing coronary heart disease. In addition, it often leads to weight gain (especially type II).
• . The higher the blood pressure, the more likely it is to develop coronary heart disease and heart attacks. It must be maintained no higher than 140/90, but it is advisable to lower it to 120/80-130/80.
• Elderly people. With age, due to adverse environmental factors, bad habits, poor nutrition, vascular wear occurs and the likelihood of thrombosis increases.

Classification

Since 1984, there has been a unified classification of forms of coronary heart disease:

1. Sudden coronary death also known as primary cardiac arrest. This definition includes the cessation of the work of the heart muscle during an attack, or within 6 hours after it. It can be of the following types, depending on the consequences:
   • fatal outcome;
   • successful resuscitation.
2. angina pectoris. It manifests itself in the form of a sharp or pulling pain in the chest, extending to the left arm, neck and jaw. The diagnostic sign is that the pain syndrome appears during physical activity (running, walking, climbing stairs), and disappears after taking nitroglycerin or rest.
   There are the following types of angina pectoris:
   • - the most dangerous period of coronary artery disease, which can end in a fatal heart attack. The pain attack lasts from 1 to 10 minutes, the pain is characterized as pressing or burning. The reason is the poor permeability of blood through an artery or vessel due to lipid accumulations. Unstable angina is divided into new onset, early postinfarction and progressive.
   • Diagnosed if symptoms do not develop within 2 months. The reason is the same as for the unstable form. The pain appears with loads on the body and lasts 5-10 minutes. It has 4 severity classes. At the first moderate physical activity is allowed, the symptomatology of the fourth class suggests the maximum restriction of movements, since angina pectoris can occur even at rest.
   • occurs regardless of whether there was a physical load or nervous strain. Otherwise, it is also called variable, spontaneous, Prinzmetal's angina. This type is considered rare, it is characteristic of only 2% of patients with angina pectoris.
   • Coronary syndrome X or is a pathology in which an imbalance in the supply of oxygen to the cells of the heart (ischemia) was not provoked by arterial hypertension or atherosclerosis. The cause of coronary syndrome X has not been established. There are several theories on this subject: anatomical or metabolic disorders in the vessels, increased pain sensitivity. Women are more susceptible to this type of angina pectoris.
3. myocardial infarction, that is, necrosis of part of the tissues of the heart muscle caused by oxygen starvation. Usually death occurs half an hour after the onset of an attack, which, unlike angina pectoris, is not blocked by taking nitroglycerin. But there are atypical heart attacks, in which there is no pain in the sternum, but there is shortness of breath, pain in the abdomen, confusion of speech and consciousness. With the last symptoms, it can be confused with. Due to diabetes, a “silent” myocardial infarction can occur, that is, there will be no signs of the death of heart tissue.
   Depending on the degree of tissue damage, there are:
   • Small-focal infarction - diagnosed when the occlusion of the vessel was incomplete, in the affected area there were bypass routes for blood flow, or there was a blockage of small branches of the artery, which did not lead to large-scale tissue necrosis.
   • Large-focal myocardial infarction implies complete or significant damage to the heart muscle. It is extremely dangerous, in 30-40% of cases this type of heart attack ends with the death of the patient on the very first day after the attack.
4. Postinfarction cardiosclerosis manifests itself if myocardial infarction has passed relatively well. It is diagnosed after 2-4 months. After an attack. Such scars are dangerous in themselves, as they can interfere with the normal functioning of the heart muscle. A scar that is too large leads to an aneurysm of the heart. It is removed operably, otherwise it can burst and kill a person.
   Depending on the location of the scars on the heart, there are various symptoms of postinfarction cardiosclerosis. Attacks of cardiac asthma may occur, angina pectoris, atrial fibrillation, edema of the lower extremities, atrioventricular blockade, acrocyanosis appear.

   

5. Heart failure occurs when the body's metabolic requirements are greater than the activity of the heart muscle can provide. That is, the frequency and strength of heart beats is not enough to drive enough blood through the body and enrich all tissues with oxygen and nutrients. There are 4 classes, 2 stages (chronic and acute) and 3 types of localization (left ventricular, right ventricular and mixed) of heart failure. The main symptoms are severe shortness of breath and heart rhythm disturbances.
6. stand out in a separate form of IHD. The main forms are tachycardia (increase) and bradycardia (deceleration). Also, arrhythmias are divided depending on the place and causes of occurrence.
7. Painless form of myocardial ischemia is a special type of manifestation of IHD. It has all the causes and consequences of coronary disease, but the patient has no pain syndrome at all. This is associated with the death of nerve cells in previous heart attacks, short manifestations of ischemia (less than 3 minutes), a decrease in receptors that recognize adenosine (an activator of painful impulses), or a decrease in the production of adenosine, the release of natural painkillers by the body, the influence of toxins and the reaction to drugs.
8. Acute coronary syndrome- this is a combination and constant or one-time joint course of various forms of coronary heart disease. Often, angina pectoris is accompanied by arrhythmia and can result in myocardial infarction or postinfarction cardiosclerosis and stable angina pectoris with concomitant chronic heart failure, which are observed simultaneously.

Symptoms

Ischemic disease can progress very slowly, for example, over decades. Therefore, it is important to pay attention to the first signs of coronary artery disease, which often appear in combination. These include:

• fast fatiguability;
• shortness of breath with little physical exertion;
• sweating;
• sudden fainting;
• dizziness;
• cloudiness of consciousness;
• leg swelling.

In the process of development of IHD, the above forms appear with their characteristic symptoms. Most often, they are heart rhythm failures and retrosternal pain, which radiates to the arm, neck, jaw, and even teeth.

Ischemic heart disease has an undulating course, which means periods of exacerbation and normal well-being. They can be related to the weather, sleep and nutrition, the level of physical activity, the course of diseases that led to the development of coronary artery disease.

In women, exacerbations of heart disease are often associated with the period of the menstrual cycle or the onset of menopause.

Diagnostics

Diagnosis always begins with an examination and questioning of the patient. It is important not only to determine the presence of ischemia, but also to find out the specific form of the disease for the correct treatment.

Then you need to donate blood for tests to find out the content of sugar, cholesterol and enzymes characteristic of angina pectoris.

If you suspect the presence of heart disease appoint:

• Electrocardiogram (ECG). It is a recording of the electrical activity of the heart. The procedure takes several minutes. Conductors are attached to the chest, legs and arms, and a special device records the work of the heart.
• There is a variation of the ECG with stress. She is prescribed to clarify the diagnosis. A person undergoes an ECG while doing physical activity, usually they are running on a treadmill.
• If the previous test did not give a clear result, then the patient is injected with a radionuclide, usually a thallium isotope is used, which is why this diagnostic method has a second name - a thallium examination. After, the sick person spends some time in a calm state, and the second part of the test involves a load. At this time, it is filmed by a special camera. Based on the analysis of the record, a diagnosis is made. There are cases when the direct implementation of physical exercises is impossible, due to age, excessive excess weight or injuries. Then the subject is injected with drugs that simulate the load: dobutamine, adenosine, dipyridamole.
• Holter ECG. This examination is prescribed if a person complains of occasional arrhythmia, shortness of breath, fainting and other symptoms of coronary artery disease.
• The subject is put on a device that records all changes in the heart rhythm during the day. Along the way, the patient keeps a diary. Based on the data obtained, a diagnosis is made. Diagnostics can be carried out both on an outpatient basis and in a hospital. Depending on the state of health of the patient.

This method of diagnosis allows you to identify what situations of everyday life provoke seizures, how they affect the work of the heart muscle.

• Ultrasound of the heart. Thanks to him, in 85% of cases, the degree of heart damage is accurately determined. On ultrasound, you can see scars, clogged vessels, dystrophy of individual sections of the heart muscle.
• MRI of the heart. Carried out under the influence of frequency radio pulses and a magnetic field. As a result of information processing on a computer, images of the heart, blood vessels and pericardial tissues are obtained.
• Coronography. A catheter with an iodine-containing contrast agent is inserted into the artery of the inguinal zone and brought to the cardiac artery, where the drug is released into the bloodstream. This method gives a clear picture of the state of the vessels of the heart.
• High quality computed radiography. This diagnostic method has become available only recently. An x-ray beam scans the heart at high speed. The data obtained make it possible to create a detailed three-dimensional model of the organ and its sections.

Treatment

IHD therapy involves reducing the oxygen consumed by the heart or creating conditions for its greater access. Conventionally, treatment can be divided into several groups.

Conservative medical treatment

It includes the following groups of drugs:

• Antiplatelet agents. They are designed to remove the viscosity of the blood, to make it less thick. These include clopidogrel, acetylsalicylic acid.
• Diuretics. Necessary to remove excess fluid from the body. This reduces the load on the myocardium.
• Anticoagulants. A proven heparin is usually prescribed. It perfectly thins the blood and prevents thrombosis.
• Beta blockers. These drugs reduce the frequency of myocardial contractions. These include metoprolol, carvedilol. But, they can not be taken in diseases of the bronchi and lungs.
• Nitrates. The main one is nitroglycerin. It relieves an attack of angina pectoris, as it dilates blood vessels and lowers blood pressure. Therefore, taking this drug with low blood pressure is prohibited.
• Beds and fibrators. They are designed to lower blood cholesterol levels.

Non-drug methods

These include:

• massages;
• quantum therapy;
• hirudotherapy;
• shock wave treatment;
• increased external counterpulsation.

Preliminary consultation with the attending physician is required.

Surgical intervention

It is resorted to, as a last resort, if drug treatment has not shown a positive trend. There are such types of surgery:

1. An operation that removes a blockage in a blood vessel is called bypass. The patient's own veins removed from the thigh or internal mammary artery act as shunts. Shunting is of 2 types:
   • Coronary. During it, the coronary vessels are connected by shunts to the external ones.
   • Aortocoronary - fastening of the aorta and coronary artery.
2. Balloon vascular dilatation method. It involves the introduction of special substances through a balloon. These drugs expand the damaged vessel.
3. Percutaneous intraluminal angioplasty is an operation to introduce a metal ring that restores the lumen in the vessel and maintains it.

Folk remedies

Before using any method of alternative medicine, the patient should consult with the attending cardiologist and therapist.

It should be remembered that medicinal herbs do not give a quick therapeutic effect.

The most common folk remedies:

• hawthorn tea. Regular use with weekly breaks once a month is allowed. Hawthorn fruits normalize blood pressure, increase blood supply to the coronary vessels. When brewing, motherwort can be added to it, which calms the nervous system. Tea can be drunk cold or hot, but sweeteners should not be added to it. If there is inflammation in the body, then ordinary chamomile flowers are added.
• Heather decoction. After brewing, it is insisted for a day. Then you can use 50 milliliters per day. Heather helps regulate heart rhythms.
• Garlic removes cholesterol from the body, dilates blood vessels. To prepare it in the most useful way for the treatment of ischemia, it is necessary to grind, mix with honey in equal proportions and put in a cool dark place for 7 days. After taking 1 tablespoon half an hour before meals three times a day.

Medicinal herbs useful in IHD include sweet clover, linden, meadowsweet, raspberries, horsetail, oregano, moritz, and a letter.

1. You can not play sports, overstrain physically and emotionally. In the initial stages of the development of the disease, walking, cycling and swimming are allowed.
2. Follow a prescribed diet that excludes:
   • salty;
   • smoked meats;
   • fried food;
   • fast digestible carbohydrates (chocolate, pastries, cakes, cookies, etc.);
   • animal fats (butter, lard, fatty meats).
3. If you are overweight, your daily calorie intake is reduced in order to lose weight.
4. It is recommended to eat foods rich in magnesium, potassium, fiber and proteins:
   • nuts;
   • grenades;
   • citruses;
   • seaweed;
   • seafood.

   Any diet will be powerless if a person does not give up passive or active smoking, drinking alcohol.

5. Stick to a daily routine and sleep well. Sleep is very beneficial for vascular health.

Forecast how long they live

It is impossible to say unequivocally who and how long will live with coronary heart disease. It develops individually. The prognosis is generally considered unfavorable, since the disease is chronic.

Treatment involves a complete change in the habits and daily routine of the patient. He must adhere to a healthy lifestyle, regularly undergo examinations and take courses of drugs.

It is also important what form the IHD took and how quickly it was detected. The earlier the diagnosis is made, the easier it is to stop the development of the disease.

Possible Complications

It is difficult to talk about complications in the context of the disease, the forms of which are heart attack and cardiac arrest. By itself, IHD is already terrible in its manifestations.

But myocardial ischemia can create favorable conditions for the appearance and development of:

• congestive gastritis;
• flatulence;
• abdominal dropsy;
• stroke.

Prevention

The most effective prevention is to eliminate the causes that can trigger the development of coronary heart disease. This will require:

• Quit nicotine addiction.
• Avoid alcohol intoxication.
• Monitor weight, cholesterol and sugar levels.
• Eat properly.
• Exercise moderately to control body weight, but not overstrain the heart muscle.
• Normalize the daily routine so that there is enough time left for sleep and leisure.
• Find a way to psycho-emotional unloading. It can be a hobby, travel, sessions with a psychotherapist.
• Start keeping a blood pressure diary. Data is entered in the morning and evening, if sharp jumps are noticed, it is necessary to visit a doctor.

In addition to all of the above, it is very important to observe your mental state. Stressful work, difficulties in the family, crises in creativity - all this first of all strikes at the heart. You should learn an even internal approach to life's troubles, or, if possible, change the traumatic environment to a more gentle one.

You can find out more information about the nature, causes and course of coronary heart disease by watching the video:

Ischemic heart disease is a life-threatening disease caused by lack of oxygen in the heart muscle. IHD is difficult to diagnose, treatment depends on the degree of its neglect. For timely detection of violations, you should regularly visit a cardiologist and monitor the level of cholesterol in the blood.

Ischemic heart disease is not in vain considered one of the most common and dangerous heart diseases. Unfortunately, it knows no boundaries, neither age, nor geographical, nor economic.

Ischemic heart disease can strike by surprise

Sometimes, instead of the term "coronary heart disease", the names "ischemia", "coronary disease" or "coronary sclerosis" are used, these terms were in the list of diseases of the WHO in the last century. But even now, in some sources, and in medical practice, these names of the disease are found, which have different stages, require different methods of treatment, and therefore bear different names.

signs

Most often, ischemia signals its presence with periodic bouts of burning pain in the chest. The pain is severe, its character is oppressive.

Sometimes signs of coronary heart disease are complaints of patients about a feeling of general weakness, nausea and an unpleasant feeling of lack of air. Pain in this case can be localized between the shoulder blades, felt behind the sternum, in the neck or left arm.

Painful sensations are the first signs of this disease. You should listen carefully to your own well-being, and as soon as the slightest suspicion of heart problems is felt, it is better to immediately contact a cardiologist.

If before such reactions of the body did not occur, this is the first sign of the need for a cardiological examination.

Discomfort in the chest is also an alarm signal of the body.

In some people suffering from this ailment, it is manifested by pain in the back, left arm, lower jaw. Also, symptoms of coronary heart disease are changes in heart rate, shortness of breath, heavy sweating, nausea.

If none of the listed signs of the disease is present, it is still sometimes important to be examined, albeit with a preventive purpose, because coronary heart disease in a third of patients does not manifest itself at all.

The reasons

Clinically, coronary heart disease (CHD) characterizes a chronic pathological process caused by insufficient blood supply to the myocardium, or heart muscle.

Violation of the blood supply to the myocardium occurs due to damage to the coronary arteries, and can be absolute or relative.

The reason for the lack of oxygen in the myocardium is the blockage of the coronary arteries, which can be caused by a thrombus formed, a temporary spasm of the coronary artery, or atherosclerotic plaques accumulated in the vessel. Sometimes the reason lies in their fatal combination. Violation of normal blood flow in the coronary arteries and causes myocardial ischemia.

Throughout life, each person to some extent has deposits of cholesterol and calcium, in the walls of the coronary vessels there is an overgrowth of connective tissue, which leads to a thickening of their inner membrane and a narrowing of the total lumen of the vessel.

As you can see, the risk of the disease increases with age.

Narrowing of the coronary arteries, which leads to a partial limitation of the blood supply to the heart muscle, can cause angina attacks. These attacks most often occur with a sharp increase in the workload on the heart and its need for additional oxygen.

The occurrence of thrombosis of the coronary arteries is also caused by the narrowing of their lumen. The danger of coronary thrombosis is that it is the cause of myocardial infarction, leading to necrosis and further scarring of the affected area of ​​the heart tissue.

In addition, this also leads to dysrhythmia or heart block, in the worst case scenario of the progression of the disease.

Classification

In accordance with the clinical manifestations, causes of occurrence and degree of progression, IHD has several clinical forms that occur in patients individually or in combination: angina pectoris, myocardial infarction, cardiosclerosis.

Currently, physicians use the modern classification of coronary heart disease, adopted in 1984 by the WHO with amendments and additions by the VKSC.

According to this classification, all the various features of the clinical manifestations of cardiac ischemia, as well as the corresponding prognosis and treatment methods, can be combined into the following groups:

• sudden coronary death, or primary cardiac arrest - according to the results of treatment, two groups of primary cardiac arrest are distinguished - with the practice of successful resuscitation or with a fatal outcome;
• angina pectoris, which in turn is subdivided into angina pectoris, unstable and vasospastic angina pectoris;
• myocardial infarction;
• postinfarction cardiosclerosis;
• heart rhythm disturbances;
• heart failure.

In addition to this systematizing picture of the various manifestations of coronary artery disease, until recently there was another classification recommended by WHO experts in 1979.

Death statistics

According to the then method of dividing coronary artery disease into classification groups, in the clinical form "angina pectoris" a subgroup "coronary syndrome X" was distinguished, unstable angina pectoris was considered in three different clinical manifestations. Also, such a picture of the disease as “painless form of coronary artery disease” was allocated to a separate diagnosed group.

Compliance with the classification of the disease when making a diagnosis is of paramount importance for the success of all further treatment of the patient.

It is unacceptable to formulate a diagnosis of coronary artery disease for a patient without subsequent decoding of the form, because in general such a diagnosis does not at all clarify the real information either about the nature of the disease or about the criteria for choosing the optimal method of treatment.

A correctly formulated diagnosis, in which the clinical form of the disease through the colon follows the general diagnosis of CAD, is the first step towards choosing a further course of treatment.

Acute and chronic forms

The course of cardiac ischemia is undulating, alternating periods of acute coronary insufficiency (coronary crises) that occur against the background of chronic, or relative, insufficiency of the coronary circulation. Accordingly, acute and chronic forms of coronary artery disease are distinguished.

The acute form of IHD is manifested by ischemic myocardial dystrophy and myocardial infarction. Often, ischemic myocardial dystrophy leads to acute heart failure, a complication that often becomes the direct cause of sudden death.

myocardial infarction

Myocardial infarction is the necrosis of the heart muscle caused by coronary artery disease. As a rule, this is an ischemic infarction with a hemorrhagic corolla.

In the systematization of IHD, the forms that characterize chronic coronary heart disease are diffuse small-focal cardiosclerosis or large-focal post-infarction. The latter in some cases is complicated by chronic aneurysm of the heart.

Both acute ischemic heart disease and the chronic form of this disease can cause irreparable damage to the health and life of the patient.

The impact of bad habits

According to WHO statistics, among the various causes of coronary artery disease and other cardiovascular diseases, there are those that most often lead to the development of cardiac pathologies.

Risk factors for CAD include:

• increased blood cholesterol, or hypercholesterolemia;
• carbohydrate metabolism disorders, especially diabetes mellitus;
• arterial hypertension;
• prolonged use of alcohol;
• smoking;
• obesity;
• physical inactivity against the background of stress instability;
• individual characteristics of behavior.

As can be seen from the listed causes leading to the occurrence of coronary artery disease, this disease often has a number of causes, being complex. Therefore, measures for its prevention and treatment should also be comprehensive. Patients suffering from ischemia of the heart, you must first get rid of bad habits.

Smoking

One of the habits that most often lead to coronary atherosclerosis and myocardial infarction is smoking. Long-term smoking has a narrowing effect on the coronary vessels, and also leads to increased blood clotting and slowing of blood flow.

smoking is poison

Another reason for the harmful effects of nicotine on the heart is that nicotine causes an increased flow of adrenaline and norepinephrine into the blood, substances that are released in large quantities during emotional and physical overload, or stress.

Their excessive concentration leads to insufficiency of the coronary circulation due to an increase in the demand of the heart muscle for oxygen. Also, adrenaline and norepinephrine have a damaging effect on the inner surface of blood vessels.

The recently established similarity of the negative effects on the cardiovascular system of long-term negative emotions and nicotine proves how mistaken is the habit of many smokers to puff on the next cigarette to calm down.

Alcohol

This is the second most harmful habit for patients diagnosed with coronary artery disease. According to statistical medical data, among men, about a third of patients with myocardial infarction abuse alcohol. Drinking alcohol often causes an attack of angina pectoris.

A feature of coronary artery lesions in alcohol-dependent patients is a high degree of development of the disease process. Among non-alcoholic patients of the same age, this process is much less associated with pain.

The insidiousness of alcohol is that immediately after taking it, a slight narcotic effect occurs, pain disappears and a false impression arises about the vasodilating effect of alcohol on the heart. Very soon, however, there is a rapid vasospasm, an increase in blood viscosity leads to impaired blood flow.

Therefore, in the stage of intoxication of patients, there are so many heart and brain attacks that are very difficult to stop, especially if we take into account the incorrect action of cardiac glycosides against the background of the presence of alcohol in the blood.

Obesity

Obesity is another scourge that whips up the heart muscle. It has a negative effect on the cardiovascular system through a direct effect on the heart muscle (muscle obesity), as well as setting in motion a complex mechanism of nervous and hormonal effects.

Hypodynamia

Physical inactivity is now recognized as one of the most influential factors triggering the occurrence of coronary heart disease.

Passive lifestyle is the right way to CHD

A sedentary lifestyle is a serious reason for the development of atherosclerosis, thrombosis and other disorders of the normal functioning of the cardiovascular system.

A global problem

The dynamics of recovery of patients with IHD is largely determined by the timeliness and quality of diagnosis of the clinical form of the disease, the adequacy of the prescribed outpatient treatment, as well as the timeliness of urgent hospitalization and emergency cardiac surgery.

Sad European statistics claim that coronary artery disease, together with a stroke of the brain, make up a catastrophic majority, namely 90% of all diseases of the cardiovascular system.

This indicates that coronary heart disease is one of the most common diseases, as well as the most common causes of death in modern man.

It often leads to long-term and permanent disability of the active population, even in the most developed countries of the world. All this characterizes the task of finding more effective methods of treating IHD as one of the leading tasks among the first medical problems of the 21st century.

Signs of coronary heart disease

In this article, we will look at the main signs of coronary artery disease in adults.

Symptoms

The main clinical forms of ischemic heart disease include: angina pectoris (the most common initial form), acute myocardial infarction. cardiac arrhythmias, heart failure. as well as sudden coronary cardiac arrest. All of the above stages of coronary artery disease differ from each other in their severity and the presence of secondary complications.

The main signs of coronary artery disease, which should alert the patient and force him to consult a doctor for medical help, are: frequent shortness of breath, weakness, periodic pain in the chest, dizziness, sweating. These symptoms occur in more than 80% of all initial stages of coronary disease.

In most cases, patients note a significant deterioration in general well-being as a result of increased physical activity on the body, which aggravates the course of the disease.

As coronary heart disease progresses, there may be a significant aggravation of the resulting angina attacks, which indicates a fairly rapid deterioration of the underlying disease.

It should also be noted that recently there has been a fairly large number of cases of the development of painless forms of coronary artery disease, which are quite difficult to detect in the early stages of development, and which are much worse treatable. Therefore, it is very important at the slightest disturbance of the heart to consult a cardiologist in a timely manner to prevent the development of undesirable consequences.

angina pectoris is an early and initial sign of coronary artery disease, which is manifested by periodic pain in the region of the heart, chest, giving under the left arm, shoulder blade, in the jaw. The pain may be accompanied by tingling, squeezing, be quite pressing, and generally last no more than 10-15 minutes. then remissions are possible again.

Angina pectoris or, as the people say, "angina pectoris" can be of 2 types: tension and calm. The first occurs under the influence of physical stress on the body, it can develop as a result of stress or psycho-emotional disorders. Rest angina mostly occurs without cause, in some cases an attack can occur during sleep.

Both types of angina pectoris are very well removed by taking 1-2 tons of nitroglycerin under the tongue with a minimum interval between doses of at least 10 minutes.

Remember: this type of coronary artery disease requires a mandatory consultation with a cardiologist with a cardiogram of the heart and the appointment of an appropriate treatment so as not to provoke further progression of the disease and its possible transition to a more severe, life-threatening stage for the patient.

Advanced myocardial infarction is a very serious complication of coronary artery disease requiring emergency medical care. The main signs of a heart attack are severe, pressing and compressive pain in the region of the heart, which is not relieved by nitroglycerin preparations. In addition, a heart attack may be accompanied by shortness of breath, weakness, nausea, or vomiting, mostly yellowish in color.

The attack causes a feeling of fear, anxiety, general weakness, dizziness, in the area of ​​\u200b\u200bthe heart there may be a strong contraction, tingling.

In some cases, a feeling of severe pain can cause a sudden loss of consciousness in the patient.

Therefore, in cases of acute myocardial infarction, the patient should be immediately hospitalized in order to avoid death and prevent the possible development of unwanted complications.

Chronic heart failure is one of the main signs of coronary heart disease, which is manifested by constant shortness of breath, the patient complains that he does not have enough air, he begins to periodically suffocate, the upper and lower tissue covers of the body become bluish in color, as a result of acute circulatory disorders, local blood stagnation occurs , the patient's chest becomes barrel-shaped.

With all the data, the above signs of coronary artery disease, it is necessary to go to the hospital as soon as possible to a cardiologist in order to timely diagnose the disease, since the development of coronary artery disease at its first stage can be at least slightly suspended in its further progression.

Sudden cardiac arrest(coronary death) is a formidable complication of acute myocardial infarction, as a result of untimely provision of emergency medical care for it. It is manifested by a sharp cessation of cardiac activity with a stop to the further functioning of all vital organs and systems.

If in the next 2-3 minutes. the patient will not be provided with urgent resuscitation, then after 4-6 minutes. irreversible processes occur in the cerebral cortex and central nervous system, which leads to complete biological death.

Attention: timely diagnosis of the disease at an early stage of its development will allow you to carry out a fairly effective treatment, as well as prevent the further development of unwanted complications.

Diagnostics

• examination of the patient by a doctor, patient complaints of pain in the chest area;
• obligatory electrocardiogram of the heart;
• coronary angiography (makes it possible to determine the state of the coronary arteries of the heart, as well as to identify the presence of pathological changes in them);
• computed tomography of the chest cavity;
• angiography of the main arteries of the heart.

In this article, we found out the main signs of coronary heart disease.

Manifestations of coronary heart disease

The word heart attack means the necrosis of a part of the tissue of any organ due to a violation of the patency of the vessel that feeds this tissue. In addition to myocardial infarction (heart), there are infarctions of the lung, kidney, spleen and other organs. All of them occur in cases where one of the relatively large arteries supplying this organ with blood is clogged and a part of the tissue that received oxygen and all the substances necessary for its vital activity from this artery undergoes dystrophy and dies. Due to the morphological and functional features of the heart muscle and the arteries supplying it, the frequency of myocardial infarction is incomparably higher than the frequency of lesions of this kind of other organs. At the site of the formed myocardial infarction (Fig. 4), scar connective tissue gradually develops in the future, which is functionally unequal to the heart muscle. In this regard, if the myocardial infarction is large in area, heart weakness and other complications occur, leading to adverse consequences.

A person with a completely healthy heart can suffer from a myocardial infarction due to damage to one of the coronary arteries that feed the heart.

So, myocardial infarction is a catastrophe caused by complete or partial blockage of the coronary artery. When the lumen of the vessel is partially closed, the possibility of infarction will be determined by how large the discrepancy between the needs of the myocardium in

oxygen (which depends on the intensity of the work of the heart) and the actual supply of the heart muscle with arterial blood.

With complete blockage of the coronary artery, energy-rich phosphorus compounds - ATP and CF - are quickly consumed in the heart muscle. This leads to the fact that a part of the heart muscle, the supply of which has stopped due to a violation of the patency of the artery, stops contracting after a short time, and the muscle cells in this place do not recover ATP and CF

soon die. As a result of the cessation of contractions of a relatively large part of the left ventricle, cardiac weakness (failure) develops, which sharply aggravates the condition of a sick person.

In most cases, the lumen of the coronary artery narrows gradually as a result of the formation of one or more atherosclerotic plaques in one of the sections of the vessel, which we will discuss in more detail below. Sometimes the plaque itself is small, but a blood clot forms on its rough or ulcerated surface, which completely or partially closes the lumen of the artery. An increase in blood pressure contributes to an additional narrowing of the artery at the location of the atherosclerotic plaque. With excessive physical stress, even a small plaque can be an obstacle to a sharply increasing blood flow through the coronary arteries and cause the development of myocardial infarction. It is very likely that the episode known to us from the history of Ancient Greece with the messenger from Marathon, who ran 42 km to Athens and fell dead, is such an example.

Close to a heart attack is another manifestation of atherosclerosis of the coronary arteries - angina pectoris, characterized by pain in the heart, behind the sternum, often radiating to the left arm or shoulder blade. Just like myocardial infarction, angina is the result of insufficient blood supply to the heart muscle (ischemia).

At the suggestion of the World Health Organization, the term "ischemic heart disease" has been established, which refers to all conditions accompanied by insufficient blood supply to the heart muscle.

Rice. 4. Myocardial infarction, which developed as a result of blockage of one of the branches of the left coronary artery (indicated by an arrow)

Thus, angina pectoris, myocardial infarction, very often various disturbances in the rhythmic work of the heart (arrhythmias), as well as cases of sudden death (see below) are manifestations of the same disease - coronary heart disease (CHD).

In coronary artery disease, the supply of oxygen to the heart muscle lags behind the actual need for oxygen, while normally, the supply of oxygen to the myocardium exceeds the need for it. As a result of myocardial ischemia, signs characteristic of IHD appear (Fig. 5).

Rice. 5. Scheme of the occurrence of myocardial ischemia and some of its manifestations

Of course, there are many different forms of myocardial infarction and angina pectoris. Sometimes it is difficult to draw a clear clinical line between a prolonged attack of angina pectoris and a non-severe myocardial infarction. Some patients suffer from angina pectoris for many years without causing serious consequences. However, more often angina pectoris serves as a prelude to myocardial infarction or eventually leads to cardiac weakness or irregular work of the heart.

There are many cases when a myocardial infarction is preceded by only a few attacks of angina pectoris, to which a person did not attach any importance and did not consider it necessary to consult a doctor.

In close connection with the problem of finding out the causes of myocardial infarction, there is the problem of studying the causes of the so-called sudden death that occurs a few hours after the first manifestations of the disease (in a practically healthy person). The basis of sudden death, as a rule, is a rapidly occurring coronary insufficiency due to a sharp and prolonged spasm of one of the coronary arteries or an acutely developed large-focal myocardial infarction. And the immediate cause of death is deep heart rhythm disturbances: instead of ordered effective contractions of the heart muscle, chaotic twitches of individual muscle bundles begin, the so-called ventricular fibrillation, or heart asystole, develops, and the effective work of the heart stops. Such a state, if it is delayed for several minutes, becomes incompatible with life.

In order to seek help in a timely manner and develop the correct line of one's behavior, it is important to know well how IHD manifests itself.

Signs of angina pectoris and myocardial infarction. For the first time, the classic description of an attack of "angina pectoris" (the so-called angina pectoris) was made by V. Heberden in 1768 at a lecture at the Royal College of Therapeutics in London.

During an attack of angina pectoris, a person has a feeling of pressure, heaviness, mixed with a feeling of dull pain in the central part of the chest, behind the sternum, sometimes somewhere deep in the throat. In some people, relatively severe pain is accompanied by fear, weakness, the appearance of cold sweat, but after 2-3 minutes the pain disappears and the person feels healthy again. In other people, this is not pain, but a kind of burning sensation, pressure behind the sternum or in the neck. (Fig. 6)

Usually, such short-term attacks occur in the morning when a person is in a hurry to work, especially in cold windy weather. This is a typical exertional angina.

Often, angina attacks develop after a hearty meal, during physical exertion, or shortly after great emotional stress, negative mental influences, or other unrest.

Figure 6. The area of ​​distribution of pain in angina pectoris

With rest angina, often occurring at night or early in the morning, when the patient is at rest, a large role is played by the factor of vascular spasm (one of the sections of the coronary artery). As a rule, such spasms occur in patients with arterial hypertension or with coronary arteries affected by atherosclerosis.

In recent years, the term "unstable angina" has become widespread. It is opposed to the definition of "stable angina", which is understood as a condition characterized by the patient's habitual attacks of short-term retrosternal pain that occurs in certain situations (fast walking against the wind, especially after eating, during unrest, etc.). A patient with stable angina pectoris should be systematically treated. There are no indications for his urgent hospitalization. Another thing is if angina pectoris appeared for the first time in life or its attacks became more frequent, if, along with angina pectoris, angina pectoris appeared at rest, attacks began to be worse removed by nitroglycerin, became sharper or longer. This type of angina is called unstable. Patients with unstable angina pectoris should be taken under special supervision, sharply limit their physical and emotional stress, monitor their ECG, and strengthen treatment with vasodilators. In most cases, such patients need to be hospitalized for intensive monitoring and active treatment. Attacks of unstable angina are also harbingers of myocardial infarction.

As already noted, it is not always easy to define a clear line between angina pectoris and myocardial infarction. Sometimes patients endure non-severe myocardial infarction “on their feet”, without medical assistance. However, for myocardial infarction in the initial period, a more typically violent and severe course. Acute myocardial infarction most often occurs as an attack of sharp, piercing, lingering pain or as a very painful feeling of squeezing the chest, as if someone is squeezing it in a vise. The patient is frightened, restless, he has difficulty breathing, he rushes about the room, not finding a place for himself. Excitation is replaced by weakness, cold sweat, especially if the pain lasts more than 1-2 hours.

During such an attack, nitroglycerin, which previously relieved the condition, almost does not reduce pain or has only a short-term effect. In the midst of pain, the patient becomes pale, his pulse is weak and frequent, the rise in blood pressure is replaced by its fall. This is the most dangerous period of the disease. Immediate medical intervention is required. Only by administering special medicines, an ambulance or emergency doctor manages to cope with an attack, and sometimes the patient has to be urgently hospitalized.

If a person first has an attack of angina or develops an attack of chest pain, accompanied by weakness, cold sweat, nausea and vomiting, dizziness, or a brief loss of consciousness, it is extremely important to call a doctor right away. Only a doctor is able to assess the characteristics of certain manifestations of the disease and prescribe additional studies, the results of which can make an accurate diagnosis, decide on the need for hospitalization and recommend the correct treatment.

All patients who are suspected of having a myocardial infarction should be in a hospital where there is the possibility of careful examination, observation and intensive treatment. There are wards in specialized departments where especially seriously ill patients are sent in order to establish permanent electrocardiographic monitoring for them, enhanced monitoring of medical and paramedical personnel and, as a result, to promptly recognize and treat such complications of myocardial infarction, which 10-15 years ago were considered incompatible with life.

In some patients, myocardial infarction develops suddenly, almost without any precursors, in the midst of seeming complete health. However, if such “healthy” people are examined before a myocardial infarction, then the vast majority of them can detect certain signs of atherosclerosis of the heart vessels or metabolic disorders that developed long before the heart attack.

Establishing a diagnosis of myocardial infarction is sometimes difficult. An electrocardiogram, the results of a study of the cellular and biochemical composition of the blood, and data from other auxiliary diagnostic methods help to recognize the disease.

In many countries of the world, a preventive examination of the population is being carried out to detect latent HBO and underlying atherosclerosis of the coronary arteries. But so far, such inspections are not widespread. To prove that active prevention of myocardial infarction is necessary, we will provide some information about the spread of coronary artery disease and some of its complications.

Prevalence of coronary heart disease

It cannot be assumed that atherosclerosis did not occur in ancient times. Thus, atherosclerotic vascular lesions were found in Egyptian mummies. In the surviving ancient manuscripts of the Egyptians, in the Bible, heart pains are described, similar to those of angina pectoris. Hippocrates mentioned cases of blockage of blood vessels. The descriptions of the narrowed, tortuous sections of the vessels that Leonardo da Vinci left are interesting. He also noted that such changes are most often manifested in older people and suggested that they adversely affect the nutrition of tissues.

Since the 18th century, Italian anatomists began to describe cases of myocardial rupture in the dead, who during their lifetime suffered from pain in the heart. Correspondence of English scientists V. Heberden and E. Jenner (70s of the XVIII century) is known, in which E. Jenner gave examples of blockage of the coronary arteries in patients who died from an attack of angina pectoris (angina pectoris).

Russian doctors V. P. Obraztsov and N. D. Strazhesko in 1909 created a modern understanding of the clinical picture and the nature of acute coronary heart disease. The doctrine of coronary disease began to develop especially rapidly with the introduction of the method of electrocardiography (ECG) into clinical studies. In 1920, X. Purdy demonstrated ECG changes characteristic of myocardial infarction. Since 1928, the ECG method has been widely used in advanced cardiology clinics around the world. In our time, an electrocardiological study in 12-15 leads has become an integral method for diagnosing heart disease, not only in stationary, but also outpatient conditions. According to the results of an ECG examination of people during physical exertion, it is often possible to reveal hidden coronary disorders. Other subtle methods for diagnosing myocardial infarction are being improved by determining the activity of certain blood serum enzymes, for example, creatine phosphokinase, etc.

Thus, it is safe to say that myocardial infarction did not appear in the 20th century. Nevertheless, there is a complex of reasons that led to the widespread occurrence of this disease in our time.

Many do not imagine the whole danger of a sharp increase in cases of myocardial infarction and angina pectoris, since human psychology is being rebuilt gradually. Meanwhile, there are indisputable statistics showing that myocardial infarction and other "coronary catastrophes" have become the main cause of death in most of the most economically developed countries.

World Health Organization experts concluded that in the 70s of the XX century, mortality from cardiovascular diseases among men over 35 worldwide increased by 60%. At an international symposium in Vienna in 1979, it was reported that. of the 2 million deaths annually recorded in the United States, more than half are due to cardiovascular disease, including more than a third accounted for by coronary artery disease. In the US, about 650,000 people die from coronary artery disease every year.

The mortality rates of the population from cardiovascular diseases, including coronary artery disease, for a number of countries are shown in Fig. 7.

In general, in highly developed countries, out of ten people over 40 years old, five die from cardiovascular diseases. In Germany, about 250 thousand cases of myocardial infarction are registered annually, and the number of deaths from this disease from 1952 to 1974 increased by 5 times. In the Soviet Union, 514.4 thousand people died from atherosclerotic heart disease in 1976, in 1977 - 529.9 thousand people. According to the Central Statistical Bureau of the USSR for 1981, mortality from cardiovascular diseases in the country has stabilized, and in some union republics there has been a tendency to decrease it.

Rice. 7. Mortality of men aged 35-74 from various diseases per 100 thousand inhabitants in different countries

A population survey of large groups of residents of the largest cities of our country - Moscow, Leningrad and Kyiv - was carried out in order to identify the prevalence of coronary artery disease among them and the factors contributing to its development. As expected, there was a regular increase in the prevalence of coronary artery disease with an increase in the age of the examined. So, among men of the city of Leningrad at the age of 20-29 years, the prevalence of coronary artery disease is less than 1%, 30-39 years - 5%, 40-49 years - 9%, 50-59 years - 18% and at the age of 60-69 years - 28 %. In general, it can be said that every sixth man aged 50-59 and every fourth man aged 60-69 are mountains. Leningrad suffer from coronary artery disease. Among women, the prevalence of coronary artery disease was approximately the same as among men, but severe forms of coronary artery disease were less common. According to the medical statistics of many countries, women in the premenopausal period get myocardial infarction incomparably less often than men. Therefore, the main attention was paid to the prevention of this disease among the male part of the population, although, as the results of population studies conducted during the Soviet era, it is necessary to carry out appropriate preventive measures among women.

It has already been noted above that coronary artery disease and myocardial infarction arise on the basis of atherosclerotic lesions of the coronary arteries of the heart. Modern medical literature is full of descriptions of the so-called CHD risk factors that contribute to the onset and progression of this disease. But first of all, we will try to tell you what atherosclerosis is and what its essence is.

Feeling pain in the heart or regular malaise associated with discomfort in the chest, we go to a cardiologist and, after going through a series of examinations, we see three mysterious letters in the line labeled "diagnosis" - IHD. What it is? Let's figure it out.

Diagnosis: ischemic heart disease

Ischemic heart disease is a damage to the walls of the myocardium caused by impaired circulatory function, which can manifest itself in both chronic and acute forms.

The history of coronary artery disease is the occurrence of an imbalance between the required level of blood supply to the heart muscle and the actually remaining coronary blood supply. Such a condition can occur if the need for blood supply has sharply increased, but it has not happened, or under normal conditions, the level of blood flow strength decreases. Then there are various changes in the myocardium due to oxygen starvation of tissues, which are characterized by the presence of: dystrophy, sclerosis or necrosis. Such conditions can be considered as an independent disease or a component of more severe forms: myocardial infarction, angina pectoris, heart failure, cardiac arrest or postinfarction cardiosclerosis.

Thus, answering the question "IHD: what is it", we can say that this is a deficiency in the blood supply to myocardial tissues, leading to its physiological changes, that is, the development of ischemia.

Causes and risk factors

In most cases, the causes of ischemia are arterial atherosclerosis of varying degrees of complexity, from the presence of plaques to complete blockage of the lumen. In this case, a disease called "angina pectoris" develops.

Also, against the background of atherosclerotic changes, spasms of the coronary arteries can occur, as a result of which the most common forms of coronary artery disease occur - this is angina pectoris, arrhythmia, hypertension.

Factors contributing to the development of this disease include:

• Arterial hypertension, which increases the chances of ischemia by 5 times.
• Hyperlipidemia causes the development of atherosclerosis and, as a consequence, ischemia.
• Smoking. Nicotine causes a stable contraction of the muscle tissue of blood vessels, impairing blood circulation throughout the body.
• Impaired carbohydrate tolerance due to diabetes mellitus.
• Obesity and physical inactivity become prerequisites for the development of ischemia.
• Heredity and old age.

Classification

"CHS: what is it?" - a question arises for a person and his relatives if such a diagnosis is made by a doctor. To understand what risks a patient has, it is necessary to refer to the WHO recommendations for identifying and systematizing the forms of the disease:

• Coronary death or cardiac arrest usually develops suddenly and is an unforeseen condition. In the event that such a patient is at a distance from other people and is not able to call for help, sudden death after a heart attack may occur.
• Angina, which is stable, post-infarction, spontaneous.
• Painless form of ischemia.
• Myocardial infarction.
• Postinfarction cardiosclerosis.
• Arrhythmia.
• Heart failure.

IHD: symptoms

Depending on the form in which ischemia develops, clinical manifestations may be different. However, as a rule, the disease is not permanent, but periodic, when states of exacerbation and complete absence of symptoms can alternate. Most often, patients who are diagnosed with coronary artery disease are unaware of the presence of any heart disease, since they do not feel constant ailments or any regular pain in the heart area. Therefore, the disease can develop over several years and be aggravated by other conditions of a more severe form.

With IBS, symptoms can manifest as follows:

• Pain in the region of the heart muscle, especially during physical exertion and stressful conditions.
• Pain that occurs on the left side of the body: in the back, arm, left side of the jaw.
• Shortness of breath, rapid heart rate, sensations of rhythmic failure.
• The state of general weakness, nausea, dizziness, excessive sweating.
• Swelling in the lower limbs.

It is rare that all these symptoms appear at the same time to give a complete picture of what is happening. However, any sensation of discomfort in the sternum or the presence of the above symptoms, especially with a stable or frequently recurring occurrence, should be a signal for examination for the presence of coronary artery disease in any of the forms.

Disease progression

Possible complications in ischemic disease are damage or functional changes in the state of the myocardium, which cause:

• Violations of diastolic and systolic functions.
• Development of atherosclerotic lesions.
• Violations of the contractile function of the left ventricle of the heart.
• Disorders of automatic contractility and excitability of myocardial tissues.
• Insufficient level of ergonomics and metabolism of myocardial cells.

Such changes can lead to a significant and prolonged deterioration in coronary circulation and may progress to heart failure.

IHD diagnosis

Ischemia can be detected by using various methods of instrumental observation and analysis together, as well as during the initial examination of the patient and the collection of anamnesis.

When conducting an oral survey, the cardiologist draws attention to the patient's complaints, the presence of some uncomfortable sensations in the heart area, regular descending edema in the lower extremities, as well as cyanosis of skin tissues.

Laboratory diagnostic analysis is used to study the presence of specific enzymes, the level of which increases with the occurrence of coronary artery disease, these are: creatine phosphokinase, aminotransferase, myoglobin.

Additionally, a study of the level of sugar in the blood, cholesterol, lipoproteins, triglycerides, the level of androgenic and antiandrogenic densities, nonspecific markers of cytolysis is prescribed.

The most informative and mandatory are ECG and EchoCG studies. They allow you to detect the slightest changes in the work of the myocardium, as well as visually assess the size and condition of the heart muscle, its valves, the presence of noise in the heart and its ability to contract.

In the early stages of development, when there are no pronounced symptoms that could be recorded during a survey or standard studies, such ECG studies are used when a special load is given to the heart muscle in the form of physical exercises that help to identify the most minor changes in the state of the myocardium.

Also, when the symptoms are intermittent, Holter daily ECG monitoring can be used, the essence of which is to monitor the work and condition of the heart on a portable device for one day, in order to record changes in the work of the heart. Such a study is most often used in the development of angina pectoris.

Based on the diagnosis of coronary artery disease, treatment and prevention can be prescribed both preventively, in order to prevent more severe forms, and as a rehabilitation therapy. Methods can cover both traditional and traditional medicine.

Treatment

In the course of diagnosing and identifying the diagnosis of coronary artery disease, treatment consists in using various approaches aimed at achieving the best result, these are:

• Therapy with drugs.
• Non-drug treatment.
• Carrying out coronary artery bypass surgery.
• Application of methods of angioplasty of coronary vessels.

Drug therapy for coronary artery disease consists in prescribing drugs: beta-blockers, antiplatelet agents, hypocholesterolemic agents. Diuretics, nitrates, antiarrhythmic drugs may also be prescribed.

The effect of non-drug correction on the condition consists in prescribing a special diet and dosed physical activity, herbal preparations and contrasting water procedures can also be used.

When the disease of coronary heart disease is poorly amenable to medical treatment, the question may be raised about the need for coronary artery bypass surgery or coronary angioplasty.

The method of coronary artery bypass grafting consists in the imposition of an autovenous anastomosis, bypassing the place of narrowing of the arteries, and thereby ensuring normal blood supply to the damaged area of ​​the myocardium. Coronary angioplasty is the expansion of blood vessels by placing special balloons in them and imposing frame structures that ensure normal blood flow through the lumen of the vessel.

Forecast

When a diagnosis of coronary artery disease is made, treatment is prescribed to stop further development and prevent its more severe forms. However, changes in the state of the myocardium are irreversible, and therefore any of the types of treatment will not lead to complete healing.

Prevention of coronary artery disease

As preventive measures, the most effective is the elimination of threat factors that provoke the development of the disease and compliance with a special diet, as well as exercises with moderate physical activity.

Having received an answer to the question: "IHD diagnosis, what is it?" - first of all, it is necessary to seek advice from a cardiologist and follow all his recommendations, as well as take seriously the possible consequences in the absence of treatment and preventive measures.

Coronary artery disease (CHD) is when the heart suffers due to a cessation or reduction in blood supply to it. The reason for this is the painful processes that occur in the coronary vessels.

It is easier to say that IHD is the general name of the disease, which means several more diseases (angina pectoris, myocardial infarction, etc.) and they arise due to poor blood delivery to the heart due to the fact that the coronary vessels are affected by atherosclerosis (atherosclerotic plaques, vasospasm, thrombosis).

Look at the picture, which shows what a clean and healthy coronary vessel looks like (on the right) and what a vessel affected by atherosclerosis looks like from the inside (on the left).

For a person to develop a disease such as angina pectoris, it is necessary that about 50% of the area of ​​​​one of the coronary vessels be affected by atherosclerosis, and this does not happen in one day, month or year.

What causes coronary artery disease (IHD)?

Numerous studies have shown that people who regularly engage in physical labor suffer from coronary artery disease less often than people who do mental work.

The first and main factor occurrence of coronary artery disease is hypertension. In 70% of patients with coronary artery disease, this disease arose against the background of hypertension, when high blood pressure remains above 160/95 for a long time. Atherosclerosis and spasm of the coronary vessels develop much faster with hypertension, which is why it is important to treat hypertension in the early stages.

Second factor is diabetes. The metabolism of proteins and lipids is disturbed in diabetes mellitus, and this also contributes to the development of atherosclerosis.

Third factor - smoking. Many smokers do not believe that nicotine affects the heart, but statistics show that people who smoke are more likely to have myocardial infarction than non-smokers. And there is an explanation for this:
When smoking, blood clotting increases, which contributes to the formation of thrombosis and at the same time, spasms of the coronary vessels are formed, which leads to a change in the coronary vessels.

The fourth and stable factor is obesity. In obesity, atherosclerosis develops much more intensively and several times more often than in people with normal weight. The amount of cholesterol in overweight people is greatly increased, and a sedentary lifestyle that obese people lead, more quickly contributes to the development of atherosclerosis and coronary artery disease.

not excluded and genetic factor . It has been repeatedly found that the children of those people who have suffered or are suffering from coronary artery disease, fall ill with this disease 5 times more often than children of healthy people.

There are 4 forms of coronary heart disease:

The first form is ANGINA is one of the many forms of coronary heart disease. In the people it is called "angina pectoris". It occurs when, as a result of oncoming ischemia, the myocardium is not sufficiently supplied with blood.

The main and main cause of angina pectoris is atherosclerosis of the coronary vessels of the heart, but not infrequently the cause of angina pectoris is: coronaritis, myocarditis, syphilitic aortitis, etc.

What are the symptoms and signs of angina pectoris?

The main symptom of angina pectoris is pain in the left side of the chest.

These pains are severe and paroxysmal. It is not uncommon that this pain, which first occurs in the left side of the chest, spreads to the left arm, to the neck, or to the left shoulder blade.

The pain can have a compressive character - then the person has a feeling that someone has strongly squeezed (squeezed) the heart from the inside and such a pain syndrome lasts for several minutes.

The pain can also have a stabbing character - then a person has a feeling of a strong prick in the region of the heart and there is no way to inhale or exhale air from the chest. This pain also lasts for several minutes.

These pains can occur while eating or walking. Often they occur when going out of heat into cold. When the pain occurs when walking, it quickly stops if the person stops.

At the very beginning of this disease, attacks of pain appear rarely and only during physical exertion or with strong emotional excitement. But then such attacks become more frequent and occur even when the person is at rest.

At such moments, you need to quickly put a tablet of nitroglycerin or validol under the tongue, then the pain disappears within 1 minute.

If the pain is not completely stopped by nitroglycerin or validol, then such angina is not a sign of coronary artery disease, but is reflex in nature. Reflex angina always occurs against the background of other diseases, such as diaphragmatic hernia, cholecystitis, intestinal flatulence, gastric ulcer, cancer of the cardinal section of the stomach, etc. And in order to get rid of angina pectoris of this nature, it is necessary to treat the disease against which it manifests itself.

The second form of ischemic heart disease MYOCARDIAL INFARCTION.

What is a myocardial infarction?

What causes myocardial infarction?

Myocardium- the muscle tissue of the heart, which contracts, pushes the blood. This is the main part of the entire mass of the heart.

When a myocardial infarction occurs, this means that some part of the myocardium (muscle tissue) does not receive nutrition due to the blockage of one of the coronary vessels.

The figure shows the heart and the circle shows where the blockage occurred in the coronary vessel.

As a result of such a blockage, in this area of ​​​​the myocardium (heart), necrosis occurs or otherwise - cell death (it is indicated in the figure by blue spots).

Depending on the size of the affected necrotic area, myocardial infarction is small-focal and large-focal.

Massive infarction - this means that more than half of the mass of the heart (myocardium) is affected by necrosis. Rarely does a patient survive such an attack.

What are the symptoms and signs of myocardial infarction?

There are three forms of this disease: asthmatic pain and abdominal.

The asthmatic form can be painless. At this point, left ventricular failure occurs, similar to cardiac asthma.

In the painful form, myocardial infarction begins, like angina pectoris, with severe pain in the region of the heart (left side of the chest).

And with the abdominal form - the pain occurs in the chest area, but closer to the stomach.

But in all forms, pain (if any) is not stopped by validol and nitroglycerin, as with angina pectoris. And even more powerful painkillers do not eliminate it. The patient at this moment turns pale, or rather his face becomes gray. He breaks out in cold sweat. Often at the same time, a person rushes about and becomes extremely restless. During an attack, nausea and vomiting are not excluded. Blood pressure usually falls, and the pulse becomes quiet and frequent.

How many attacks of myocardial infarction can there be?

and What is the most dangerous attack of myocardial infarction?

An attack of myocardial infarction happens:

primary if before that the person had never had coronary circulation disorders;

repeated if a heart attack developed elsewhere in the heart muscle some time after the first and

recurrent, if a heart attack developed after 2 - 3 months at the same place where it was primary.

Depending on how many percent of the total area of ​​the myocardium is affected by necrosis, attacks can be less life-threatening and very dangerous.

Due to the fact that some part of the heart muscle stops working, the heart rhythm is disturbed, as a result, tachycardia and extrasystole may occur. There are many complications after a heart attack, and most of them are fatal if qualified, urgent medical care is not provided to the patient in a timely manner. And in most cases, this is an urgent surgical intervention.

Can coronary heart disease be cured?

Of course you can if you're not lazy. There is no such medicine in the world that you have taken once and you are healthy.

To become healthy again, you have to go long and hard to this. Below, traditional medicine remedies that really help are described.

The third form of CAD is Acute Coronary Insufficiency., but we will not describe it, since one of the signs of this acute (i.e. sudden) disease is the death of the patient. It occurs due to coronal atherosclerosis, which affects more than 60% of the coronary vessels.

The fourth form of coronary artery disease is circulatory failure. or a heart rhythm disorder. This is a painless form of coronary artery disease and, like the diseases described above, it originates in the heart vessels.

Folk remedies for the treatment of coronary artery disease

Those who know or have read the causes of coronary artery disease have already understood that it is really possible to cure ischemia only by clearing the vessels of atherosclerosis and blood clots.

And in order for the vessels to always be clean and healthy, it is necessary to lower the level of cholesterol in the blood and drink those medicinal infusions that thin the blood, and do not thicken it.

Recipe 1.

Garlic tincture or Elixir of youth.

It is not by chance that we give this very first recipe. Everyone who has ever used this tincture in treatment unanimously speaks about the miraculous property of garlic tincture to heal heart ailments. It is taken for all cardiovascular diseases (hypertension, ischemia, atherosclerosis,

I, the author of these lines, personally confirm their words. My mother suffered from hypertension, she took pills every day, but they only reduced the pressure for a while. After she drank several courses of garlic tincture, her pressure has been normal for several years now.

Now the recipe itself:

250 grams of peeled garlic (preferably homemade, not store-bought) must be crushed in a ceramic or wooden mortar. Why can't you grind garlic through a meat grinder or rub it on a grater? The fact is that in contact with metal products, garlic loses half of its healing properties.

As soon as the garlic is well crushed and gives juice, fill it with 96% alcohol - 250 grams. Mix well with a wooden spatula, pour everything into a dark bottle or jar. Garlic should be infused for 2 weeks. During this time, shake the composition sometimes (every other day) so that the alcohol absorbs as many useful substances from garlic as possible.

After two weeks, filter the tincture (possibly through a thin cloth) and start taking this elixir of youth 3 times a day 30 minutes before meals, according to the following scheme:

The first day - 1 drop. It is necessary to drip the tincture in 50 ml (half a glass) of milk(with other liquids it is impossible).

The second day - 2 drops, the third day - 3 drops and so on.

On day 15, take 15 drops, and then you will reduce one drop daily as follows:

on the 16th day - 14 drops each, on the 17th day - 13 drops each, on the 18th day - 12 drops each, and so you will reach 1 drop on the 29th day.

After you have drunk 1 drop 3 times a day on the 29th day, then starting from the next (30th) day, drink the tincture 25 drops 3 times a day until the entire tincture is over. This is one course of admission.

How many times and for what period of time to do such a course depends on the condition of your vessels.

For example, my mother is slightly overweight and was in the initial stage of diabetes, so she took courses one at a time in five years. Only 3 courses are needed. Already two weeks after the start of taking this elixir, her blood pressure returned to normal, sleep was restored, headaches disappeared, and her mood improved.

If you have only the initial stage of the disease, then it is enough to clean the vessels in this way once every 5 years.

Medicinal formulations, infusions and tinctures of garlic are contraindicated if the patient has hyperacid gastritis.

Recipe number 2.

There is a very good and proven recipe for coronary heart disease. Pills and injections help temporarily, but this recipe relieves seizures much better and, most importantly, for a long time.

The recipe is complicated, but in terms of the degree of healing it is simply irreplaceable.

To get started, you need to take 50 grams the following components:

1. Dog-rose fruit
2. pine buds
3. Sagebrush
4. yarrow

Pour all the components with three liters of plain but clean water and leave for 3 hours so that the dry components get wet.

After the allotted time, put it all to boil in an enamel pan. The fire should be very, very weak, so that the water in the pan does not boil much, but slowly wanders for 2 hours. Close the pot lid tightly.

After that, wrap the pan with something warm so that it brews for another 24 hours.

After 24 hours, add to the filtered infusion:

1. Chaga extract- 200 grams
2. Aloe leaf juice- 200 grams
3. Honey- 500 grams
4. Cognac- 250 grams.

Now put this composition in a dark place, but for 4 days, and then you can begin to treat your IHD by taking the composition 3 times a day.
It is necessary to drink it 2 hours before meals, 1 teaspoon. The course is 2-3 months (if less, then the attacks may reappear after a while).

Recipe number 3. Hawthorn fruits (BOTWARE).

We collect 3 tablespoons of dry hawthorn balls, pour them with 0.5 liters of boiling water and cook the fruits over low heat for about 10 minutes. We insist the broth for another hour or two. Drink 150 ml (a little more than half a glass) before meals three times a day, and the 4th time at bedtime. This medicinal drink must be taken by all patients with atherosclerosis, hypertension, dizziness, insomnia, angina, palpitations.

Daily intake - a month - this is a course, a break is needed - 10 - 14 days and drink again. For a year it is necessary to make 6 - 7 such courses.

With long-term treatment with a decoction of hawthorn, even in patients with severe atherosclerosis, performance improves. At the same time, high blood pressure drops (stabilizes), sleep becomes strong and long. Blood circulation in the heart muscle (in the myocardium) and in the brain improves, overstrain and wear of the heart are prevented.

Recipe number 4. A tincture of hawthorn fruit (on alcohol) acts in the same way as a decoction, and the result of taking the tincture is identical to the decoction.

Mash half a glass of hawthorn fruit in a mortar and mix with 100 ml of alcohol.

You have to wait 3 weeks for the fruits to give all their healing power to the infusion (sometimes you need to shake it) and after straining, take 1 teaspoon 3 times a day.

The course, break and number of courses per year is the same as when using a decoction, only the infusion still helps with thyrotoxicosis and nervous excitement.

The main cause of heart disease is atherosclerosis, so see more recipes at.

Recipe number 5. From Bolotov.

With heart disease, as well as the inability to play sports, you can really with the help of a steamer, improve the activity of the heart and very strongly (at least 10 - 20 procedures with weekly breaks). In fact, it is easy to achieve such a result that, regardless of age, you can completely get rid of heart problems. We must also remember that it is very important to eat 0.1 grams of dry food daily. gray jaundice herb powder. Its bitterness stimulates the pancreas and it begins to produce a sufficient amount of insulin, which, in turn, breaks down sugars, which ensures the production of adrenaline and nutrition for the heart. And avoid cooking with vegetable fats, they turn into drying oil in the body, and this is not only a poison for the kidneys, but also for the vessels of the heart.

You only need to sweat well in the bath, and not overheat and not whip with a broom. An hour before the steam room, eat 100 grams of boiled animal heart, it contains a lot of trace elements that are needed for the normal nutrition of your main organ. 15 minutes before entering the steam room, drink half a glass hearty kvass. Mandatory after the steam room massage whole body to improve blood circulation. At this point, the heart will work halfway, while the masseur will take on the burden of distilling blood. Ask someone close to you to temporarily be your massage therapist.

Heart kvass recipe.

For 3 liters of water, add 1 cup of gray jaundice or foxglove, or adonis, or lily of the valley, or sage (whatever you have), + 1 cup of sugar, 1 teaspoon of sour cream. Tie the throat of the jar with gauze and let it ferment in the heat for 2 weeks. A single dose is half a cup.

We will be adding more recipes soon.