Today, ischemic heart disease means a whole complex of diseases. All of them are characterized by unstable blood flow in the arteries responsible for ensuring the functioning of the myocardium. Inadequate blood supply in this case can be caused by narrowing of the coronary vessels.
Such a pathology can manifest itself under the influence of both external and internal factors. How is ECG ischemia determined? Can I protect myself from such a disease and what does the course of treatment include? With these questions we will try to understand this review.
Causes of occurrence
Coronary heart disease can lead to disability and even death. According to the World Health Organization, every year this disease causes the death of 7 million people. Mortality by 2020 may be twice as high. At risk are men aged 40 to 62 years.
However, the risk of the disease increases significantly when exposed to the following negative factors:
- Atherosclerosis is a disease that affects arteries located in the immediate vicinity of the heart muscle. As a result, the walls of the vessels become denser and lose their elasticity. Clearance can also narrow due to plaques formed by calcium and fat.
- Coronary spasm - a similar ailment due to the development of atherosclerosis, but is able to form without it. May result from stress. Spasm has a negative effect on the functioning of the arteries. With hypertension, the heart has to deal with high pressure in the aorta. This can disrupt blood circulation, cause angina pectoris and heart attack.
- Thrombosis. As a result of plaque decay, a thrombus may form in the coronary artery. Also, the vessel is blocked by a blood clot formed in another part of the circulatory system.
- Congenital and acquired malformations.
Risk factors
Why does myocardial ischemia occur? On the ECG, the first signs of this disease can usually be seen after 40 years. Of great importance in this case is such a factor as heredity. If parents suffered from coronary heart disease, then children will most likely have a similar illness.
Negative factors also include:
- high blood cholesterol;
- fat metabolism disorders;
- obesity of any degree;
- diabetes;
- sedentary lifestyle;
- frequent disorders and character traits;
- gender: among men, coronary heart disease is more common;
- malnutrition.
Classification
What is she like? Specialists distinguish several forms of coronary heart disease:
- Primary cardiac arrest.
- Acute coronary insufficiency.
- Angina pectoris is a form of ischemic heart disease, characterized by compressive and pressing discomfort.
Typically, such manifestations are mainly localized behind the sternum. Painful sensations and discomfort can still be given to the left arm, epigastric region, jaw. A similar pathology usually develops as a result of physical activity. There are several forms: primary, progressive, vasospastic.
Consequences and Complications
Coronary heart disease in the absence of the required therapy can lead to the formation of progressive heart failure. Muscle contractility weakens. As a result, the heart ceases to provide the body with the required amount of blood. Patients with cardiac ischemia quickly become tired and experience constant fatigue. If no measures are taken to treat the disease, then the case may result in disability or even death.
First signs
Of course, subendocardial ischemia on the ECG is immediately noticeable. But there are symptoms that will help in the early stages to identify coronary insufficiency even without additional examinations. They can occur individually or in a complex. Here, more and more depends on the form of the disease. There is a direct connection between the development of pain localized in the region of the heart and physical activity.
Also, discomfort can occur under adverse conditions and after a heavy meal. With coronary artery disease, patients usually experience pressing pains. It seems to a person that he feels a lack of air, heaviness builds up in his chest. The pain is usually localized on the left edge of the sternum. Unpleasant sensations can go to the arm, shoulder and shoulder blade. As a rule, bouts of pain last no more than 10 minutes. After taking nitrates, they gradually subside.
Other symptoms include:
- fainting
- blurred consciousness;
- dizziness;
- weakness;
- nausea;
- shortness of breath
- tachycardia;
- unstable work of the heart muscle;
- excessive sweating.
If the patient does not seek medical help, the swelling of the lower extremities will also be added to the symptoms listed above.
How to diagnose a disease?
Many believe that coronary heart disease can be determined by ECG. Signs of myocardial ischemia can also be established by conducting the following examinations:
- History taking. For this purpose, the doctor should ask the patient in detail about the nature of the pain, discomfort, their localization. The doctor will also find out if the patient feels weakness and breathing problems.
- Examination by a cardiologist. At this point, the doctor should listen to the heartbeat for wheezing and noise. Also, during the examination, the doctor measures the level of blood pressure.
- General blood analysis. Allows you to identify a possible cause of ischemia. Experts evaluate indicators such as triglycerides and cholesterol. This is especially important for assessing the risk of vascular atherosclerosis. Also an important indicator is the level of troponins in the blood. When the cells of the heart muscle are destroyed, specific enzymes are released into the blood.
- Coagulogram. With coronary heart disease, blood coagulation increases significantly.
- Electrocardiography Allows you to identify excess size of the left ventricle and other specific characteristics. The doctor can easily identify signs of ischemia on the ECG.
- ECG echo. With this type of examination, the structure and dimensions of the organ are evaluated, and the blood flow inside the heart, valve function and the degree of vascular lesions are studied.
- Daily monitoring. With this method of examination, special equipment reads an electrocardiogram within 24-72 hours. This procedure allows you to objectively assess the patient’s condition and accurately determine the causes of symptoms of coronary heart disease.
- Roentgenography. It is used to detect dilatation of the left ventricle. A similar pathology may be a consequence of aortic dissection. This type of examination also reveals other complications.
What to do if the cardiac ischemia was determined on an ECG? As a rule, the doctor uses a list of additional examinations to make an accurate diagnosis. These include stress tests, an X-ray contrast examination, computed tomography, dopplerography, electrophysiological examination, etc.
Determination of IHD by ECG
What is it like? Using an ECG, you can identify the following forms of the disease:
- A mute form in which a person does not feel pain.
- Angina pectoris, characterized by significant pain in the sternum.
- Acute blood supply disturbance resulting from thrombosis.
- Pathology of myocardial contractions.
All these degrees of cardiac muscle ischemia can be determined using a cardiogram. A similar method is based on the principle of fixing cardiac impulses.
How is the procedure performed?
An electrocardiogram is a safe and accurate method for determining ischemia of the heart muscle. All necessary functioning parameters will be fixed within 10 minutes.
The procedure is carried out in the following order:
- The patient removes clothes from the chest and releases the leg from the knee to the foot.
- The specialist conducting the examination, lubricates the necessary areas with a special gel, fixes the electrodes.
- Data is transmitted through the electrodes to the sensor.
- The device displays the transmitted information on paper in the form of graphs.
- The specialist decrypts the results.
What helps determine the ECG?
An electrocardiogram can detect pathologies in the cardiac cycle. Also, with the help of such an examination, you can determine the signs of myocardial infarction and pathological changes in the heart muscle. Thus, the ECG helps to know which area was most damaged. This type of examination is also used when the symptoms appear paroxysmally.
ECG myocardial ischemia is as follows:
- Violations of the polarity of the T-teeth are negative and have an amplitude of more than 6 mm. Due to muscle relaxation, the teeth are symmetrical.
- Subepicardial ischemia on the ECG is determined by the inversion of the T-wave.
- With coronary heart disease, the QRS should not deviate from the normal value.
- Transmural ischemia on the ECG manifests itself in the form of a negative symmetrical tooth. Only a qualified specialist can see this.
- ECG ischemia can occur in a smoothed T-wave form or in the presence of two phases.
Treatment
The entire course of therapy for coronary heart disease is based on several principles.
These include:
- Regular cardio training (walking, swimming, gymnastics). The size and duration of the training should be determined by the doctor.
- Special diet. A patient suffering from coronary heart disease should not be eaten salty and fatty.
- Emotional peace.
Also, the patient's condition can be maintained through the use of pharmacological preparations.
Conclusion
Modern diagnostic equipment allows early detection of coronary heart disease. Timely detection of a problem plays a crucial role in the success of treatment. However, it should be borne in mind that only a qualified cardiologist can decipher the results of an electrocardiogram correctly.