Subepicardial ischemia begins to develop when there is an insufficient supply of oxygen and blood to the myocardium. Initially, a sick person may not notice strong changes in his body, since the manifestations will be periodic. As a rule, from the very beginning, the disease manifests itself in small attacks that quickly pass. Cramps affect certain areas of the body, thus affecting the areas of the heart, the epicardial and endocardial zones suffer in complex forms.
How to recognize subepicardial ischemia?
First of all, one must clearly understand that myocardial ischemia is a violation of blood circulation in the heart muscle. This is not to say that this phenomenon is ongoing, no, it is temporary, but it can cause the most dire consequences. Subepicardial myocardial ischemia occurs if an insufficient amount of blood enters the myocardium. This happens when the disease is in a late stage, so the affected area is large-scale.
You can see the deviations after an ECG in the septum and apical compartment. Let us consider in more detail what subepicardial myocardial ischemia of the apical region may look like:
- This kind of ischemia is characterized in that the lesion in the area spreads close to the electrode, which is connected during the ECG. The recovery process of the excited ventricle occurs from the endocardium to the epicardium.
- When an electrocardiogram is done, this form of ischemia may look like a negative T wave, which has an expanded type due to the slow repolarization process.
With the development of subepicardial myocardial ischemia in the lower wall, the restoration of the nerve membrane of the ventricle occurs from the epicardium to the endocardium. In this case, the signs of cardiac pathology on the cardiogram will differ from the previous form, the scar will have the form of a positive T wave, which is mainly characterized by pointedness and extension.
Why can a disease develop?
The most important reason that can cause ischemic diseases lies in the presence of atherosclerosis or arterial hypertension in a person. When people have a healthy cardiovascular system, they are unlikely to have ischemic attacks. If a person develops atherosclerosis, then plaques begin to appear in the vessels, due to which the lumen decreases, as a result of such changes, little oxygen enters the heart. With high blood pressure, plaques can rupture and their particles will peel off, completely blocking the vessel. In this case, the blood flow in the damaged area stops, and myocardial cells cease to receive the necessary nutrition, as a result of which ischemia develops. Consider the main causes that can lead to cardiac ischemia:
- The disease appears in those people who lead an immobile lifestyle and gain excess weight.
- People who already had relatives with the disease in the family may also suffer from this disease.
- Bad habits negatively affect the elasticity of blood vessels and the heart as a whole.
- The reason can be hidden in constant stress and depression.
- If the body is subjected to frequent excessive physical exertion, subepicardial ischemia may also develop.
- Often the reason lies in acute infectious diseases and pathologies of the endocrine system.
It is worth paying attention to the fact that the likelihood of developing ischemic disease increases with age. Most often at risk are men 45 years old, women 65 years old. To exclude the development of the disease, or rather, to prevent it at an early stage, doctors recommend an examination every year.
Symptoms
Myocardial ischemia can be accompanied by various symptoms, it all depends on what stage the pathology is at. Very often, the patient may not notice that he is sick until he gets to the hospital and a routine examination is completed. Consider the main symptoms of the disease:
- There is pain in the chest area, which can be of a different nature and manifest with different intensity. Most often, people say that there is a burning and severe pain that radiates to the left side of the body.
- Shortness of breath may occur even when a person is at rest.
- A sick person will feel weak throughout the body.
- It happens that nausea occurs.
- An unreasonable feeling of anxiety appears.
Symptoms may not last long, so people habitually attribute all the signs of the disease to ordinary malaise. But few people know that subepicardial ischemia of the anterior region may indicate an imminent heart attack, so you should immediately consult a doctor.
Diagnosis and treatment
To make an accurate diagnosis, doctors can prescribe different methods of examining the body. First of all, blood and urine tests are prescribed, and an ECG is also required. After passing the ECG, it will immediately be clear whether the patient has heart problems or not. As a rule, treatment after the detection of a disease such as subepicardial myocardial ischemia of the anterior region is carried out in a complex. The specialist selects methods that will be aimed at eliminating all negative factors that can provoke the development of the disease.
During therapy, the patient should follow these rules:
- Completely abandon bad habits.
- You should go on a diet prescribed by your doctor and monitor your blood cholesterol.
- In every possible way to avoid stressful situations and walk more in the fresh air.
- Try to avoid excessive physical exertion.
Specialists can use medicines as the main method of treatment, and in more complex cases, surgery is performed.
Drug treatment
To eliminate an attack of ischemia, most often doctors use Nitroglycerin. People who suffer from low blood pressure should take these drugs with caution, as drugs can lower the pressure even more. Additionally, the doctor may prescribe funds that relate to adrenergic blockers. Such drugs will help prevent vasoconstriction and normalize blood circulation. If an arrhythmia is observed in a sick person, then antiarrhythmic drugs should be taken.
Experts recommend taking medications that help quickly restore metabolic processes in cells and adapt tissues to exist without a large amount of oxygen.
Subepicardial ischemia may not be completely cured, but a person is quite capable of maintaining his body in a normal condition if he takes statins every day. Such drugs primarily help lower blood cholesterol and prevent the development of atherosclerosis.
Surgical treatment
Surgical intervention for ischemia can be carried out only in extreme cases, when other methods are useless. Thanks to modern cardiac surgery, surgery can completely restore blood circulation and improve the functioning of the heart muscle. Surgeons often during operations insert a stent into the vessel, which makes it possible to increase its lumen.
Naturally, a doctor can prescribe an operation only after a person has undergone a complete diagnosis.
How is the rehabilitation period?
If a person underwent treatment after detecting a disease such as subepicardial ischemia, then the rehabilitation period should also be considered. The main goal of rehabilitation is to normalize the state of blood vessels and the heart, in this way it is possible to improve the general state of health and prepare the body for simple physical exertion.
The patient must comply with all the rules that were established for him during treatment. Be sure to abandon addictions and avoid stressful situations.
If it is necessary to increase physical activity, then this must be done very carefully and gradually. For this, a specialist can develop a special set of exercises.
Forecasts
Predictions for myocardial ischemia may depend on many factors. Let's consider them in more detail:
- First of all, the degree of development of pathologies and where exactly the damage to the heart muscle is localized is taken into account.
- It is necessary to pay attention to age, since the state of the heart muscle directly depends on this.
- The patient should not have any other chronic diseases, as this can also affect the recovery period.
In all other cases, the patient must consult a doctor and begin treatment, the outcome of which is likely to be successful. It is worth noting that treatment can be complicated with high blood pressure, diabetes, metabolic disorders.
Prevention
Regardless of what type of disease the person has, subepicardial myocardial ischemia of the lower or upper region, immediate treatment is required. Everyone should lead an active lifestyle and play sports, it is important to ensure that the body does not have a strong physical impact, so you should learn to alternate work and rest. To improve the condition of your body, you should eat right and exclude foods that contribute to clogging of arteries with cholesterol.
All people are advised to be examined by a cardiologist at least once a year for preventive purposes.