Diseases of the heart and blood vessels are in first place in the world in frequency of occurrence. Almost every second person at least once during his life complained of discomfort in the heart, a feeling of interruptions in his work, etc.
All this is connected, for the most part, with improper nutrition, non-observance of the regime of work and rest, excessive physical exertion and exposure to stress. As a result, there is an overload of the heart muscles, as well as the walls of the vessels, which leads to the development of circulatory disorders, myocardial infarction and coronary heart disease.
Features of the disease
Myocardial infarction is a rather serious disease, often leading to the death of the patient. It is based on the development of necrosis (death) of cardiac muscle cells - cardiomyocytes. If the patient was promptly provided with emergency care and he survived, a recovery period ensues, during which the affected muscle fibers are replaced with connective tissue. This phenomenon is called cardiosclerosis.
Depending on the localization of these changes, focal and atherosclerotic diffuse cardiosclerosis is revealed, what it is, not many know.
The first variant of the pathology most often develops as a result of myocardial infarction (the connective tissue is formed precisely in the place of the ischemic zone that arose against the blockage of the blood vessels supplying the heart). Diffuse cardiosclerosis is very common and occupies almost the entire surface of the myocardium. It develops precisely due to the prolonged effect of ischemia (lack of oxygen) on the heart.
However, with coronary heart disease (coronary heart disease), this shortage develops slowly and is partially compensated, as a result of which such patients can live longer than with acute myocardial pathology.
Diffuse cardiosclerosis according to ICD 10 code has I25. It is encrypted as an atherosclerotic heart disease.
This also includes coronary heart disease, the consequences of myocardial infarction (detected by ECG and ultrasound), as well as aneurysms of the heart and coronary arteries, ischemic cardiomyopathy. That is, in the ICD and coronary heart disease, and diffuse cardiosclerosis are almost in the same row.
Causes
What are the main causes of diffuse cardiosclerosis, not everyone knows.
As mentioned above, a huge number of factors influence the heart. Among them, it is especially worth highlighting:
- Atherosclerosis of the heart and blood vessels. This disease is found in almost every person. Its appearance is associated with malnutrition, in particular, with increased consumption of low-density lipoproteins with food. They have a decisive role in the development of atherosclerotic plaques - cholesterol deposits on the walls of blood vessels and the heart. As a result of this, narrowing of the walls of blood vessels occurs, which leads to a lack of blood circulation (acute or chronic) in the heart muscle and, as a result, the development of cardiosclerosis.
- Excessive exercise. Unfortunately, few people look after themselves, in particular, about their activity and physical fitness. Because of this, many muscles of the human body, which include the myocardium, are not ready for physical exertion, as a result of which they have to work “for wear”, which, in the end, leads to oxygen starvation.
- Stress. As they say, “all diseases are from nerves”, and this expression has its own truth. Against the background of excitement, a person has a rapid heartbeat, pressure rises, which significantly increases the load on the heart. And if the patient has the above risk factors (atherosclerosis, unpreparedness for stress), most likely, against the background of stress, such a person risks “earning” a heart attack, which will lead in the future to the development of cardiosclerosis.
- Past endocardial diseases. Sometimes, against the background of inadequate treatment of colds (tonsillitis, SARS), cardiomyocytes can be damaged (as a result of an autoimmune attack of these cells), which is the main cause of the development of ischemic cardiomyopathy and diffuse cardiosclerosis.
- Hereditary abnormalities and heart rhythm disturbances. This group of diseases leads mainly to acute cardiac circulatory disorders. However, it is considered in conjunction with the above reasons.
What are the clinical manifestations of diffuse cardiosclerosis?
In the early stages, diffuse small focal cardiosclerosis is completely asymptomatic and is most often an accidental finding during an additional examination for another pathology.
The first symptoms of pathology may be a feeling of heaviness in the chest and shortness of breath after the usual load (for example, it has become harder to climb to your floor or to carry some kind of burden).
As diffuse small focal cardiosclerosis develops, the heart gradually loses its ability to contract, resulting in stagnation of blood in the vessels of the body. Such a decrease in blood flow is manifested by the appearance of edema on the legs (more towards evening), shortness of breath and coughing (with stagnation of blood in the vessels of the lungs). Pain in the right hypochondrium can also join them (which is due to stagnation of blood in the portal vein system and plethora of the liver).
Pain
The most common symptom of developing diffuse cardiosclerosis is pain. It is usually not intense, is aching in nature, appears and intensifies during physical exertion.
Over time, which is observed in older people, it becomes permanent. It can be either local (in the region of the heart), or spread along the back, into the left hand, face on the left, which often leads to incorrect diagnosis (such patients turn to neurologists and treat osteochondrosis to no avail).
How can one determine the presence of cardiosclerosis?
Implying diffuse cardiosclerosis, what it is and how to determine the pathology, not everyone knows.
First of all, the patient must undergo a biochemical blood test and determine the level of cholesterol, high and low density lipoproteins and triglycerides in it. All of these substances, with their increase (with the exception of high density lipoproteins), indicate the presence of atherosclerotic deposits on the vessels of the patient.
If possible, the level of creatine kinase and lactate dehydrogenase (MV-KFK and LDH), enzymes that are specific for cardiomyocytes, should also be determined in the blood. Their increase in blood indicates damage to heart cells (since these enzymes are inside the cell and appear when it is destroyed). The most informative is the troponin test (also allows you to differentiate acute myocardial infarction from coronary heart disease)
Other general clinical studies (general analysis of blood and urine) are not informative when making this diagnosis.
Of the simplest instrumental examinations, electrocardiography comes first. It is on the ECG that you can notice the first signs of damage to the heart muscle (a change in the amplitude of the teeth, an increase in the T wave, and more). An experienced doctor of functional diagnostics can detect the presence of focal and diffuse changes in the myocardium with an exact indication of their localization.
An ultrasound examination of the heart is also necessary, which allows you to visualize it and determine whether the changes detected on the cardiogram are focal or diffuse in nature (based on myocardial contractility, activity of its valves and walls).
In some cases, the patient undergoes transesophageal echocardiography. Its essence is the same as with conventional ECHO-KG, however, it allows you to more accurately determine all visible indicators.
It is definitely recommended to conduct an examination of the vessels of the neck and lower extremities (to clarify the diagnosis of diffuse cardiosclerosis, what it is, the doctor will explain according to the results of the examination, if the diagnosis is confirmed).
You can directly see the defeat of the inner wall of the myocardium during endoscopic examinations - coronarography or arteriography.
Among thoracic X-ray studies, thallium scintigraphy is informative (allows one to determine the possibility of myocardial accumulation of isotope-labeled substances).
A conventional chest x-ray allows you to indirectly judge the state of the heart (based on its size, position, mediastinal state). In cases of massive atherosclerotic aortic lesions, the diagnosis of cardiosclerosis can even be made based on this image.
Additionally, the patient undergoes various functional tests (walking on a treadmill, a bicycle) with simultaneous fixation of myocardial and blood pressure indicators.
Treatment
What to do if the patient is diagnosed with ischemic heart disease or diffuse cardiosclerosis (what it is, discussed above), not everyone knows.
First of all, you should pay attention to your daily diet and, if possible, eliminate fatty and spicy foods from it, as well as table salt (something that will provoke the development of atherosclerosis and arterial hypertension) or at least limit its use. Priority should be given to fish, vegetables and fruits, various broths and cereals.
In addition, you should bring into your life minimal physical exertion, for example, morning exercises, begin to walk in the evenings. In a word, to refuse, as far as possible, a sedentary lifestyle. It will be useful to swim, Scandinavian walking.
Preparations
From medicines, first of all, attention should be paid to drugs from the group of statins. These drugs help to lower blood cholesterol, thereby preventing atherosclerosis from developing. Such drugs include Atorvastatin, Lovastatin and others.
Another mandatory medicine for prescribing to patients with a diagnosis of cardiosclerosis is Aspicard (ASA, cardiomagnyl, acetylsalicylic acid). It contributes to some blood thinning, which improves its rheological properties and reduces the risk of ischemic events in the myocardium.
It will be useful to use some metabolic preparations, such as Mildronate, vitamins of group B. These drugs improve metabolic processes in the cells of the heart muscle, which improves its reparative properties and functional activity.
To reduce pain in the heart, you can use "Nitroglycerin", "Molsidomin" (or "Dilasidom"), validol, drops of Zelenin. These drugs affect the blood vessels of the heart, cause their expansion and thereby contribute to the improvement of blood circulation in them.
Of the cardioprotectors, it is recommended to use "Thiotriazolin" or "Trizidine". Their main function is to improve the resistance of cardiomyocytes to stress and to prevent the development of necrotic changes.
Other therapies
Of the non-pharmacological methods, climatotherapy and spa treatment well help. In some cases, if there is no decompensated hypertension, a pressure chamber may help.
Among surgical treatments, stenting or coronary artery bypass grafting helps.
Forecast
What awaits those people who have been diagnosed with diffuse cardiosclerosis, code in ICD 10 - I25, each patient needs to know.
First of all, it should be understood that the presence of coronary heart disease is an indicator of human life, or rather, its relative passivity. If nothing is done, over time, the risk of developing myocardial infarction, stroke, stenosing lesions of peripheral vessels (brachiocephalic arteries, vessels of the lower extremities) will significantly increase. It is proved that adequate daily physical activity reduces the risk of developing diseases of the cardiovascular system by 50%.
The development of these diseases significantly reduces the patient’s activity, his interaction with society, leads to his disability, which affects not only the person and his relatives, but also the economy of the state as a whole (especially if young able-bodied people get sick). With the development of acute heart disease, a fatal outcome is possible. There are frequent cases when diffuse cardiosclerosis is the cause of death of the patient.
Conclusion
It must be borne in mind that if the disease is detected in a timely manner and all measures for its treatment are taken, the prognosis is favorable. In addition to drug therapy, you should adhere to recommendations regarding diet and physical activity. It is recommended to lead a healthy lifestyle.
Regular exercise, proper nutrition, timely examination and access to doctors, adequate rehabilitation contribute to a favorable course of the disease and reduce the risk of patient disability. In any case, it is not worth ignoring the first symptoms of the disease, but it is better to consult a specialist in a timely manner for a comprehensive examination.