What is cardiosclerosis? Symptoms and treatment of heart muscle disease

Cardiosclerosis is a pathology of the heart muscle, which manifests itself in the proliferation of connective scar tissue that occurs in the myocardium. The disease is serious, as it leads to deformation of the valves and the replacement of muscle fibers. And this is fraught with grave consequences.

Why does this pathology arise? What symptoms indicate its presence? How to deal with it? Well, this will be discussed now.

Classification

First of all, it should be noted that the pathology under consideration is not an independent nosological unit, but one of the varieties of coronary heart disease (CHD).

Cardiosclerosis, however, is usually considered according to the international classification of diseases. In Russia, it was introduced into medical practice in 1999. This is a directory, divided into rubrics where diseases are listed, and all of them are assigned an alphanumeric designation.

The gradation of the diagnosis of cardiosclerosis in the ICD looks like this:

• Circulatory system diseases - I00-I90.
• Postmyocarditis cardiosclerosis - I20.0-I20.9.
• CHD - I10-I25.
• Atherosclerotic heart disease - I25.1.
• Postinfarction cardiosclerosis - I2020-I2525.
• IHD of a chronic form - I25.

Well, briefly familiarizing yourself with the ICD-10 cardiosclerosis codes, you can move on to a more important topic. Namely, to consider its types, causes, symptoms and treatment.

Types and forms of the disease

One cannot but touch upon this topic. The codes of cardiosclerosis in the ICD-10 were considered above, but it should be noted that in this classification there is no information on the forms of the disease. And there are only two of them:

• Focal cardiosclerosis. In this case, in the myocardium, separate, varying in size scar areas are formed. As a rule, the pathology of this form occurs as a result of myocardial infarction or myocarditis.
• Diffuse cardiosclerosis. This form is characterized by a uniform lesion of the myocardium and foci of connective tissue. They are distributed over the area of ​​the entire heart muscle. As a rule, cardiosclerosis of this form occurs with coronary heart disease.

It is also customary to distinguish etiological types of the disease. But they are the outcome of the primary disease, which entails the replacement of myocardial functional fibers with scars. In ICD-10, cardiosclerosis of some etiological varieties is isolated. In general, there are three of them:

• Atherosclerotic form. It arises as a result of transferred atherosclerosis.
• Post-infarction. It is formed due to myocardial infarction.
• Myocarditis. It is the result of myocarditis and rheumatism.

It is important to note that in rare cases other forms are observed. They can be associated with injuries, dystrophy, and other damage to the heart muscle.

Atherocardiosclerosis

It occurs due to damage to the coronary arteries. The symptoms of progressive coronary disease indicate the presence of this pathology:

• Pain behind the sternum arising from stress or physical exertion.
• Dyspnea.
• Discomfort felt in the lower jaw, arm and back.
• Increased heart rate. Often there are interruptions.
• Fainting.
• Dizziness, nausea, and weakness.
• Clouding of consciousness.
• Excessive sweating.
• Swelling of the lower extremities.
• Psycho-emotional lability.

As the disease develops, pulmonary edema or attacks of cardiac asthma, ascites and pleurisy, atrial fibrillation, extrasystole, atrioventricular blockade, atherosclerosis of the aorta and arteries can occur.

To establish a diagnosis, a cardiologist examines the patient’s history. It is important to consider whether he had atherosclerosis, coronary heart disease, arrhythmia, heart attacks, etc. He will also need to undergo such diagnostic tests:

• Blood chemistry. Helps identify elevated levels of beta-lipoproteins and the presence of hypercholesterolemia.
• ECG. It is necessary to detect coronary insufficiency, rhythm disturbance, postinfarction scars, moderate hypertrophy and intracardiac conduction.
• Echocardiography. Allows to determine violations of myocardial contractility.
• Bicycle ergometry. With its help, it is possible to clarify how strong myocardial dysfunction is, as well as in what state the functional reserves of the heart are.

Also, the patient can be sent for pharmacological tests, polycardiography, cardiac MRI, ventriculography, daily ECG monitoring, coronary angiography and rhythmocardiography. And to clarify whether there is an effusion, a chest x-ray, ultrasound of the abdominal and pleural cavities are performed.

Postinfarction cardiosclerosis

Continuing to talk about the symptoms of this disease, it is worth paying attention to this form of it. From a medical point of view, this pathology is one of the varieties of ischemic heart disease. Postinfarction cardiosclerosis is manifested by symptoms of heart failure:

• An increase in pressure in the pulmonary veins, capillaries and arterioles, accompanied by an increase in their permeability.
• Decreased exercise tolerance.
• Fatigue.
• Hard breathing with dry rales.
• Alveolar pulmonary edema.
• Cardiac asthma, triggered by neuropsychic or physical stress.
• Severe shortness of breath, acrocyanosis, cold sweat.
• Blanching of the skin. Covers may have a grayish tint.
• Increased intracranial pressure.
• Weakening and increased peripheral pulse.
• Low blood pressure.

To establish the diagnosis of "Cardiosclerosis of postinfarction etiology," the doctor, in addition to collecting an anamnesis and studying symptoms, directs the patient to the studies listed above. But besides them, one of the following can also be assigned:

• Pet heart. It helps to assess myocardial nutrition, the presence of deficient areas, and also to determine the degree of cell viability.
• Physical examination. Allows you to identify a shift down or to the left of the apical impulse and attenuation at the apex of the first tone. In rare cases, systolic murmur is detected on the mitral valve.
• Exercise tests (treadmill test and bicycle ergometry) and Holter monitoring. These studies help identify transient ischemia.

Especially informative in this case is echocardiography. It helps to detect left ventricular hypertrophy, dilation, chronic heart aneurysm and contractility disorders.

Myocarditis cardiosclerosis

And about this disease is worth telling separately. Myocarditis cardiosclerosis is a pathology leading to heart failure. In this case, myocardial tissue dies and is replaced by fibrous. Over time, the heart adapts to it, and this leads to an increase in its size. As a result - a violation of blood circulation and failure.

As a rule, patients complain of the following symptoms:

• Dizziness.
• Dyspnea.
• Heart palpitations.
• Fatigue too fast.
• Heart pains of a constricting or stitching nature.
• Increase or decrease heart rate.
• Heart rhythm disturbances. They are manifested in extrasystole, atrial fibrillation and heart block.
• Aneurysm. This is the name of the expansion and subsequent protrusion of tissue from the wall of the heart. If aneurysm rupture occurs, then a fatal outcome cannot be avoided.

To establish the correct diagnosis, the doctor conducts an auscultation examination, and then directs it to an ECG and MRI to obtain an image of the heart in several planes. This will allow you to study its condition, as well as consider valves, walls and chambers.

Other causes of the disease

What are the prerequisites for pathologies related to the above forms is clear. But you need to know that there are other causes of cardiosclerosis. The more rare prerequisites for the occurrence of this disease include:

• Radiation exposure. It can penetrate into the thickness of tissues and affect various systems and organs. If the heart muscle is irradiated, restructuring in the structure of cells occurs at the molecular level.
• Sarcoidosis This disease is systemic, so it can affect various tissues of the body. If sarcoidosis takes on a heart shape, inflammatory granulomas form in the myocardium.
• Hemochromatosis. It is characterized by active deposition of iron in cardiac tissue. Over time, this gives a toxic effect. As a result, inflammation forms, the result of which is the growing connective tissue.
• Scleroderma. Connective tissue begins to grow from the capillaries. And myocardium is rich in them. The heart begins to grow as the walls thicken, but there are no signs of cardiomyocyte destruction or inflammation.

And of course, medicine knows cases where the patient had idiopathic cardiosclerosis. This is a pathology that has formed for no apparent reason. Scientists suggest that the prerequisites are mechanisms that have not yet been discovered.

Perhaps there are hereditary factors that provoke the growth of connective tissue at a certain stage in life. But this probability is so far only discussed by specialists.

Vasodilator treatment

Much has been said above about the ICD cardiosclerosis codes, symptoms of this pathology, and diagnostic methods. Now we can talk about how it is treated.

Immediately need to stipulate one point. Cardiosclerosis is a very serious disease. Self-medication in this case is unacceptable! What kind of medicine will need to be drunk to alleviate symptoms is determined only by the doctor, taking into account the results of the diagnosis and the individuality of the patient's case.

As a rule, vasodilators are often prescribed. These drugs significantly improve local blood circulation. Usually prescribed such means:

• Cavinton Improves brain metabolism and blood circulation. Increases brain tissue oxygen and glucose uptake. Significantly increases the resistance of hypoxia to neurons and reduces platelet aggregation, dilutes blood. Increases cerebral blood flow. It enhances blood supply in those ischemic areas where there is low perfusion.
• Cinatropil. A combined drug that has a vasodilating, antihypoxic and nootropic effect. It improves metabolism in the central nervous system, cerebral circulation and erythrocyte membrane elasticity, reduces the excitability of the vestibular apparatus.

With cardiosclerosis, they should be taken in periodic courses, 1 tablet 2-3 times a day. The first period of therapy lasts, as a rule, 2-3 months.

Heart medications

There are countless of these tools, and they are all divided into groups. Some drugs regulate blood circulation and control vascular tone, others reduce pain, some act directly on the muscle, providing an anti-sclerotic and hypolipidemic effect, etc.

Cardiosclerosis of the heart is a complex disease, so drugs of different groups are prescribed, and here are the most popular:

• Korglikon. Glycoside, which has a positive inotropic effect. It has a plant origin, the basis of the drug is an extract of the leaves of May lily of the valley. Increases the sensitivity of cardiopulmonary baroreceptors, increases the activity of the vagus nerve.
• Asparkam. It replenishes the deficiency of magnesium and potassium in the body, regulates metabolic processes, reduces myocardial conductivity and excitability, and eliminates the electrolyte imbalance.
• "Digoxin". The basis of this preparation is the extract of woolly digitalis. Improves heart function and lengthens diastole. Increases myocardial contractility, and, consequently, minute and stroke volume.
• Verapamil. A calcium channel blocker that has antihypertensive, antiarrhythmic and antianginal effects. It affects both the myocardium and peripheral hemodynamics. Reduces myocardial oxygen demand, reduces its tone. If there is supraventricular arrhythmia, it also has an antiarrhythmic effect.

These drugs should be drunk 1 tablet 1-2 times a day. The course, as a rule, is 1-2 months.

Antiplatelet agents

These agents are also used in the treatment of focal and diffuse cardiosclerosis. They do not allow platelet aggregation (gluing), and this is precisely what leads to the formation of blood clots in the vessels. The best drugs in this category are:

• Cardiomagnyl. This tool not only inhibits platelet aggregation, it also has an antipyretic, analgesic and anti-inflammatory effect.
• Aspekard and Aspirin. These two drugs are analogues. They have the same effect as Cardiomagnyl. The antiplatelet effect in platelets is especially pronounced, since they cannot re-synthesize COX.

These drugs should be taken 1 tablet 1-2 times a day. All three of these drugs have a good thinning effect on the blood, and also improve blood circulation in the vessels and in the heart.

Other drugs

Continuing to talk about what it is - cardiosclerosis, and how to treat this disease, it is necessary to list the medicines of other groups that are prescribed to relieve symptoms.

With this pathology, nootropics are often prescribed, which have a specific effect on higher mental functions:

• Fezam. It also has a vasodilator and antihypoxic effect. It improves blood flow, reduces the resistance of brain vessels and blood viscosity, improves the elasticity of red blood cell membranes.
• Piracetam. It positively affects metabolic brain processes and integrative activity. Improves blood flow and communication between the hemispheres, stabilizes cerebral functions.

These drugs should be drunk on an ongoing basis, 1 tablet 2-3 times a day.

Also, medications that improve heart rate are often prescribed. These include "Cordaron" and "Coronal."

Edema such as Veroshpiron and Furosemide help cope with edema, which is one of the symptoms of the pathology in question. They should be taken 1 tablet 1 time per day for 2-3 weeks.

In addition to the above, with cardiosclerosis, it is absolutely necessary to drink restorative. Namely, vitamins of group B. Their regular intake increases immunity and the body's defenses. This is necessary when it is weakened due to illness.

Food

One of the key points in the effective treatment of cardiosclerosis is dieting. You can not create a load on the internal organs with food. Therefore, it is important to follow these rules:

• Eat 5-6 times a day in small portions.
• Do not exceed the norm of daily calorie content of 2500-2700 kcal.
• Discard salt. Or at least keep its consumption to a minimum.
• Cook only steamed. Fried, stewed, baked, etc. is prohibited.
• Include a maximum of trace elements and vitamins in your daily diet. That is, eat more fresh vegetables and fruits. Especially those where the content of calcium and magnesium is high, which is necessary to improve the functioning of the cardiovascular system.

You will also need to abandon these products:

• Cholesterol-rich foods (sausage, fish, lard, meat).
• Alcohol.
• Some vegetables and herbs: radishes, onions, peas, parsley, beans, cabbage and garlic.
• Energy, strong tea, cocoa, coffee.
• Eggs and dairy products.

It is still necessary to reduce the amount of fluid drunk. A day - no more than 0.5 liters. What can be used for cardiosclerosis? In fact, a complete diet is realistic. And so, from which:

• Fruits: cherries, apples, tangerines, kiwi, bananas and grapes. You can make compotes, jellies, puddings, etc.
• Nuts.
• Vegetables other than those listed previously.
• Rice and buckwheat cereal in low-fat milk.
• Fruit juices, especially carrot, apple and orange.
• Meat, poultry and fish with minimal fat (rare).

A more detailed list of prohibited and permitted will be a doctor. He will discuss the topic of nutrition with the patient without fail.

Forecast

Much has been said above about the ICD codes of cardiosclerosis, the symptoms and causes of this disease, as well as how it should be treated. Finally - a few words about the forecast.

In this case, the change in the patient's condition, as well as his ability to work, depends on the severity of the pathology and the nature of its manifestation. If it is not burdened by circulatory and rhythm disturbances, then the disease will proceed more favorably.

But in case of complications, the prognosis worsens. Significantly complicates the course of the disease ventricular extrasystole, atrial fibrillation and circulatory failure. Also a significant danger is ventricular paroxysmal tachycardia, atrioventricular blockade and aneurysm, which was mentioned earlier.

Pathology is highly recommended. If there are alarming symptoms, consult a doctor immediately, as well as promptly and actively treat atherosclerosis, coronary insufficiency and myocarditis.

People who have problems with the cardiovascular system or are prone to their appearance should undergo a scheduled examination every six months with a cardiologist.