Coronary heart disease (CHD) is a condition characterized by a violation of the blood supply to the area of the heart muscle as a result of narrowing of the coronary vessels (vessels through which blood flows to the heart).
Coronary artery disease begins to appear if the degree of vasoconstriction reaches a level of 50%. According to the WHO classification, sudden coronary death, myocardial infarction and angina are referred to coronary heart disease.
Causes of IHD
Many factors can lead to vasoconstriction, atherosclerosis is the first among them. The blockage of the vessel from the inside occurs gradually due to the deposition of salts and fats on its inner wall. Men are more susceptible to this phenomenon, but arterial hypertension, smoking, alcohol consumption, a sedentary lifestyle, increased blood coagulation, heredity and metabolic disorders can be considered predisposing factors for both sexes.
Separately, I would like to note stress when the lumen of the vessel narrows due to the action of hormones.
It doesn’t matter which vessels of the organ were damaged (ischemia of the heart, kidneys or ischemic stroke), the symptoms may be different, but the pathological process is the same everywhere. It consists in the necrosis of part of the cells due to lack of blood supply.
Signs of coronary heart disease
One form of coronary heart disease is sudden coronary death. Its cause can only be determined at autopsy, and in most cases it is vascular atherosclerosis. Almost all of the dead suddenly had heart disease.
Angina pectoris (popularly referred to as angina pectoris) is manifested by pain behind the sternum, extending to the left shoulder and arm, as well as discomfort in the chest area (burning, bursting).
An attack can occur after physical exertion, plentiful food, a sharp change in temperature, and in severe cases, even at rest. The attack lasts up to 15 minutes. If you eliminate the cause (relax, calm down) and take nitroglycerin, then the condition normalizes, because nitrates dilate blood vessels, restoring blood flow to the heart.
Myocardial infarction is also a coronary heart disease, which is characterized by the death of part of the cells of the heart muscle due to the lack of blood supply in this area.
The signs of coronary heart disease that occur during a heart attack resemble angina pectoris, manifested by pain behind the sternum, extending to the scapula, left arm and stomach. However, it lasts more than 30 minutes and does not pass after taking nitroglycerin. In addition, pain is accompanied by a decrease or increase in blood pressure, tachycardia (not always). Nausea, vomiting, cold sweat, shortness of breath, muscle tremors, and fear of death may appear.
Diagnosis of IHD
Coronary heart disease develops for a long time, therefore, timely diagnosis of cardiac blood flow disorders prevents severe consequences.
First of all, the doctor conducts a survey and examination, but a more complete picture of the state of the vessels can be obtained only after the following procedures:
- ECG at rest;
- bicycle ergometry (stress test) - ECG performed during exercise;
- Echocardiography;
- Cardiac catheterization and angiography are the most modern and accurate tests to determine the blood supply to the heart.
IHD treatment
Therapeutic measures for coronary heart disease are aimed at improving blood supply and vasodilation. However, the range of activities also includes therapeutic nutrition and physiotherapy.
Therapeutic nutrition. With improper nutrition, even the most expensive and effective treatment will not have the desired effect on the body. Coronary disease requires a decrease in salt and fat intake, an increase in fiber, vitamins and minerals in the diet.
Medicines In coronary heart disease, nitrates (to relieve vasospasm) and antiplatelet agents (to reduce blood viscosity) are used. Beta-blockers, ACE inhibitors and calcium channel blockers improve blood flow . In case of excess weight, lipid-lowering drugs (lowering blood cholesterol) are prescribed.
All drugs are taken only as prescribed by the doctor and in strict accordance with the recommended dosages.
Physiotherapy. It should be carried out under the guidance of a coach outside of periods of exacerbation of the disease.
It is worth saying that all these measures must be taken immediately after the detection of ischemic disease, without waiting for the development of a heart attack, more severe angina pectoris or sudden death.
Coronary artery bypass surgery is performed in severe cases to expand the lumen of the vessel.