Currently, coronary heart disease is considered one of the most common pathologies in the world. It is a consequence of the narrowing of the lumen of the coronary arteries, responsible for the blood supply to the most important organ. Over time, the number of atherosclerotic plaques on the walls of blood vessels increases, and the severity of symptoms of cardiac ischemia becomes brighter. Ignoring the disease can lead to complete blockage of blood vessels, the logical result of which is the death of a person.
The mechanism of development and form of the disease
Cardiac ischemia occurs when there is an imbalance between the actual blood supply to the organ and its need for liquid connective tissue that delivers oxygen and nutrients.
In medical terminology, there are also other names for pathology: coronary disease and coronary sclerosis. This is due to the fact that cardiac ischemia is not one ailment, but a whole group of them. Moreover, all diseases that are included in it are characterized by circulatory disorders in the arteries, the task of which is to provide blood to a vital organ.
As a rule, narrowing of the lumen of blood vessels occurs due to the deposition of atherosclerotic plaques on their walls, resulting from an increase in the level of "bad" cholesterol in the blood. The situation may be aggravated by the fact that sometimes a thrombus forms in the area of partial blockage, which completely blocks the blood flow. In this case, there are 2 possible scenarios: either the artery independently restores its conductive function, or partial or complete tissue necrosis occurs.
Ischemia is a heart disease that includes both acute and chronic conditions, as a result of which the myocardium undergoes changes. In practice, they can also be considered as independent nosological units.
Currently, doctors use the following classification of forms of ischemic disease:
- Sudden coronary death. Its other name is primary cardiac arrest. This is an acute condition that develops as soon as possible (instantly or no later than 6 hours after the attack). In case of sudden coronary death, 2 variants of the development of events are possible - successful resuscitation or death.
- Angina pectoris. It manifests itself in the form of an attack, which is a signal of the occurrence of oxygen starvation. Thus, one of the main signs of cardiac ischemia is angina pectoris. It can be stable, or stress (divided into 4 functional classes, depending on the load that a person can bear), unstable (appears at rest, after myocardial infarction or immediately in front of it), spontaneous (occurs due to a sudden spasm of the coronary arteries) .
- Painless form. A third of all patients are not even aware of the presence of the disease, since they have absolutely no signs of cardiac ischemia.
- Myocardial infarction. This is an acute lesion of the heart, resulting from the blockage of one of the vessels by an atherosclerotic plaque. In this case, part of the muscle tissue dies. Myocardial infarction can be large or small focal.
- Violation of the rhythm of the heart and its conduction.
- Postinfarction cardiosclerosis. This is a condition characterized by the replacement of dead tissue of the heart with connective tissue. In this case, the functioning of the organ is disrupted.
- Heart failure. With this pathology, the muscle cannot fully provide other organs and systems with blood.
And now, regarding the danger of cardiac ischemia. If the muscle does not receive enough oxygen and nutrients with the blood, its work is disrupted. As a result, the heart cannot fully perform its function and all organs and systems are already involved in the pathological process.
Causes
In 98% of cases, coronary artery disease is a consequence of atherosclerosis of the coronary arteries. In this case, the lumen of the blood vessels of the heart can be partially or completely blocked. Blockage of arteries by 75% already leads to angina pectoris, as the body begins to respond to a pronounced lack of oxygen. According to statistics, the ventricle of the heart located on the left is most prone to developing ischemia.
In rare cases, the disease occurs due to thromboembolism or coronary spasm. But these states also develop, as a rule, against the background of already existing atherosclerosis.
There are many factors that significantly increase the risk of developing cardiac ischemia. The main ones are:
- high blood pressure;
- genetic predisposition;
- smoking;
- lack of physical activity;
- high level of "bad" cholesterol in the blood;
- alcohol abuse;
- diseases due to which there is an increase in the blood coagulation index;
- physical and emotional overwork;
- incorrect organization of the working day, due to which there is practically no time for a good rest;
- diabetes;
- overweight;
- frequent stress;
- eating harmful food.
In addition, the natural process of aging of the body plays an important role. The larger the person’s age, the higher the risk of developing coronary heart disease. According to statistics, middle-aged men are more likely to suffer from the disease.
Symptoms
Coronary disease can have an acute course or develop very slowly over many years. Clinical manifestations depend on the specific form of pathology.
As a rule, the disease has a wave-like character, that is, calm periods during which the patient's well-being is satisfactory, alternate with episodes of exacerbation.
The following symptoms are common symptoms of cardiac ischemia:
- Pain behind the sternum arising from physical exertion or stress.
- Shortness of breath when committing any motor activity.
- Pain in the back, arms (usually left). Often there is discomfort in the lower jaw.
- Interruptions in the heartbeat, rapid rhythm.
- Constant feeling of weakness.
- Nausea.
- Short-term loss of consciousness.
- Dizziness.
- Increased sweating.
- Swelling of the lower extremities.
Often, the above signs of cardiac ischemia do not occur simultaneously. As a rule, there is a predominance of certain symptoms with a certain form of the disease.
Before a sudden cardiac arrest occurs, a person feels pain behind the sternum, having a paroxysmal character. In addition, he has a sharp mood swings, there is a strong fear of death. Then a person loses consciousness, the process of breathing stops, the skin turns pale, the pupils begin to expand, attempts to feel his pulse are unsuccessful. In case of sudden coronary death, it is necessary to carry out resuscitation measures, the methodology of which everyone must know. According to statistics, most cases of death occur precisely at the prehospital stage.
Diagnostics
If there are alarming signs, you need to contact a cardiologist. At the initial appointment, he finds out what symptoms the patient is concerned about, examines his skin for cyanosis, confirms or eliminates the presence of edema of the lower extremities. In addition, with the help of a phonendoscope, the doctor can detect heart murmurs and various disorders in the functioning of the organ. After collecting an anamnesis, the doctor gives a referral for examination.
The main methods for diagnosing coronary disease are:
- Echocardiography. This method involves ultrasound, in which the doctor receives information regarding the size of the heart and its condition. In some cases, echocardiography is carried out after a little physical activity, which makes it possible to detect ischemia.
- Functional tests with load. ECG sensors are installed on the patient’s body, after which he is asked to perform one of the tests, for example, walk quickly, jump, climb stairs, etc. The method is informative enough to detect ischemic disease at an early stage of development, but is not applicable to to patients who, due to health reasons, cannot make active movements.
- ECG according to Holter. The method involves daily monitoring of the work of the heart muscle using a portable device that is mounted on the patient’s belt or shoulder. In addition to the readings of the device, the doctor must provide an observation diary. In it, the patient must hourly note his activity and record changes in well-being.
- CHPECG. The essence of the method is that a special sensor is introduced into the esophagus, with the help of which the doctor is able to assess the condition of the myocardium. The method is considered highly informative, since in the process of diagnosis there are no interferences created by the skin, adipose tissue and chest.
- Coronarography The method is based on the introduction of a reagent to the patient and subsequent contrasting of the myocardial vessels. With its help it is possible to assess the degree of violation of patency of arteries. As a rule, resort to coronarography in the case when it is necessary to decide on the feasibility of surgical intervention.
In addition, the doctor prescribes a blood test, the results of which can also be used to judge circulatory disorders.
Conservative treatment
It includes several main stages:
- Taking medication.
- Physiotherapy.
- Physiotherapeutic procedures.
Only a cardiologist should decide on how to treat cardiac ischemia in each case. Self-administration of drugs can only aggravate the situation and lead to sad consequences.
As a rule, the doctor recommends taking the following funds:
- "Nitroglycerin" and its derivatives. The action of the drugs is aimed at eliminating spasms and widening the lumen of the coronary vessels. Due to this, the access of oxygen and nutrients to the heart with blood is restored.
- Medicines that reduce blood coagulation. In the treatment of cardiac ischemia, it is necessary to reduce the risk of blood clots. Often, the doctor prescribes Aspirin for this purpose.
- Drugs that prevent the absorption of cholesterol, improve metabolism and promote the removal of lipids from the body.
- Vitamins P and E. In order to maximize the benefits of their intake, it is recommended to combine them with ascorbic acid.
Regardless of the severity of symptoms, treatment of cardiac ischemia must necessarily include physical activity. At the initial stage of the development of the disease are shown: cycling, running, swimming. During the period of exacerbation, loads are prohibited.
In severe forms of the disease, the patient must regularly perform a set of therapeutic exercises. Classes are held exclusively in a hospital with an instructor and under the supervision of a cardiologist. All exercises are performed slowly and with a small amplitude. Before classes, during and after them, the patient measured the pulse.
In the absence of contraindications in the treatment of cardiac ischemia, it is recommended to undergo a course of physiotherapy. The method is chosen by the doctor, taking into account the individual health characteristics of each patient.
The most effective are:
- therapeutic baths;
- electrophoresis;
- galvanic collar;
- electric sleep.
In large cardiac centers, the method of laser therapy is widespread.
In addition to the above, the patient needs to adjust the diet and minimize the impact of harmful factors.
Surgical intervention
Currently, the most common surgical method for the treatment of coronary artery disease is coronary artery bypass grafting. The decision on its implementation is made in the case when conservative methods do not bring results.
The essence of coronary artery bypass grafting is that during the operation, workarounds are created. Through them, blood will flow to the heart, bypassing the vessels, the lumen of which is narrowed by atherosclerotic plaques. The aim of treatment is to improve the patient's condition and reduce the number of exacerbations, in the event of which urgent hospitalization is indicated.
Diet
With cardiac ischemia, the diet should be strictly observed. It is required to abandon products containing a large amount of animal fat. They contribute to an increase in the level of "bad" cholesterol in the blood, which significantly increases the risk of complications of ischemic disease.
It is necessary to eat the following foods as often as possible:
- nuts
- cottage cheese;
- raisins;
- wild strawberries;
- honey;
- pumpkin;
- peas;
- eggplant;
- cranberries;
- sea kale;
- rose hip drinks.
In addition, the doctor may recommend taking vitamin complexes.
Unconventional methods of dealing with the disease
Treatment of cardiac ischemia with folk remedies does not exclude the need to see a doctor if there are alarming symptoms. The use of any unconventional methods must also be agreed with a specialist.
The most effective recipes for ischemia:
- Beat 2 egg whites with 2 tsp. sour cream and 1 tsp. honey. Take the resulting mixture on an empty stomach.
- Take 1 tbsp. l crushed seeds or herbs of dill and pour 300 ml of boiling water. Let it brew for about an hour. Drink small meals throughout the day.
- Grind 5 heads of garlic and mix it with juice of 10 lemons and 1 liter of honey (preferably lime). Close the container tightly and put it in a cool place for 7 days. After this period, the mixture must be taken daily at 4 tbsp. l In this case, it is important to observe one condition - between the use of each spoon, it is necessary to withstand a minute pause.
Prevention
In order to reduce the likelihood of developing coronary disease, you need to reduce the number of harmful factors:
- give up alcohol and smoking;
- with obesity, reduce body weight;
- to live an active lifestyle;
- observe the principles of proper nutrition;
- avoid stressful situations;
- properly organize the working day;
- timely treat existing diseases.
Maintaining a healthy lifestyle minimizes the risk of dangerous pathologies.
Finally
The main cause of coronary artery disease is atherosclerosis. As a result of narrowing of the lumen of the coronary arteries, the heart does not receive enough oxygen and nutrients with the blood.
The disease can take several forms, each of which poses a serious threat to a person’s life while ignoring alarm signs.
The treatment of ischemia is carried out by several methods simultaneously. If conservative therapy has not yielded results, surgical intervention is indicated. As a rule, in practice the method of coronary artery bypass grafting is most often used.