Coronary insufficiency is a pathological condition that is characterized by a partial decrease or complete stop of coronary blood flow. This condition is a manifestation of coronary heart disease.
It is classified into the following groups:
- Acute coronary insufficiency.
- Chronic course of the disease.
Coronary insufficiency syndrome is treated depending on the form. Both surgical methods and medical and folk remedies are used.
Causes
The main cause of coronary insufficiency is spasms, atherosclerotic and thrombotic stenosis. An increased load on the myocardium can lead to the formation of an ailment. The load increases with the following factors:
- adrenaline rush into the blood (stress);
- anemia;
- fever;
- infectious processes;
- hypertension.
Also, the cause of coronary insufficiency can be:
- heart disease;
- aortic aneurysm;
- heart bruise;
- heartbreak;
- pulmonary embolism ;
- anaphylactic shock;
- pulmonary stenosis;
- impaired patency of the arteries (due to cramping, thrombosis, narrowing of the lumen of the arteries);
- intoxication as a result of alcohol or nicotine addiction (release of substances that cause the onset of coronospasm).
The reasons why coronary insufficiency occurs are a factor that activates a series of pathological mechanisms that can lead to death, among other things.
Symptomatology
You should pay attention to the appearance of alarming signs. Coronary insufficiency is a fairly common cause of death from heart disease. There is a fairly extensive list of symptoms indicating its presence.
- Tense pain in the area of the heart, lasting for ten minutes.
- A kind of "rigor" of the body that occurs during increased physical exertion.
- Permanent pallor.
- Heart palpitations.
As a rule, the above symptoms are found in a complex. It is also worth considering that there are a number of other signals. They are presented below.
- Superficial, slow breathing indicates an ailment.
- Nausea and vomiting. They are also harbingers of a pathological condition.
- Increased salivation. In other words, a lot of saliva is constantly released.
- Excessively light color of urine released in too large quantities.
These symptoms of coronary insufficiency clearly indicate problems in the body. If they are found, you must immediately consult a doctor in the appropriate direction, since this condition necessarily requires treatment.
Diagnostics
Diagnosis is carried out using several methods, they are able to cause symptoms by which this disease is detected. Here are some diagnostic methods:
- The most significant contribution to the recognition of coronary insufficiency is made by electrocardiography, it is performed with dosed physical activity. ECG - signs of this disease, appear after the peak of physical activity, and depression of the ST segment may also begin in 3-6 minutes. Another indirect sign of coronary insufficiency is arrhythmia that occurs after physical exertion.
- They also perform coronarography in order to assess the condition of the coronary arteries, as well as to accurately determine the sites of occlusal or stenotic lesions. This is a radiological diagnostic technique in which contrast agents are used.
- To determine the amount of electrolytes, glucose, lipoproteins, total low and high density cholesterol, T and I, laboratory diagnosis of coronary insufficiency is carried out. The detection of these signs means that a heart attack or myocardial infarction has already occurred.
Acute form
The statistics of an unexpected passing away are very sad: every year there are more and more such deaths. The factor is heart failure. The heart muscle needs to “breathe” (be supplied with oxygen) and eat (provide itself with microelements). This task is performed by blood vessels.
The causes of acute coronary insufficiency are the same as the general ones. Arteries are located near the heart in the image of the crown, which is why the name came about - coronary or coronary. If blood flow weakens due to external or internal narrowing of blood vessels, the heart muscle feels a lack of nutrition and oxygen. A similar sensation in medical terms is called coronary insufficiency. If a disruption in work occurs gradually, then heart failure becomes a chronic deficiency. Fast (in a few hours or minutes) is an acute coronary insufficiency. As a result, the oxidation product accumulates, which gives a malfunction in the working activity of the “motor”, rupture of the vessel, tissue necrosis, cardiac arrest, death.
Mostly acute coronary insufficiency leads to coronary artery disease. Often there is its development in the form of such ailments as heart disease, trauma, cerebral edema, pancreatitis, bacterial endocarditis.
Chronic form
It is worth considering that the chronic form of the pathology arises from the acute stage. In other words, if a person has acute coronary insufficiency, then after a certain period of time it will turn into chronic.
The condition is provoked by a reduced blood flow to the myocardium. This, as a rule, is caused either by atherosclerosis of the vessels, or by some change in the properties of the blood. Also, we must not forget that this disease can be inherited.
There is a fairly extensive list of symptoms that signal coronary insufficiency. Thus, the possible presence of the disease can be judged if the patient has:
- Unreasonable shortness of breath.
- Hacking cough.
- Pressing pain in the myocardium.
It should be clarified that at the beginning of the disease, symptoms occur with increased physical exertion, however, as the pathology develops, they also manifest themselves at rest.
In addition to the above signals, coronary insufficiency can indicate:
- Nausea.
- Vomiting
- Imperative urge - a constant desire to urinate.
Sudden death
A phenomenon such as coronary insufficiency can lead to sudden death. There are a lot of such cases, even if the patient received medical attention. This pathology is currently poorly studied, this phenomenon requires a more thorough study. It is known that this phenomenon is often found in older people, but the development of pathology in people of 20 years of age is also possible.
Often there are such cases that people did not complain about their health, did not even visit a doctor, but they had a coronary death. In this condition, a process occurs that blocks normal coronary circulation, and this is fraught with a dangerous failure in the supply of oxygen to the heart muscles. The muscle of the heart is susceptible to a decrease in oxygen levels and after a few minutes with a lack of nutrition tissue dies.
In many cases, sudden death in coronary insufficiency is associated with hypertension or with inflammatory processes that affect the heart muscles. The following factors provoke a fatal outcome:
- increased blood coagulability;
- infectious diseases that are accompanied by sepsis;
- state of overheating of the body;
- lack of potassium, magnesium;
- penetration of air bubbles into the coronary artery.
Drug treatment
The main method of combating coronary insufficiency is medical treatment. The goal of therapy is to eliminate the cause of the disease and its symptoms. One of the goals of this treatment is to restore oxygen access to the tissues of the heart. What remedies are prescribed for coronary insufficiency?
1. Emergency care:
- Aspirin is a drug that can thin the blood and prevent the appearance of blood clots. Facilitates the passage of blood through the vessels, even if they are narrowed.
- "Nitroglycerin" - supplies oxygen to the heart cells, thereby improving blood circulation. It is used for sudden coronary insufficiency.
- "Clopidogrel" - acts on the enzymatic system of platelets, changing their receptors and preventing the formation of.
- "Ticlopidine" - does not allow platelet adhesion, reducing blood viscosity, as a result of which blood clots do not form.
2. Anesthetics:
- "Droperidol" - blocks dopamine receptors in the brain.
- "Morphine" (analogue of "Fentanyl") - is able to cause mild arterial and venous dilation. It is a narcotic opioid substance.
- "Promedol" - acts by relaxing the muscles, which leads to the elimination of spasms.
3. Thrombolytic agents:
- They are used to dissolve blood clots, most often such drugs as Tenecteplase, Streptokinase, Urokinase, Alteplaza.
Therapy is prescribed by the attending cardiologist, depending on the state of the body.
Surgery
When therapy in the treatment of coronary insufficiency no longer helps, a surgical intervention is used, the purpose of which is to restore blood supply in the problem area of the vessel. There are 2 main types of surgical treatment for the disease:
- Bypass surgery.
- Angioplasty.
When bypassing, doctors create additional blood flow bypassing the narrowed area in the vessel. For this, the patient’s own vessels — veins or arteries — are most often used. This extra blood flow is called a shunt.
Angioplasty can be:
With balloon angioplasty, a balloon is inserted into the narrowed section of the vessel, which expands the problem area. During this operation, a small incision is made in the aorta, a tube is inserted with a balloon at the end, which advances to the point of narrowing of the vessel.
With laser treatment, a quartz thread is inserted into the incision instead of a tube. She also advances to the site of narrowing. After that, the laser is turned on, which acts on cholesterol - the main problem of narrowing in the vessels. The cholesterol plaque is destroyed and the lumen in the vessel becomes larger.
The effectiveness of angioplasty reaches 95%. Therefore, this type of surgical treatment of coronary insufficiency is used more often.
Danger
Coronary heart disease is often almost asymptomatic, progressing and leading to a number of complications, the most serious and irreversible of which is coronary death. Among the most common complications are:
- changes in the structure of the heart muscle;
- rupture of the heart wall;
- aortic aneurysm;
- pericarditis (inflammatory lesion of the pericardial sac);
- various types of arrhythmias;
- involuntary vasoconstriction;
- minor but dangerous changes in the anatomy of the heart.
In addition to the above, coronary insufficiency can also cause two extremely serious conditions: unstable angina and myocardial infarction.
There are three stages of the negative consequences of the disease:
- High risk of death. It is characterized by angina attacks lasting more than 20 minutes, pulmonary edema with sputum discharge, low blood pressure, shortness of breath, darkening in the eyes, and loss of consciousness.
- The average degree of death threat is determined by angina attacks of less than 20 minutes (manifested within the last couple of weeks, easily eliminated by the resorption of Nitroglycerin), night attacks of chest pain, the patient's age over 65 years.
- A low degree of risk is caused by a more frequent occurrence of angina attacks in the last two months, even after light physical exertion, the absence of new changes on the ECG, in comparison with the previously obtained results.
Prevention
When entering a risk group for coronary insufficiency, it is necessary to adhere to a lifestyle aimed at preventing this condition. Criteria for entering the risk group:
- overweight;
- constant overwork, stress;
- high cholesterol;
- sedentary lifestyle;
- smoking.
Recommendations for the prevention of the disease:
- Maintaining an active lifestyle: regular exercise, swimming in the pool, slow walking. It is recommended to abandon the use of the elevator and give preference to the stairs. You can not dramatically increase the load, this should happen gradually. If necessary, you can seek the advice of a cardiologist.
- Compliance with a healthy diet, the diet should be balanced. The intake of foods rich in cholesterol and animal fats should be reduced. It is worth making a choice in favor of vegetable oils, such as corn. The consumption of sweets and flour products is also recommended to limit. Overeating should be avoided.
- Reduce stressful situations. Try to worry as little as possible.
If you adhere to the above recommendations, the likelihood of coronary insufficiency will be minimized.