Coronary heart disease (CHD) is a dangerous pathology caused by insufficient blood supply to the heart muscle. The disease can occur in acute and chronic form. Often a lack of blood supply leads to death. Symptoms of the disease will depend on its form. The wording of the diagnosis of coronary heart disease will also differ.
Description of the pathological process
More than 50% of elderly deaths are associated with coronary heart disease. Pathology is a serious problem of modern cardiology. To a greater extent, the disease affects men of working age (up to 65 years). Ischemia often results in disability of the patient. The pathological process is based on an imbalance between the need of the heart muscle for blood supply and the real flow of blood to the organ.
As a result of the disease, oxygen starvation occurs. All organs and systems of the patient are affected. Depending on the formulation of the diagnosis of coronary heart disease, the manifestations of the pathological process will also differ. This includes both acute and chronic myocardial ischemia.
Causes of the disease
In more than 90% of cases, the development of the disease is associated with atherosclerosis of the coronary arteries. The pathological process can develop with varying degrees of severity. With a slight narrowing of the lumen, the symptoms may practically not appear. With complete vascular occlusion, the risk of death is increased. The diagnosis of "IHD: acute coronary syndrome" is the reason for the hospitalization of the patient.
Against the background of an existing atherosclerotic lesion, elderly men and women often develop arterial thromboembolism. A spasm is manifested, which further exacerbates the obstruction of the coronary vessels.
The risk of developing the disease increases with an increased level of lipids in the patient’s blood. Overweight people who eat fatty foods rich in cholesterol are faced with problems. Hyperlipidemia can develop in the stronger sex after 40 years. In women, the pathology manifests itself most often with the onset of menopause.
Another negative factor that provokes coronary heart disease is arterial hypertension. This pathology increases the risk of disorders of the cardiovascular system several times. At an early stage, the disease may not manifest itself in any way. The patient does not feel increased pressure and continues to lead a familiar lifestyle. Coronary heart disease can be detected with a diagnosis of hypertension stage II stage 2. As a rule, this happens when a patient enters an ambulance medical facility. The patient develops a hypertensive crisis.
Significantly increases the risk of experiencing coronary heart disease in men and women with bad habits. Representatives of the stronger sex aged 35-50 years significantly increase the risk of death, provided that more than 20 cigarettes are smoked per day. It is enough for women to smoke periodically to face unpleasant symptoms. Patients suffering from alcoholism experience heart diseases much earlier.
Diabetes mellitus, a sedentary lifestyle, an unhealthy diet, and constant stress can also provoke the development of coronary disease. The risk of developing a pathological process increases significantly with the combination of several negative factors.
IHD classification
What does the diagnosis of IHD mean? This means that you need to pay special attention to your health, regularly visit a cardiologist for preventive examinations. The severity of ischemia, the speed of its development, causes - all this will depend on the form of the pathological process.
Sudden coronary death is the most dangerous form of coronary artery disease. This is an unforeseen condition associated with a complete cessation of blood supply to the heart muscle. Only in 20% of cases can a patient be successfully resuscitated.
The risk of death is reduced with the diagnosis "IHD: exertional angina." Attacks of ischemia periodically manifest against stress or excessive physical exertion. With timely medical care, the patient's condition improves. Angina pectoris is divided into three subgroups: stable, unstable and spontaneous.
Myocardial infarction is a type of coronary heart disease, often leading to death. The pathological process is associated with a sharp cessation of blood supply to the heart muscle. A heart attack can be small focal or large focal. If the patient’s life was saved, postinfarction cardiosclerosis may develop in the future. What it is? This is a condition in which the cells of the heart muscle are replaced by scar tissue.
Heart failure is another form of the pathological process. This is a syndrome that leads to a violation of the pumping function of the heart due to blockage of blood vessels. At an early stage, the disease may not manifest itself in any way. The risk to life arises from advanced heart failure.
Options for the diagnosis of coronary heart disease
In the International Classification of Diseases, IHD is classified as class XI - circulatory diseases. Chronic ischemic heart disease and acute angina are distinguished. Possible wording for the diagnosis of coronary heart disease:
- atrial fibrillation;
- coronary artery aneurysm;
- unstable angina pectoris;
- angina pectoris;
- heart aneurysm;
- asymptomatic myocardial ischemia, etc.
In the medical records of patients, you can find other names of the pathological process. However, the international classifier is most often used to formulate a diagnosis of coronary heart disease (an example can be seen above). This allows the specialist to quickly find their bearings if the patient is receiving treatment from another country.
Symptomatology
How is coronary heart disease manifested ? Symptoms and treatment will depend on the form of the pathological process. In general, the disease can have a wave-like course with periods of remissions and exacerbations. A third of patients do not feel any signs of a pathological process at all and learn about their condition at the first heart attack or during a preventive examination. Coronary heart disease can develop gradually. As the pathological process develops, its forms will also change.
Most often, the disease manifests itself against the background of excessive physical exertion or stress. Unpleasant signs such as shortness of breath, chest pain, weakness of the extremities appear. Many patients complain of increased fatigue, dizziness. In some cases, the disease can be detected after loss of consciousness. With a diagnosis of coronary heart disease: paroxysmal atrial fibrillation, it is possible to identify the pathological process against the background of already developing heart failure. The patient appears severe shortness of breath, swelling of the lower and upper extremities develop.
Before a heart attack, patients may also manifest psycho-emotional symptoms - panic attacks, fear of death. With a sudden coronary syndrome, the patient loses consciousness, breathing and pulse may be absent. The chances of a patient's life depend on the correct first aid.
Diagnosis of the disease
Based on only individual signs, it is impossible to identify coronary heart disease. The cardiologist makes the diagnosis in a hospital. Special instrumental techniques are used. The patient is sent for examination after characteristic complaints - rapid fatigue, swelling of the limbs, pain behind the sternum.
An important method for examining any diseases of the cardiovascular system is an electrocardiogram (ECG). The device registers the electrical work of the heart. If there are any abnormalities in the work of the myocardium, this will be immediately detected. By the names of the graph, you can determine the localization of pathological changes in the heart muscle. Using an ECG, acute and chronic diseases can be detected. In some cases, a deeper study is prescribed - daily monitoring of the ECG. The technique makes it possible to identify abnormalities in the work of the heart that occur periodically.
Heart ultrasound is another technique available in many medical institutions. During the scan of the heart tissue, it is possible to determine the size of the organ, its pathological changes. In addition to that, the technique allows you to assess the condition of the heart during physical or medical stress.
Of great importance are laboratory diagnostic tests. The study reveals a form of coronary heart disease. Symptoms and treatment will directly depend on the type of pathological process. The patient must be tested for blood. An increase in the number of certain enzymes will indicate the development of the disease. Also, a specialist will study the level of lipids and cholesterol in the blood.
Disease treatment
The choice of treatment methods depends on the formulation of the diagnosis of coronary heart disease. However, there are main directions that will be the same for all types of coronary heart disease. All treatment methods are divided into drug and non-drug. Endovascular treatment is widely used. In the most difficult cases, specialists resort to surgical intervention.
Non-drug therapy includes, first of all, lifestyle changes. The patient needs to give up smoking and alcohol, adjust nutrition, spend more time in the fresh air. Limitations will also depend on the wording of the diagnosis. With valve insufficiency in coronary heart disease, the patient will have to abandon excessive physical activity. Some patients have to change their profession or retire early.
In coronary heart disease, special attention should be paid to nutrition. To limit the load on the heart muscle, it is necessary to reduce the level of salt and water intake. This will reduce the manifestation of edema. A low-calorie diet will slow down the progression of atherosclerosis. It is recommended to completely abandon animal fats. The patient’s diet is made taking into account the individual characteristics of his body.
Comprehensive drug therapy allows the patient to prolong his life with coronary heart disease. Adrenergic blockers, antiarrhythmic drugs are prescribed. With hypertension, additional drugs that normalize blood pressure are additionally used. Diuretics allow reducing edema. If drug therapy carried out in a hospital does not show good results, the patient is referred for a consultation with a cardiac surgeon.
To restore normal blood supply to the damaged area, coronary artery bypass grafting is performed. A bypass vascular bed is created through which blood can fully flow to the heart muscle. Surgery can be performed on a working heart or using cardiopulmonary bypass.
With minor lesions, minimally invasive techniques are used. Coronary angioplasty is the balloon expansion of a damaged vessel. A lumen is created necessary for normal blood supply to the heart.
Complications of Coronary Heart Disease
Prevention of coronary heart disease is of great importance. Failure to timely therapy can lead to serious complications that threaten the patient's life. Myocardial infarction is one of the dangerous consequences that leads to a refusal to seek help. Due to blockage of the lumen of blood vessels, the blood supply to the heart muscle is disturbed. In most cases, necrosis of the affected tissue develops. The following symptoms may indicate the development of a heart attack: severe pain behind the sternum, developing in a calm state, an increasing sense of fear, familiar painkillers do not improve the condition. With such symptoms, an ambulance must be called immediately.
It is worth considering that with myocardial infarction, uncharacteristic symptoms can also develop. Sometimes there are symptoms of "acute abdomen" - bloating, nausea, diarrhea. Some patients have asthmatic syndrome. The patient begins to choke for no apparent reason. In this case, the patient has confusion of consciousness and speech.
Patients with diabetes often develop a heart attack without any symptoms. The only sign of the pathological process will be increased fatigue after work, which was previously given easily.
Heart failure is another dangerous complication of coronary artery disease. Myocardial contractility decreases sharply. The patient cannot perform simple actions. Even with minor physical exertion, shortness of breath appears. Acute heart failure is dangerous for pulmonary edema and death. In the chronic form of the disease, a complete oxygen supply to the organs is disrupted.
Treatment prognosis
Unfortunately, it is impossible to completely cure coronary heart disease. However, with proper therapy and compliance with all the requirements of a specialist, the patient can live for many more years. Direct forecast depends on the interaction of various factors. So, with a combination of hypertension and coronary heart disease, the chances of a full life are sharply reduced. Adverse factors include overweight and diabetes.
Disease prevention
A healthy lifestyle, periodic preventive examinations, timely access to medical care for any unpleasant symptoms are the best prevention of coronary heart disease. Proper nutrition is of great importance. A balanced diet will reduce the likelihood of cholesterol plaques.
You will have to reconsider your lifestyle if you have already been diagnosed with Coronary Heart Disease. It is impossible to stop the development of the pathological process. However, timely treatment and rejection of bad habits will significantly slow down the progression of the disease.