Post-infarction cardiosclerosis is one of the forms of coronary heart disease, which manifests itself as a replacement of part of the muscle fibers of the myocardium with connective tissue.
With circulatory disorders in any part of the heart, this area dies. The necrotic site can be of different sizes and located anywhere. To compensate for lost muscle tissue, the heart has to produce even more connective tissue. Therefore, post-infarction cardiosclerosis is the only outcome after myocardial infarction, and it will take at least three weeks to completely heal the area with necrosis and scar formation. The diagnosis is set automatically only after this period.
Often, cardiosclerosis becomes fatal, therefore, the disease must be taken seriously and all the recommendations of the attending doctor should be followed. Before proceeding with treatment, it is necessary to establish a type of cardiosclerosis.
Types of postinfarction cardiosclerosis
Depending on the area of scars, there are several types of ailment:
- Large focal. It is formed after an extensive myocardial infarction.
- Scattered small focal. A large number of small inclusions of connective tissue in the myocardium. Appears after several micro-infarctions.
A large-focal postinfarction cardiosclerosis most often leads to death, and all because a large-sized scar prevents the heart from working fully. As for the localization of the disease, most often it forms on the left ventricle, on the anterior wall, as well as on the interventricular septum.
Causes of the disease
The main reason for the development of the disease is myocardial infarction. Doctors detect post-infarction cardiosclerosis only 2-4 months after the attack. It takes so much time to complete the scarring process. Affected cells are replaced by scar tissue. Depending on the location and degree of disturbance, various problems in the functioning of the heart are manifested.
Connective tissue is not able to contract and transmit electrical impulses, which ultimately leads to disturbances. As a result, heart tissues are deformed and stretched, sometimes even affecting heart valves, it all depends on the location.
There is another reason for the development of pathology - myocardial dystrophy. This deviation is manifested in those patients who have problems with metabolic processes. As a result, malfunctions of the circulatory system occur, as the contractility of the heart muscles decreases. Trauma can provoke the development of this ailment.
To establish the exact causes of the development of pathology can be quite difficult, but it is important in order to choose the right treatment for postinfarction cardiosclerosis. Only after eliminating the root cause can the development of the disease be stopped. But only a specialist should do this. Jokes with a heart are bad, so self-medication is not allowed.
Symptomatology
If the disease develops gradually and slowly, then there are no obvious symptoms. With moderate growth of connective tissue, the walls of the heart do not lose their elasticity and muscle strength does not become weaker.
Symptoms may also be absent if the lesion is located on the surface of the connective tissue and is small in size.
In other cases, disturbances in the heart can be accompanied by such manifestations:
- Dyspnea. This is one of the signs of chronic heart failure, which often accompanies severe cardiosclerosis. This symptom is manifested more rapidly after a heart attack or myocarditis. It manifests itself in the form of respiratory failure, in which a person is not able to normalize his rhythm. More often, shortness of breath is observed during physical exertion or stress. It will not work out on its own, because irreversible processes occur in the heart.
- Cough. This symptom is manifested due to stagnation of blood in the lungs. The walls of the bronchi are filled with fluid and become thicker. This feature provokes irritation of cough receptors. With a diagnosis of postinfarction cardiosclerosis, the cough is dry and appears in the same cases as shortness of breath.
- Arrhythmia. This is a consequence of the defeat of the conduction system of the heart. Fibers conducting impulses are damaged. As a result of this feature, the zones of the heart contract later. This provokes a decrease in blood circulation. In addition, an uneven contraction of the heart muscles leads to the fact that blood moves more strongly in the heart chamber and increases the risk of blood clots. Arrhythmia is most often observed in patients with severe post-infarction cardiosclerosis of the heart.
- Heart palpitations. It is observed due to rhythm disturbance and lack of synchronism. With this pathology, the patient feels the heartbeat in the neck or abdomen.
- Fatigue. With problems with the work of the heart, blood flow decreases, a weak contraction of the heart muscles does not allow maintaining normal blood pressure, which leads to rapid fatigue.
- Angina pectoris.
- Swelling of the veins on the neck, as well as their strong pulsation, which can be easily seen, you only need to look at the patient.
- Swelling. This symptom appears later than anything else and is the result of stagnation in a large circle of blood circulation. In most cases, it is the legs that swell. Initially, the symptom manifests itself in the morning, but as it develops, it can persist throughout the day.
- Accumulation of fluid in the pleural cavity or heart shirt.
- Stagnation in the liver or spleen, possible enlargement of organs in size.
- Dizziness. This symptom manifests itself in the form of episodic syncope in the later stages of the disease. These disorders are the result of acute cerebral hypoxia associated with cardiac arrhythmias and a sharp decrease in pressure.
If at least a few of the symptoms described appear, then you should immediately consult a doctor and undergo a thorough examination to find out the causes of post-infarction cardiosclerosis and to eliminate them.
Diagnostic methods
The health status of patients who have had a heart attack is constantly monitored by doctors. After all, as mentioned earlier, only after the scarring process can the final diagnosis of “post-infarction cardiosclerosis” be made. The medical history of some patients who have suffered only a microinfarction may not even contain records that they are facing cardiosclerosis. They most often seek help, complaining of chest pain, shortness of breath, and other symptoms indicating heart failure.
Already at the first examination, cardiosclerosis can be suspected in a patient. And they reveal it by such signs:
- heart murmur;
- heart tone is deaf;
- high blood pressure;
- disturbed rhythm.
All these manifestations can also talk about pathologies associated with the cardiovascular system. Additionally, the following procedures can be prescribed to the patient:
- An ECG allows you to study the features of conduction and electrical activity of the heart, to identify arrhythmia. It is she who indicates the manifestations of cardiosclerosis.
- Echocardiography helps to detect an increase in the walls of the left ventricle (normal - not more than 11 mm), a decrease in the fraction of ejection of blood by the left ventricle (normal - within 60%).
- Myocardial scintigraphy is performed using radioactive isotopes, so that you can easily determine the location of healthy and damaged areas of the heart. When carrying out this method, a radiopharmaceutical is administered to the patient, which enters only into healthy cells. It is thanks to this drug that you can easily find damaged ones.
- An x-ray helps to identify the condition of the left ventricle: how stretched and deformed it is.
All of these methods are also used to control treatment. After confirming the diagnosis, complex therapy is selected.
IHD and cardiosclerosis
Such heart lesions as coronary heart disease, cardiosclerosis are common, especially in people who suffer from atherosclerosis. In such patients, coronary heart disease begins to develop initially, which provokes changes in the myocardium associated with proliferation and the formation of connective tissue. Therefore, most often, no symptoms indicate the development of postinfarction cardiosclerosis. Angina pectoris and other forms of coronary heart disease account for most of the manifestations. Today, several forms of coronary heart disease are distinguished: exertional angina, Prinzmetal angina, myocardial infarction, arrhythmia, and cardiosclerosis.
Therefore, it is important to undergo a thorough examination, find out the exact diagnosis, find out the form of pathology and begin timely treatment, which will allow the patient to feel like a full-fledged person in society. Therapy, depending on the form of pathology, may vary.
Cardiosclerosis Treatment
Today, there is no effective treatment for cardiosclerosis, and all because a drug has not yet been created that could create functional cardiomyocytes from connective tissue. That is why until the end of life, the patient will have to take medicines.
Recommendations for the treatment of coronary heart disease, post-infarction cardiosclerosis can only be given by cardiologists. But it is worth remembering that therapy is carried out in order to solve such problems:
- remove the causes of the disease;
- eliminate all aggravating factors;
- prevent complications;
- improve the quality of life of the patient;
- remove the manifestations of coronary heart disease and heart failure.
There are several areas of treatment, and they are selected individually for each patient.
Cardinal surgery
This method involves heart transplantation. Only by replacing the organ, you can cope with the symptoms and completely restore the supply of oxygen to the heart.
But such an operation is performed only in patients in whom most of the heart is affected. Today, transplantation is already a simple procedure, it is successfully carried out in many countries. The main indicators for its implementation are:
- decrease in cardiac output less than 20% of normal;
- young age;
- the absence of severe pathologies of the liver, lungs, kidneys;
- lack of positive results after drug treatment.
But among the contraindications, one thing can be distinguished - if an accurate diagnosis is not made. If the cause of post-infarction cardiosclerosis, whose ICD-10 code is I25.1, is an undefined systemic disease or infection, then transplantation will not give the desired results. Without adequate therapy, a new heart will fail. But the main problem of this method of therapy is to find a suitable donor.
Palliative surgery
This method is used to combat the signs or consequences of cardiosclerosis, while eliminating the disease itself does not work. This technique makes it possible to extend the life of the patient and make it better. Palliative therapy includes the following procedures:
- coronary artery bypass grafting;
- treatment for aneurysm;
- installation of pacemakers.
All these measures will help the patient live a few more years of life and not feel disabled.
Drug treatment
The use of medications depends on the severity of the manifestation of post-infarction cardiosclerosis, the ICD-10 code of which is I25.1. The doctor makes the selection of drugs specifically for each patient after passing the examination. Most drugs to normalize heart function are characterized by the presence of a large number of undesirable manifestations, such drugs are rarely combined with other drugs. That is why self-medication can be harmful to the health or cost the life of the patient.
To eliminate the chronic form of heart failure, doctors use these drugs:
- Inhibitors of the angiotensin-converting enzyme, which affect the enzyme and activate the production of angiotensin II, due to this it is possible to reduce the load on the heart and effectively cope with the symptoms of the disease.
- Aldosterone antagonists block the hormone aldosterone, which is involved in the normalization of blood pressure, and affect the function of the heart, but it is worth remembering that these drugs do not combine well with ACE inhibitors and beta-blockers.
- Beta-blockers normalize the rhythm of the heart and reduce the risk of complications associated with this symptomatology, in addition, they reduce the heart's need for oxygen. They are taken first in a minimum dose.
- Cardiac glycosides help strengthen heart contractions, which favorably affects the pumping function, but you should take these drugs with extreme caution.
- Diuretics are recommended for patients who have swelling, they help modify kidney function and increase the amount of urine excreted.
As the symptoms manifest, the doctor can constantly change the treatment of post-infarction cardiosclerosis of the ICD.
To prevent blood clots, antiplatelet drugs can be prescribed to thin the blood and prevent platelet adhesion.
In addition, there is a mass of antiarrhythmic drugs that can remove heart rhythm disturbances in the initial stages.
Preventative measures
The diagnosis of IHD of post-infarction cardiosclerosis is a serious record in the patient’s history. To maintain health and prevent complications, you need to constantly observe several important rules:
- eat a balanced diet, there should be a lot of vitamins and minerals in the diet, it is especially important to include foods rich in magnesium and potassium; eat 5-6 times in small portions;
- monitor body weight;
- not to allow serious physical exertion;
- sleep well and have a good rest;
- no stress;
- consult a doctor in a timely manner if there are heart problems, and especially with myocardial infarction;
- engage in physiotherapy exercises;
- regularly undergo examinations;
- daily walks in the fresh air, ventilate the room as often as possible;
- visit the masseur.
It is also important to exclude coffee and alcohol from the diet, you should avoid eating foods that excite the nervous and cardiac systems. These include cocoa, strong tea, fatty meat and fish.
For the effective treatment of post-infarction cardiosclerosis, the code according to ICD-10 of which is indicated above, it is necessary to avoid taking products that lead to increased gas formation. These products include:
- radish;
- radish;
- cabbage;
- legumes.
Reduce or eliminate the use of offal, which lead to an increase in blood cholesterol. Do not eat smoked and spicy dishes.
Forecast
The prognosis of survival in post-infarction cardiosclerosis (according to ICD-10, the disease code is indicated above) directly depends on where the changes are located, and on the severity of the pathology.
If the disease affects the left ventricle, and the blood flow decreases by more than 20%, then there is a serious threat to health.
In this case, taking medications helps to maintain the patient’s condition, but they will not be able to recover completely. If a heart transplant is not performed, the prognosis is 5 years, no more.
Complications
If postinfarction cardiosclerosis (in ICD-10, the disease is in the group called "Coronary heart disease") is left unattended and no measures are taken, then the disease can trigger the development of such complications:
- atrial fibrillation;
- an aneurysm of the left ventricle may occur, which provokes the development of a chronic form of the disease;
- blockades of various kinds;
- the threat of thrombosis and thromboembolic symptoms;
- sick sinus syndrome;
- paroxysmal ventricular tachycardia;
- ventricular extrasystole;
- complete atrioventricular block;
- tamponade of the pericardial cavity.
The cause of death in post-infarction cardiosclerosis, the ICD-10 code of which you already know, may be due to aneurysm rupture. Also, death can occur due to asystole or cardiogenic shock.
Ventricular fibrillation can provoke a fatal outcome, it consists in a scattered contraction of the myocardial bundles.
Cardiosclerosis is a serious disorder that, without proper treatment and constant monitoring, can lead to the death of the patient.
To date, such a method has not yet been created that would allow the patient to completely recover from the ailment, but if you follow all the doctor's recommendations and constantly monitor the condition, you can live for many more years without really denying yourself anything.
It is better to lead a healthy lifestyle and pay attention to the slightest malfunctions in the body, so as not to lead to serious complications. You can prevent heart disease, but only, unfortunately, we begin to think about it when the disease knocks on the door.