Vascular insufficiency is observed in approximately 1-2% of the total population. This condition is always the result of a disease. In most cases, diseases of the cardiovascular system lead to it. These include cardiomyopathies, angina pectoris, myocardial infarction, heart defects.
Damage to the heart muscle provokes a violation of the blood supply to the body, due to its weakening and unsatisfactory performance of its pumping function.
Vascular insufficiency is characterized as a pathological condition in which there is a decrease in tone in the smooth muscles of the walls of the vessels. This provokes arterial hypotension, a violation in the venous return and blood flow.
Vascular insufficiency is caused by primary lesions of the heart, accompanied by organ failure and the inevitable vascular reaction. This reaction is compensatory in nature. In this case, acute cardiovascular insufficiency is accompanied by a reaction manifested in the form of vasoconstriction in response to the influence of pressor mechanisms. This leads to an increase in vascular resistance for a certain period, a certain increase in blood pressure and normalization of blood supply to organs important for life. In a chronic condition, vasoconstriction is replaced by hypertrophy of smooth muscle cells in the walls of blood vessels.
With the depletion of compensatory mechanisms , vascular insufficiency joins in heart failure. At the same time, the general peripheral resistance decreases, small veins, venules and capillaries expand sharply.
Almost every process in which the heart is forced to work hard for a long time, or structural damage occurs in the myocardium, provokes heart and vascular insufficiency. As practice shows, most often the condition is noted against such diseases as coronary heart disease, heart defects (acquired and congenital), myocarditis, hypertensive conditions, cardiomyopathies. In addition, the disease can also occur with diseases of an endocrine nature, metabolic lesions, and malnutrition.
The most common cause of death (more than 80% of cases) with cardiovascular failure is ischemic heart disease.
Various causes can cause the disease. Specialists distinguish three main groups of etiological factors.
The first group includes factors that have a direct damaging effect on the myocardium. It can be physical injuries, chemical effects (for example, an overdose of drugs). In addition, biological factors (toxins, infectious agents, parasites) can also have a direct damaging effect.
The second group of reasons includes factors that provoke functional myocardial overload. These include an excessive increase in the volume of incoming blood to the heart ("volume overload"). This can occur with heart valve failure, the presence of extracardiac and intracardiac shunts, as well as with hypervolemia. Myocardial overload also causes an increase in resistance when ejecting blood from the heart cavity (“pressure overload”). In this case, cardiovascular failure develops against the background of myocardial hypertrophy. It should be noted that hypertrophy occurs in that department of the body that performs the intensive work.
And the third group includes factors under the influence of which the diastolic ventricular filling is disturbed. This condition is due to a significant decrease in the volume of circulating blood (with severe blood loss or shock), as well as a violation in diastolic relaxation of the heart when it is compressed with fluid that accumulates in the pericardium (blood, transudate, exudate).