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Cardiac ischemia

Cardiac ischemia

Ischemic heart disease (ischemia) - this concept includes a whole group of diseases. In connection with the latter, coronary artery disease is often called coronary artery disease or coronary heart disease.

There are chronic (symptoms of which are arrhythmia, heart failure, etc.) and acute (manifestation of which may be myocardial infarction) forms of the course of this disease. Ischemia poses a threat not only to the heart, but also to many other organs and organ systems. Ischemic heart disease is directly related to anemia.

One of the forms of coronary heart disease is angina pectoris. The main symptoms of angina pectoris are pulling pain behind the sternum, which, however, can spread to both the left shoulder and the left arm. Other symptoms of angina pectoris include a feeling of heaviness and tightness, a feeling of discomfort and shortness of breath.

Among the methods for diagnosing coronary heart disease: a detailed survey of the patient, an electrocardiogram (at rest and after a dosed load), ultrasound, laboratory data.

Treatment of coronary heart disease is complex and is aimed at minimizing risk factors for the development of complications, as well as eliminating the symptoms of the disease and ensuring the normal life of the patient. In difficult cases, surgical treatment is indicated.

Ischemic heart disease, in particular angina pectoris, should in no case be treated on its own, since this greatly increases the risk of developing such a serious complication of coronary heart disease as myocardial infarction.

Ischemic heart disease is one of the most common diseases of this organ. This disease has no boundaries. It is common in both developing countries and economically developed ones. However, statistics indicate that the male part of the population suffers more from coronary heart disease than the female.

Ischemic disease is associated with anemia. Because of this relationship, the disease got its name, because anemia and ischemia are synonyms. In the case of coronary artery disease, ischemia is directly related to an insufficient amount of blood entering the heart muscle.

Ischemia can occur even in a healthy person. In this case, they speak of transient ischemia of the heart. This form can take place as a reaction of the body to physical activity, cold or stressful situations.

Ischemia is a threat to the heart. Practice shows that not only this body. In some cases, cerebral ischemia is diagnosed. In this case, we are talking about a lack of blood circulation in the brain. Sometimes limb ischemia is diagnosed. The cardiovascular and nervous systems of the human body are more susceptible to ischemia.

Atherosclerosis - ischemia of the heart muscle (myocardium). The cause of myocardial ischemia is associated with high cholesterol levels, resulting in the accumulation of atherosclerotic plaques in the vessels. The latter leads to a narrowing of the vascular lumen. As a result of such a narrowing, blood cannot enter the organ in the same amount, sufficient for normal operation.

For myocardial ischemia, periods of exacerbation and remission are characteristic. In this case, we can say that the course of ischemia of the heart muscle goes along a sinusoid - periods of exacerbation of the disease alternate with periods when ischemia does not manifest itself at all. But it should be understood that such "asymptomatic" periods are not a reason to refuse treatment of the disease - if the diagnosis is made, then the ischemic disease must be treated in any case.

Physical activity provokes the appearance of signs of coronary heart disease. The same can be said about the mental stress on the human body. For an exacerbation of the disease, the appearance of paroxysmal pain in the region of the heart is characteristic. These attacks, as coronary artery disease progresses, may appear even at rest. Further development of coronary heart disease can trigger the development of myocardial infarction.

Diagnosis of coronary heart disease is based on modern methods. A cardiologist can diagnose this disease. Naturally, the diagnosis of any disease at the initial stage is associated with a patient survey - on the basis of this survey, an experienced cardiologist can say a lot, even without resorting to instrumental techniques, although they, of course, are very necessary. Examination of a patient can provide a wealth of meaningful information.
First, the specialist listens to the existing heart murmurs.
Secondly, the cardiologist determines the presence of edema in the patient. Often, examination helps to establish the presence of arrhythmia in the patient.
During laboratory tests, the level of cholesterol and sugar in the blood is determined, as well as enzymes that appear in the blood during heart attack and unstable angina pectoris. The main method for diagnosing ischemic heart disease is electrocardiography (ECG). This type of research is effective in the diagnosis of all diseases of the cardiovascular system. ECG is often used in combination with physical activity. Electrocardiography allows you to see the existing deviations from the normal functioning of the myocardium, which is very important for diagnosing coronary heart disease. In addition, laboratory data, in particular the level of cholesterol and blood sugar, are of great importance.

Holter monitoring of the electrocardiogram is an effective research method. As a rule, this is an electrocardiogram that lasts for a day. This study is carried out either in an inpatient setting or on an outpatient basis. Of great importance is the fact that such an examination should be, as much as possible, associated with the patient's everyday life. Holter monitoring of the electrocardiogram makes it possible to track the causes of the onset of symptoms of coronary heart disease - to record when they occur (during physical exertion or at rest).
The patient's self-observation diary is especially important during Holter monitoring of the electrocardiogram. This diary should contain detailed data on what happens during the day (the one in which the study is taking place) with the patient - when he takes medications, experiences any pain, etc. Thanks to this, a fairly reliable picture of a person's condition is created.

Timely diagnosis of coronary heart disease is impossible without the initiative of the patient himself. Symptoms of coronary heart disease often reveal themselves in the form of individual sensations in each patient. The sooner a person pays close attention to them, the more likely it is that the treatment of the disease will begin on time. In connection with the above, the patient should tell the cardiologist in as much detail as possible about the sensations that he has recently noted in the area of ​​the heart and which he experienced earlier. The patient must say with confidence whether he has symptoms such as dizziness, shortness of breath, increased heart rate, and so on.

The death rate from coronary heart disease is high. This is more true for the twentieth century. The explanation for this is that in the last century there were no such effective methods for diagnosing coronary heart disease, which are now, and the very course of coronary heart disease is replete with a large number of symptoms or there are no symptoms at all.

Angina pectoris is a form of coronary artery disease. Angina pectoris is also called angina pectoris, the reason for this is simple - the main symptom of this disease is attacks of pressing compressive pain, which are localized behind the sternum (in this case, they say that "the toad is strangling"). With angina pectoris, pain can be felt in the left shoulder and in the left arm, there are times when they are accompanied by a sharp feeling of fear.
The cause of angina pectoris can be called atherosclerosis of the coronary arteries. Risk factors include more than thirty factors, including an increase in blood cholesterol (which can lead to atherosclerosis), overweight, bad habits (in particular, smoking and alcohol abuse), a sedentary lifestyle, concomitant diabetes mellitus and others. The combination of risk factors dramatically increases the likelihood of developing angina.

Myocardial infarction is a form of coronary heart disease. Myocardial infarction is associated with acute insufficiency of blood supply to the heart muscle. The result of this deficiency is the emergence of a focus of tissue necrosis (necrosis). The main cause of myocardial infarction is the complete blockage of the coronary arteries by a plaque or thrombus. Of course, it is senseless and dangerous to treat this form of coronary heart disease at home. Therefore, if an attack of angina pectoris is not relieved by nitroglycerin, you must immediately call an ambulance.

Postinfarction cardiosclerosis is another manifestation of ischemic heart disease. It is a direct consequence of myocardial infarction and is a damage to the myocardium (and often heart valves). Such a lesion is caused by the development of scar tissue in the heart muscle and in the heart valves, which replaces the heart muscle, that is, the dead parts of the myocardium are not restored.

Rest angina and exertional angina are different. A sign of this classification is the dependence of an attack on the circumstances that cause it. Rest angina has no connection with physical stress, in this case, pain most often manifests itself at night and early morning. At the same time, patients often complain of a feeling of lack of air. With angina pectoris, attacks appear after physical exertion on the patient's body. This can be walking up stairs, walking after a meal, brisk walking, and so on. In addition, bouts of angina pectoris can also occur in stressful situations, can occur after smoking.
It should be noted that for angina pectoris, pain is characteristic precisely in the form of attacks. This means that a person can accurately indicate the time when the pain began and the time when it disappeared (as a rule, the attack is relieved by taking nitroglycerin - under the tongue, this drug relieves pain usually within two to three minutes). If the first nitroglycerin tablet does not relieve pain, then the second is taken. If there is no positive effect in this case, then there is a likelihood of developing a pre-infarction state. Therefore, in no case should you be frivolous about such a situation and you need to call an ambulance as soon as possible.

In the diagnosis of angina pectoris, electrocardiographic stress tests are of great importance. This method consists in the fact that the electrocardiogram is recorded during the period of time when the patient receives physical activity - it is selected strictly individually. At the same time, the patient is provided with such conditions under which a sufficiently high supply of oxygen to the heart muscle is created. Such conditions make it possible to determine the existing discrepancy between the ability of the coronary arteries to supply the heart with sufficient blood volume and the metabolic requirements of the heart muscle. Similar methods are used to recognize coronary artery disease at the initial stage of the development of this disease.

Heart ultrasound (heart echocardiography) is another method for diagnosing coronary heart disease. This examination allows us to understand the acoustic phenomena of the beating heart. In addition, ultrasound examination of the organ makes it possible to recognize the signs of a significant number of diseases associated with impaired heart function - for example, this study allows you to determine the extent to which the correct functioning of the heart is impaired, as well as to identify the state of the heart valves and the size of the cavities (in particular, to determine them change).

Prevention of coronary heart disease is of great importance for every person. This, of course, is so, however, people who are in the so-called risk group should think about such prevention to the greatest extent. For such people, the prevention of coronary heart disease is not just prevention (as strange as it may sound), but also a vital necessity.
What is this risk group. Firstly, these are patients who have been diagnosed with coronary heart disease - prevention in this case comes down to preventing the development of various complications of coronary heart disease. Secondly, these are healthy people, but at risk of developing coronary disease. The degree of this risk is due to the presence of one or several factors for the development of coronary heart disease (this is an increased level of cholesterol, high blood pressure, overweight, etc., as mentioned above).

Increasing physical activity is a significant item in the prevention of coronary heart disease. However, it is by no means the only one. Prevention of coronary heart disease is reduced to negating the factors in the development of this disease. That is, if a person moves a little, then for his own health he should start moving much more. According to the advice of experts, any city dweller should devote at least half an hour a day to playing sports and physical education - these activities should not go under the duress, but give pleasure.
In addition, a sane person should quit smoking, switch to a healthy diet, etc. It should be noted that "passive" smoking has almost identical negative effects on the cardiovascular system, as active. Therefore, you should not wait for the doctor's words - something like this: "Each smoked cigarette in your case may be the last" - but think about getting rid of this habit as soon as possible. As for proper nutrition, it should contain less animal fat. The goal is to prevent the formation of cholesterol plaques on the walls of the arteries. It is worth eating more vegetables and fruits, limiting the use of alcohol, coffee and strong tea.
In a word, a healthy lifestyle should become not something transcendental, which can only be read about in newspapers and heard on radio and television, but the most real and real.

The emotional background plays an important role in the prevention of coronary heart disease. We are talking, of course, about a favorable and benevolent emotional background. After all, it is known that people who call themselves happy rarely get sick with any diseases.

Coronary heart disease requires complex treatment. It involves the mutual work of both the doctor and the patient.
First, the patient should pay attention to his lifestyle and try to minimize risk factors for the development of coronary heart disease and its complications (smoking cessation, increased physical activity, normalization of body weight, etc.).
Secondly, a mandatory component is drug treatment, the purpose of which in a significant number of cases is to get rid of the signs of angina pectoris, prevent the development of complications (myocardial infarction, unstable angina pectoris, etc.), provide the patient with the possibility of normal life, as well as increase life expectancy. Medicines, which are prescribed to a patient with coronary heart disease, increase the volume of the coronary bed, and also affect a decrease in the oxygen demand of the heart muscle.
Thirdly, patients with coronary heart disease are advised to adhere to a certain diet. The patient's diet should include fruits and vegetables, fish and seafood dishes.
In addition, if coronary heart disease has developed against the background of other diseases - diabetes mellitus or hypertension - then an effective result is provided by treatment for these diseases.

Coronary artery disease requires surgical treatment. Not always. The fact is that medications cannot cope with the main task in the treatment of coronary heart disease. The latter consists in the release of already blocked vessels.
In severe cases of coronary artery disease, surgical treatment is necessary. One of the methods of surgical treatment is coronary artery bypass grafting. The essence of this treatment is that the artery, the blood flow through which is obstructed as a result of blocking it with a thrombus or plaque, is replaced by an "artificial vessel".
The latter takes over the function of conducting blood flow. However, this operation is rather complicated, since, firstly, it is performed on a non-working heart (the patient's circulation is artificial), and secondly, the postoperative period for the patient is rather difficult. This complexity is due to the need to recover from an extensive surgical wound. In addition, this wound limits the possibility of another operation, if the need arises.
If coronary artery bypass grafting is successful, then the effect of this operation is very favorable.

Endovascular surgery is the most promising treatment for coronary artery disease. Literally, the translation of the word "endovascular" means "inside the vessel". It is this concept that determines the specificity of endovascular surgery. This type of treatment does not require incisions. Endovascular surgery is performed through punctures in the skin under local anesthesia. All this is done under X-ray observation.
The importance of this method increases for those patients who cannot undergo traditional surgical treatment, for example, due to the general weakening of the body.
Endovascular surgery is usually performed with balloon angioplasty and stenting. The goal of treatment is to restore patency in diseased coronary arteries. The bottom line is that a balloon is introduced into the affected vessel, which "pushes" the plaques on the walls of the vessels, after which a stent is inserted into the artery, which retains the shape given to the vessel.

Self-medication for coronary heart disease is possible. This is not true. Those medications that can now be bought in a pharmacy must be prescribed by a doctor, since different of them are aimed at treating different forms of coronary heart disease. In addition, these drugs can only be used under the supervision of a cardiologist.
Everyone should be aware that most of the powerful drugs that the patient can take as self-medication can have very serious side effects. Urgent medical attention will be required to eliminate them.


Watch the video: Treatment of Coronary Artery Disease (September 2021).