Ischemia of the heart

Ischemic heart disease is a common and dangerous pathology. Most often, the disease occurs in representatives of the male half. Women from the development of ischemia are protected by the hormonal background.

The diagnosis is made when the arteries, which should provide the myocardium with a sufficient amount of blood, are disturbed by blood circulation.

Atherosclerosis contributes to the development of pathology. With the progression of the disease, the lumen of the vessels narrows, blood circulation slows down, the heart muscle does not receive as much oxygen as it needs for the normal functioning of the heart.

Ischemia: general characteristics

According to statistics, ischemic syndrome of the left ventricle most often develops. The part of the left ventricle on the side of the anterior wall of the heart is especially vulnerable. The reasons are in the peculiarities of the blood circulation of this zone. Ischemic disorders of the left ventricle have a complex pathogenesis and hidden nature. Left ventricular dysfunction can have different forms, which depend on the pathogenesis and severity of ischemic damage.

In second place is ischemia of the posterior wall of the left ventricle.

The lateral parts of the heart and the right ventricle rarely suffer from circulatory disorders.

Causes and symptoms of pathology

Predispose to the development of IHD:

• Improper diet, which causes the accumulation of cholesterol in the blood. It begins to cover the vascular walls and forms plaques. Because of this, the lumen of the vessels narrows and blood circulation is disturbed.
• Excess weight.
• Wrong physical activity. It is necessary to evenly distribute the load and not expose the body to training that exceeds its capabilities.
• Bad habits. Alcoholic drinks and cigarettes lead to the fact that the heart muscle begins to function poorly. Chemicals contained in cigarettes cause atherosclerosis and promote thrombosis.
• genetic predisposition.
• Arterial hypertension.
• Constant stress. Under the influence of constant nervous strains, the walls of blood vessels begin to become covered with cholesterol. Therefore, IHD develops.
• Diabetes. To reduce the risk of coronary artery disease, diabetics need to normalize carbohydrate metabolism.

Signs of coronary heart disease may be pronounced / weakly expressed or completely absent.

Symptoms of coronary heart disease appear at night, upon awakening, less often during the day.

Pathology is accompanied by such sensations:

• Pain in the chest region. A person feels stabbing, squeezing, baking pain sensations. The symptom may occur unexpectedly, and after a few minutes the pain recedes. In the initial stages of the development of coronary artery disease, the patient may feel slight discomfort. With the development of pathology, pain intensifies and can be given to the left arm and shoulder, sometimes to the right arm and jaw. Pain begins to bother when a person exposes the body to physical or emotional stress. First, you can get rid of discomfort, just a little rest. In the future, only medications will help to eliminate the symptom.
• Shortness of breath has a complex pathogenesis. Initially, it occurs during physical exertion, and later it can overtake the patient even at rest.
• The heartbeat is disturbed. In some situations, the heart may beat very fast or hardly noticeable at all.
• General weakness. A person gets tired quickly even with minor loads. The head may be very dizzy, nausea, vomiting occurs. The patient may lose consciousness.
• Angina. This symptom is characterized by a burning sensation and squeezing in the chest area. Such sensations can be given to the shoulder or arm. Some believe that this is heartburn, and begin to treat it with soda, but this is the main symptom of ischemia, which allows you to prevent myocardial infarction in time.

A heart attack is confused with an angina attack. However, a heart attack is accompanied by severe chest pain, which can last for several hours and is not relieved by nitroglycerin. During a heart attack, pressure rises, temperature rises, and asthma attacks occur.

• Emotional disorder. With coronary artery disease, a person may worry or be afraid of something for no reason.

These are the main signs of the disease that develop in most patients.

Classification of forms of ischemic disease

Allocates the following types of pathology:

Asymptomatic form. Coronary heart disease of this form occurs if a person has a high pain threshold. The causes of its occurrence are alcoholism and hard physical labor. Most often, the disease develops in the elderly and diabetics. It does not cause any complaints in patients, in some cases there may be slight discomfort in the cardiac region. This form is accompanied by general weakness and increased pressure.

Sudden coronary death. The patient dies immediately after a heart attack or a few hours later. The causes of this form are obesity, hypertension, smoking, ventricular fibrillation. If the patient is given timely medical care, then he can survive, but in most cases, patients die.

Angina. Myocardial ischemia of this form is characterized by squeezing pain in the chest. Unpleasant sensations occur when the patient's blood pressure rises, during meals or during physical exertion. The causes of this form of the disease are stress and hypothermia of the body. In such situations, the heart muscle needs oxygen the most, but the arteries are clogged with plaque, air does not enter. You can eliminate the painful manifestations of the disease if you rest for a while and take Nitroglycerin.

There is a classification of angina pectoris:

• stable;
• unstable.

The reasons for stable - in physical activity and bad habits. Nitroglycerin helps to cope with its manifestations, if it ceases to act, then unstable angina develops.

The classification of unstable angina divides it:

• for the first time;
• to progressive.

The angina pectoris that arose for the first time manifests itself after emotional or physical exertion. No disturbances in the functioning of the coronary arteries may be observed. This form may develop into stable angina or will not manifest itself for several years, but it is still necessary to undergo periodic examinations.

During progressive angina attacks occur more often and stronger. This condition is complemented by suffocation, shortness of breath and tachycardia. In this case, a small physical activity is enough to cause an attack. The patient's well-being worsens at night or in stressful situations. Nitroglycerin will not help in this situation. Progressive angina most often ends in myocardial infarction, but there may be a complete cessation of attacks.

Myocardial infarction. This is how acute coronary heart disease manifests itself. The causes of this condition are shock or overstrain (emotional, physical). In this condition, one of the departments of the heart suffers from a lack of blood. This may take several hours. Plaques on the walls of arteries during a heart attack can come off and turn into blood clots. They disrupt blood circulation. Nutrients and oxygen are not supplied in sufficient quantities, heart cells begin to die.

During a myocardial infarction, a person feels severe pain in the region of the heart. Nitroglycerin does not help here. The causes of a heart attack are not always stressful. It happens that such a condition develops at rest, for example, during sleep.

Heart attack symptoms:

• abdominal discomfort;
• nausea;
• vomit.

People with diabetes may not have any signs of a heart attack. In this case, changes are determined during the ECG (electrocardiogram).

At the first sign of a heart attack, you should consult a doctor. He prescribes treatment and bed rest. With the help of modern drugs after a myocardial infarction, it will take several days to recover. A person whose ischemia of the heart was accompanied by such an attack should avoid physical exertion and engage in special gymnastics. It is impossible to completely cure the consequences of a heart attack, so the patient needs to use special drugs throughout his life.

Cardiosclerosis. Ischemic heart disease leads to the death of heart cells. This causes heart failure.

The classification of the cardiosclerotic form of ischemia is as follows:

• diffuse;
• focal.

With diffuse cardiosclerosis, scar tissue is gradually distributed throughout the entire heart muscle, and with focal cardiosclerosis, it occupies only some areas. This form usually begins to develop after a heart attack. This form of ischemia is as dangerous as all the others.

Ischemic disease of the left ventricle can be short-lived. It can only be determined during an angina attack. In this case, dysfunction of the left ventricle is accompanied by pain, shortness of breath and arrhythmia.

Left ventricular dysfunction can be long-term. Violation of the state of the left ventricle after the restoration of normal blood circulation can last several days and even weeks.

Diagnosis and treatment of ischemia

Before starting treatment, it is necessary to diagnose the disease.

Diagnosis of IHD consists of the following activities:

ECG (electrocardiogram). This method allows you to determine how much the heart lacks oxygen and whether the likelihood of a heart attack is high. In some patients with angina pectoris and coronary artery disease, the ECG gives good results. An ECG is the main method for checking the condition of the heart. Diagnosis of any heart disease begins with this event.

ECG changes depend on factors such as the severity of the lesions, the duration of the pathology, and the location of the infarction.

Diagnosis of ischemia and myocardial infarction using ECG is inaccurate. An ischemic attack may not be expressed in any way on the ECG. Even with myocardial infarction, if the ECG is done once, there will be normal results. Therefore, the procedure should be carried out several times.

In some cases, according to the results of the ECG, it is impossible to recognize coronary artery disease or a heart attack.

After an ECG, valoergometry may be prescribed. This is a kind of stress test that allows you to determine the parameters of the heart during physical exertion.

Coronography allows you to determine the condition of the coronary vessels.

Diagnosis of coronary artery disease, in addition to these procedures and listening to complaints, consists of collecting information. The physician should be aware of the patient's previous illnesses, surgeries, and medications taken. They may also order laboratory tests.

How to treat coronary heart disease

How to treat cardiac ischemia is determined after a thorough diagnosis.

Treatment is determined by such parameters as the form of pathology (ischemia of the heart of the left ventricle, anterior, posterior or lower wall of the heart).

Therapy is aimed at reducing myocardial oxygen demand or increasing its supply to the heart. Treatment of IHD consists of conservative and surgical methods.

Conservative treatment includes medication and a special diet.

Ischemic heart disease is treated with the following medications:

1. Nitrates are used to prevent seizures.
2. Antiplatelet agents thin the blood and prevent the formation of blood clots.
3. Calcium antagonists contribute to the expansion of the veins, through which nutrients enter the myocardium.
4. Medicines improve the metabolism in the heart muscle.

Treatment may involve the use of several drugs at the same time. In the early stages of coronary heart disease can be treated with diuretics.

If the patient has myocardial ischemia, then doctors advise you to always have Nitroglycerin tablets with you. They will help you deal with an attack.

Treatment eliminates any stress - both physical and emotional.

A disease such as myocardial ischemia requires compliance with the rules of nutrition. It is necessary to reduce the consumption of foods containing cholesterol and glucose. These substances complicate the ischemic syndrome.

You can use:

• low-fat dairy products;
• boiled fish;
• vegetables, fruits in unlimited quantities;
• drink green tea, juices, mineral water without gas.

So people who have ischemic syndrome should eat throughout their lives. With the help of diet, you can keep the progression of atherosclerosis.

If conservative treatment does not give any results and the ischemic syndrome continues to progress, it is necessary to turn to surgical methods.

Treatment consists of the following procedures:

1. Intraluminal angioplasty. A special device is introduced that does not allow narrowing of the lumen of the arteries.
2. Coronary artery bypass grafting. To bypass the affected areas of the coronary arteries, shunts are applied, in the role of which the saphenous vein of the thigh is most often used.

Such treatment improves the patient's condition and prolongs his life.

Preventive measures

Ischemic syndrome has irreversible consequences. This means that the disease cannot be completely cured by any means. Modern methods only slow down the development of the disease, but cannot stop it. In addition to the left ventricle, posterior, anterior wall and other areas of the heart, the disease also has serious consequences for the kidneys, brain, and pancreas. Many diseases can occur, the cause of which is an ischemic syndrome.

Pathology has a complex pathogenesis, which means that prevention of coronary heart disease is important.

Preventive measures include:

1. Proper nutrition without fatty, smoked, salty foods. Eat more vegetables, fruits and dairy products.
2. Weight control. Low calorie foods allow you to avoid excess weight and its attendant problems.
3. To improve the functioning of the heart, you need to play sports or at least do light therapeutic exercises.
4. Avoid stressful, conflict situations.
5. To refuse from bad habits.
6. Monitor blood pressure parameters.

The classification and pathogenesis of coronary heart disease is quite complex. This disease significantly impairs the quality of human life and often has sad consequences. Therefore, it is advisable to make every effort to strengthen the cardiovascular system. Prevention of coronary heart disease allows you to protect yourself from a serious disease.