Coronary heart disease (CHD ) : what it is
Disease / / August 12, 2017
- Causes of ischemic heart disease
- forms the heart and symptoms of ischemia
- Urgent measures with retrosternal pain
- Treatment of coronary heart disease
- Prevention of coronary disease
Causescoronary heart disease
cardiac ischemia is directly linked to pathological changes in coronary vessels (spasms, persistent narrowing due to plaque formation).Atherosclerosis of vessels of the heart - a process that gives the development of cardiac ischemia.Inadequate blood supply to the myocardium leads to oxygen starvation of the heart tissue, causing irreversible changes sometimes patchy.Such a violation is more common in people:
- with a family history (the presence of the parents of hypertension, obesity, diabetes);
- menopause in women.
to the formation of atherosclerotic plaques in the coronary vessels and the development of ischemia result:
- lipid metabolism (obesity);
- smoking, alcohol;
- culinary habits (fatty foods);
- low physical activity and, on the contrary, exercise to the limit;
- regular stressful situations ( "washout" from the body of vitamins and minerals leads to disruption of metabolism and impaired myocardial power).
Important!The vast majority of heart disease due to chronic lack of magnesium in the body.
Forms and symptoms of cardiac ischemia
Elan developing heart disease and symptomatic features determine several forms of ischemic heart disease:
- «Silent» ischemia.Pathological changes are not manifest symptomatically, only recorded in the survey.Pretty dangerous because of the lack of symptoms (late diagnosis).
- Angina.As a result of provocation (stress, physical exertion, pressure jump) abruptly appears chest tightness and pressing pain behind the sternum, radiating to the neck, left arm, shoulder blade.It is accompanied by shortness of breath, a lump in the throat and shortness of breath, skin pallor, anxiety, often raises a / d.The patient was forced to sit down (lying strengthened dyspnea).The attack lasts 1-10 minutes.(Rarely up to half an hour), gradually passes after the abolition of physical activity and when taking sublingual nitroglycerin (can cause intolerance, manifested by episodes of severe headache).In patients with angina often occurs leg swelling.Important!Validol often received with chest pain, reflex acts.Until the termination of pain can be taken under the tongue up to 6 tab.at intervals of 5 min., but the time lost can lead to a heart attack.ECG changes in angina only recorded case of acute pain during an attack.
- rest angina (spontaneous).Heart pain and shortness of breath occur without provocation, often at night (close to morning).
- Unstable angina.It is characterized by progressive course.With each attack symptoms exacerbated and amplified coronary insufficiency.Important!Chest pain - a symptom that can not be tolerated.It is this symptom indicates that the onset of acute coronary disease.Pharmaceutical care has to be immediate in order to avoid a heart attack.
- Arrhythmias.Changed the rhythm of heart beats manifested by shortness of breath, palpitations (tachycardia) or slowing of rhythms (bradycardia).In case of violation of the conduction system recorded beats (extraordinary reduction) and blockade ( "fading" of the heart).
- infarction.At the close of more than 75% lumen thrombus or detached cholesterol plaques occurs necrosis of the heart muscle.Often there is a history of angina and arrhythmia.Intensive (dagger), not passing pain accompanied by panic, there are signs of acute coronary failure (shortness of breath, sweating, skin cyanosis, nausea).Atypical localization of pain - epigastrium, lower jaw, interscapular area.Simple inspection reveals a violation of cardiac rhythm tones and reduced pressure.Mikroinfakt (the development of the small size of necrosis) often goes unnoticed by the patient due to the erased symptoms (pain not strong, unexpressed shortness of breath, weakness), but after a while it may happen extensive necrotic and rapid death.
- Postinfarction cardio.Chronic heart ischemia.Diagnosed after 2 months.after suffering a heart attack in the absence of clinical manifestations (angina attacks) against fixed by changes in the study (persistent arrhythmia, signs of change in the myocardium on the type of scarring, and so on. d.).Sclerotic changes in the myocardium leads to chronic heart failure (hepatomegaly, pulmonary edema, and so on. D.).
- sudden coronary death.With the general welfare of a sudden heart attack occurs.There is a permanent violation of the electrical conductivity, manifested by the pressure drop, thready pulse, shallow breathing.Death occurs within a few minutes.. To 6 hours
General examination of the patient with suspected coronary artery disease include:
- history taking and ordering of complaints;
- identify swelling, score the skin;
- measurement and / d, pulsometry;
- auscultation (listening to heart sounds);
- veloergometry (monitoring heart activity during exercise).
reveal the pathology of coronary blood flow helps the following studies:
- ECG (angina attack - negative T-wave, decrease in the ST segment, myocardial - reduction of the R-wave, Q wave deepened, the ST segment elevated, arched);
- ECG Holter monitoring and load (daily ECG);
- ultrasound (enlargement of heart cavities, hypertrophy, thinning of the heart wall);
- blood (a heart attack - high ESR, neutrophilia);
- blood biochemistry (found in myocardial specific enzymes, increased AST, ALT);
- coronagraph (determination of the degree of narrowing of the coronary vessels using a contrast agent);
- echocardiography and Doppler study of the coronary vessels (detects abnormal operation of vessels and a violation of the contractility of the individual sections of the heart muscle);
- Angiography (vascular contrast agent fixes narrowing on X-rays or CT scans, usually used when deciding on the need for surgery).
Important!ECG - the most simple and fairly in conducting informative examination of the heart, can reliably identify myocardial infarction stage.
Urgent measures with retrosternal pain
- Peace physical, emotional.
- Open window (fresh air).
- reception sedatives drops (motherwort, valerian).
- nitroglycerin 1 tab.under the tongue.Repeat twice every 5 minutes.before leveling pain.
- In the absence of the effect of aspirin 500 mg (chewed!) And again nitroglycerin, call an ambulance.
Treatment of coronary heart disease
treatment selection and management of patients with coronary artery disease involved in a cardiologist.
When detecting cardiac ischemia must first change the mode:
- limit physical exertion angina, myocardial - bed rest 1 month.(First week of complete immobility);
- diet (with the exception of fats and carbohydrates, fried / smoked, salt).
Choice of drugs, their dose and duration of administration depends on the form of coronary ischemia.Used products:
- nitrates (nitroglycerin, Nitrosorbid) - veins widen, reducing the load on the myocardium;
- β-blockers (Betaloc, Concor, Talliton, Rizoprol) - are struggling with tachycardia;
- antiarrhythmics (amiodarone);
- anticoagulants (Heparin, Aspirin-cardio Cardiomagnyl) - reduces blood clotting;
- diuretics (Lasix, Hypothiazid) - reduced blood volume;
- ACE inhibitors (captopril, lisinopril) - relieves spasms of blood vessels;
- calcium antagonists (Nifedipine) - has a marked anti-anginal activity (including reducing the pressure), however, can cause arrhythmia;
- holesterinsnizhayuschie agents (simvastatin, rosuvastatin);
- lipid-lowering agents (Polikonazol) - reduce pressure and influence on body weight.typically used in combination with aspirin.
Important!Medicines applied comprehensively.Only a specialist determines the need for a particular drug.
Modern technology allows with minimal intervention in the body to restore the work of the coronary vessels.The most effective technique:
- stenting - expansion of the damaged vessel a special mesh tube, installed itself into the lumen;
- bypass surgery - forming a workaround by suturing blood vessels.
Prevention of coronary disease
- balanced diet (fruit / vegetables, cereals, pulses, vegetable oil, nuts).
- struggle with being overweight.
- Smoking Cessation: Nicotine - one of the most corrosive substances that damage the walls of blood vessels.
- alcohol exception: taken regularly, even small amounts of alcohol adversely affects the blood vessels.
- Physical activity: rational mobility protects the body against many diseases.
- Parenting stress.
- pressure control.
Coronary heart disease - not just recurring pain, prolonged violation of the coronary circulation leads to irreversible changes in the myocardium and internal organs, and sometimes death.Treatment of the disease for a long period, sometimes requires lifelong treatment.Therefore, heart disease is easier to prevent entering into their lives some limitations and optimizing lifestyle.