Atherosclerotic cardiosclerosis: complications. Cardiosclerosis: treatment, symptoms, causes

Diseases of the cardiovascular system rank first in the frequency of occurrence worldwide. At one of the first places is coronary heart disease and its complications.

What is ischemic heart disease?

By ischemic heart disease is understood a condition that develops as a result of a decrease in blood flow along the main system of the heart vessels - the coronary arteries. As a result, the myocardium of the heart loses oxygen and experiences oxygen starvation. For this reason, the heart can not properly perform its function, as it works at the limit of its own capabilities. Because of this, there is a thickening of the walls of the heart and its increase in size. At some point, in the conditions of lack of blood and oxygen, there is excessive muscle strain, and as a result, either a rupture of the myocardium or damage to the vessel with the development of hemorrhage (myocardial infarction) develops. Most often, this condition is fixed against the background of an atherosclerotic lesion of the coronary vessels, but there may be many reasons for its appearance. It is worthwhile to understand why the most important and frequent condition develops in IHD - atherosclerotic cardiosclerosis.

What is this disease - cardiosclerosis?

Usually under cardiosclerosis is understood as an irreversible process, passing in the thickness of the heart muscle. With it, there is a replacement of normal cardiomyocytes with connective tissue, which significantly worsens the heart.

There are two main forms, into which cardiosclerosis is divided - atherosclerotic and postinfarction.

As the name implies, postinfarction cardiosclerosis develops on the site of the former necrosis of cardiomyocytes - a heart attack. With it, the replacement of damaged tissues is a physiological process, an attempt by the body to restore the affected organ. In its activation lie complex mechanisms of interaction between the cells of the myocardium, connective tissue and cells of the immune system.

With atherosclerotic cardiosclerosis, the process is usually pathological and proceeds somewhat differently than post-MF sclerosis. At the heart are complex reactions of accumulation and consumption of fat molecules.

This disease is also mentioned in the international classification of diseases. If there is atherosclerotic cardiosclerosis - the ICD code, which is exposed in the diagnosis - I24. By the way. This diagnosis is exhibited to all patients without exception, older than 55 years. What is characteristic for him?

Atherosclerosis as the basis of heart disease

How does atherosclerotic cardiosclerosis develop? The causes of the appearance of this pathology - metabolic disorders, associated primarily with the metabolism of fats.

It all begins with a violation of the balance of lipoproteins in the body. Important role is played by low density lipoproteins (recognized as the most atherogenic - capable of forming atherosclerotic plaques). Another, no less important factor, is the local destruction of the vascular endothelium. Normally, the endothelium is covered with special substances that prevent the deposition of lipoproteins and blood clots on them. Since it is affected, conditions are created for the accumulation of lipoproteins at the site of the disorder. As a result, an atherosclerotic plaque develops on the site of the vascular defect. As it grows, the coronary vessel gradually shrinks, which creates conditions for oxygen starvation. As a result of a virtually total reduction in the lumen of the blood vessel, the blood ceases to pass to the myocardium, and its infarction develops.

Atherosclerotic changes in the walls of the heart

This form of ischemic heart disease - atherosclerotic cardiosclerosis - is the main cause of heart failure. As a result of disturbances in the supply of oxygen to the myocardium and the development of sclerosis of coronary vessels, the process passes to the muscles of the heart. Because of this, it becomes total and captures the entire thickness of the body. The diagnosis of atherosclerotic cardiosclerosis is authorized in the formulation of all persons older than 55-60 years. It is necessary to have an increased number of lipoproteins. An extremely small percentage of people can avoid the development of this disease, because of what should be aware of the peculiarities of this pathology.

It develops over a long period of time. Violations grow gradually, because of which it is impossible to establish a diagnosis of atherosclerotic lesion without conducting appropriate studies. What are the manifestations of this disease and how do they manifest themselves in different people?

Clinic of the disease

Any clinical signs do not manifest themselves until the whole myocardium is involved in the process, as well as other heart membranes. Especially important is the narrowing of the lumen of the coronary vessels. The clinic does not appear until the diameter of the heart arteries is reduced by at least 70 percent and atherosclerotic cardiosclerosis of the heart does not develop.

Initial manifestations of the disease are shortness of breath, pain in the heart, periodic rise in blood pressure.

Dyspnoea manifests itself gradually. Initially, its development is typical for excessive physical exertion, but over time, its appearance can be at rest.

As for heart pain, they are noisy and usually appear when the heart is overloaded. It can not be said that they have a stenocardic character (compressive pain, giving in the hands or back). With the progression of the pain become permanent and react poorly to the use of vasodilators.

If such a patient comes to you, and the clinic and the case history described above are observed, atherosclerotic cardiosclerosis is what a competent specialist should think about

Diagnosis of the disease

To make a verdict and answer the question of what happened to the person and why he makes such complaints, it is necessary to conduct a follow-up examination of the patient. The diagnosis of "atherosclerotic cardiosclerosis" can be detected if all of these symptoms and risk factors are present. Additional components of the latter, affecting the development of the process, are the age of patients older than 55 years, male sex, sedentary lifestyle, irrational nutrition.

To clarify the diagnosis should be done some more research. Among them, the biochemical blood test for cholesterol, electrocardiogram and coronarography come first.

Changes in the cardiogram, characteristic for atherosclerosis of the heart, is a decrease in the voltage of the teeth (a decrease in their normal size) with quite normal teeth and widths.

Coronarography allows to reveal the narrowing of the lumen of the coronary vessels and to assume the lack of oxygen in the myocardium.

Treatment

Given the complexity of the pathogenesis of the disease, it should be understood that therapy should also be comprehensive. The balance of non-pharmacological measures, as well as of medicinal and surgical interventions, makes it possible to achieve significant success in the treatment of coronary heart disease.

First and foremost, a healthy lifestyle should be promoted. As is known, the violation of proper nutrition is the main cause of damage to the heart vessels and heart. In addition, competent physical activity allows you to properly prepare the heart for subsequent overstraining in work.

Compliance with these simple rules (rational nutrition and exercise) makes it possible to delay the development of ischemic disease for a while. Use of medicines will eliminate the cause of the disease and restore normal metabolism.

The main thing that you should pay attention to if you need to cure atherosclerotic cardiosclerosis is the pathogenesis of the disease. By influencing its main links, it is possible to achieve significant success in treating the disease.

Medication Therapy

Treatment of atherosclerotic cardiosclerosis with medicines should be started only in case of reliable and confirmed presence of heart failure and vascular lesions. For this purpose, groups of agents are used, such as antihypertensive drugs, agents for controlling heart failure, statins, fibrates and metabolites.

Hypotensive therapy includes the use of angiotensin-converting enzyme inhibitors (Enalapril, Captopril), diuretics (Indap, Furosemide). Diuretics are also used in the presence of heart failure and are one of those drugs that are prescribed in the first place.

To improve the heart, it is recommended to use metabolic drugs ("Mildronate", "Cardiomagnolo"). They allow to improve blood supply to the heart muscle, and also promote the start of regenerative processes.

In addition, with increased heartbeats and violations of his work is best to use cardiac glycosides ("Digoxin", "Strofantin").

Use of statins and fibrates

Statins are the main drugs in the treatment of atherosclerosis. The essence of their action is to reduce the level of atherogenic lipoproteins in the blood plasma, their splitting and excretion, as well as in the saturation of blood with anti-atherogenic lipoproteins (HDL - high density proteins). Increasing their concentration, improving the protective properties of the vascular endothelium, it strengthens, which prevents the development of new plaques.

Fibrates have a similar effect, but use them together with statins is strictly prohibited due to the development of side effects.

For treatment, such drugs as "Lovastatin", "Simvastatin", "Rosuvastatin" are used. Of the fibrates, wide use was made of "Clofibrate," "Bezafibrate," "Gemfibrozil."

These drugs should be used only for the doctor's prescription and with mandatory monitoring of the health status, since not all patients tolerate these drugs well.

Surgery

When ineffectiveness of non-pharmacological methods and prescribed drug therapy are resorted to the use of surgical intervention. The range of operations performed with this pathology is small, and all of them are aimed primarily at dilating the narrowed coronary vessels and restoring blood flow. The most common are shunting, stenting and balloon angioplasty.

Shunting is usually performed on the open heart and is a rather complicated and dangerous operation.

Stenting consists in the introduction into the cavity of the vessel of a metal structure, the purpose of which is the mechanical expansion of the narrowed vessels.

Balloon angioplasty is formally the initial stage of stenting, but sometimes it can be used independently. It is carried out under X-ray control. A catheter with a balloon is placed in the vessel. When the narrowing site is reached, the balloon swells, thereby flattening the plaque and widening the vessel.

Physiotherapy

In the treatment of cardiovascular diseases, physiotherapeutic methods of special application have not been found, but to alleviate the condition of patients and some suspension of the pathological process, they can be used.

Usually, local electrophoresis is applied to the heart area using drugs. Most often, with the help of a current, statins are delivered directly to the heart. At the same time, it is possible to create a local concentration of the substance, which will act directly on the heart and be carried along with the blood stream in all the vessels.

Do not hurt patients and spa treatment in the mountains. It is there that the transport function of blood, the saturation of the myocardium and other organs of oxygen-enriched blood is significantly improved.

Therapeutic exercise helps to normalize blood pressure, partially reduce, due to physical exercises, the level of cholesterol and carbohydrates and bring yourself and your body into tone.

Atherosclerotic cardiosclerosis - complications

Like all diseases, ischemic heart disease has its own negative outcomes, or complications.

First of all, a violation of the heart as a result of its defeat by atherosclerosis affects the lifestyle of the patient. Severe dyspnea may develop in the performance of any work.

Often, if atherosclerotic cardiosclerosis develops, complications can manifest itself in the form of cardiac arrhythmias and the appearance of rhythm failures. Usually there are fibrillation of the ventricles and atria, the development of blockades, syndrome of weakness of the sinus node. In rare cases, there is asystole and sudden cardiac death.

If a person has atherosclerotic cardiosclerosis, complications often develop outside the heart. Perhaps a violation of sensitivity on the limbs, especially on the hands and feet, cooling of these areas of the body, the development of atrophy. The vessels of the brain, eyes, and other organ systems may also suffer.

Over time, the vascular lesions spread throughout the body. In this case, the treatment is not particularly effective and operates only symptomatically. When the process is running, the only outcome that a person who has atherosclerotic cardiosclerosis can be counted on is death.

Prevention of atherosclerosis

As you know, any disease is easier to prevent than treat. Heart diseases also fit this formulation. That's why you should know about the main measures and methods that can prevent atherosclerotic cardiosclerosis. Complications in this case, if done correctly, may never manifest themselves.

First of all, we should pay attention to the regime of the day and the food ration. You should not eat after six in the evening, and if it is already unbearable, it is better to drink a glass of low-fat milk or kefir.

It is necessary to give time and physical education. Heart training will never be superfluous. For it, fast walking, swimming is perfect.

Do not neglect and preventive examinations. Usually during them, and this or that problem is revealed, and therefore it is better to give a study of your health for a couple of days, than to treat yourself for the rest of your life.

In the presence of the first symptoms of the disease, it is best to seek medical advice immediately in order to determine a further plan of action.