Consequence of ischemia. Adverse consequences of ischemia. By source of appearance

Ischemia is a pathological condition that occurs when there is a sharp weakening of blood circulation in a certain area of an organ, or in the entire organ. Pathology develops due to decreased blood flow. A lack of blood circulation causes metabolic disorders and also leads to disruption of the functioning of certain organs. It is worth noting that all tissues and organs in the human body have different sensitivity to lack of blood supply. Less susceptible are cartilage and bone structures. More vulnerable are the brain and heart.

Etiology

The causes of ischemia are as follows:

blood diseases;
severe stress;
injuries of varying severity;
large blood loss;
mechanical compression of a vessel by a benign or malignant tumor;
spasm blood vessels;
(blockage of a vessel with an embolus);
poisoning with biological and chemical poisons.

Also the cause of progression of cardiac ischemia, lower limbs, intestines may become thickening of the walls of blood vessels, increasing pressure on the artery.

Classification

Acute form

This process is characterized by a sudden disruption of the nutrition of tissues and organs, which occurs due to a slowdown or cessation of blood flow. Acute ischemia of the myocardium, lower extremities, and brain is divided into 3 degrees:

1 – absolute. This is the most severe form of the disease, which leads to disruption of the normal functioning of organs and tissues. If ischemia is observed for a long time, then changes in the affected organs may become irreversible.

2 – subcompensated. The speed of blood flow is critical, so there is no possibility of to the fullest preserve the functionality of the affected organs.

3 – compensated. This degree of pathology is the mildest.

Chronic form

In this case, blood circulation is disrupted gradually. It is worth noting that the term “chronic ischemia” combines a large number of pathologies, each of which has its own clinical picture. The most common pathology of these is cerebral ischemia. The main reasons for its progression are: atherosclerosis, hypertonic disease, as well as heart disease.

Forms

The mechanism of development of circulatory disorders has several forms, depending on which the classification of this pathology is carried out. The disease comes in 4 forms:

obstructive. This form of pathology begins to progress due to the formation of blood clots, emboli and atherosclerotic plaques in the artery. These elements interfere with the normal outflow of blood;
angiopathic. The main reason is a spasm of a blood vessel;
compression Progresses due to mechanical compression of blood vessels;
redistributive. The reason for the progression of ischemia is the interorgan redistribution of blood flow.

Symptoms

Symptoms of ischemia directly depend on in which organ the progression of the pathological process is observed.

With the development of chronic cerebral ischemia, the patient's memory is impaired, a feeling of lack of air occurs, and coordination of movements is significantly impaired. The ability to concentrate on certain actions also decreases.

Signs of cerebral ischemia occur abruptly and are similar in nature to the symptoms of a pre-stroke condition. Transient cerebral ischemia is characterized by the following symptoms:

noise in ears;
weakness of the upper and lower extremities;
disorders speech apparatus– one of the main symptoms of transient cerebral ischemia. The patient’s speech becomes incoherent, words are unclear, etc.;
violation visual function;
headache;
dizziness;
numbness of the face. This sign of transient ischemia is very important for subsequent diagnosis.

Transient cerebral ischemia is very dangerous, as it can lead to irreversible changes in the organ. Therefore, it is necessary to hospitalize the patient as soon as possible so that doctors can provide him with qualified care. Transient ischemia is treated only in inpatient conditions so that doctors can constantly monitor general state patient and prevent progression of complications.

It is worth noting that transient ischemic cerebral disease is a rather unpredictable condition. Significant neurological symptoms may completely disappear before the patient is taken to the hospital.

Poor circulation in the intestines

Intestinal ischemia manifests itself by the appearance of severe pain localized in the navel area, as well as in the upper right part of the abdomen. Intestinal motility increases, and the patient experiences a frequent urge to defecate. During the first stages of progression of intestinal ischemia, the following symptoms are observed:

stool disorder;
nausea and vomiting;
streaks of blood appear in the excrement.

Body temperature at the first stage of intestinal ischemia is within normal limits. As the disease develops, the following is observed:

hypovolemia;
metabolic acidosis;
hyperamylasemia.

Circulatory failure in the extremities

Ischemia of the lower extremities is diagnosed very often. As a rule, the symptoms of the pathology are pronounced. Due to poor circulation in the lower extremities, the following symptoms occur:

pain syndrome in the muscle structures of the lower extremities. Tends to increase at night;
due to inadequate blood supply and nutrients, trophic ulcers form on the skin of the legs. The main localization is the feet and toes;
intermittent claudication. A person with ischemic disease of the lower extremities cannot fully move. Due to circulatory disorders and severe pain in calf muscles, he is forced to periodically stop and rest.

If you don't pay attention to indicated symptoms, then progression of critical ischemia of the lower extremities is possible. The pain syndrome is observed constantly and its intensity does not decrease during rest. Along with trophic ulcers, necrosis also develops on the skin of the lower extremities. If ischemia is not treated, a person may lose part of a limb.

Poor circulation in the heart muscle

The main symptom of coronary heart disease is the appearance. The patient notes that he has developed severe pain behind the sternum, as well as a feeling of lack of oxygen. It is worth noting that pain syndrome usually manifests itself during physical overload or severe psycho-emotional shock.

Myocardial ischemia can occur without pronounced pain. The progression of the pathology can be detected by examining the heart. Indirect signs of the disease:

dyspnea. With myocardial ischemia, shortness of breath is usually observed during exercise. The patient feels much better when he sits down;
weakness and pain in the left hand;
decrease in blood pressure;
cyanosis skin;
increased frequency of extrasystoles;
heartburn.

Myocardial ischemia – extremely dangerous condition, which can lead to death if a heart attack develops in the affected area.

Diagnostics

The standard diagnostic plan for coronary disease of the heart, brain and other organs includes the following methods:

ECG is one of the most informative methods for diagnosing cardiac ischemia;
coronary angiography – allows you to assess the condition of the coronary vessels of the heart;
stress testing;
Ultrasound cardiography.

Treatment

Treatment of coronary heart disease or other organs is carried out only after a thorough diagnosis, identification of the true cause of the pathology, as well as an assessment of the severity of the disease. Treatment of ischemia is carried out using physiotherapeutic, medicinal and surgical techniques. If drug treatment is chosen, the patient is given intravenous prostaglandins, thrombolytics, and drugs to improve blood flow.

The cause of vessel blockage can be completely eliminated and its patency can be normalized by stenting the anterior wall of the vessel. Doctors also often resort to coronary angioplasty.

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Diseases with similar symptoms:

Pulmonary failure is a condition characterized by the inability of the pulmonary system to maintain normal blood gas composition, or it is stabilized due to severe overstrain of the compensatory mechanisms of the external respiration apparatus. The basis of this pathological process is a violation of gas exchange in the pulmonary system. Because of this, the required volume of oxygen does not enter the human body, and the level carbon dioxide is constantly increasing. All this causes oxygen starvation of organs.

Reasons for increased resistance to blood flow in the arteries:

Compression (external pressure) of afferent vessels (tumor, scar, ligature, foreign body). This type of ischemia is called compression ischemia.

Obstruction of the afferent vessels - as a result of complete or partial closure of the artery lumen from the inside by a thrombus or embolus.

Angiospasm of the afferent arteries is a result of vasoconstriction of vascular smooth muscles. Mechanisms of arterial spasm: a) extracellular – associated with long-term circulation of vasoconstrictor substances in the blood. These are: catecholamines, serotonin; b) membrane – associated with disruption of the process of repolarization of membranes of smooth muscle cells; c) intracellular - the intracellular transport of calcium ions is disrupted, hence the unrelaxing contraction of smooth muscle cells.

Microcirculation during ischemia:

The arteriovenous pressure difference is reduced due to a decrease in hydrostatic pressure in the arterial part of the bed.

Resistance to blood flow in the arterial part of the bed is increased due to obstruction of blood flow in the afferent arteries.

The volumetric velocity of blood flow is reduced due to a decrease in the arteriovenous pressure difference and an increase in resistance to blood flow.

The linear velocity of blood flow is reduced due to a decrease in the arteriovenous pressure difference and increased resistance to blood flow.

The total cross-sectional area of the capillary bed is reduced by closing part of the functioning capillaries.

A decrease in the diameter and number of visible arterial vessels due to their narrowing and decreased blood supply.

Pallor of tissues or organs due to decreased blood supply and a decrease in the number of functioning capillaries.

A decrease in the pulsation of the arteries as a result of their filling with blood.

A decrease in the temperature of ischemic tissue or an organ is a consequence of a decrease in the influx of warm arterial blood, further reducing metabolism.

Decreased lymph formation as a result of decreased perfusion pressure in tissue microvessels.

A decrease in the volume and turgor of tissues and organs due to insufficient blood and lymph filling.

Decreased specific functions.

Decrease in nonspecific functions and processes: local defensive reactions, lymph formation, plastic processes.

Development of dystrophic processes, tissue hypotrophy and atrophy.

Necrosis and infarction.

The importance of the level of tissue and organ functioning, shunting and collateral circulation in the outcome of ischemia. Heart attack as a consequence of ischemia.

29. Emboli: etiology, classification by type of emboli, consequences. Embolism of the systemic and pulmonary circulation. Paradoxical and retrograde embolism.

Embolism – pathological process, which is caused by various substrates (emboli) circulating in the blood/lymph, which are not found normally, but can cause acute occlusion with impaired blood supply to the organ/tissue.

From the venous system great circle blood circulation and the right parts of the heart into the pulmonary circle.

From the small to the systemic circulation

From the portal system to the portal vein

Thromboembolism is a blockage by a blood clot that breaks away from the site of its formation and enters the circulating blood, as a result of which ischemia and necrosis develop.

Fatty – transport with blood and occlusion of small vessels

Tissue – occlusion of blood vessels by decay products of one’s own tissues

Microbial - vascular occlusion by MOmi or fragments of an infected thromboembolus subject to purulent inflammation

Air – entry of air bubbles into the bloodstream

Gas - release of gases dissolved in the blood (usually nitrogen)

Embolism by foreign bodies: shot, bullet, fragments

Embolism of the pulmonary circulation. Emboli close the lumen pulmonary arteries. Foreign particles enter the pulmonary arteries from the venous vessels of the systemic circulation and the right half of the heart. The consequences depend on the composition, size of emboli, and their total mass. Multiple embolism of small pulmonary arteries is especially dangerous. Blood flow is disrupted. Blood pressure in the vessels of the pulmonary circulation increases, blood flow into the left atrium and ventricle is limited, stroke and cardiac output decreases, and blood pressure drops sharply. Hypotension - characteristic feature massive embolism of vessels of the pulmonary circulation. Decline blood pressure negatively affects the functional activity of the heart itself due to myocardial hypoxia. A drop in blood pressure is combined with a significant increase in systemic venous pressure with the development of acute right ventricular failure (acute cor pulmonale syndrome).

Pulmonary embolism is accompanied by changes in blood gas composition. Shortness of breath occurs as a reflex reaction to irritation of the chemoreceptors of the reflexogenic zones of the systemic circulation and as a reaction from the receptor fields of the pulmonary circulation system. Shortness of breath helps to increase blood oxygenation and release it from CO 2.

The mesenteric arteries, arteries of the kidneys, spleen, brain, and heart muscle are most often affected by embolism.

Retrograde embolism, in which the movement of the embolus occurs against the natural flow of blood. As a rule, this is typical for vertically oriented venous vessels, the embolus in which has a greater density than blood plasma, and its movement is subject to gravity to a greater extent than to hemodynamics. Also retrograde embolism from distal sections arteries may be caused by a pathological gradient of blood pressure.

Also known paradoxical embolism. With paradoxical embolism, the particle freely penetrates from the venous system of the systemic circle into the arterial system, bypassing the small circle, due to an existing heart defect. This happens with a defect of the interventricular or interatrial septum or with another defect with a right-to-left shunt.

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Consequences of ischemia

1. With short-term ischemia or with well-developed collaterals, the tissue may be virtually undamaged.

2. With shallow but prolonged ischemia, atrophic changes in parenchymal cells with proliferation of connective tissue also develop.

3. If blood flow in the ischemic tissue is not restored, a heart attack occurs. A heart attack is ischemic necrosis of an area of an organ or tissue due to a sudden cessation of blood flow. In rare cases, a heart attack can develop due to a violation of venous outflow - with venous hyperemia.

Based on the color of the damaged tissue, white and red infarction are distinguished. White infarction is formed in the process of necrosis (necrosis) of ischemic tissue containing a small amount of blood due to the absence or very weak development of collateral vessels (functionally absolutely insufficient collaterals). Blood vessels in ischemic tissue are filled mainly with blood plasma and contain almost no red blood cells. White infarction develops, for example, in the spleen, heart and kidneys. The formation of a red infarction is the result of ischemic necrosis of tissue that has a small collateral blood supply (functionally relatively sufficient collaterals), but sufficient for the accumulation of a significant amount of blood in this tissue. During ischemic damage to the vascular walls, their permeability increases. Red blood cells enter the extravascular space by diapedesis. Subsequently, the walls of the blood vessels are destroyed and red blood cells with their decay products “stuff the tissue.” The fabric turns red.

Coronary heart disease consequences

Consequences of IHD

If not treated promptly, coronary heart disease can lead to irreversible consequences. What are the most dangerous consequences IBS?

The patient develops chronic heart failure over time. But even in the initial stages of diseases with coronary artery disease, sudden cardiac arrest or myocardial infarction can occur.

In addition, according to statistics, 1/3 of deaths occur precisely because of coronary heart disease.

If the disease has just made itself felt, its development can be stopped with the help of conservative therapy, including physiotherapeutic procedures and medications.

The goal of pharmacotherapy is to block angina attacks. and also prevent the development of myocardial infarction.

At home, if you feel the onset of an attack, you should take a nitroglycerin tablet. This drug dilates blood vessels and improves nutrition of the heart muscle.

Under no circumstances should you take other medications without a doctor’s prescription.

Depending on the condition of the body and taking into account the current pathology, the doctor will prescribe you certain medications and vasodilators.

At a later stage of the disease, surgery may be required. Its task is to expand a vessel that is blocked by a plaque or thrombus.

One of the most effective surgical interventions for ischemic heart disease is coronary artery bypass surgery, as well as stenting of coronary arteries.

To perform such an operation, local anesthesia is sufficient. However, in the future, during the rehabilitation period, it is necessary to strictly follow all the doctor’s recommendations.

The most important thing is to reconsider your lifestyle and diet.

The basis of the diet should be vegetables and lean meats and fish. Mandatory exercise stress.

It is also necessary to stop smoking and drinking strong alcoholic drinks. It is advisable to normalize blood cholesterol levels and blood pressure.

Treatment of coronary heart disease is already for a long time It is also successfully carried out in City Clinical Hospital No. 57.

When selecting drug treatment, only drugs that have successfully passed clinical trials and proven to be highly effective are used.

Treatment of coronary heart disease and its consequences

Don't be careless with your heart! Did you know that in economically developed countries, a third of deaths occur from coronary heart disease. This disease, if left untreated, can lead to serious consequences. The patient develops chronic heart failure over time. The quality of life drops sharply. With coronary heart disease, patients quite often experience sudden cardiac arrest. Therefore, be sure to contact a specialist if the first signs of problems with your heart occur. Doctors have a sufficient arsenal of tools to help you.

Most often, if the disease is not too advanced, coronary heart disease is treated with medications. Medicines are prescribed for the most part to prevent the recurrence of heart attacks, as well as to prevent the development of myocardial infarction.

If you feel the onset of an attack of coronary heart disease, you should take a nitroglycerin tablet. This drug dilates blood vessels and improves nutrition of the heart muscle. You should not take any more medications without a doctor’s prescription.

What can a doctor prescribe? These are medications that reduce the need for oxygen in your myocardium, vasodilators.

It should be remembered that the cause of coronary heart disease is that the vessel is blocked by a plaque or thrombus. This situation cannot be changed with conservative treatment. To cleanse the vessel bed, surgical intervention is necessary. But this is an extreme measure that is not always resorted to. One type of surgical intervention for coronary heart disease is bypass surgery. During this operation, a piece of the vessel is cut out and an artificial section is inserted in its place. The operation is complicated because the patient is connected to a heart-lung machine during it, because the heart should not beat. After bypass surgery, the body takes quite a long time to recover. Such operations also have a fairly large number of contraindications.

For many years, acetylsalicylic acid has been used for the prevention and treatment of coronary heart disease. Created today medicines, replacing aspirin and at the same time affecting the body more gently and sparingly.

Do not try to self-medicate. Pharmacies actually have a lot of remedies for the treatment of coronary heart disease. Each of these drugs has a very strong effect on the body, so it can significantly disrupt the functioning of the heart. Treatment of coronary heart disease can only be carried out under the supervision of a doctor.

Most in a modern way The treatment for coronary heart disease is endovascular surgery. The lumen of the vessel is cleaned using microinstruments inserted through a small hole in the skin. The surgeon monitors the progress of the operation using x-rays. The patient is not even given general anesthesia. To perform such an operation, local anesthesia is sufficient.

According to doctors, everything surgical methods Treatments for coronary heart disease are very effective. In addition, after them the patient practically does not develop any complications.

After treatment for coronary heart disease, you will need to reconsider your lifestyle and diet. The basis of the diet should now be vegetables and lean meats and fish. Strong physical activity is required. You will have to give up smoking and drinking strong alcoholic drinks. It is also advisable to normalize blood cholesterol levels and blood pressure.

To improve blood circulation, the medical board of tiensmed.ru (www.tiensmed.ru) advises purchasing a Circulatory Stimulator. produced by Tianshi Corporation. The operation of the device is based on the effect on biological active points Your body. The method is completely safe. Included with the device detailed instructions by use. You can easily find the necessary areas on your body for treatment. With the help of the Blood Circulation Stimulator, you will not only improve blood circulation, but also improve the health of the body as a whole.

Before use, you should consult a specialist.

Coronary heart disease: causes and consequences

Causes of development of coronary heart disease (CHD)

Coronary heart disease occurs as a result of insufficient blood supply to the myocardium. The result is the death of a section of the heart muscle, or myocardial infarction. An imbalance between the heart's need for oxygen and the ability of the blood vessels to meet this need can be caused by a number of reasons. In general, they can be divided into two groups:

1. Intravascular changes.

atherosclerosis - narrowing of the lumen of the coronary arteries due to the proliferation of cholesterol plaques;
thrombosis - blockage of blood vessels with blood clots (thrombi), which can occur against the background of atherosclerosis;
spasm of the coronary arteries (vasospasm) - narrowing of the vascular lumen due to contraction of the smooth muscles of the arteries;

tachycardia - increased heart rate (HR);
arterial hypertension- increased blood pressure;
myocardial hypertrophy - an increase in the volume of the heart muscle, occurs due to high load on the myocardium.

Some of the above causes of ischemia are reversible (tachycardia) or easily treatable if detected early (arterial hypertension), some appear suddenly (thrombosis) and pose a huge threat to life.

Risk factors for developing ischemia

Causal changes in the cardiovascular system do not occur spontaneously; as a rule, they take years to develop. And if you pay attention to your own well-being in time and exclude possible risk factors, ischemia, in most cases, can be avoided. The main risk factors for the development of coronary artery disease can be divided into reversible and irreversible.

Irreversible risk factors:

Heredity is of great importance in the development of coronary heart disease. According to various sources, hereditary predisposition occurs in 80-90% of cases of thrombophilia development, common cause thrombosis of the coronary arteries.

Diabetes mellitus - in addition to the danger of hyperglycemia, diabetes mellitus can significantly accelerate the risk of developing ischemia. Increased level glucose in the blood contributes to damage to the vascular wall, including the coronary vessels. In addition to the direct danger to blood vessels, diabetes mellitus promotes the accumulation of fat, thereby exacerbating the negative effect on the heart arteries.

Hypothyroidism - insufficient production of hormones thyroid gland. As is the case with diabetes mellitus, hypothyroidism, in addition to its negative impact on the condition of the coronary arteries, contributes to obesity, which is, in turn, an additional risk factor for the development of ischemia and related complications.

Physical inactivity - low physical activity, or hypotension, also poses a serious threat to the health of the coronary arteries. Negative consequences physical inactivity manifests itself in a state of activity, when the heart, unaccustomed to stress, is forced to pump an unexpectedly large amount of blood.

Obesity is a fairly common cause of heart disease, in particular coronary artery disease. In addition, excess fat deposition further increases the risk of complications during cardiac ischemia. Despite its danger, obesity, in most cases, is a reversible risk factor - the load on the heart decreases in direct proportion to the decrease in body weight.

Smoking is another reversible, but rather dangerous factor in the development of IHD. According to various studies, the risk of developing ischemia in the smoking part of the world's population is 2-7 times higher than in non-smokers. Despite the difference in numbers, bad influence The impact of tobacco addiction on heart health is clearly supported by numerous studies.

Alcoholism - those who still did not know about it or doubted it should be warned: alcohol has a detrimental effect on the health of your heart, as well as on your health in general. Despite periodic statements by some “luminaries” about the harmlessness and even benefits of alcohol, the statistics are inexorable - about 20% of deaths from cardiovascular diseases caused by excessive alcohol consumption. Except obvious signs development of ischemic heart disease due to alcohol abuse, there are so-called “sober” cases, when the consequences harmful effects appear after years of living without alcohol. Negative effects of ethylene on cardiovascular system goes in several directions:

By affecting the distribution of electrolytes, alcohol causes disruption of the coronary vessels.
Once in the blood, alcohol causes hemolysis (the breakdown of red blood cells, the very ones that carry them).
Alcohol disrupts the mechanisms of blood sugar regulation, changing its level up to a state of hypoglycemia.

In most cases of ischemia, several factors occur at once. At the same time, the presence of reversible risk factors, annoying as it may be, is usually facilitated by trivial human carelessness. With a responsible attitude towards your own health, the risk of developing coronary heart disease can be significantly reduced by getting rid of bad habits, maintaining moderation in food consumption and maintaining physical activity.

Consequences of myocardial ischemia

Structural and ultrastructural changes

Metabolic changes

Heart dysfunction

Arrhythmias

Reflex sympathetic activation

Anginal pain

Ischemic cascade

decreased pH and increased concentration of K+ ions in venous blood flowing from the ischemic area;
regional abnormal LV wall motion and signs of global LV diastolic and systolic dysfunction;
the appearance of ST segment changes.

Acute coronary syndrome- acute phase IHD. Atherosclerosis, which underlies ischemic heart disease, is not a linearly progressive, stable process. Atherosclerosis of the coronary arteries is characterized by alternating phases of stable progression and exacerbation of the disease.

IHD - mismatch coronary blood flow metabolic needs of the myocardium, i.e. volume of myocardial oxygen consumption (PMO2).

In some cases clinical picture Chronic stable ischemic heart disease is caused by symptoms and signs of LV dysfunction. This condition is defined as ischemic cardiomyopathy. Ischemic cardiomyopathy- the most common form of HF in developed countries, reaching a level of 2/3 to 3/4 of cases.

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Consequences of chronic coronary heart disease

Coronary heart disease, depending on the nature of the disease, is divided into two clinical forms - acute and chronic. Chronic ischemic heart disease is one of the most important problems of humanity. The disease is characterized by a high mortality rate due to cardiac arrest. Every year, more than 70% of people around the world die from this disease. Elderly people are more susceptible to Hibs than others, of whom most of– men aged 50–60 years.

The heart muscle (myocardium), thanks to the blood flow, consumes a lot of oxygen. When the heart muscle is damaged, its blood supply is disrupted or stopped. The cause of this condition is cholesterol plaques that form on the walls of the coronary vessels of the myocardium. They interfere with the delivery of oxygen and other nutrients to the heart. As a result, a state of oxygen starvation develops – ischemia.

Symptoms of HIBS disease

Chronic ischemic heart disease is characterized by a gradual development, during which signs of the disease appear and disappear. If the disease is not treated at this stage, it will progress and can be fatal.

In chronic ischemia, the following symptoms are expressed:

increased blood pressure;
heaviness or paroxysmal pain behind the sternum, radiating to the left arm, shoulder, and sometimes to the shoulder blade, back, and abdominal area;
pain that occurs during any activity and goes away at rest;
interruptions in myocardial function (changes in heart rate);
swelling of the lower extremities;
shortness of breath, difficulty breathing;
severe weakness with minor exertion;
pronounced pallor of the skin;
anxiety, panic states.

Due to stagnation of blood in the vessels, work deteriorates internal organs: stomach, liver and kidneys.

Diagnosis of the disease

For the diagnosis of chronic ischemic heart disease early stage there are a number of modern informative methods. With their help, the clinical diagnosis is clarified and the method of subsequent treatment is determined.

First of all, the doctor conducts a detailed survey of the patient, auscultates, analyzes complaints, and finds out family history.

The next stage is laboratory tests to identify various inflammatory processes in the patient’s body and other disorders. For this purpose the following is carried out:

biochemical and general blood test;
coagulogram;
lipidogram.

Instrumental research methods

The use of specific instrumental techniques in diagnosis gives a fairly accurate picture of the disease.

ECG is a diagnostic method that records the electrical activity of the myocardium. It detects various changes in heart rhythm and is also able to detect myocardial infarction or its consequences. Various options coronary disease have been studied for a long time, and the electrocardiography method can provide sufficient information on ECG changes during the examination.

Using the echocardiography method, you can measure the size of the heart muscle, examine the contractility of the heart, cardiac cavities and valves, and acoustic noise. The combination of ultrasound diagnostics with physical activity (stress echocardiography) makes it possible to register ischemic disorders in the myocardium.

Bicycle ergometry is a common functional test. With its help, changes in the activity of the heart are revealed that are invisible at rest, but only during physical activity - in particular, in the form of exercises on an exercise bike.

To record disturbances in myocardial activity, a special device is used - a Holter monitor. It is attached to the patient’s belt or shoulder, and the device takes readings for a full day. For a more accurate study, the patient should keep a diary of monitoring his well-being.

Such careful monitoring allows specialists to find out and study:

under what conditions does a patient develop manifestations of chronic ischemic heart disease;
the nature of disturbances in the functioning of the myocardium, the degree of their severity;
study the frequency of heart rhythm interruptions;
catch heart beats.

Transesophageal electrocardiography (TEECG) is very exact method studies using a sensor inserted into the esophagus, where it records the performance of the myocardium without interference created by external manifestations human life activity.

The coronary angiography method is used in severe cases. Coronary angiography examines the vessels of the heart muscle, determines violations of their patency, the degree of stenosis, and the location of the affected arteries by administering a specific substance. This research method allows you to diagnose HIHD and distinguish it from any similar disease. Coronary angiography helps in deciding the need for surgery on myocardial vessels.

Left ventriculography is performed at the same time as coronary angiography. This method is also used to clarify indications for surgery.

Radionuclide testing helps to conduct a more accurate diagnosis of the myocardium, its functional state, on the basis of which one can judge the effectiveness surgery for the patient.

To diagnose symptoms of complications of ischemic disease - myocardial aneurysm, some manifestations of heart failure, an x-ray examination is prescribed.

After fully diagnosing the disease, the doctor prescribes proper treatment for the patient.

Treatment methods for HIBS

Depending on the clinical forms diseases, treatment of cardiac ischemia is carried out in the main areas:

therapy without the use of drugs;
drug therapy;
surgical intervention.

Non-drug therapy

Non-drug therapy is aimed at correcting the patient’s lifestyle. Physical activity requires an increased supply of oxygen to the heart, but during illness the body cannot satisfy this need due to damaged heart arteries. Therefore, during the treatment process, the patient’s activity is minimized.

The patient is prescribed physical therapy and short walks - such loads help the heart adapt to the limited blood supply during the period of illness.

The healing process is influenced by the patient's diet. Limit the amount of salt in food and water consumption to reduce the load on the heart. To improve the condition of blood vessels and normalize weight in obesity, the patient is prescribed a low-fat diet, including fiber, fruits, vegetables and fish products. Excluded from the diet:

Drug therapy

Drug therapy for chronic forms IHD follows the “A-B-C” formula and consists of antiplatelet agents, β-blockers and hypocholesterolemic drugs. Patients are also prescribed:

diuretics;
antiarrhythmic, antianginal drugs;
nitrites;
ACE inhibitors;
calcium channel blockers;
anticoagulants;
statins;
fibrates.

Medicines are prescribed to each patient individually. The age, features of the course of the disease and the absence of pathologies in the patient are taken into account. Self-medicating or taking medications without the advice of a medical specialist is life-threatening.

Surgical intervention

Surgery is necessary if drug therapy does not help required result. Before prescribing it, the cardiac surgeon conducts a thorough diagnosis to determine:

contractile function of the myocardium;
condition of the coronary arteries;
level and localization of narrowing of the coronary arteries;
severity of the disease;
resistance of the disease to drug therapy.

Surgical intervention is aimed at restoring the patency of clogged vessels and improving blood flow in them. The operation is prescribed in the following conditions:

unstable angina resistant to drug therapy;
narrowing of the trunk of the left coronary artery by 70%, damage to three coronary arteries;
damaged coronary bed with artery narrowing by 75%;
ischemic myocardial dysfunction;
intolerance to minimal physical activity on the heart;

Basic surgical methods for chronic ischemic heart disease:

coronary artery bypass grafting;
coronary angioplasty;
walling.

IN in some cases These operations are contraindicated in certain groups of patients:

those suffering from concomitant serious diseases;
in cases with constantly elevated blood pressure;
having excess weight;
with certain lesions in the myocardium.

Complications of chronic ischemic heart disease

Coronary heart disease provokes extremely negative consequences for the entire human body if it is not treated.

Angina pectoris is the main manifestation of ischemic myocardial disease. The reasons for its occurrence are blood clots that block the passage in the arteries, which are formed when hyperaggregation (increased adhesiveness) of platelets occurs due to spasms in the vessels.

Treatment methods for angina pectoris are widely known and available, but the disease responds poorly to them. This disease can be caused not only by ischemic heart disease; there are many other causes of heart rhythm disturbances.

In chronic ischemic heart disease, these disorders arise precisely because of the presence of ischemic foci in the heart muscle.

Stable, or exertional angina, occurs under the influence of physical or emotional stress. It manifests itself as pain, which can be relieved by taking nitroglycerin. Sometimes they go away on their own if you lie quietly in a well-ventilated area.

With unstable angina (rest and stress), pain occurs regardless of physical or emotional stress, most often at rest. In fact, this is an intermediate stage between chronic cardiac ischemia and heart attack. The occurrence of such attacks means that the disease is progressing and the heart is experiencing a lack of oxygen even at rest. If attacks of pain become more frequent and intense, this indicates the possible development of acute myocardial infarction.

Heart failure is also a complication of chronic ischemic heart disease. It is formed under the influence of various functional disorders in the functioning of the heart muscle.

A common complication of myocardial ischemia is the formation of congestive heart failure (CHF). In CHF, the heart muscle contracts weakly and therefore pumps insufficient volume of blood necessary for normal operation internal organs. For this reason, various violations occur in them. Acquiring a chronic form, congestive heart failure sharply reduces the patient's chances of survival.

Complications of HIHD in the form of chronic heart failure are expressed by symptoms such as:

swelling;
dyspnea;
inability to exercise;
irreversible changes in internal organs.

Acute heart failure (AHF) most often develops in various heart diseases. AHF syndrome affects the left ventricle of the myocardium; the patient develops signs of pulmonary edema in the form of shortness of breath and pink sputum during coughing. Acute heart failure often progresses to a heart attack or stroke.

Arrhythmia is also a complication of chronic ischemic heart disease. This is a fairly common pathology. The most common types of arrhythmia:

sinus tachycardia;
bradycardia;
extrasystoles;
heart conduction disturbance (block).

Arrhythmia sometimes goes unnoticed and patients do not attach serious importance to it. This attitude is dangerous, since any form of arrhythmia can be fatal.

The chronic form of cardiac ischemia is a rather dangerous disease. Almost any of the listed complications of HIHD lead to the death of the patient without timely and correct treatment.

Acute form of ischemic disease

Acute coronary heart disease is another form of myocardial disease, expressed by such complications as:

myocardial infarction;
cardiogenic shock;
sudden coronary death (primary cardiac arrest).

Myocardial infarction is a very common complication of acute cardiac ischemia. The reason for its occurrence is the blockage of one of the heart arteries by the resulting plaque. Infarction can be large-focal or small-focal.

Sharp pain on the left behind the sternum, radiating to the left side of the body (arm, shoulder blade, lower jaw). Occurs suddenly or grows rapidly in a short period of time. Within half an hour from the moment of the attack, in the absence of medical assistance, the pain intensifies.
Severe shortness of breath. When trying to take a deep breath, the pain behind the sternum intensifies, which prevents the patient from breathing normally. There is a noticeable lack of oxygen, and suffocation may occur.
A sharp drop in blood pressure leading to loss of consciousness. The reasons are a spontaneous change in heart rate, a decrease in the contractile function of the heart.
Taking nitroglycerin during a heart attack does not eliminate pain due to a serious violation of the viability of cardiomyocytes (myocardial cells responsible for the contractility of the heart).

Acute complications

Another of the severe manifestations acute form coronary heart disease – cardiogenic shock. Its signs:

rapid drop in blood pressure;
unconscious state;
extremely weak pulse;
shallow breathing.

Lack of blood supply leads to serious complications in the functioning of internal organs:

acute renal and liver failure develops;
pulmonary edema;
disruptions in the functioning of the central nervous system are observed.

In this condition, a person needs urgent medical attention to prevent death.

Sudden coronary death is also a complication of acute ischemic heart disease. Death can overtake a person in an instant or within six hours from the onset of the attack. The approach of the VKS can be determined by several signs:

emerging and intensifying feeling of suffocation;
strong pressure behind the sternum;
heaviness in the shoulders;
dilated pupils;
loss of consciousness;
respiratory arrest;
cessation of cardiac activity.

Most often, it overtakes active men who do not complain about their health. The cause of VCS is a violation of the heart rhythm: the contraction of myocardial fibers occurs chaotically, out of order, the heart rate per minute is more than three hundred.

It is rarely possible to save a person in such a condition. Even with timely implementation of all possible resuscitation procedures, death occurs in four out of five cases.

If heart failure syndrome occurs against the background of acute myocardial ischemia, it manifests itself as cardiac asthma or pulmonary edema.

A person with any acute form of ischemic disease needs emergency assistance. For resuscitation, the following means are used:

painkillers;
thrombolytics;
plasma replacement drugs;
carrying out defibrillation.

Measures to prevent VCS

People who die suddenly sometimes have no obvious signs of death. fatal outcome. But you should know that it is extremely rare that a person dies instantly without any pathology in the cardiovascular system. This means that you can and should carefully focus on your unhealthy feelings. This primarily applies to those who have suffered a myocardial infarction.

In the process of studying cases of VS, it was found that almost half of the patients had clear signs of its approach several hours before death. This means that they had the opportunity to avoid tragedy with timely examination and treatment.

Another risk group is patients with myocardial ischemia who do not have pain or other symptoms of the disease or are extremely mild. For this reason, people do not undergo the necessary examination and do not receive treatment. Death in this case occurs due to a serious heart rhythm disorder.

The third group of people at risk of VCS are patients in whom acute disorder myocardium is not possible in any way. Here we can only hope for an emergency medical care, so as to predict sudden death in in this case does not seem possible.

Death from coronary heart disease occurs quite often due to a lack of seriousness in treating the disease. To prevent VS, doctors are required to inform patients about the possible threatening consequences of their illness. Mainly signs sudden death appear quite often. It is important not to ignore them, so as not to become a victim of your own indifference to your health.

Measures to prevent relapse of the disease

To prevent relapse of the disease, after discharge from the hospital, the patient should follow all the recommendations of the attending physician and follow certain rules:

do not stop taking medications prescribed by your doctor;
do physical therapy;
in stressful situations, go to see a psychotherapist;
undergo sanatorium-resort treatment;
regularly monitor blood pressure;
maintain normal weight;
stick to a healthy diet;
avoid states of prolonged stress (driving a car, long airplane flights, being in a poorly ventilated area);
exercise only under the supervision of a physical therapy specialist.

You should not get involved in alternative medicine without the advice of a doctor. Folk remedies are quite effective in treating various diseases, but which of them and how to use should be prescribed by a specialist.

Preventive measures to prevent coronary artery disease are almost the same as recommendations for maintaining health after hospital treatment for CHD.

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Depending on the nature of the disease, it is divided into two clinical forms - acute and chronic. Chronic ischemic heart disease is one of the most important problems of humanity. The disease is characterized by a high mortality rate due to cardiac arrest. Every year, more than 70% of people around the world die from this disease. Elderly people are more susceptible to hibs, most of whom are men aged 50–60 years.

Symptoms of HIBS disease

In chronic ischemia, the following symptoms are expressed:

increased blood pressure;
heaviness or paroxysmal pain behind the sternum, radiating to the left arm, shoulder, and sometimes to the shoulder blade, back, and abdominal area;
pain that occurs during any activity and goes away at rest;
interruptions in myocardial function (changes in heart rate);
swelling of the lower extremities;
shortness of breath, difficulty breathing;
severe weakness with minor exertion;
pronounced pallor of the skin;
anxiety, panic states.

Due to stagnation of blood in the vessels, the functioning of internal organs: the stomach, liver and kidneys deteriorates.

Diagnosis of the disease

There are a number of modern informative methods for diagnosing chronic ischemic heart disease at an early stage. With their help, the clinical diagnosis is clarified and the method of subsequent treatment is determined.

First of all, the doctor conducts a detailed survey of the patient, auscultates, analyzes complaints, and finds out family history.

The next stage is laboratory tests to identify various inflammatory processes in the patient’s body and other disorders. For this purpose the following is carried out:

biochemical and general blood test;
lipidogram.

Instrumental research methods

The use of specific instrumental techniques in diagnosis gives a fairly accurate picture of the disease.

– a diagnostic method that records the electrical activity of the myocardium. It detects various changes in heart rhythm and is also able to detect its consequences. Various variants of coronary disease have long been studied, and electrocardiography can provide sufficient information on ECG changes during the examination.

You can measure the size of the heart muscle, examine the contractility of the heart, cardiac cavities and valves, and acoustic noise. The combination of ultrasound diagnostics with physical activity (stress echocardiography) makes it possible to register ischemic disorders in the myocardium.

Such careful monitoring allows specialists to find out and study:

under what conditions does a patient develop manifestations of chronic ischemic heart disease;
the nature of disturbances in the functioning of the myocardium, the degree of their severity;
study the frequency of heart rhythm interruptions;
catch heart beats.

Transesophageal electrocardiography (TEE) is a very accurate research method using a sensor inserted into the esophagus, where it records myocardial performance without interference created by external manifestations of human activity.

Left ventriculography is performed at the same time as coronary angiography. This method is also used to clarify indications for surgery.

Radionuclide testing helps to conduct a more accurate diagnosis of the myocardium and its functional state, on the basis of which one can judge the effectiveness of the surgical operation for the patient.

To diagnose symptoms of complications of ischemic disease - myocardial aneurysm, some manifestations of heart failure, an x-ray examination is prescribed.

After fully diagnosing the disease, the doctor prescribes proper treatment for the patient.

Treatment methods for HIBS

Depending on the clinical forms of the disease, treatment of cardiac ischemia is carried out in the following main areas:

therapy without the use of drugs;
drug therapy;
surgical intervention.

Non-drug therapy

The patient is prescribed physical therapy and short walks - such loads help the heart adapt to the limited blood supply during the period of illness.

animal fats;
roast;
smoked;
baking;
alcoholic drinks.

Drug therapy

In chronic forms of IHD, it follows the “A-B-C” formula and consists of antiplatelet agents, β-blockers and hypocholesterolemic drugs. Patients are also prescribed:

diuretics;
antiarrhythmic, antianginal drugs;
nitrites;
ACE inhibitors;
calcium channel blockers;
anticoagulants;
statins;
fibrates.

Surgical intervention

Surgery is necessary if drug therapy does not bring the desired result. Before prescribing it, the cardiac surgeon conducts a thorough diagnosis to determine:

contractile function of the myocardium;
condition of the coronary arteries;
level and localization of narrowing of the coronary arteries;
severity of the disease;
resistance of the disease to drug therapy.

Surgical intervention is aimed at restoring the patency of clogged vessels and improving blood flow in them. The operation is prescribed in the following conditions:

unstable angina resistant to drug therapy;
narrowing of the trunk of the left coronary artery by 70%, damage to three coronary arteries;
damaged coronary bed with artery narrowing by 75%;
ischemic myocardial dysfunction;
intolerance to minimal physical activity on the heart;

Basic surgical methods for chronic ischemic heart disease:

coronary angioplasty;
walling.

In some cases, these operations are contraindicated in certain groups of patients:

those suffering from concomitant serious diseases;
in cases with constantly elevated blood pressure;
having excess weight;
with certain lesions in the myocardium.

Complications of chronic ischemic heart disease

Coronary heart disease provokes extremely negative consequences for the entire human body if it is not treated.

– the main manifestation of ischemic myocardial disease. The reasons for its occurrence are blood clots that block the passage in the arteries, which are formed when hyperaggregation (increased adhesiveness) of platelets occurs due to spasms in the vessels.

They are widely known and accessible, but the disease does not respond well to them. This disease can be caused not only by ischemic heart disease; there are many other causes of heart rhythm disturbances.

In chronic ischemic heart disease, these disorders arise precisely because of the presence of ischemic foci in the heart muscle.

Or, occurs under the influence of physical or emotional stress. It manifests itself as pain, which can be relieved by taking nitroglycerin. Sometimes they go away on their own if you lie quietly in a well-ventilated area.

When (and stress), pain occurs regardless of physical or emotional stress, most often at rest. In fact, this is an intermediate stage between chronic cardiac ischemia and heart attack. The occurrence of such attacks means that the disease is progressing and the heart is experiencing a lack of oxygen even at rest. If attacks of pain become more frequent and intense, this indicates the possible development of acute myocardial infarction.

Heart failure is also a complication of chronic ischemic heart disease. It is formed under the influence of various functional disorders in the functioning of the heart muscle.

A frequent complication of myocardial ischemia is formation. In CHF, the heart muscle contracts weakly and therefore pumps an insufficient volume of blood necessary for the normal functioning of internal organs. For this reason, various violations occur in them. Acquiring congestive heart failure sharply reduces the patient's chances of survival.

Complications of HIHD in the form of chronic heart failure are expressed by symptoms such as:

swelling;
dyspnea;
inability to exercise;
irreversible changes in internal organs.

Most often develops with various heart diseases. AHF syndrome affects the left ventricle of the myocardium; the patient develops signs of pulmonary edema in the form of shortness of breath and pink sputum during coughing. Acute heart failure often progresses to a heart attack or stroke.

It is also a complication of chronic ischemic heart disease. This is a fairly common pathology. The most common types of arrhythmia:

extrasystoles;

Arrhythmia sometimes goes unnoticed and patients do not attach serious importance to it. This attitude is dangerous, since any form of arrhythmia can be fatal.

The chronic form of cardiac ischemia is a rather dangerous disease. Almost any of the listed complications of HIHD lead to the death of the patient without timely and correct treatment.

Acute form of ischemic disease

Acute coronary heart disease is another form of myocardial disease, expressed by such complications as:

myocardial infarction;
cardiogenic shock;
sudden coronary death (primary cardiac arrest).

Myocardial infarction is a very common complication of acute cardiac ischemia. The reason for its occurrence is the blockage of one of the heart arteries by the resulting plaque. Infarction can be large-focal or small-focal.

Symptoms of a heart attack:

Sharp pain on the left behind the sternum, radiating to the left side of the body (arm, shoulder blade, lower jaw). Occurs suddenly or grows rapidly in a short period of time. Within half an hour from the moment of the attack, in the absence of medical assistance, the pain intensifies.
Severe shortness of breath. When trying to take a deep breath, the pain behind the sternum intensifies, which prevents the patient from breathing normally. There is a noticeable lack of oxygen, and suffocation may occur.
A sharp drop in blood pressure leading to loss of consciousness. The reasons are a spontaneous change in heart rate, a decrease in the contractile function of the heart.
Taking nitroglycerin during a heart attack does not eliminate pain due to a serious violation of the viability of cardiomyocytes (myocardial cells responsible for the contractility of the heart).

Acute complications

Another severe manifestation of the acute form of coronary heart disease is cardiogenic shock. Its signs:

rapid drop in blood pressure;
unconscious state;
extremely weak pulse;
shallow breathing.

Lack of blood supply leads to serious complications in the functioning of internal organs:

acute renal and liver failure develops;
pulmonary edema;
disruptions in the functioning of the central nervous system are observed.

In this condition, a person needs urgent medical attention to prevent death.

emerging and intensifying feeling of suffocation;
strong pressure behind the sternum;
heaviness in the shoulders;
dilated pupils;
loss of consciousness;
respiratory arrest;
cessation of cardiac activity.

Most often, it overtakes active men who do not complain about their health. The cause of VCS is a violation of the heart rhythm: the contraction of myocardial fibers occurs chaotically, out of order, the heart rate per minute is more than three hundred.

It is rarely possible to save a person in such a condition. Even with timely implementation of all possible resuscitation procedures, death occurs in four out of five cases.

If heart failure syndrome occurs against the background of acute myocardial ischemia, it manifests itself as cardiac asthma or pulmonary edema.

A person with any acute form of ischemic disease needs emergency care. For resuscitation, the following means are used:

painkillers;
thrombolytics;
plasma replacement drugs;
carrying out defibrillation.

Measures to prevent VCS

People who die suddenly sometimes have no obvious signs of impending death. But you should know that it is extremely rare that a person dies instantly without any pathology in the cardiovascular system. This means that you can and should carefully focus on your unhealthy feelings. This primarily applies to those who have suffered a myocardial infarction.

The third group of people at risk of VCS are patients in whom it is not possible to identify acute myocardial disorders in any way. Here we can only hope for emergency medical care, since it is not possible to predict sudden death in this case.

Death from coronary heart disease occurs quite often due to a lack of seriousness in treating the disease. To prevent VS, doctors are required to inform patients about the possible threatening consequences of their illness. In general, signs of sudden death appear quite often. It is important not to ignore them, so as not to become a victim of your own indifference to your health.

Measures to prevent relapse of the disease

To prevent relapse of the disease, after discharge from the hospital, the patient should follow all the recommendations of the attending physician and follow certain rules:

do not stop taking medications prescribed by your doctor;
do physical therapy;
in stressful situations, go to see a psychotherapist;
undergo sanatorium-resort treatment;
regularly monitor blood pressure;
maintain normal weight;
stick to a healthy diet;
avoid states of prolonged stress (driving a car, long airplane flights, being in a poorly ventilated area);
exercise only under the supervision of a physical therapy specialist.

You should not get involved in alternative medicine without the advice of a doctor. Folk remedies are quite effective in treating various diseases, but which ones and how to use them should be prescribed by a specialist.

To prevent coronary artery disease, they are almost the same as recommendations for maintaining health after hospital treatment for CHD.

If not treated promptly, coronary heart disease can lead to to irreversible consequences. What are the most dangerous consequences of IHD?

The patient develops chronic heart failure over time. But even in the initial stages of diseases with coronary artery disease, sudden cardiac arrest or myocardial infarction can occur.

Moreover, according to statistics, 1/3 of deaths occur due to coronary heart disease.

If the disease has just made itself felt, its development can be stopped with the help of conservative therapy, including physiotherapeutic procedures and medications.

The goal of pharmacotherapy is to block angina attacks. and also prevent the development of myocardial infarction.

At home, if you feel the onset of an attack, you should take a nitroglycerin tablet. This drug dilates blood vessels and improves nutrition of the heart muscle.

Under no circumstances should you take other medications without a doctor’s prescription.

Depending on the condition of the body and taking into account the current pathology, the doctor will prescribe you certain medications and vasodilators.

At a later stage of the disease, surgery may be required. Its task is to expand a vessel that is blocked by a plaque or thrombus.

One of the most effective surgical interventions for coronary artery disease is coronary artery bypass grafting, as well as stenting of the coronary arteries.

To perform such an operation, local anesthesia is sufficient. However, in the future, during the rehabilitation period, it is necessary to strictly follow all the doctor’s recommendations.

The most important thing is to reconsider your lifestyle and diet.

The basis of the diet should be vegetables and lean meats and fish. Physical activity is required.

It is also necessary to stop smoking and drinking strong alcoholic drinks. It is advisable to normalize blood cholesterol levels and blood pressure.

Treatment of coronary heart disease has been successfully carried out in City Clinical Hospital No. 57 for a long time.

When selecting drug treatment, only drugs that have successfully passed clinical trials and proven to be highly effective are used.

Treatment of coronary heart disease and its consequences

What can a doctor prescribe? These are medications that reduce the need for oxygen in your myocardium, vasodilators.

For many years, acetylsalicylic acid has been used for the prevention and treatment of coronary heart disease. Today, medications have been created that replace aspirin and at the same time act more gently and sparingly on the body.

The most modern method of treating coronary heart disease is endovascular surgery. The lumen of the vessel is cleaned using microinstruments inserted through a small hole in the skin. The surgeon monitors the progress of the operation using x-rays. The patient is not even given general anesthesia. To perform such an operation, local anesthesia is sufficient.

According to doctors, all surgical methods for treating coronary heart disease are very effective. In addition, after them the patient practically does not develop any complications.

To improve blood circulation, the medical board of tiensmed.ru (www.tiensmed.ru) advises purchasing a Circulatory Stimulator. produced by Tianshi Corporation. The operation of the device is based on the effect on biologically active points of your body. The method is completely safe. The device comes with detailed instructions for use. You can easily find the necessary areas on your body for treatment. With the help of the Blood Circulation Stimulator, you will not only improve blood circulation, but also improve the health of the body as a whole.

Before use, you should consult a specialist.

Coronary heart disease: causes and consequences

Causes of development of coronary heart disease (CHD)

1. Intravascular changes.

atherosclerosis - narrowing of the lumen of the coronary arteries due to the proliferation of cholesterol plaques;
thrombosis - blockage of blood vessels with blood clots (thrombi), which can occur against the background of atherosclerosis;
spasm of the coronary arteries (vasospasm) - narrowing of the vascular lumen due to contraction of the smooth muscles of the arteries;

2. Extravascular changes.

tachycardia - increased heart rate (HR);
arterial hypertension - increased blood pressure;
myocardial hypertrophy - an increase in the volume of the heart muscle, occurs due to high load on the myocardium.

Some of the given causes of ischemia are reversible ( tachycardia) or are easy to treat if detected early ( arterial hypertension), some appear suddenly ( thrombosis) and pose a huge danger to life.

Risk factors for developing ischemia

Irreversible risk factors:

Heredity - is of great importance in the development of coronary heart disease. According to various sources, hereditary predisposition occurs in 80-90% of cases of thrombophilia, a common cause of coronary artery thrombosis.

Diabetes - In addition to the danger of hyperglycemia, diabetes mellitus can significantly accelerate the risk of developing ischemia. An increased level of glucose in the blood contributes to damage to the vascular wall, including the coronary vessels. In addition to the direct danger to blood vessels, diabetes mellitus promotes the accumulation of fat, thereby exacerbating the negative effect on the heart arteries.

Hypothyroidism - insufficient production of thyroid hormones. As in the case of diabetes mellitus, hypothyroidism, in addition to its negative impact on the condition of the coronary arteries, contributes to obesity, which is, in turn, an additional risk factor for the development of ischemia and related complications.

Reversible risk factors:

Physical inactivity Low physical activity, or hypotension, also poses a serious threat to the health of the coronary arteries. The negative consequences of physical inactivity manifest themselves in a state of activity, when the heart, unaccustomed to stress, is forced to pump an unexpectedly large amount of blood.

Obesity - is a fairly common cause of heart disease, in particular ischemic heart disease. In addition, excess fat deposition further increases the risk of complications during cardiac ischemia. Despite its danger, obesity, in most cases, is a reversible risk factor - the load on the heart decreases in direct proportion to the loss of body weight.

Smoking - another reversible, but rather dangerous factor in the development of IHD. According to various studies, the risk of developing ischemia in the smoking part of the world's population is 2-7 times higher than in non-smokers. Although the numbers vary, the negative impact of tobacco addiction on heart health is clearly supported by numerous studies.

Alcoholism - those who still did not know about this or doubted it should be warned: alcohol has a detrimental effect on the health of your heart, as well as on your health in general. Despite periodic statements by some “luminaries” about the harmlessness and even benefits of alcohol, the statistics are inexorable - about 20% of deaths from cardiovascular diseases are caused by excessive alcohol consumption. In addition to obvious signs of the development of IHD due to alcohol abuse, there are so-called “sober” cases, when the consequences of harmful effects appear after years of life without alcohol. The negative impact of ethylene on the cardiovascular system occurs in several directions:

By affecting the distribution of electrolytes, alcohol causes disruption of the coronary vessels.
Once in the blood, alcohol causes hemolysis (the breakdown of red blood cells, the very ones that carry them).
Alcohol disrupts the mechanisms of blood sugar regulation, changing its level up to a state of hypoglycemia.

The brain is the center that directly controls the functionality of the entire organism. Even minor failures in its operation are reflected in a certain sector of human activity, depending on the sector that suffered from problems. Often the cause of deterioration in the functioning of the brain is a violation of its blood circulation, which in medicine is called ischemia.

Cerebral ischemia is considered a common disease in modern times, dangerous to human life and its quality. In this article we will talk about the disease, the causes of its development, types, symptoms and treatment options.

Types of pathology

Ischemia by many people who do not have medical training, or who do not face this problem in real life, is associated with stroke. Indeed, often an illness is the root cause of such a precedent, however, the ischemic state of the brain is dangerous not only due to a stroke.

Ischemia is a pathology that evolves against the background of unsatisfactory supply of oxygen to the brain tissues, which subsequently results in partial or complete death of the tissues of the hemispheres, or their incorrect functionality during.

IN medical practice the disease is classified into two types:

Focal ischemia is diagnosed by doctors when there is a blockage of a blood clot or deposits inside the lumen of a vessel, which limits the blood supply to a certain brain segment. With this development of events, a specific area of the brain suffers, which is dangerous due to tissue necrosis in this region or their partial oxygen crisis.
The second type of pathology is chronic cerebral ischemia, in which there is a deterioration or complete cessation of the blood supply to the organ. It is often diagnosed by doctors when the heart stops or the blood pressure drops to an extreme minimum.

Causes of pathology

Deterioration in the transportation of blood, and with it vital oxygen, is a condition of a special category of danger for the body, especially if it concerns the brain, which is responsible not only for speech and coordination of human movements, but also for mental, emotional, information and other functions.

In order to predict and exclude the development of a disease that responds very difficult to therapy if detected late, it is necessary to know what can become the primary source of its progression. It is worth noting that the reasons for the development of the disease are multifaceted and can be direct or indirect. Let's consider the main root causes of pathology depending on its type.

Primary sources of development of focal ischemia

A common cause of ischemia in the fragmentary category is atherosclerosis, identified by doctors as a pathology in which plaques formed from harmful fats, salts and fiber are generated on the inner surface of the vessel. At a certain stage, when the plaque reaches large-scale parameters, the surface of the vessel ruptures, a blood clot forms in the problem node, which becomes a barrier to blood flow.

Second, no less popular reason focal ischemia is embolism. In this case, the cerebral highways are blocked by an embolus, which is a blood clot that has formed in another region of the body and landed in the arteries of the hemispheres with the blood flow. The source of the embolus is often the carotid arteries and the heart.

The formation of blood clots in the heart often arises against the background of disturbances in its rhythm, defects or tumor formations in the organ, and inflammatory processes in the internal muscles. Atherosclerosis often provokes embolus rupture in the carotid arteries.

The process of blockage of a channel in the brain as a result of thrombosis or embolism is a lightning-fast phenomenon in which a clot, entering a bloodstream with a small diameter, blocks blood flow to a specific segment of the brain, with all the ensuing consequences in the form of tissue atrophy.

Global type of ischemia: causes

Large-scale or global death of brain tissue progresses mainly against the background of an absolute stop or sudden destruction of blood flow in the hemispheres.

The reasons for this precedent may be cardiac arrest or a rapid decrease in blood pressure. In the first option, factors in the progression of the disease may be myocardial infarction, cardiac ischemia, congenital or acquired defects. In the second case, a decrease in pressure can be caused by complex allergic reactions or infections pain syndrome, blood loss, cardiovascular pathologies and other complex diseases.

Characteristic symptoms

The symptoms of the disease, as well as its primary sources, have a diverse structure, mainly varying depending on the form of progression.

The acute form of the disease often develops rapidly and is characterized by deprivation of sensitivity in some regions of the body, for which the segment of the brain affected by oxygen starvation is responsible, with possible paralysis, as well as temporary loss of vision. Such precedents are defined by experts as ischemic attacks of the brain, which require immediate medical assistance to avoid irreversible aftereffects.

Chronic cerebral ischemia, or CICI for short, unlike the acute form, evolves gradually, while the symptoms of the pathology gradually worsen. Often, CICM evolves against the background of an advanced acute form of the disease, and its culmination is a stroke.

Distinctive signs of cerebral ischemia, typical for any stage of the disease and its form, are as follows:

regular weakness, fatigue and malaise;
dizziness;
frequent attacks of nausea;
presyncope, often followed by loss of consciousness;
increased causeless irritability, nervousness;
speech distortion.

As the pathology develops, its symptoms worsen, and additional signs of the disease are added. If at the first stage a person looks healthy outwardly, he is worried mainly by headaches and fatigue, and is also accompanied by depression, severe irritability, absent-mindedness and inattention, then in subsequent stages the disease makes itself known with more intense symptoms.

With second degree ischemia, the patient develops symptoms that do not go unnoticed from the outside. The patient loses everyday and professional skills, cannot fully make plans, and ceases to adequately evaluate his behavior. At this stage of the disease, a person suffers from severe and continuous headaches, nausea, and systematic fatigue.

The third stage of ischemia is considered irreversible, from a medical point of view, and is characterized by the patient’s complete or partial loss of legal capacity. At the third stage, the disease is characterized by extensive atrophy of brain cells, the subject ceases to think sensibly, does not orientate himself in space, loses coordination, and sometimes the ability to move. Mental disorders reach critical maximum, the patient experiences an absolute collapse of personality. The last stage of ischemia is practically untreatable, and the patient is at risk of disability or death.

Features of diagnosing pathology

Ischemic cerebral disease is a disease that, on the one hand, entails serious life-threatening consequences, on the other hand, it is considered very difficult to diagnose, especially in the early, reversible stages. Primary symptoms at the beginning of the development of the pathology may not be too pronounced, which provokes the patient to delay visiting specialists.

Diagnosis of ischemia is carried out by a neurologist who, based on the patient’s complaints, visual inspection, as well as determining basic reflexes and clarity of thinking may suggest the presence ischemic disease. To confirm or refute the diagnosis, the patient will be prescribed a number of hardware procedures. The task of diagnostic measures is not only to verify the diagnosis, but also to determine the nature of the pathology, the degree of its progression, the localization and extent of the affected brain segments.

If coronary artery disease is suspected, the patient is first prescribed a brain examination using computed tomography or magnetic resonance imaging. In practice, one of these methods for determining ischemia is often used, the latter of which allows one to obtain more comprehensive information about the state of the brain and its tissues.

Further procedures are carried out to identify the original source of the pathology:

Laboratory blood tests are prescribed with a focus on establishing its coagulability, measuring cholesterol and glucose.
Survey carotid arteries The ultrasound method makes it possible to identify narrowing of the lumen in them.
through echocardiography, it is prescribed to diagnose its functionality, assess its size and identify blood clots.
The performance of the heart muscle, its rhythm and conductivity, in the event of malfunctions of which ischemia can develop, is studied using electrocardiography.

The results of these studies allow the treating doctor to establish a diagnosis and determine the origin of the disease.

Therapeutic measures

The most important task in the treatment of cerebral ischemia is the immediate restoration of blood supply to the hemispheres. IN complex therapy often used drug treatment, in some cases, surgery may be necessary. Let us consider the specifics of therapeutic measures depending on the form of pathology.

Global form of ischemia: specifics of therapeutic measures

Extensive cerebral ischemia involves treatment, which consists of first determining the root cause of the evolution of the disease. In a situation where the start of the progression of the ischemic process is caused by cardiac arrest, cardiac resuscitation is performed first, if necessary, connecting the patient to a ventilator. If the cause of the development of the disease is a drop in pressure, medicine involves the administration of drugs to normalize it.

Further therapy for cerebral blood supply disorders is carried out exclusively after eliminating the primary sources of pathology development and is aimed at eliminating the consequences of the precedent. For this purpose, the patient is prescribed drugs that stimulate blood flow in the hemispheres and metabolic processes in the cells of the hemispheres.

IN difficult situations After the precedent, the patient is diagnosed with cerebral edema as a complication, for the treatment of which the prescription is regulated medications, normalizing intracranial pressure.

Focal form of the disease: specifics of therapy

Therapeutic measures aimed at eliminating the causes and consequences of focal ischemia are distinguished by a specific approach. In this case, after verification of the diagnosis, the patient is prescribed a set of drugs, some of which the patient takes for several days, while others are prescribed for a prolonged period. The sooner after an attack therapy to restore blood flow is applied, the greater the chance of regenerating some of the cells affected by ischemia and improving the prospects for recovery.

To restore blood supply, the following methodologies are used:

Thrombolysis. This approach to therapy involves the prescription of antithrombotic medications, among which the most popular and effective are Actilyse and Metalyse.
Thrombectomy is a surgical procedure that removes blood clots from blocked large vessels.
Endarterectomy is a surgical procedure that involves removing a segment of an artery affected by thrombosis.

In the complex therapy of pathology, the following categories of medications can be used:

Medicines from the group of antiplatelet agents, the effect of which is aimed at preventing the formation of blood clots by suppressing the union of platelets.
Anticoagulants are prescribed to normalize blood clotting: in hospital settings these are mainly drugs in the form of injections; at home, the patient is prescribed tablet medications from this category.
Antihypertensive drugs are prescribed to patients for systematic use with a focus on normalizing blood pressure.
Medicines are prescribed to patients who are at risk for cholesterol levels in the blood.

It is worth noting that in each specific case, the doctor, based on the diagnosis, dynamics of recovery and symptoms, selects an individual course of therapy for the patient, which may vary during the treatment process.

ethnoscience

Cerebral ischemia is such an unsafe precedent that its treatment folk remedies It is absolutely not welcomed by the luminaries of medicine; it is considered irrational and ineffective. Cure ischemia exclusively using methods alternative medicine impossible. Resources traditional medicine can only be used as adjuvant therapy, and exclusively during the recovery period, after all mandatory medical procedures.

Popular means for restoring brain functionality in rehabilitation period after ischemia, drugs based on oak bark, mint and adonis are used; fresh carrot juice is considered beneficial.

When using alternative medicine, it is important to consult a doctor so as not to harm your body, since some herbs may be contraindicated for certain pathologies of the cardiac and vascular systems, and also cannot be combined with prescribed medications.

Possible complications

Even in the initial stages of the disease, without special therapeutic procedures to eliminate the pathology, the patient suffers from intense headaches, worsening health, mood swings and many other negative factors that affect his quality of life.

The longer you do not take measures to treat the disease, the more critical complications may await the sick person in the near future. Cerebral ischemia in the absence timely treatment is dangerous due to the following complications:

degradation due to damage to brain tissue responsible for the mental abilities of the individual;
disability with full or partial loss of legal capacity;
ischemic stroke brain: its direct consequence can be the death of a person.

Specifics of patient recovery after ischemia

Ischemic disease of complex etiology often does not recede without a trace and implies complex measures to restore health. Most often, experienced cerebral vascular ischemia affects the physical and emotional state person, which requires long-term rehabilitation.

Rehabilitation of the patient is carried out after basic therapeutic procedures and includes the following areas:

Working to restore or improve speech intelligibility.
Adaptation to Everyday life by involving the patient in performing feasible everyday tasks, starting with classes to restore the ability to care for himself independently, with subsequent complication of tasks.
Physiotherapeutic activities, which include special massages and a set of exercises for the patient.
Contributes to more quick recovery support for the patient from relatives and friends, which includes communication and emotional assistance.

Forecast

It is almost impossible to answer unambiguously the question of what prognosis awaits a patient with cerebral ischemia. The chances of recovery are proportionally determined by the stage of the pathology, the state of health of the patient and his age category.

If the disease is detected in the initial stages, the prognosis for the patient is often positive character, there is every chance to return the patient’s life to normal. If the disease is diagnosed in the last phase, the prognosis is unsatisfactory, since brain cells are very difficult to regenerate, the patient is in best case scenario will remain disabled.

The verdict “ischemic cerebral stroke,” according to statistics, is the cause of death in twenty-five percent of cases. The remaining three-quarters of patients fully or partially recover from their illness. The chances of a full recovery are greater for young people who do not have bad habits, lead an active lifestyle and are in good physical shape.

Let's sum it up

Ischemia of the cerebral hemispheres is a fairly common disease today. This is due to many factors, the main ones being abuse. bad habits, leading a passive lifestyle, low level of physical mobility and poor nutrition. In general, a destructive lifestyle causes the occurrence of cardiovascular health problems, which provoke the evolution of hemispheric ischemia.

The disease is very difficult to detect in the initial stages, and in its advanced form it is difficult to treat, therefore, in order to avoid the development of pathology, medical experts advise everyone to be scrupulous about their health, popularize a healthy lifestyle, and undergo mandatory medical examinations according to the established regulations. Ischemia is exactly the case when prevention rather than treatment is considered more effective.