In medicine, ischemic heart stroke is not classified as a disease. This type of heart attack is a clinical syndrome characterized by local or general damage to the blood vessels. Ischemic stroke can lead to partial (complete) disability or death of a person.
What is ischemic heart disease
IHD is a disease, the consequences of which are difficult to cope with even with modern medical methods. For people who have had an ischemic stroke, the prognosis for life is not always favorable. According to statistics, more than seven hundred deaths are recorded annually in the Russian Federation.
With a positive outcome (in 30% of cases), the victim has to recover for a long time, since IS leads to damage to many organs and systems, as well as serious complications (for example, paralysis).
Ischemic stroke is not a disease, but a clinical syndrome that develops due to a general or local pathological vascular lesion. The risk group includes mainly men. The age category of people prone to ischemia is from 50 to 70 years. However, over the past five years, according to medical observations, the disease is often diagnosed in men over 40 years of age.
The disease is characterized by impaired blood flow to the main coronary artery and myocardial muscles. As a result, oxygen starvation becomes the main cause of the disease leading to a heart attack.
Classification
The disease is classified. In medicine, pathology is divided into several forms. The disease is classified according to the area of damage to the vascular basin of the heart, as well as to the site of brain injury.
Vascular ischemia
The defeat of the vertebrobasilar basin affects:
- basilar artery;
- posterior cerebral artery.
Ischemic stroke of the brain (or its infarction) occurs when cerebral circulation is disturbed and is manifested by neurological symptoms during the first hours from the moment of occurrence In the pathology of the carotid pool, the following is affected:
- anterior cerebral artery (ACA);
- middle cerebral artery (MCA).
The pathological process in the PMA basin is much less common than the lesion of the vessels of the middle cerebral artery basin. Only 10–25% of patients suffer from ischemia of the carotid (posterior) artery.
In 70% of cases, an ischemic stroke occurs in the basin of the middle cerebral artery, which is caused by thrombophlebitis of the main artery. Depending on the state of the vessels of the basin of the middle cerebral artery, the consequences of an attack may have a different area of damage.
cerebral ischemia
With ischemia of the heart, ischemic stroke of the brain is often diagnosed. There are two forms of the pathological condition:
- right-sided;
- left-sided.
With ischemic stroke of the left hemisphere, there is a violation of sensitivity, a decrease in muscle tone and paralysis of the right side of the body. When the right side of the brain is affected in AI, the consequences are reflected in motor function. This is due to the fact that the right side of the cerebral hemisphere is responsible for the functionality of the muscular system. Recovery from ischemic stroke of the right side occurs for a long time, often the result of an attack is paralysis.
No less dangerous ischemic stroke on the left side of the GM. As a result of the attack, there is a violation of the speech function and the psycho-emotional sphere. The patient's speech may be impaired to varying degrees. According to statistics, in more than 60% of patients, after an ischemic stroke of the left hemisphere, complete recovery of speech functions does not occur.
The causal factors are:
- atherotroitic;
- cardioemolic;
- hemodynamic;
- lacunar;
- hemorheological.
The most common is a lacunar ischemic stroke, which can be caused by diabetes mellitus or a common disease - hypertension.
Causes
The pathological condition develops in people who have bad habits (passion for alcohol and smoking) and are constantly exposed to stress. The harbinger of an attack is ischemic disease.
Thromboembolism is a blockage in the lumen of a blood vessel. Experts identify several provoking factors, under the influence of which the risk of developing diseases increases:
- overweight;
- arrhythmia of various types;
- hypertension;
- increased blood clotting;
- migraine;
- atherosclerosis;
- kidney pathology.
The causes of IS are the development of the underlying disease and the additional impact of provoking factors.
It should not be forgotten that a pathological condition is a consequence of a violation of the circulatory system associated with blockage of blood vessels due to the formation of cholesterol plaques and blood clots.
Symptoms
The symptoms of AI may differ depending on whether the brain was affected and which area of it was affected.
Symptoms of ischemic stroke are divided into cerebral, characteristic of any stroke and focal - those symptoms by which it is possible to determine which area of the brain has been affected Common symptoms include signs:
- excitement, or loss of consciousness;
- lack of coordination;
- a severe attack of headache;
- nausea with uncontrolled vomiting;
- severe sweating;
- bouts of heat.
When the brain is damaged, the victim experiences symptoms, depending on the damage to the right or left hemisphere. During an attack and in the first hours after it, symptoms can be observed in the form of a violation:
- motor activity (excessive weakness in the limbs);
- coordination (dizziness and loss of orientation);
- speech (lack of understanding of addressed speech, inability to pronounce words clearly, etc.);
- sensitivity (sense of "goosebumps" on the skin);
- swallowing (inability to make swallowing movements);
- vision (split vision, blurred vision, etc.);
- behavior skills (inability to self-service);
- memory (partial memory loss).
If a stroke occurs in the temporal lobe, patients become depressed, do not want to communicate, their logical thinking is impaired In the future, when the acute condition stabilizes, the symptoms may disappear, but with the progressive consequences of an attack, the symptoms may worsen.
Extensive ischemic stroke can lead to multiple lesions of the heart muscle and brain. The consequences and treatment that will be carried out later depend on the degree of damage to blood vessels and tissues (symptoms that have arisen).
Diagnostics
The consequences of AI largely depend on how quickly an attack is diagnosed and how much time passes before first aid is provided to the victim. If no medical care was provided in the first hours, then there is a high risk that the complications will be the most serious, and in 70% of cases the result is the death of the patient. Pathology is diagnosed on the basis of a survey and examination of the patient. However, to determine the exact diagnosis and degree of damage, laboratory and hardware diagnostics are required:
- clinical and biochemical blood tests;
- ECG, MRI and CT (the heart, brain, cervical spine are examined).
As a result of the diagnosis, limited or extensive ischemic stroke can be detected. According to the clinical picture, the doctor establishes a scheme for further treatment and rehabilitation, and also determines the prognosis for the possibility of further recovery and life expectancy.
Timely and accurate diagnosis of this disease allows you to provide the right assistance in the most acute period, start adequate treatment and prevent formidable complications, including death. Treatment
The treatment process for AI begins with the very first actions of a medical specialist. Initially, the patient's condition stabilizes and only after that the main treatment begins. Eliminating the consequences of the pathology and restoring the functionality of the damaged area takes a long time. Therapy can last several months, and rehabilitation for severe consequences can take years. In rare cases, with severe damage to the blood vessels, surgery may be recommended.
Medical therapy
With damage to the circulatory system of the heart or brain, the patient is prescribed drugs with directed action. It is possible to prescribe a complex of drugs of several groups or certain medications to eliminate the causes.
Treatment of ischemic stroke should be timely and long-term Drug groups:
- for blood thinning (acetylsalicylic acid, "Cardiomagnyl");
- anticoagulants to prevent thrombosis ("Heparin", "Fragmin");
- thrombolytics for resorption of blood clots ("Clopidogrel", "Dipyridamole");
- nootropics for tissue repair GM ("Cerebrolysin", "Pikamilon");
- calcium antagonists to lower blood pressure ("Aminophylline", "Vazobral");
- vasoactive drugs to stabilize blood pressure ("Pentoxifylline", "Sermion");
- antioxidants to prevent cell oxidation ("Mexidol", "Mildronate").
With complex drug therapy, you can speed up the recovery process and prevent a possible relapse, as well as reduce the risk of myocardial infarction, which is fatal.
Surgery
In medicine, AI treatment involves two types of surgery:
- stenting;
- endarterectomy.
The need for surgery is determined by the attending physician, the specialist, depending on the indications, also determines the type of surgical intervention.
Specific therapy for ischemic stroke involves drug, non-drug, and surgical methods of treatment. The stent placement is performed under general anesthesia. A special catheter is inserted into the patient through the femoral arterial vessel, at the end of which there is an inflatable balloon. After placing the device in the damaged area of the vessel, the balloon is inflated to the required size. Thus, the vascular passage expands. Then the surgeon implants a stent in this place that maintains the size of the vascular passage.
As a rule, in the absence of contraindications, the preferred type of surgical intervention is endarterectomy. The essence of the operation is the complete removal of plaques or a blood clot in the affected area of the artery.
The procedure can be performed under local anesthesia. During endarterectomy, the surgeon makes a small incision, through which, using modern devices (cameras), he detects the place of narrowing of the vessel. The artery is then clamped and cut. The problem area is cleaned, after which the vascular walls are sutured. Once the blockage is removed, blood flow is restored. Endarterectomy is considered a more gentle type of surgical treatment, after which rehabilitation is faster, and the risk of complications is much lower than with a stent.
ethnoscience
After the main treatment, for a patient who has had an ischemic stroke, rehabilitation at home is the next step on the path to recovery. At home, the victim of the attack should continue to take medication.
Increase vegetables and fruits in your diet In order to prevent and enhance the effects of drugs, it is recommended that after an ischemic stroke, rehabilitation at home is accompanied by the use of folk remedies. Traditional medicine recipes for the recovery of the patient are conventionally divided into two areas:
- to restore the functionality of paralyzed muscles;
- to stabilize blood circulation and blood flow pressure.
The first direction involves the use of folk recipes:
- Peony roots are crushed. Take one teaspoon of raw materials and pour a glass of boiling water. Leave to infuse for one hour, then drink a tablespoon every three hours until the infusion is over. During the week they drink, thus, a glass a day. Then take a week break and repeat the course.
- For baths, you can use a decoction of rosehip roots (brown). It is recommended to take baths with a decoction every other day for two months.
- From a tablespoon of coniferous needles filled with boiling water, a healing infusion is prepared. Pine needles are infused in boiling water for one hour, then filtered and mixed with the juice of half a lemon. Drink before breakfast daily for three months.
Other folk remedies are used to control blood pressure.
Treatment of ischemic stroke with folk remedies can only be carried out during the recovery period - Horse sorrel roots are cleaned and finely chopped. Placed in a container and poured with vodka (1:10). The medicine is infused for three weeks. Drink forty drops three times a day after eating.
- Mix the crushed roots of peony, cyanosis and valerian. 20 grams of the resulting collection are added to a liter of water and boiled for half an hour, not over high heat. Drink two weeks before going to bed for ½ cup.
- Cranberry juice is mixed with flower honey (1:1). The course of treatment is two weeks. Drink two teaspoons per day (in the morning and before bedtime). After two weeks, you can repeat the course of taking the remedy.
The advantages of folk remedies are that they do not have a negative effect on the body. But the effect of their use is not so strong as to eliminate the consequences of an attack without taking medications.
Consequences
Ischemic stroke leads to serious damage to body systems, so complications cannot be avoided. The most unfavorable outcome is the death of the victim. People who managed to withstand an attack have a long time to rehabilitate. In addition, their life expectancy is reduced. How many victims of AI live, there is no exact data. Too many factors influence this period. The age of the patient, the general state of health and the complications that have appeared have a great influence. On average, about half of the victims do not live more than five years. The most common complications are: thromboembolism, cerebral edema, pneumonia and paralysis.
Education: Volgograd State Medical University Level of education: Higher. Faculty: Medical.…
