Ischemia. Main causes of ischemia. Standard and specific symptoms of ischemia. Correct diagnosis, prevention and treatment methods for ischemia. Consequences of ischemia

For full-fledged work everyone internal organs human body oxygen is extremely important. You could even say that the more time we spend outside, inhaling Fresh air, the more functional our body will work, since here it will receive a sufficient amount of oxygen. Otherwise, a lack of this component can lead to such complex illness as ischemia.

Ischemia occurs due to insufficient blood supply to an organ. When there is insufficient blood flow, the organ does not receive the required amount of oxygen, which is essential for its healthy functioning.

In most cases, ischemia can be caused by blockage of the vessels through which blood flows from the heart to all other organs. If there is ischemia of the liver or heart, then the blockage occurs in the venous vessels, that is, in those responsible for transporting blood from the organs to the heart.

Cause of ischemia

Vascular blockage is the most common cause of ischemia. There are a number of reasons that can cause blockage of these channels.

Thrombus - a thrombus forms in the bloodstream, which can close most of the vessel. Then oxygen will enter the organ, but not into sufficient quantity, which will cause the development of ischemia. It is also possible that the resulting blood clot will completely block the tubule, then there is no longer any need to talk about the flow of blood into the organ. If the response is untimely, the organ can cause serious disruptions in the overall functioning of the body.

Also, the cause of blockage of blood vessels may lie in drops of fat that appear as a result of a fracture of tubular bones.

The cause of cerebral ischemia can be gas bubbles in the blood channels, which are formed to a greater extent in drivers when they dive incorrectly into depth.

Air bubbles in the venous vessels can also cause ischemia. They are formed subsequently malfunction lungs or when injected into a vein, when air from the syringe enters the vessel.

Another one, the most dangerous reason formation of ischemia - atherosclerosis. Atherosclerotic plaques form on the walls of blood vessels, which hide the gaps for the further “travel” of blood throughout the body. The worst thing about this reason is that it is impossible to cure atherosclerosis. You can only slow down this process. Ischemia is the most common lower limbs, since the gaps here are too small and gangrene forms on the legs over time. It is necessary to amputate the affected area in a timely manner so that the process does not spread further throughout the body.

Almost all the causes that lead to ischemia can be cured. It is important to identify deviations in a timely manner and begin to eliminate them.

Symptoms of ischemia

With the development of ischemia, the body gives clear and obvious signs a person that it is time to pay close attention to his health.

With the development of cerebral ischemia, symptoms such as fatigue and deterioration in the functioning of all organs may appear. The main symptom is that the patient will feel a lack of air, which indicates a blockage of the vessel.

With cerebral ischemia, the patient will also experience discomfort and decreased attention. It will be extremely difficult for him to concentrate on any task. With chronic cerebral ischemia, the patient breathes quickly and often, his actions are rash and unclear.

Cardiac ischemia is manifested by other symptoms - in addition to the feeling of lack of air, pain in the chest. The patient can experience such discomfort only in cases of physical or emotional stress.

Myocardial ischemia develops especially dangerously when a person does not experience any pain. For ischemia arterial vessels the patient feels pain in the lower back, stomach, and liver. Particular care should be taken in case of short-term pain in the right hand, which may occur periodically. This symptom may indicate ischemia of the inner lining of the heart.

Ischemia of the lower extremities - a person constantly complains about their fatigue, you can also emphasize their pallor, which has arisen due to a lack of blood supply. The patient experiences discomfort and frequent desire sit down to give your legs a rest.

It is especially difficult to identify ischemia in newborns, when the child is not able to show certain signs aimed at identifying the source of pain. Ischemia in young children develops as a result of their prematurity. It is not for nothing that premature babies are carefully examined.

Diagnosis of ischemia

Only a specialist can make a diagnosis of ischemia. Since the symptoms of this disease are also characteristic of other diseases, it is impossible for the patient himself to accurately diagnose himself. The first thing you should pay attention to is the patient’s complaints, which will help identify the likelihood of ischemia of which organ is occurring. For example, if there is a risk of developing cardiac ischemia, ECG monitoring should be done.

Treatment of ischemia

Effective treatment includes several components:

1. Treatment begins with taking painkillers, as this helps the patient relax and prepare the body for more serious procedures.

2. It is necessary to identify blood supply routes that will allow replacing the blocked vessel. They may also prescribe procedures such as magnet, electrophoresis, etc.

3. Blood fluidity should be restored. Blood tests are taken, problems are identified and ways to eliminate them are developed.

4. The body should be provided required quantity oxygen, which can be obtained in a specialized chamber.

5. It is important to do and concomitant diseases which can cause relapse of the disease.

Prevention of ischemia

Preventive measures that can reduce the risk of ischemia are extremely simple. Enough to lead healthy image life, give up bad habits and undergo timely examinations by specialists, which will help identify the slightest violations in the activity of the body. Sports and healthly food- deposit strong body!

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There are no pleasant diseases. Every ailment causes a mass unpleasant symptoms, which sometimes leave consequences even after recovery. Therefore, you cannot ignore any symptoms of poor health, but you need to consult a doctor in a timely manner. In addition, there are diseases whose symptoms should be given more attention than a common cold or runny nose. It's about about cardiovascular diseases. Today they are becoming more common among young people. This is due to changes in lifestyle, especially an increase in the amount of stress, lack of diet and greater emotional stress. Heart attacks and strokes are diagnosed by doctors every day. Another disease in this category, which is also often mentioned in diagnoses, is ischemia.

Coronary artery disease is characterized by insufficient blood supply various organs. The main reason for this condition is a decrease in the lumen in the artery. In other words, this disease can also be called local anemia, that is, a decrease in the amount of blood in certain parts body, which leads to malfunctions of one or another organ.

Types of ischemia

Ischemia, like most diseases, has its own subtypes. The first step is to determine the classification depending on the duration of symptoms. Ischemic disease in this context has the following types:

transitional;
long lasting

The first type can appear even in healthy person. This is due to the fact that physiological regulation blood flow can sometimes have some disruptions. Cold, pain, various kinds hormonal disorders, stress can lead to a reflex spasm of the artery, which causes an attack of ischemia.

The second type is already more dangerous to health, since it has a long period poor blood supply to organs. This ischemia is caused by various biological stimuli or a blood clot. The cause may also be compression of the artery, which is caused by foreign body, tumor or scar.

Ischemic disease is also classified according to the organs affected:

ischemia of the upper extremities;
ischemia of the lower extremities;
cerebral ischemia;
cardiac ischemia and others.

The most common is coronary heart disease. It is caused by a disease of the heart vessels, which are clogged with fat cells that are marked on the walls of the blood vessels. The consequence of this process is the complication of blood flow, which leads to inadequate filling of the organ. A blood clot, which leads to oxygen starvation of the main human organ, can also cause ischemic disease.

The manifestation of this disease in the brain is very dangerous. Cerebral ischemic disease is caused by insufficient blood supply to cells, which leads to their hypoxia. The reason for this is most often determined by a previously diagnosed atherosclerosis or arterial hypertension.

Cerebral ischemic disease is quite dangerous, as it can affect motor, speech and other functions that are necessary for a quality standard of living.

There are three main stages of cerebral ischemia:

The first changes in the patient’s behavior occur, namely:

gait changes significantly;
some nervousness, irritability, and depression appear;
coordination of movements decreases;
self-control becomes more difficult.

Neurological disorders become more noticeable, and they also have a greater impact on vital functions:

irritability and nervousness are very pronounced;
the patient is practically unable to control his emotions.

All symptoms of the previous stages intensify several times. In addition, changes are possible that will lead to non-negotiable processes and disability, as well as incapacity for work. At the most severe stages, cerebral ischemia can manifest itself as a complete loss of the ability to control oneself. As a result, the patient is unable even to elementary functions self-service.

Other types coronary disease are also quite dangerous and can affect the style and quality of life. But the cardiac and cerebral have indications that show them especially severe form passing.

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Only a doctor can determine the presence of any disease in a person. You should not diagnose yourself by referring to the words of a friend or neighbor, or to something you read somewhere. But there are symptoms that indicate that it is time to go to the doctor and get checked.

Symptoms of coronary artery disease consist of the following signs:

Pressing sensation in the region of the heart.
Burning, paroxysmal pain is felt in the chest.
It’s hard to breathe, it seems like there’s not enough air.
Weakness, nausea.
Profuse sweating.
Pain in the neck, left arm, between the shoulder blades, back.
Changes in heart rate.
Frequent nausea, shortness of breath, increased sweating.

Each of these symptoms should be the first signal that you need to see a cardiologist. Although the absence of signs is not a 100% guarantee of health. A third of patients with ischemia do not experience any of the symptoms. Therefore, it is necessary to conduct a complete medical examination from time to time.

How to diagnose ischemia?

It is quite difficult to diagnose coronary artery disease, since the symptoms are very similar to some other cardiovascular diseases. Identification in progress of this disease based on observation of the patient, namely his complaints about bad feeling, as well as the results of a number of studies. It is not at all easy to identify signs of ischemia if the patient cannot determine the nature of his pain.

In the case when the patient comes without specific complaints of pain, ECG monitoring is performed, which can detect irregularities in the heartbeat rhythm. Coronary angiography is also performed, which can identify terosclerotic plaques that may be the cause of ischemia. The cause of concern about the presence of silent ischemia may be complaints of increased heartburn, increased shortness of breath, weakening of the left arm, changes in the number of heart beats per minute. Experienced specialist You will immediately be interested in such signs that, at first glance, have nothing to do with the heart.

Fighting ischemia

The first stage of treatment for ischemia should be the organization of conditions for the patient so that the body can compensate for the damaged areas. That is, a new one must be formed blood vessel, which will replace the old one. Moreover, its renewal must occur in such a way as to bypass the old vessels to the organ that has suffered from a lack of blood. The desired result is achieved using several methods:

physiotherapeutic procedures;
surgical intervention;
use of medications.

If the patient is diagnosed with acute ischemia, then he urgently painkillers are injected into the blood.

Ischemic disease is treated in several stages. Each of them is aimed at achieving a certain result, which as a whole will help overcome the disease. The following are steps to improve the condition:

relieving vasospasm;
expand arteries that have been damaged by atherosclerosis, strengthening their walls, and stopping the deposition of cholesterol plaques;
removal of a blood clot that closes the lumen;
blood viscosity decreases;
conditions are created for the formation of a collateral network;
carrying out procedures to protect the tissue of the damaged organ.

During treatment of ischemia, it is necessary to monitor so that sugar spikes do not occur, blood pressure, and cholesterol in the body was not increased.

Prevention of coronary disease

Every disease is easier to prevent than to treat. That is why doctors have developed a number of rules that the risk group should adhere to in order to avoid a diagnosis of ischemia.

The first step is to approach your diet. It is necessary to completely remove it from the foods you consume. fatty foods, as well as fried foods and others that increase cholesterol levels in the body. In addition, you need to eat in quantities corresponding to physical activity.

The second stage to prevent coronary disease should be a daily routine in which it is necessary to increase physical exercise. It is especially worth increasing the intensity of the load for those who lead sedentary image life.

The third step in the prevention of ischemia is constant monitoring of the structure of the blood and its viscosity, coagulability, in order to prevent the occurrence of blockages in case of detection of deviations from the norm.

In addition, you need to give up bad habits. Smoking has a particularly negative effect. Therefore, this harmful and dubious pleasure must be abandoned immediately.

By adhering to all these simple rules, you can avoid ischemia. And it's worth it. After all ischemic insufficiency always occurs in combination with a disease of an organ that lacks blood. The main thing is to prevent tissue necrosis in this part of the body, because this process is irreversible. But a timely start to combat the problem will lead to rapid improvement health status.

DO YOU STILL THINK THAT IT IS IMPOSSIBLE TO GET RID OF HEART DISEASE!?

Do you often have discomfort in the head area (pain, dizziness)?
You may suddenly feel weak and tired...
I constantly feel high blood pressure...
About shortness of breath after the slightest physical stress and there is nothing to say...
And you have been taking a bunch of medications for a long time, going on a diet and watching your weight...

But judging by the fact that you are reading these lines, victory is not on your side. That is why we recommend reading what the Chief Cardiac Surgeon of the Ministry of Health of the Russian Federation, Leo Antonovich Bokeria, advises.

Coronary heart disease is a pathology caused by circulatory disorders in one or more parts of the body. Oxygen starvation of tissues occurs, which disrupts their functioning processes. There are a number of risk factors that, if not addressed in a timely manner, can lead to ischemic heart disease. The disease poses a danger not only to human health, but also affects life expectancy.

What causes coronary heart disease?

In order to promptly diagnose the development of ischemia, it is necessary to familiarize yourself with the list of causes that provoke this pathology. With proper treatment, you can reduce the risk of dangerous complications.

The causes of coronary heart disease are divided into two categories:

External, provoked by the introduction of an incorrect lifestyle.
Internal ones occur when there is a malfunction important organs and systems.

External

Signs and causes of coronary heart disease have Negative influence on the state of the cardiovascular system. Sometimes a person does not pay attention to some unpleasant manifestations, which is why he does not adjust his lifestyle or eliminate factors that over time can lead to serious problems.

In most cases, ischemia develops under the influence of the following factors:

excessive physical activity;
dangerous bad habits:
unbalanced diet;
inadequate response to stress;
active work.

Insufficient physical activity

Improper lifestyle associated with work or entertainment that is not required physical activity provokes a number of violations. There is an increase in body weight, which negatively affects the functioning of the cardiovascular system. The load on the heart muscle gradually increases, after some time symptoms appear. dangerous pathologies.

With the development of physical inactivity, in the wrong way life, maintained for several years, shows a gradual narrowing vascular walls. This phenomenon may occur in case of a sharp increase physical activity, when passing intensive training. To avoid negative consequences, it is necessary to gradually increase the load.

Nutrition

At unbalanced diet, eating excessive amounts of unhealthy food, food with big amount fats, preservatives, and other substances that contribute to weight gain, the load on the heart muscle increases. Vasoconstriction occurs, which can cause blockage of arteries and veins. This phenomenon occurs as a result of the formation of plaques, their subsequent transformation into connective tissue. As a result, atherosclerotic changes develop, and the heart muscle receives an insufficient amount blood.

Stress

With excessive worries associated with any events in life, it worsens general state human health, in particular, the cardiovascular system suffers. The condition becomes more complicated if anxiety occurs during an accelerated pace of life and the need for regular work activity.

With frequent increases in adrenaline levels, the lumen of the vascular walls narrows and the heart rate accelerates. This process is a natural reaction of the body to negative emotions, stress factors. If a person additionally refuses physical activity, the likelihood of coronary heart disease increases by 2 times.

If negative factors will be eliminated in a timely manner, while the person experiences stress when in good condition health, powerful emotions cannot provoke dangerous pathologies. In case of presence excessive loads accompanied by stress, the appearance of systemic pathologies and acute disturbances in the functioning of the cardiovascular system is possible.

Bad habits

In case of consumption of increased doses of alcohol, with strong drug or tobacco addiction, a lot of substances enter the body, causing poisoning of important cells and organs. Functioning is impaired various systems body. With severe addiction, there is a possibility of developing negative changes in the structure of blood vessels and heart muscle. The body is subjected to regular intoxication, the heart rate increases, which is why the organ wears out at an accelerated pace.

Domestic

There are a number internal factors risk of ischemic heart disease, characterized by deterioration of the patient's health. This pathology negatively affects the activity of the cardiovascular system.

Hypertension

With a significant increase in blood pressure, other causes of ischemia are activated. As a result, it is required accelerated work heart, manifests itself increased load on the vessels. Disturbances occur in the structure of the heart muscle. In case of constant pressure changes, a heart attack occurs or persistent angina develops.

Metabolic disorders

With pathologies associated with the absorption of fats and carbohydrates, many changes occur in the body. The likelihood of developing ischemia increases upon reaching the age of 50 years. When fat metabolism is disturbed, atherosclerosis is provoked, which can lead to pathologies of the blood circulation of the heart muscle. If carbohydrates are not absorbed properly, you may develop diabetes, as well as other metabolic disorders.

When blood sugar levels rise, small blood vessels are destroyed. As the walls of veins and arteries thicken, their permeability gradually decreases, which is why they receive insufficient amounts of oxygen and nutrients.

Heart defects

If the patient already has heart disease, the risk of ischemia increases. Both congenital and acquired heart defects during life are especially dangerous. With the development of pathological processes, there is a need to increase the intensity of contractions of the heart muscle. If the patient does not receive timely medical care, a number of dangerous complications develop.

Vascular pathologies are one of the main risk factors

In most cases, the development of coronary heart disease is influenced by disorders associated with the structure of the coronary arteries, more small vessels. Also, disturbances in the structure of the myocardium come to the fore during the development of the disease.

To ensure proper blood supply to the organs and systems of the body, the heart muscle must be absolutely healthy. To exclude the possibility of developing various pathologies The level of blood viscosity is diagnosed and the patency of blood vessels is determined. Coronary vessels are responsible for the flow important substances and oxygen to the myocardium. If this mechanism fails, coronary heart disease may develop.

Atherosclerosis

With the development of pathological processes in the vessels, their lumens gradually narrow, and a large number of plaques form. There is a decrease in the amount of blood entering the tissues, and thrombosis may form. With the development of atherosclerosis, a combination of coronary heart disease with arrhythmia, heart attacks and strokes is possible.

If timely measures are not taken to relieve the causes of ischemia in atherosclerosis, rapid progression of the disease occurs. In case of using effective therapeutic measures The process can be left, but it is impossible to completely cure the pathology. Thanks to the use of modern medicines The general condition of the patient improves, but maintenance therapy should be carried out regularly.

As the symptoms of atherosclerosis progress, the likelihood of coronary heart disease increases. The intensity of negative signs depends on the degree of the disease:

Stage 1 of atherosclerosis is characterized by the appearance of fatty deposits on the walls of blood vessels. This phenomenon occurs in an area where there is poor circulation, however specific symptoms do not appear. Depending on the characteristics of the body pathological process It can either continue for several years or quickly progress to stage 2.
Stage 2 is characterized by the gradual transformation of fatty deposits into connective tissue. Plaques form and constantly increase in size. The formations are characterized by a liquid structure, which is why their dissolution is possible when used medications. This condition does not pose a great danger if treated in a timely manner negative symptoms. If you start the process, a rupture is possible atherosclerotic plaque, provoking partial or complete blockage, possible narrowing of the vessel. It is during this period that the likelihood of developing coronary heart disease and other complications increases.
Stage 3 occurs when the structure of plaques changes, hardening pathological tissue. This process occurs when they accumulate large quantity calcium salts. From this moment on, the plaque practically does not increase in size, however, when it is detached, it is possible to apply more harm than in previous stages of the disease.

There is an extensive list of reasons for which coronary heart disease develops. To prevent its occurrence, you need to adjust your lifestyle, completely abandon bad habits, and form proper diet nutrition, exercise daily, paying attention to general health. Moderate weight loss and visiting a doctor if minimal negative signs are detected will help reduce the likelihood of coronary artery 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 issues humanity. The disease is characteristic high rate mortality 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.

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 reason for this condition is cholesterol plaques, formed on the walls coronary vessels myocardium. They interfere with the delivery of oxygen and other nutrients to the heart. As a result, a condition develops oxygen starvation– 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 with impact in left hand, shoulder, sometimes - in the shoulder blade, back, in the 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

For the diagnosis of chronic ischemic heart disease early stage exists whole line modern informative methods. With their help it is clarified clinical diagnosis 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.

Next stage - lab tests to identify different inflammatory processes in the patient’s body and other disorders. For this purpose the following is carried out:

biochemical and general analysis blood;
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. He reveals various changes heart rate, 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 echocardiography, you can measure the size of the heart muscle and examine contractility hearts, cardiac cavities and valves, acoustic noise. The combination of ultrasound diagnostics with physical activity (stress echocardiography) makes it possible to register ischemic disorders in the myocardium.

Bicycle ergometry – 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 other 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 research helps to conduct more accurate diagnosis myocardium, its functional state, on the basis of which one can judge the effectiveness surgery for the patient.

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

After spending full diagnostics 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

Not drug therapy 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 physiotherapy and short hiking– such loads help the heart adapt to 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, vegetable and fish products. Excluded from the diet:

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

Drug therapy

Drug therapy for chronic forms of IHD follows the “A-B-C” formula and consists of antiplatelet agents, β-blockers and cholesterol-lowering 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 bring the desired result. Before prescribing it, the cardiac surgeon conducts a thorough diagnosis to determine:

contractile function 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 left trunk coronary artery 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 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 left untreated.

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. Essentially, this is an intermediate stage between chronic ischemia heart 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 possible development acute heart attack myocardium.

Heart failure is also a complication of chronic ischemic heart disease. It is formed under the influence of various functional disorders in the work 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, they arise various disorders. By purchasing chronic form, congestive heart failure dramatically reduces a 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.

Chronic form of cardiac ischemia – quite 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 acute ischemia hearts. 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 left side body (arm, shoulder blade, lower jaw). Occurs suddenly or grows rapidly in short period 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 do deep breath pain in the chest increases, 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 work 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 ischemic disease requires 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 the presence of any pathology in 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 when 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 don't pass necessary examination and do not engage in 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, 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 possible threatening consequences their illnesses. 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;
V stressful situations go to see a psychotherapist;
undergo sanatorium-resort treatment;
regularly monitor blood pressure;
maintain normal weight;
stick to a healthy diet;
avoid conditions long-term stress(driving a car, long flights by plane, being in a poorly ventilated area);
exercise only under the supervision of a physical therapy specialist.

Don't get carried away alternative medicine without doctor's advice. Folk remedies quite effective in treatment 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 HIBS.