Myocardial ischemia of the heart muscle. Myocardial ischemia: causes, symptoms, diagnosis, treatment Ventricular myocardium similar ischemic changes
Diseases of the myocardium, the muscle tissue of the heart, can occur unexpectedly in any person. One of these is ischemia. This disease has no boundaries, as it affects people of different positions and ages. It is sometimes called coronary sclerosis or coronary disease.
Ischemic myocardial disease occurs due to insufficient blood supply. This means that the amount of oxygen delivered to the muscle does not meet its needs. Simply put, less oxygen is absorbed than necessary.
Causes of the disease
The causes of insufficient blood supply can be divided into two groups.
- Changes inside the vessels: atherosclerosis, thrombosis, spasm.
- Changes outside the vessels: arterial hypertension, tachycardia and myocardial hypertrophy, that is, an increase in its volume.
In addition, there are certain prerequisites related to lifestyle that affect the malfunction of the heart:
- unhealthy diet: eating large quantities of fatty foods;
- sedentary lifestyle;
- smoking;
- obesity;
- stress;
- diabetes;
- heredity.
Types of disease
- Acute form of ischemia. This includes myocardial infarction and sudden death, also called coronary death.
- Coronary form of ischemia. This is heart failure, all types of arrhythmia and angina pectoris. Symptoms may appear all at once or just one.
There is also a transient form that can occur even in a completely healthy person. This may be a kind of reaction to cold, exercise or stress due to spasm of an unchanged artery.
Signs of illness
Symptoms of the disease depend on its form. However, it is possible to identify general signs that indicate that there is a malfunction in the functioning of the heart.
The first thing worth mentioning is any painful sensations. Of course, these are subjective signs, however, the sooner you pay attention to them, the less consequences there will be due to timely treatment. In addition, pain may occur in the chest area during various types of stress, emotional or physical.
Cardiac ischemia sometimes takes decades to develop. During progression, the forms of the disease and clinical manifestations may change. Symptoms can appear individually or in different combinations. Complications such as heart failure, intracardiac conduction, and cardiac arrhythmias may also occur. Let's clarify the symptoms that are characteristic of different forms of coronary disease.
Angina pectoris manifests itself in the form of attacks behind the sternum. They are periodic and appear during periods of emotional or physical stress. In addition, discomfort and burning may be felt. The attack stops as soon as the load disappears or after taking nitroglycerin. The pain may radiate to the left shoulder blade or arm. Stable exertional angina can be diagnosed as a result of ECG changes or persistent manifestations of the disease. If effective treatment is not prescribed, this stage will develop into a progressive stage, the symptoms of which are more frequent and severe, and may also appear even at rest.
The main symptom of an acute form of ischemia, that is, myocardial infarction, is pain behind the sternum. You may feel discomfort, pain in the left shoulder blade, arm, or abdomen. The pain may last from 15 minutes to an hour. Symptoms of heart failure may appear, such as arrhythmia, profuse sweating and cough. A heart attack at the initial stage can be confused with angina pectoris. However, the subsequent course of the disease, the ineffectiveness of nitroglycerin, the inability to stop the attack in the first hours, arrhythmias, elevated blood pressure and temperature indicate that this is not angina pectoris at all, but a myocardial infarction.
When the muscle fibers of the heart are replaced by scar tissue, cardiosclerosis is formed. Its development can be the result of atherosclerosis of the coronary vessels (ischemia), inflammation or myocardial dystrophy. At the initial stages, hypertrophy of the heart muscle is detected, and then the ventricular cavities expand, which is accompanied by valvular insufficiency. For primary diagnosis, an ECG is used, which helps to establish the localization of the scar.
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Causes of cicatricial changes in the myocardium
The most common factors in the formation of coarse fibrous tissue in the heart muscle are inflammatory and atherosclerotic processes.
In this case, it occurs mainly in young people, in childhood and adolescence, and blockage of the coronary arteries due to cholesterol deposition is almost always detected in patients after 40 years of age.
Formed in the area of inflammation. Occur after infectious diseases, allergic processes.
On the cardiogram, changes of a widespread nature, more often in the right ventricle, indicate that the blood pressure is normal or.
Circulatory failure also has signs of right ventricular failure (edema, liver enlargement, cardiac asthma). A blood test reveals a normal lipid profile, eosinophilia or increased.
Atherosclerotic form
Develops slowly against the background of chronic myocardial ischemia. The damage to the heart muscle is diffuse. Muscle fibers die due to lack of oxygen and metabolic disorders. At the initial stages, clinical signs of scar formation do not differ from the standard course.
Subsequently, the following violations are added:
- increased muscle mass of the left ventricle;
- labored breathing;
- accelerated heartbeat;
- and accumulation of fluid in the chest, pericardium, and abdominal cavity;
- sick sinus syndrome with bradycardia;
- formation;
- weakening of heart sounds, more than the first;
- murmur during systole over the aorta and apex;
- various types of blockades, atrial fibrillation, extrasystoles;
- in blood.
Post-infarction cardiosclerosis
Unlike the two previous forms, the scar in the myocardium after necrosis (infarction) is located in the zone of destruction and does not extend to the rest of the heart muscle.
With repeated attacks of acute ischemia, the connective tissue may have a varied location and length, and some of the scars may intersect. In this case, the cavities of the heart expand after a period of hypertrophy. High blood pressure in the area of scar tissue can cause the wall to bulge and form an aneurysm. Symptoms for post-infarction lesions do not differ from atherosclerotic lesions.
Watch the video about coronary heart disease:
What will the ECG show during changes?
For the first stage of diagnosing scar structures in the myocardium, it is used; it can help in topical (location) diagnosis.
Left ventricle
Scar tissue leads to the formation of:
- abnormal Q in the first three standard leads, as well as V1 - 6;
- ST is located on the isoline;
- T is often positive, low and smooth.
In this case, the connective tissue fibers cannot generate signals, as well as the source of destruction. But the lesion becomes smaller due to the contraction of the remaining muscle fibers.
Therefore, with repeated ECG studies in the scarring stage, positive dynamics are noted.
Bottom wall
Pathological Q is noted in the second standard lead, and a lower (negative) ventricular complex is also found there compared to the third standard lead.
Septal region
For a scarring infarction in the septal area, the Q waves in leads V1, V2 are of diagnostic value, and the R waves in V1,2,3 are low or cannot be determined.
Additional examinations
In addition to electrocardiographic examination, patients are prescribed:
- Ultrasound of the heart to assess the extent and expansion of cavities;
- CT or if there is a discrepancy between clinical signs and ECG data;
- myocardial scintigraphy to detect diffuse or focal defects in the accumulation of radioisotopes;
- blood tests - lipid profile, coagulogram, immunological complex, specific enzymes (troponin, myoglobin, creatine phosphokinase).
How to treat deviations
It is not possible to influence already formed scars in the myocardium.
For this purpose, medications from various groups are prescribed:
- for angina pectoris - beta blockers (Bisoprol), nitrates (), (Enap), diuretics (Trifas), anticoagulants (, Clopidogrel);
- for myocarditis - antibiotics (Augmentin), anti-inflammatory (Nimid), antiviral and immunomodulators (Cycloferon), vitamin complexes (Milgamma);
- to improve myocardial nutrition - antioxidants (Kudesan, Cytochrome C), metabolism stimulants (Mexidol, Panangin, Riboxin);
- hypolipidemic - Tulip, Roxera;
- – Ritmonorm, Kordaron;
- – Korglykon, Digoxin.
If there is no result from drug therapy, and the threat remains, in case of severe rhythm disturbance, surgical treatment is performed: installation of a stent or suturing of the aneurysm.
Scar formation in the heart muscle is the final stage after myocarditis or myocardial infarction; it is also considered the outcome of atherosclerotic lesions of the coronary vessels.
An ECG is used to detect focal or diffuse myocardial scarring.
To clarify the diagnosis, an in-depth clinical and instrumental examination is recommended. Symptoms and prognosis of cardiosclerosis depend on the severity of the underlying pathology. There are no specific manifestations; complications can include various heart rhythm disturbances and circulatory failure. For treatment, drug therapy is used; in case of threatening conditions, surgery is prescribed.
Recognizing myocardial infarction on an ECG can be difficult due to the fact that different stages have different signs and variations of waveforms. For example, the acute and acute stage may not be noticeable in the first hours. Localization also has its own characteristics: the infarction on the ECG is transmural, q, anterior, posterior, transferred, large-focal, lateral, different.
All people know that the most important organ in the human body is the heart. Any disturbances in its work immediately have a negative impact on well-being. A person cannot live without this organ. Therefore, it is very important to monitor the condition and activity of the cardiovascular system.
And if after the ECG some changes were detected, and the doctor said that you have moderate changes in the myocardium. Should I be concerned in this case, and what measures should be taken?
What are moderate changes in the myocardium
The human heart works throughout life without rest or interruption. Therefore, over the years, even in a healthy person, this organ gets tired, and various disturbances in the functioning of the cardiovascular system arise. Changes in the myocardium are not always life-threatening; some simply require correction of the daily routine and nutrition.
If a person does not complain, and changes are detected only during a routine medical examination, then there is no need to worry.
But if various deviations in well-being occur, you need to sound the alarm. And the first thing you need to do is make an appointment with a cardiologist.
The main complaints of the patient with changes in the myocardium
- interruptions in the heart;
- heart pain;
- fluctuations in blood pressure;
- lack of air at the slightest physical exertion;
- drowsiness;
- fatigue, weakness.
Is treatment required in this case? It all depends on the appearance of the transformations, because they are all classified into varieties.
Types of pathological changes
There are several types of myocardial transformations
- nonspecific;
- dystrophic;
- metabolic;
- diffuse.
Depending on the type, therapy is prescribed. Let's look at each variety.
Nonspecific changes
Moderate nonspecific changes in the ventricular myocardium are the safest type
Usually these conditions do not pose a particular danger to life and health, they can be completely reversible. Often they do not manifest themselves in any way, but are only noticed on a cardiogram. A patient with nonspecific changes in the myocardium most often does not present any complaints.
They arise for a reason
- food or chemical poisoning ;
- frequent stress;
- infectious diseases;
- poor nutrition;
- overwork;
- violations of the daily routine;
- lack of sleep;
- drinking alcoholic beverages.
Otherwise, nonspecific changes in the myocardium are called repolarization. In this case, usually no special therapy is required, but the doctor may advise adjusting the work and rest schedule, diet, and feasible sports activities.
Dystrophic changes
Dystrophic changes in the myocardium occur due to a lack of nutrients that the heart muscle should receive. Otherwise, this condition is also called “cardiac dystrophy.”
Cardiac dystrophy occurs for many reasons
- physical overload;
- frequent stress;
- low hemoglobin;
- diseases of the endocrine system, in particular diabetes mellitus;
- poisoning;
- dehydration of the body;
- infectious diseases;
- chronic diseases;
- disorders of the kidneys and liver, causing intoxication;
- diets leading to a lack of vitamins;
- alcohol intoxication.
Sometimes dystrophic changes occur in childhood. In this case, they do not require treatment, since the child's heart is prone to change. The same can be said for older people, whose cardiovascular system is already susceptible to fatigue and, as a result, imperfect.
Often, dystrophic changes in the myocardium can be seen in schoolchildren taking exams.
Diffuse changes
These are changes that uniformly affect the heart muscle. They arise as a result of inflammation of the myocardium due to a large number of medications or a violation of the water-salt balance. This leads to metabolic disorders and disease, hypoxia.
Among the causes of hypoxia are the following:
- frequent stress;
- chronic diseases;
- physical overload;
- excess weight;
- hypothermia of the body;
- alcohol intoxication.
This condition is easily corrected with the help of a proper diet and daily routine. Have a good night's sleep.
The symptoms of the disease are as follows
- dark circles under the eyes;
- dyspnea;
- increased fatigue;
- spots before the eyes;
- decreased performance;
- lack of air;
- drowsiness.
If these signs appear, you must urgently contact a specialist and conduct an examination.
Metabolic changes
Dysmetabolic changes in the myocardium are considered the most harmless and do not have any symptoms and, as a rule, are detected after the next examination. They arise due to overwork, stress, and as a result of taking certain medications.
Usually the doctor recommends in these cases to simply change your daily routine or rest. However, you should not take this disease lightly and neglect the doctor’s advice, because this can lead to serious consequences.
Left ventricular hypertrophy
This is already a dangerous change in the myocardium, requiring careful conservative and sometimes surgical treatment.
Normally, the thickness of the left ventricular myocardial wall is 7-11 mm, but with some complications (high blood pressure, for example), the heart has to pump more blood. As a result, the myocardial wall stretches, unable to withstand the overload, and an increase in the size of the ventricle develops.
This condition is called left ventricular hypertrophy. It can be either congenital or acquired. The latter occurs in athletes and people experiencing constant physical overload. Therefore, people who have connected their lives with sports are recommended to undergo regular medical examinations.
Otherwise, LVMH is called an “overworked heart.” It is especially dangerous when LVH occurs during pregnancy. Then there is a threat to both the life of the mother and the fetus. Therefore, it is urgent to take action.
There are diseases that provoke left ventricular myocardial hypertrophy:
- arterial hypertension;
- atherosclerosis of the aorta;
- narrowing of the aortic valve.
But if the myocardial expansion is no more than 18 mm, then no treatment is prescribed.
What are the symptoms of this disease?
Usually a person feels with left ventricular hypertrophy:
- dizziness;
- weakness;
- shortness of breath;
- swelling;
- chest pain;
- interruptions in the heart.
Symptoms usually increase after exercise and stress. They also intensify during pregnancy.
Diagnostic and treatment methods
If these symptoms appear, a person should immediately contact a medical facility for examination.
It usually consists of procedures such as
- external examination of the patient, measuring blood pressure, pulse;
- echocardiograms;
- electrocardiograms;
- duplex scanning of the aorta.
Doppler echocardiography is sometimes ordered to determine blood flow velocity and turbulence.
If identified moderate changes in the left ventricular myocardium, then supportive treatment can be prescribed. These are usually drugs containing potassium and magnesium (for example, Panangin or Asparkam).
The doctor will also recommend a special diet, which involves avoiding salty, smoked, and fatty foods. On the contrary, it will be useful to include foods rich in potassium and magnesium in your diet.
Healthy foods
- fish roe;
- dried apricots;
- raisin;
- buckwheat;
- bananas;
- prunes;
- walnuts;
- fish of the salmon family.
But if there is left ventricular hypertrophy, special treatment is required. When this disease is combined with hypertension, antihypertensive drugs are usually prescribed.
This is usually
- angioconverting enzyme inhibitors;
- beta blockers;
- drugs that block calcium channels.
If LVMH is accompanied by aortic atherosclerosis, then the following medications are prescribed
- statins;
- endotheliotropic drugs;
- blood thinners.
For concomitant arrhythmia, nitrates and antiarrhythmic substances are prescribed
If left ventricular myocardial hypertrophy is caused by a heart defect, then surgery cannot be avoided.
Typically, there are two types of operations for LVH: aortic valve replacement and aortic stenting.
There is treatment for this condition with folk remedies. This recipe works well.
You need to take a lemon, pass it through a meat grinder, add dried apricots, prunes, raisins, and pour honey. Take a teaspoon of the mixture in the morning.
Forecast
With a mild course of the disease, the prognosis is favorable if you follow all the doctor’s recommendations: normalize your daily routine, establish a balanced diet, and get proper rest.
If there is hypotrophy of the left ventricle, complicated by a heart defect, then surgery is necessary. In its absence, life expectancy is no more than five years in 95% of patients.
The myocardium is the heart muscle; some of its structural changes are often provoked by external and internal factors. Transformations do not always indicate pathology or any negative disorder, but in any case, they need to be focused on. After all, the heart is an important organ of the human body; it is akin to a car engine: it converts biochemical reactions into mechanical energy. The movements of the heart muscle must maintain rhythm; any disturbances in this process and changes in the myocardium are shown by an electrocardiogram (ECG).
Signs of a problem
Cardiac activity depends on many criteria that affect intracellular metabolism in the tissues of the heart muscle. The constancy of the internal environment can be periodically disrupted, which can lead to disruptions in the functioning of the heart cells. Diffuse changes in the myocardium are not considered a disease; it is a syndrome that means an accumulation of changed cells with impaired conduction of electrical impulses in a given area, clearly displayed on the ECG. It is important to determine the cause of such failures; it may be hormonal in nature, infectious in origin, or a consequence of heart disease of varying severity.
Changes are not always only diffuse, covering sectors in each department of the organ. They can be focal as a result of the formation of scars in the myocardium of any size. The scar is a connective tissue that does not conduct impulses; the electrical inertia of this area is visible on the cardiogram.
The variety of myocardial diseases is very large, but the general signs of problems with the cardiovascular system and symptoms of myocardial changes are as follows:
- burning and pressing pain behind the sternum;
- shortness of breath at the slightest physical exertion or even at rest;
- disturbances of heart rhythm and contraction frequency;
- increased fatigue, general weakness, chronic fatigue.
The primary change in the heart muscle provokes the development of certain processes:
- myocardial hypoxia;
- circulatory disorders;
- disruptions in the transport of oxygen to cells and tissues;
- irreversible necrotic consequences.
A critical case of the development of myocarditis is an acute infarction; its course also varies.
Causes of myocardial changes
The detected deviations have different origins. The reasons can be minor or significant. The latter provoke a fatal outcome. A thorough examination will reveal the problem to an experienced cardiologist.
Changes in the myocardium can form several groups of factors:
- Inflammatory. They cause myocarditis. Its nature can be infectious or aseptic, that is, pathogenic microorganisms do not take part in this process. Typically, such areas are diffuse in location, but sometimes there are foci of inflammation.
Manifestations of myocarditis, expressed with varying degrees of intensity, accompany the following pathologies:
- typhus, diphtheria;
- acute rheumatic fever or rheumatism of streptococcal origin, which is a consequence of tonsillitis, tonsillitis, scarlet fever;
- weakened immune system (systemic lupus erythematosus, rheumatoid arthritis affecting the heart, etc.);
- damage by viruses of rubella, measles, influenza, etc.
- diseases of the endocrine system: hyperfunction of the thyroid gland, diabetes mellitus, tumor of the adrenal glands, as a result, an excessive amount of hormones or a lack of glucose in the heart cells provoke disruptions in metabolic processes within these cells;
- liver and kidney failure lead to the accumulation of toxins in the blood resulting from metabolic processes;
- anemia - a decrease in hemoglobin levels - brings with it a lack of air for the heart muscle cells;
- dehydration, fever;
- severe physical conditions: frequent stress, hard work, constant overwork, malnutrition and starvation;
- mental stress combined with increased emotional stress leads to changes in the myocardium in children, especially if the child is not active enough; here among the consequences are vegetative-vascular dystonia and disruptions in the control of the nervous system of the heart;
- infections: tuberculosis, influenza, malaria;
- intoxication - acute or chronic, including alcoholism, work in hazardous industries, constant contact with chemicals;
- food unsaturated with vitamins.
Diagnosing and fixing the problem
Minor changes in the myocardium will not require drastic measures. The patient will be advised to adjust blood pressure, take a course of vitamins and adhere to a healthy lifestyle.
More serious changes in the myocardium already imply the presence of a disease; for diagnosis, the following measures are usually performed:
- Clinical blood test. Examines hemoglobin levels and inflammation criteria.
- Biochemistry of blood. Determines the condition of the liver, kidneys, the amount of glucose, protein, cholesterol.
- General urine analysis. Evaluates renal activity.
- Ultrasound. Visual examination of internal organs.
- ECG. Diffuse changes are indicated by a decrease in T waves, responsible for ventricular repolarization. Negative T waves in 1–2 sectors indicate focal changes.
- Echocardiogram. The most informative method that identifies the causes of changes in the heart muscle thanks to clear visualization of its parts.
Therapy must be combined with correction of diet and lifestyle. Changes in the myocardium of a dystrophic or metabolic nature by default require proper rest, adherence to sleep patterns and diet.
The heart responds well to those present in the diet:
- nuts;
- spinach;
- carrots and potatoes;
- apricots, peaches, bananas;
- lean poultry and meat;
- red fish and caviar;
- cereals, grains;
- dairy products.
Chocolate and confectionery products should be consumed to a minimum. Fatty meat and poultry are extremely rare. Soda, coffee and alcohol are excluded. You should also remove spicy, fatty, salty, spicy and fried foods.
The following drugs help improve metabolic processes in heart muscle cells:
- “Asparkam”, “Panangin”, “Magne B6”, “Magnerot” - potassium and magnesium stabilize the frequency of contractions.
- Mexidol and Actovegin are antioxidants that eliminate lipid oxidation products in myocardial cells.
- Vitamins A, B, C, E - without them, intracellular metabolism is impossible.
If the cause of myocardial changes is a disease, then appropriate therapy will correct the situation. The lack of hemoglobin is compensated for with iron-containing drugs; for myocardial inflammation, antibiotics and Prednisolone are prescribed; for cardiosclerosis, urinary agents and cardiac glycosides are indicated.
An ECG can diagnose most heart pathologies. The reasons for their appearance are due to concomitant diseases and lifestyle characteristics of the patient.
What does this mean if changes in the myocardium are detected on the ECG? In most cases, the patient requires conservative treatment and lifestyle modification.
Electrocardiogram (ECG) – one of the most informative, simple and accessible cardiological research. It analyzes the characteristics of the electrical charge that causes the heart muscle to contract.
Dynamic recording of charge characteristics is carried out in several areas of the muscle. The electrocardiograph reads information from electrodes placed on the ankles, wrists and chest skin in the area where the heart is projected, and converts them into graphs.
Normal and deviations - possible reasons
Normally, the electrical activity of the myocardial areas, which is recorded by the ECG, should be uniform. This means that intracellular biochemical metabolism in heart cells occurs without pathologies and allows the heart muscle to produce mechanical energy for contractions.
If the balance in the internal environment of the body is disturbed for various reasons - The following characteristics are recorded on the ECG:
- diffuse changes in the myocardium;
- focal changes in the myocardium.
The reasons for such changes in the myocardium on the ECG may be harmless conditions, not threatening the life and health of the subject, and serious dystrophic pathologies requiring emergency medical care.
One of these serious pathologies is myocarditis, or. Regardless of its etiology, areas of inflammation can be located either in the form of foci or diffusely throughout the heart tissue.
Causes of myocarditis:
- , as a consequence of scarlet fever, tonsillitis, chronic tonsillitis;
- complications of typhus, scarlet fever;
- consequences of viral diseases: influenza, rubella, measles;
- autoimmune diseases: rheumatoid arthritis, systemic lupus erythematosus.
One of the reasons for changes in muscle tissue may be cardiodystrophy - a metabolic disorder in heart cells without damage to the coronary arteries. Lack of cell nutrition leads to changes in their normal functioning and impaired contractility.
Causes of cardiac dystrophy:
- Ingress of toxic metabolic products into the blood due to severe impairment of kidney and liver function;
- Endocrine diseases: hyperthyroidism, diabetes mellitus, adrenal tumor, and, as a result, excess hormones or metabolic disorders;
- Constant psycho-emotional stress, stress, chronic fatigue, starvation, unbalanced diet with nutritional deficiencies;
- In children, a combination of increased stress with a sedentary lifestyle, vegetative-vascular dystonia;
- Lack of hemoglobin (anemia) and its consequences - oxygen starvation of myocardial cells;
- Severe infectious diseases in acute and chronic form: influenza, tuberculosis, malaria;
- Dehydration of the body;
- Avitaminosis;
- Alcohol intoxication, occupational hazards.
Determination by cardiogram
For diffuse lesions heart deviations from the normal pattern are noted in all leads. They look like numerous areas with impaired conduction of electrical impulses.
This is expressed on the cardiogram as a decrease in T waves, which are responsible for. With focal lesions, such deviations are recorded in one or two leads. These deviations are expressed on the graph as negative T waves in the leads.
If focal changes are represented, for example, by scars remaining in the connective tissue; they appear on the cardiogram as electrically inert areas.
Diagnostics
Decoding electrocardiogram data takes 5-15 minutes. Its data can reveal:
- Size and depth of ischemic lesion;
- Localization of myocardial infarction, how long ago it occurred in the patient;
- Electrolyte metabolism disorders;
- Enlarged heart cavities;
- Thickening of the walls of the heart muscle;
- Intracardiac conduction disorders;
- Heart rhythm disturbances;
- Toxic damage to the myocardium.
Features of diagnosis for various myocardial pathologies:
- myocarditis– the cardiogram data clearly shows a decrease in the waves in all leads, a violation of the heart rhythm, the result of a general blood test shows the presence of an inflammatory process in the body;
- myocardial dystrophy– ECG indicators are identical to the data obtained for myocarditis; this diagnosis can only be differentiated using laboratory data (blood biochemistry);
- myocardial ischemia– ECG data show changes in the amplitude, polarity and shape of the T wave in those leads that are associated with the ischemic zone;
- acute myocardial infarction– horizontal displacement of the ST segment upward from the isoline, trough-shaped displacement of this segment;
- cardiac muscle necrosis– irreversible death of myocardial cells is reflected on the ECG graph as a pathological Q wave;
- transmural necrosis– this irreversible damage to the entire thickness of the cardiac muscle wall is expressed in the cardiogram data as the disappearance of the R wave and the acquisition of the QS type by the ventricular complex.
In case of hypertensive crisis, decompensated heart failure, electrolyte disturbances or suspicion of acute myocardial infarction, a coronary T scar appears on the ECG graph.
Upon diagnosis, additional you should pay attention to the symptoms of concomitant diseases. This may include pain in the heart with myocardial ischemia, swelling of the legs and arms with, signs of heart failure as a result of a heart attack suffered on the legs, trembling of the hands, sudden weight loss and exophthalmos with hyperthyroidism, weakness and dizziness with anemia.
The combination of such symptoms with diffuse changes detected on the ECG requires an in-depth examination.
What diseases do they accompany?
Pathological changes in the myocardium detected on the ECG may be accompanied by impaired blood supply to the heart muscle, reprolarization processes, inflammatory processes and other metabolic changes.
A patient with diffuse changes may exhibit the following symptoms:
- dyspnea,
- chest pain,
- increased fatigue,
- cyanosis (blanching) of the skin,
- rapid heartbeat (tachycardia).
Such manifestations most often become the reason for an electrocardiogram. In medical practice, there are many examples when myocardial pathologies did not cause noticeable changes in the well-being of patients and were discovered during preventive examinations.
Diseases accompanied by changes in the heart muscle:
- Myocardial dystrophy– disruption of biochemical metabolic processes occurring in the heart;
- Allergic, toxic, infectious myocarditis– myocardial inflammation of various etiologies;
- Myocardiosclerosis– replacement of cardiac muscle cells with connective tissue, as a consequence of inflammation or metabolic diseases;
- Violations water-salt metabolism;
- Hypertrophy parts of the heart muscle.
Additional examinations are needed to differentiate them.
Additional diagnostic tests
These cardiograms, despite their information content, cannot be the basis for making an accurate diagnosis. In order to fully assess the degree of myocardial changes, The cardiologist prescribes additional diagnostic measures:
- – the level of hemoglobin and such indicators of the inflammatory process as the level of leukocytes and (erythrocyte sedimentation) in the blood are assessed;
- Blood biochemistry test– indicators of protein, cholesterol, and glucose levels are assessed to analyze the functioning of the kidneys and liver;
- General clinical urine test– kidney function indicators are assessed;
- Ultrasound if there is a suspicion of pathology of internal organs - according to indications;
- ECG indicators;
- Carrying out ECG with stress;
- Ultrasound of the heart(echocardiography) – the condition of the parts of the heart is assessed to determine the cause of myocardial pathology: expansion (dilatation), hypertrophy of the heart muscle, signs of decreased myocardial contractility, disruption of its motor activity.
After analyzing the medical history and laboratory and instrumental examination data, the cardiologist determines the method of treating the changes.
Treatment for focal and diffuse disorders
In the treatment of myocardial pathologies they are used various groups of drugs:
If conservative treatment does not lead to significant improvements in the condition of a patient with myocardial diseases, he undergoes surgery to implant a myocardial pacemaker.
In addition to medications, the patient is recommended to change his lifestyle and establish a balanced diet. For a patient with such pathological manifestations, physical activity, drinking alcohol and smoking are unacceptable. He is prescribed physical therapy and feasible labor.
Basic principles of dietary nutrition:
- The consumption of salt and excess liquid is limited to a minimum;
- Spicy and fatty foods are not recommended;
- The menu should include vegetables, fruits, lean fish and meat, and dairy products.
Myocardial changes detected on ECG require additional laboratory and instrumental examination. If necessary, the cardiologist will prescribe treatment in a hospital or on an outpatient basis. Timely measures taken will help avoid serious complications.
