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 borders, as it affects people of different status and age. Sometimes it is called coronary sclerosis or coronary disease.

Ischemic myocardial disease occurs due to its insufficient blood supply. This means that the amount of oxygen delivered to the muscle does not match 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 and affecting the failure of the heart:

malnutrition: eating large amounts 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 only one.

There is also a transient form that can occur even in a perfectly healthy person. This may be a kind of reaction to cold, exercise or stress due to spasm of the normal artery.

Signs of illness

Symptoms of the disease depend on its form. However, there are general signs that indicate that the heart has failed.

The first thing to say is any painful sensations. Of course, these are subjective signs, however, the sooner attention is paid to them, the less consequences there will be due to the timely prescribed treatment. In addition, in the retrosternal region, pain may occur during various kinds of stress, emotional or physical.

Cardiac ischemia sometimes develops over decades. During progression, the forms of the disease and clinical manifestations may change. Symptoms can appear both separately and in different combinations. Complications may also occur, such as heart failure, intracardiac conduction, and abnormal heart rhythms. 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 in nature and appear during a period of emotional or physical stress. In addition, discomfort and burning sensation 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 delivered as a result of ECG changes or a persistent manifestation of the disease. If effective treatment is not prescribed, this stage will develop into a progressive stage, the signs of which are more frequent and severe, and can also occur even at rest.

The main symptom of an acute form of ischemia, that is, myocardial infarction, is chest pain. Discomfort, pain in the left shoulder blade, arm, abdomen may be felt. The pain can last from 15 minutes to an hour. Symptoms of heart failure may appear, such as arrhythmias, profuse sweating, and coughing. 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 impossibility of stopping an attack in the first hours, arrhythmias, high blood pressure and temperature suggest that this is not angina pectoris at all, but myocardial infarction.

When the muscle fibers of the heart are replaced by scar tissue, cardiosclerosis is formed. Its development may be the outcome 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 over 40 years of age.

Scars with myocarditis

Formed in the area of inflammation. Occur after infectious diseases, allergic processes.

On the cardiogram, changes of a common nature, more often in the right ventricle, are noted, blood pressure is normal or.

Circulatory failure also has signs of right ventricular (edema, liver enlargement, cardiac asthma). In a blood test - a normal lipid profile, eosinophilia or an increase.

Atherosclerotic form

It develops slowly against the background of chronic myocardial ischemia. Diffuse damage to the heart muscle. Muscle fibers die due to lack of oxygen and metabolic disorders. In the initial stages, the clinical signs of scarring do not differ from the standard course.

Subsequently, the following violations are added:

increase in muscle mass of the left ventricle;
labored breathing;
accelerated heartbeat;
and accumulation of fluid in the chest, pericardium, abdominal cavity;
sick sinus syndrome with bradycardia;
formation;
weakening of cardiac tones, more than the first;
noise during systole over the aorta and apex;
various types of blockades, atrial fibrillation, extrasystoles;
in blood.

Postinfarction 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 variety of localization and length, 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 scar tissue area can lead to wall bulge and aneurysm formation. Symptoms in post-infarction lesions do not differ from atherosclerotic ones.

Watch a video about coronary heart disease:

What will the ECG show with 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 more often positive, low and smooth.

At the same time, connective tissue fibers cannot generate signals, as well as the focus of destruction. But the focus becomes smaller due to the contraction of the remaining muscle fibers.

Therefore, with repeated ECG studies in the stage of scarring, there is a positive trend.

bottom wall

Pathological Q is noted in the second standard lead, a lower (negative) ventricular complex is also found there compared to the third standard lead.

Septal area

For a scarring infarction in the septal zone, Q waves in leads V1, V2 are of diagnostic value, and R waves in V1,2,3 are low or cannot be determined.

Additional examinations

In addition to an electrocardiographic study, patients are prescribed:

Ultrasound of the heart to assess the extent and expansion of the cavities;
CT scan 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 - lipidogram, 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, drugs from various groups are prescribed:

with angina - beta-blockers (Bisoprol), nitrates (), (Enap), diuretics (Trifas), anticoagulants (, Clopidogrel);
with myocarditis - antibiotics (Augmentin), anti-inflammatory (Nimide), 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;
- Korglikon, Digoxin.

If there is no result from drug therapy, and there is also a threat, in case of severe arrhythmias, surgical treatment is performed: installing a stent or, suturing the aneurysm.

Scarring 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. ECG is used to detect focal or diffuse scarring of the myocardium.

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 be a variety of heart rhythm disturbances, circulatory failure. For treatment, drug therapy is used, in case of threatening conditions, an operation is prescribed.

What are moderate changes in the myocardium

The human heart works throughout life without rest and interruption. Therefore, over the years, even in a healthy person, this organ gets tired, and various disorders in the work of the cardiovascular system occur. 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 you should not worry.

But if there are various deviations in well-being, it is necessary to sound the alarm. And the first thing to do is to 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.

Varieties of pathological changes

There are several types of myocardial transformations.

non-specific;
dystrophic;
metabolic;
diffuse.

Treatment depends on the type. Let's consider each variety.

Non-specific changes

Moderate non-specific changes in the ventricular myocardium is 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 seen only on a cardiogram. A patient with nonspecific changes in the myocardium most often does not present any complaints.

They arise due to

food or chemical poisoning ;
frequent stress;
infectious diseases;
malnutrition;
overwork;
violations of the daily routine;
lack of sleep;
intake of 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 you to adjust the mode of work and rest, diet, and feasible sports.

Dystrophic changes

Dystrophic changes in the myocardium occur due to the lack of nutrients that the heart muscle should receive. Otherwise, this condition is also called "cardiodystrophy".

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 children's heart is prone to changes. The same can be said about the elderly, whose cardiovascular system is already prone 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 evenly affect the heart muscle. They arise due to inflammation of the myocardium due to a large amount 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 right diet, daily routine. Full sleep.

The symptoms of the disease are as follows

dark circles under the eyes;
dyspnea;
increased fatigue;
flies before the eyes;
decrease in working capacity;
lack of air;
drowsiness.

When these signs appear, it is necessary to urgently contact a specialist, 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, due to the intake of certain drugs.

Usually, the doctor recommends in these cases simply change the daily routine or take a break. However, you should not take this disease lightly and neglect the advice of a doctor, 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 wall thickness of the myocardium of the left ventricle is 7-11 mm, but with some complications (high blood pressure, for example), the heart has to distill more blood. As a result, the myocardial wall is stretched, unable to withstand overload, and an increase in the size of the ventricle develops.

This condition is called left ventricular hypertrophy. It is both congenital and 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 "overworked heart". It is especially dangerous when LVMH occurs during pregnancy. Then there is a threat to both the life of the mother and the fetus. Therefore, urgent action is needed.

There are diseases that provoke hypertrophy of the myocardium of the left ventricle:

arterial hypertension;
atherosclerosis of the aorta;
narrowing of the aortic valve.

But if the expansion of the myocardium is not 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;
pain in the chest;
interruptions in the heart.

Usually, symptoms increase after physical exertion and stress. During pregnancy, they also increase.

Methods of diagnosis and treatment

If these symptoms appear, a person should immediately contact a medical institution for the purpose of examination.

It usually consists of procedures such as

external examination of the patient, measurement of blood pressure, pulse;
echocardiograms;
electrocardiograms;
duplex scanning of the aorta.

Doppler echocardiography is sometimes prescribed to determine blood flow velocity and turbulence.

If identified moderate changes in the myocardium of the left ventricle, then supportive treatment may be prescribed. These are usually preparations containing potassium and magnesium (for example, Panangin or Asparkam).

Also, the doctor will advise a special diet, which involves the rejection of salty, smoked, fatty foods. On the contrary, it will be useful to include foods rich in potassium and magnesium in the diet.

Healthy foods

fish caviar;
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 atherosclerosis of the aorta, then the following drugs are prescribed

statins;
endotheliotropic drugs;
blood thinners.

With concomitant arrhythmia, nitrates and antiarrhythmic substances are prescribed

If left ventricular myocardial hypertrophy is caused by heart disease, then surgery cannot be avoided.

There are usually two types of surgery for LVH: aortic valve replacement and aortic stenting.

There is a treatment for this condition with folk remedies. This recipe helps a lot.

You need to take a lemon, pass it through a meat grinder, add dried apricots, prunes, raisins, pour honey. Take the mixture in a teaspoon in the morning.

Forecast

With a mild course of the disease, the prognosis is favorable if all the doctor's recommendations are followed: normalize the daily routine, establish a balanced diet, and have a good rest.

If there is hypotrophy of the left ventricle, complicated by heart disease, then surgery is necessary. In its absence, life expectancy is no more than five years in 95% of patients.

The myocardium is a heart muscle, some of its structural changes are often provoked by external and internal factors. Transformations do not always speak of pathology or some kind of negative violation, 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 follow the rhythm, all sorts of violations of 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 violated, which is fraught with malfunctions in the work of the heart cells. Diffuse changes in the myocardium are not considered a disease, this is a syndrome that means an accumulation of changed cells with a violation of the conduction of electrical impulses in this area, clearly displayed on the ECG. It is important to determine the cause of such failures, it may be of a hormonal nature, of an infectious origin, or be 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 inertness of this area is visible on the cardiogram.

The variety of myocardial diseases is very large, but common signs of problems with the cardiovascular system and symptoms of changes in the myocardium are as follows:

burning and pressing pain behind the sternum;
shortness of breath with the slightest exertion or even at rest;
violations of the heart rhythm and frequency of contractions;
increased fatigue, general weakness, chronic fatigue.

The primary change in the heart muscle provokes the development of some processes:

myocardial hypoxia;
circulatory disorders;
failures in the transport of oxygen to cells and tissues;
irreversible necrotic consequences.

A critical case of myocarditis development is an acute infarction, its course also varies.

Causes of myocardial changes

The detected deviations are of different origin. 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, pathogens do not participate in this process. Typically, such areas have a diffuse nature of the 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 immunity (systemic lupus erythematosus, rheumatoid arthritis affecting the heart, etc.);
infection with 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 cells of the heart provoke disruptions in the metabolic processes inside these cells;
liver and kidney failure lead to the accumulation of toxins in the blood resulting from metabolic processes;
anemia - a decrease in the level of hemoglobin - brings with it a lack of air for the cells of the heart muscle;
dehydration, fever;
severe physical conditions: frequent stress, hard work, constant overwork, malnutrition and starvation;
mental stress combined with increased emotional stress lead to changes in the myocardium in children, especially if the child is not active enough; here among the consequences are vegetovascular dystonia and failures in the control of the nervous system of the activity of the heart;
infections: tuberculosis, influenza, malaria;
intoxication - acute or chronic, including alcoholism, work in hazardous industries, constant contact with chemicals;
food deficient in 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, drink a course of vitamins and maintain 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 and inflammation criteria.
Biochemistry of blood. Determines the state of the liver, kidneys, the amount of glucose, proteins, cholesterol.
General urine analysis. Evaluates renal activity.
ultrasound. Visual examination of internal organs.
ECG. Diffuse changes are indicated by a decrease in T waves, which are responsible for ventricular repolarization. Negative T waves in 1–2 sectors testify to focal changes.
Echocardiogram. The most informative method that reveals the causes of changes in the heart muscle due to a clear visualization of its departments.

Therapy must be combined with dietary and lifestyle changes. Changes in the myocardium of dystrophic or metabolic nature by default require proper rest, adherence to sleep 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, cereals;
dairy.

Chocolate and confectionery products should be consumed to a minimum. Fatty meat and poultry are extremely rare. Soda, coffee and alcohol are excluded. You also need to remove spicy, fatty, salty, spicy and fried foods.

The following drugs contribute to the improvement of metabolic processes in the cells of the heart muscle:

"Asparkam", "Panangin", "Magne B6", "Magnerot" - potassium and magnesium stabilize the frequency of contractions.
"Mexidol", "Actovegin" - 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 replenished with iron-containing drugs, with inflammation of the myocardium, antibiotics and Prednisolone are prescribed, with cardiosclerosis, urinary agents, cardiac glycosides are indicated.

Most heart pathologies can be diagnosed on an ECG. The reasons for their appearance are due to concomitant diseases and the characteristics of the patient's lifestyle.

What does it mean if changes in the myocardium were found on the ECG? In most cases, the patient requires conservative treatment and lifestyle changes.

Electrocardiogram (ECG) - one of the most informative, simple and accessible cardiology research. It analyzes the characteristics of the electrical charge that causes the heart muscle to contract.

Dynamic recording of the characteristics of the charge is carried out in several areas of the muscle. An electrocardiograph reads information from electrodes placed on the ankles, wrists, and chest skin in the heart projection area and converts them into graphs.

Norm and deviations - possible causes

Normally, the electrical activity of areas of the myocardium, which is recorded by the ECG, should be homogeneous. 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 by 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 can be both harmless states that do not threaten the life and health of the subject, as well as 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 both in the form of foci and diffusely throughout the heart tissue.

Causes of myocarditis:

as a result 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 the cells of the heart without damage to the coronary arteries. Lack of nutrition of cells leads to a change in their normal life, a violation of contractility.

Causes of cardiodystrophy:

The entry into the blood of toxic metabolic products due to severe violations of the kidneys and liver;
Endocrine diseases: hyperthyroidism, diabetes mellitus, adrenal tumor, and, as a result, an excess of hormones or metabolic disorders;
Constant psycho-emotional stress, stress, chronic overwork, starvation, unbalanced nutrition with nutritional deficiency;
In children, a combination of increased loads 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.

Definition by cardiogram

For diffuse lesions heart deviations from the normal picture 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 the T waves, which are responsible for. With a focal lesion, such deviations are recorded in one or two leads. These deviations are expressed on the graph as negative T waves in leads.

If a focal changes represented, for example, by scars remaining in the connective tissue, they look on the cardiogram as electrically inert areas.

Diagnostics

Interpretation of electrocardiogram data takes 5-15 minutes. Her data can reveal:

The size and depth of the ischemic lesion;
Localization of myocardial infarction, how long ago it happened in the patient;
Electrolyte metabolism disorders;
Enlargement of the heart cavities;
Thickening of the walls of the heart muscle;
Violations of intracardiac conduction;
Heart rhythm disturbances;
Toxic damage to the myocardium.

Features of diagnosis in various pathologies of the myocardium:

myocarditis- on the data of the cardiogram, a decrease in the teeth in all leads is clearly visible, 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 those obtained with myocarditis, this diagnosis can be differentiated only with the help of laboratory data (blood biochemistry);
myocardial ischemia- data on the ECG 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 upwards from the isoline, trough-shaped displacement of this segment;
necrosis of the heart muscle- irreversible death of myocardial cells is reflected on the ECG graph as a pathological Q wave;
transmural necrosis- this is an irreversible lesion of the wall of the heart muscle throughout the entire thickness 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 the case of a hypertensive crisis, decompensated heart failure, electrolyte disturbances, or suspicion of acute myocardial infarction, a coronary scar T appears on the ECG graph.

When making a diagnosis, additional attention should be paid to the symptoms of concomitant diseases. These can be pains 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, hand tremors, 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 experience the following symptoms:

dyspnea,
chest pain,
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 tangible changes in the well-being of patients and were detected during preventive examinations.

Diseases accompanied by changes in the heart muscle:

Myocardial dystrophy- violation of biochemical metabolic processes occurring in the heart;
Allergic, toxic, infectious myocarditis- inflammation of the myocardium of various etiologies;
Myocardiosclerosis- replacement of heart muscle cells with connective tissue, as a consequence of inflammation or metabolic diseases;
Violations water-salt metabolism;
Hypertrophy sections of the heart muscle.

Further investigations are needed to differentiate them.

Additional diagnostic studies

Cardiogram data, despite their informativeness, cannot be the basis for making an accurate diagnosis. In order to fully assess the degree of changes in the myocardium, additional diagnostic measures are prescribed by the cardiologist:

- the level of hemoglobin and such indicators of the inflammatory process as the level of leukocytes in the blood and (erythrocyte sedimentation) are assessed;
Analysis for blood biochemistry- indicators of the content of protein, cholesterol, glucose are evaluated to analyze the work of the kidneys, liver;
General clinical analysis of urine- evaluates the performance of the kidneys;
ultrasound if you suspect a pathology of internal organs - according to indications;
ECG indicators;
Holding ECG with exercise;
Ultrasound of the heart(echocardiography) - the state of the heart is assessed to determine the cause of myocardial pathology: expansion (dilation), hypertrophy of the heart muscle, signs of a decrease in myocardial contractility, a violation of its motor activity.

After analyzing the history and data of laboratory and instrumental examinations, the cardiologist determines the method of treating changes.

Treatment for focal and diffuse disorders

Used in the treatment of myocardial pathologies different groups of drugs:

If conservative treatment does not lead to significant improvements in the condition of a patient with myocardial diseases, he is pacemaker implantation surgery.

In addition to therapeutic agents, the patient is advised to change his lifestyle and establish a balanced diet. For a patient with such pathological manifestations, physical activity, alcohol consumption and smoking are unacceptable. He is shown physiotherapy exercises and feasible work.

The main provisions of dietary nutrition:

The use of salt and excess fluid is limited to a minimum;
Spicy and fatty foods are not recommended;
The menu should include vegetables, fruits, lean fish and meat, dairy products.

Myocardial changes detected on ECG require additional laboratory and instrumental examination. If necessary, a cardiologist will prescribe treatment in a hospital or on an outpatient basis. Timely measures taken will help to avoid serious complications.