To cure atherosclerosis of any type is quite possible. To do this, just follow a healthy lifestyle and use all the necessary medicines.
A very dangerous type of disease is atherosclerosis of the aorta and coronary arteries. The disease is fraught with myocardial infarction, heart failure, coronary heart disease.
It is possible to stabilize the coronary circulation by adequate conservative therapy. If the plaque is susceptible to calcification or thrombosis, surgery is indicated.
Pathogenesis and causes of illness
What is atherosclerosis of the aorta and coronary arteries? To deal with this issue, recall the school course of anatomy. The aorta is a large blood vessel that originates in the left heart ventricle.
The aorta is divided into two vessels. The upper branch in medicine is called the thoracic aorta, and the lower - the abdominal aorta. The coronary arteries are the bloodstream that is responsible for the blood supply to the heart and the upper branch of the coronary artery.
With this sorted out. Now let's remember the concept of atherosclerosis. This term hides a disease in which fatty plaques consisting of low density lipoproteins and esters are deposited on the inner side of the arteries and vessels.
At the initial stages, atherosclerosis does not manifest itself at all. Initially, a small fatty spot forms on the inside of the vessel or artery, which causes an inflammatory process. Disruption of lipid metabolism leads to the top that the lipid stain gradually increases in size.
At the terminal stage of atherosclerosis, the lipid plaque is amenable to calcification, that is, calcium salts gradually accumulate in it. The plaque becomes more dense, increases in size, and narrows the lumen of the vessels even more. As a result, blood circulation in the area of the valve leaflet, myocardial bundles and ventricles is disturbed.
Why does aortic atherosclerosis of the brain and heart vessels develop? The exact causes of the disease are unknown. But doctors say that there are a number of predisposing factors to the development of the disease.
- Ischemic heart disease, hypertension, and other pathologies of the cardiovascular system.
- Diabetes. Atherosclerotic plaques can be the result of both insulin-dependent and insulin-independent forms of the disease.
- The use of large amounts of animal fats. Also excessive use of sweets has a negative effect on lipid metabolism.
- Hypothyroidism and other diseases of the thyroid gland.
- Stress, depression.
- Predisposition (genetic).
- Belonging to the male sex.
- Period of menopause.
- Harmful habits. Extremely negative impact on the work of the cardiovascular system, alcoholism, drug addiction and smoking.
- Sedentary lifestyle (hypodynamia).
- Elderly age.
It is worth noting that the disease is multifactorial, that is, it develops in the presence of more than 2-3 predisposing factors.
How is atherosclerosis of the aorta and coronary arteries manifested?
Atherosclerotic lesions of the coronary arteries and the aorta are asymptomatic in stage 1. The disease can only occasionally cause paroxysmal pain in the chest.
Over time, the disease leads to the onset of exertional angina. The patient has a sharp burning pain in the chest. Pain syndrome radiates to the cervical spine.
Also, when the aorta and coronary arteries are affected, the patient develops:
- Blood pressure jumps. Often, blood pressure indicators exceed the mark of 140/90 mm Hg.Against the background of atherosclerosis, hypertonic disease may well develop.
- Increased sweating.
- If the abdominal aorta is affected, the patient has constipation, diarrhea, abdominal pain after eating, nausea or vomiting.
- If the aorta of the brain is affected, memory is reduced, headaches, dizziness occur, memory and mental performance decrease.
- Sleep disturbance
- Tinnitus, reduced hearing acuity.
Symptoms become more pronounced when atherosclerotic plaques are susceptible to calcification.
Diagnosis of atherosclerosis of the coronary arteries and aorta
When the first symptoms of atherosclerosis appear, you should immediately contact a cardiologist. Initially, a physical examination and an oral survey are conducted to clarify complaints.
It is mandatory to pass a biochemical blood test. The analysis will show the level of triglycerides, low and high density lipoproteins, total cholesterol. What indicators are normal are shown in the table.
Also, the diagnosis of atherosclerosis is complemented by such studies:
- General analysis of blood and urine.
- Coronary angiography.
Based on the data obtained, a final diagnosis is made, and treatment tactics are selected.
In atherosclerosis of the aorta and coronary arteries, treatment may be performed surgically or conservatively. Surgical intervention is indicated for the development of calcification or thrombosis. Also, surgical manipulations are indicated when life threatening and a high probability of myocardial infarction.
The most used techniques are coronary artery bypass grafting and stenting. Also recently, endovascular and laser methods are widely used.
In most cases, atherosclerosis is treated conservatively. Therapy involves compliance with a number of recommendations. The patient should:
- Take medications that normalize lipid metabolism and prevent blood clots. You should take statins, fibrates, sequestra of bile acids, nicotinic acid, multivitamin complexes, anticoagulants. For supplementary purposes, bioadditives and herbal tinctures (hawthorn, motherwort, valerian) are used.
- For cerebral disorders, use cerebrotectors (Piracetam, Ceraxon, Semax, Actovegin, Picamilon).
- Refrain from eating fatty and sweet foods. Diet for atherosclerosis should be observed for life. Be sure to consume unsaturated fats, as they increase the level of high-density lipoprotein (good cholesterol). The best sources of fat are walnuts, pistachios, olive and flaxseed oil.
- Move more, play sports.
- With elevated blood pressure, take hypotonic drugs. The use of diuretics, ACE inhibitors, sartans, beta-blockers, calcium channel blockers is allowed.
- Lead a healthy lifestyle. Cardiologists insist that the patient should not drink alcohol or smoke, otherwise the effect of therapeutic interventions will not.
Still need to regularly undergo preventive diagnosis. It will allow you to track the dynamics of the disease, and if necessary, make adjustments.
Complications and Prevention
Delayed treatment of atherosclerosis of the coronary arteries and the aorta can cause many complications. The disease is fraught with such complications as cardiosclerosis, aortic stenosis, aortic aneurysm, thrombosis, myocardial infarction.
It is also impossible to exclude the possibility of the occurrence of such consequences as ischemic or hemorrhagic stroke, coronary heart disease, hypertension, cardiac or renal failure. With the defeat of the abdominal aorta may develop aneurysm and necrosis.
- Compliance with the rules of healthy eating.
- BMI level tracking.For obesity, appropriate measures should be taken - to engage in sports, follow a low-carb diet.
- Timely treatment of diseases of the CAS, endocrine pathologies, diabetes.
- Maintain an active and healthy lifestyle.
- Periodic examinations by doctors.
By the way, with the development of atherosclerosis of the aorta and coronary arteries, a patient may be assigned a disability.
Usually, benefits are given to patients who have suffered a stroke or myocardial infarction, and have lost their working capacity.
Why does the disease occur?
Under-oxidized lipids begin to deposit on the inside of the aorta, impeding circulation and reducing the size of the artery. Elderly people suffering from bad habits are more likely to suffer from aortic and coronary artery diseases.
Anticoagulants help prevent the formation of fatty plaques. The addition of folic acid, vitamin C, group B, corn, flax oil to food reduces the risk of aortic narrowing. In the summer, spring periods it is recommended to use iodine.
Types of product limitations:
- Meat animals, fatty fish.
- Salted, smoked, pickled products.
- Food salt.
- Components of active quality.
- Liquid with high acid and lipid content.
- GMO products.
An important condition for a healthy life is a regulated time for work and rest, exercise, walking. It is necessary to create conditions that exclude stressful situations, nervous tension. Travel to resorts, mountain walks, sea cruises.
A feature of the disease is the appearance of shortness of breath, headache, dizziness, nausea, pain in the chest. The chest begins to hurt, eventually moving under the left shoulder blade, the humerus, the jaw. Due to lack of air, the respiratory process is disturbed, the blood stops flowing to the brain, hypoxia and the death of nerve endings begin.
To establish the diagnosis that determines the factor of atherosclerosis, they undergo a comprehensive examination, identifying the focus of the disease. A blocked cerebral artery causes stroke.
Causes and symptoms
The development of the disease leads to a wrong lifestyle. The use of hypercholesterol products, hypodynamia, smoking and alcohol consumption, hereditary diseases of the cardiovascular system - these are the main factors in the appearance of the disease.
In atherosclerosis of the aorta, a gradual narrowing of the circulatory "line" occurs, and the pathological process can develop over several months, years.
The period when atherosclerosis of the aorta of the coronary arteries proceeds without any symptoms is called preclinical.
Violation and failure to comply with the diet lead to the formation of atherosclerosis of the aorta. Cholesterol blocks the blood vessel supplying blood to the brain.
The reasons as a result of which the disease develops:
- excessive drinking,
- a lot of fatty, salty foods,
- tobacco smoking
- sedentary lifestyle,
- damage to the nervous system
- thyroid dysfunction.
These factors lead to atherosclerosis of the aorta and coronary arteries. The sooner to neutralize them, the higher the chance to cure coronary vascular disease. Stenosis in the area of the heart valve is caused by atherosclerosis. Subtotal factor affects arteries.
The reasons that cannot be regulated include: age category, dependence on the sex of a person (men suffer more often than women), congenital defects, the disease is transmitted at the gene level. They can affect the body, cause illness. Women under 40 years old do not suffer from atherosclerosis, men fall ill at the age of 30 years and older.
The aorta undergoes atherosclerotic changes, but the course of the disease is not as dangerous as the narrowing of the lumen of the coronary arteries.A decrease in blood flow provokes a heart attack. Nausea and vomiting indicates the presence of angina. There is a risk of developing lipid diseases.
Symptoms are different, but there are identical, constant signs of determining the initial stage:
- Pain in the chest.
- Constantly dizzy.
- Pain in the stomach after eating.
- Weight reduction.
- Food is poorly digested.
Acute stage, severe form
- pressure drops, heart rate,
- rapid pulse,
- memory impairment
- decrease in intellectual abilities.
Women are protected from the disease while the body produces the hormone estrogen. The situation changes when there is a menopause.
Severe form is not treatable, but going to a doctor and following his recommendations will prolong life.
Other types of myocardial damage
In medicine, there is an alternative view of what is aortic atherosclerosis. In fact, this is coronary artery disease. Pathology is classified according to the forms and stages of the disease:
- proceeding without pain,
- angina of three kinds,
- heart rhythm disorders
- primary cardiac arrest
- myocardial infarction.
Each of the forms is characterized by its own course and symptoms.
The focus of atherosclerosis of the coronary arteries is determined by the localization of the pathology. Since the coronary vessels are affected, the main impact falls on the heart muscle that they supply - the myocardium.
Along with the classical form of organ damage, there are new variations:
- Hibernation. Alternative name sleeping myocardium. There is a long-lasting muscle dysfunction. In fact, the myocardium adapts to a decrease in blood flow.
- Stunning. It is characterized by a moderate degree of muscle damage, without cell death. The name stupor is associated with a long period of normalization of myocardial function after the restoration of blood flow. The process takes hours or days.
- Ischemic preconditioning. The phenomenon is observed after a number of cases of short-term ischemia. The myocardium adapts to these manifestations, which makes it possible to better tolerate longer periods of ischemia.
To avoid serious manifestations of atherosclerosis of the aorta of the coronary vessels will help rapid response to the first symptoms of the disease. Attacks of chest pain are a sufficient reason to consult a doctor as soon as possible.
Stages of development of the disease
There are three stages of the disease. The latter is incurable.
The first stage of the disease begins at the time of lipid deposition on the artery wall. Subsequently, cholesterol plaque appears. The artery becomes fragile, there is a seal of the vessel walls, a decrease in the internal diameter. The possibility of complete elimination of the ischemic stage.
The second stage of the disease can be partially eliminated. The atherosclerotic lipid process slows down blood flow, leading to the formation of blood clots.
Coronary thrombosis and lack of oxygen entering the brain develops. Mandatory condition in the treatment - the use of medicines.
The stage is called the state of thrombosis. Diagnosis shows an increase in cholesterol, lipids.
The third stage of development provokes cerebral palsy, disability. Cardiac function is impaired and cannot be eliminated. The fibrous stage is incurable.
Atherosclerosis of the aorta: ICD code 10 coronary vessels should be treated immediately.
After detection, the doctor makes a diagnosis, picks up medication, physical therapy.
Cardiosclerosis (myocardiosclerosis) is a process of focal or diffuse replacement of myocardial muscle fibers with connective tissue. Taking into account the etiology, it is customary to distinguish between myocarditis (due to myocarditis, rheumatism), atherosclerotic, post-infarction and primary (with congenital collagenosis, fibroelastosis) cardiosclerosis.
Atherosclerotic cardiosclerosis in cardiology is considered as a manifestation of coronary heart disease caused by the progression of coronary atherosclerosis. Atherosclerotic cardiosclerosis is detected predominantly in males of middle and old age.
Treatment of pathology of the coronary arteries and aorta in a complex, with the use of drug and non-drug agents. Non-drug exposure involves the correction of lifestyle, which led to the development of the disease.
The patient is prescribed a special diet consisting mainly of hypocholesterol products. The patient should be excluded from the diet of foods high in animal fats, eat plenty of greens, vegetables and fruits.
If we talk about drug therapy, then it is made and prescribed only by the attending physician. Self-treatment can only aggravate the development of the disease, provoke the development of serious complications. Patients suffering from coronary artery disease are prescribed the following groups of drugs:
- Statins. They block the production of cholesterol in the body, reduce its content in the blood, prevent the growth of atherosclerotic plaques. Drugs are selected based on individual indications and contraindications.
- Fibrates. Lowers the level of lipid compounds in the blood, accelerates the reproduction of enzymes involved in the breakdown of fats.
- Sequestrants of bile acids. Drugs of this group prevent the accumulation of cholesterol in the body, contribute to the expansion of the lumen of the coronary arteries.
- Vitamins PP. Contribute to the acceleration of the synthesis of cholesterol in the body, remove its surplus.
Before using all of the above drugs, it is necessary to exclude the presence of pregnancy, allergic reactions and individual intolerance to the components, gastritis and gout. With caution, prescribe such drug therapy to patients suffering from serious diseases of the endocrine system.
Even if you know what aortic atherosclerosis is and what this disease threatens with, do not try to cure it at home with folk remedies. Herbal medicine can be used as a supplement to medication effects and only after consultation with your doctor.
In conclusion, it must be said that the lack of treatment can be fatal. The patient may experience sudden death due to stroke, heart attack, aortic aneurysm. Observed and the development of extensive necrosis of soft tissue due to thrombotic processes. That is why it is important to promptly consult a cardiologist, correct lifestyle and begin treatment.
The choice of treatment for atherosclerosis of the aorta and coronary arteries, its effectiveness depends on the degree of vascular lesion and on the individual parameters of the body.
Atherosclerosis is a dangerous disease, at the first signs of the disease, you should seek the advice of a specialist. The treatment consists of several stages - normalization of blood lipid parameters, blood flow in the arteries, reduction of the degree of ischemia.
The choice and duration of therapy depends primarily on the stage at which the disease was diagnosed. If the disease is detected at the initial stage, drug therapy is enough to reduce cholesterol and correct lifestyle.
Refusal of bad habits, moderate exercise under the supervision of a cardiologist, diet - these are the main methods of prevention and treatment of the first manifestations of the disease of the intima of the vessel. Patients with diabetes and obesity should pay special attention to nutrition and weight control.
If a patient has advanced atherosclerosis of the coronary arteries of the heart, the doctor may prescribe a surgical intervention. There are several types of operations used in the treatment. The most common:
- Coronary angioplasty is a type of surgery to increase the lumen of the coronary arteries, which refers to the methods of endovascular surgery. A special “catheter” is inserted into the vessel - it expands the artery and restores blood flow. After the stent is implanted to prevent re-contraction.
- Coronary artery bypass surgery. The essence of the operation with the help of healthy vessels to create a "workaround" for the blood without the participation of a blocked part of the artery. Thanks to this manipulation, more blood flows to the heart.
The main rule that everyone should remember is a clear and timely observance of all the recommendations of the doctor. It does not matter if you are prescribed to run in the morning or preparing for an operation. Lost time can cost you health and even life!
There are drugs that can affect the metabolism of fat. They are called statins, and inhibit the increase in "bad" cholesterol, which causes atherosclerosis.
Statins also reduce total blood cholesterol. According to some scientific data, these drugs can even slightly reduce atherosclerotic plaques, but you should not really count on it.
The appointment and selection of a dose of drugs of this kind should be carried out only by a doctor. Like any other medications, they have a number of side effects, for example, affect the function of the liver.
For this reason, they are prescribed strictly according to indications, focusing on the analyzes and severity of the disease. Timely taking statins in suitable dosages is one of the most powerful means of preventing atherosclerosis.
It would seem that the size of the affected vessels in ischemic heart disease is quite small for surgery. But fortunately, modern medicine can even do this.
In severe angina or acute infarction, a special intervention is performed - coronary angiography. A microscopic sensor is inserted into the heart vessel and contrast is injected. Under high magnification, doctors can see where blood flow is difficult and correct the problem.
With a special balloon, the site of the narrowing expands and the stent is installed - a mesh-like structure that increases the lumen. This operation is performed under local anesthesia.
Moreover, the opening of the chest is not required, only a small puncture on the arm or thigh.
Stenting could be considered as salvation, if not for one thing. Vessels on which the intervention occurred, again affected by atherosclerosis, if you do not take statins and a number of other medicines. After surgery, the patient is simply obliged to drink medications for life, according to a certain scheme.
Summarizing, we can say that atherosclerosis is really the number one enemy. But having seen it from all sides, we can successfully repel the attacks. The main thing is to act on time and reasonably.
Consequences of atherosclerosis of the heart vessels: increased heart rate, increased left ventricle, the development of preinfarction state. Arterial hypertension is formed. Effect on the brain with a change in mental state, hemorrhage.
The development of stenosis, hypoxia, stroke, sclerosis with rare foci. Acute blood shortage, heart attack. Aneurysm and tissue rupture leads to bleeding and death. Necrosis of the lung, development of paralysis, impaired vision and hearing, or complete atrophy of the organs.
It is mandatory to use food supplements after the diagnosis and detection of coronary artery aortic atherosclerosis. It is useful to add: folic acid, lecithin, methionine, choline, lipic and ascorbic acid, linseed oil, a complex of vitamins. Add vegetable products and protein to the diet.
In the initial stage of atherosclerosis, physical exercise is applied, diet and popular recipes are prescribed, which allows avoiding complications and improving well-being.
Pathogenesis of the disease
Atherosclerotic changes in the vessels of the heart, as a rule, are accompanied by metabolic and ischemic disorders in the muscular layer of the heart. Local foci of necrosis become a consequence of ischemia, followed by substitution by connective tissue fibers. Together with muscle fibers, the receptors responsible for the sensitivity of the myocardium to oxygen molecules die.
This condition leads to the rapid progression of coronary artery disease and angina (angina pectoris). Atherosclerotic cardiosclerosis and so-called angina pectoris is characterized by prolonged progression and diffuse spread. In the process of development, a person forms the so-called compensatory hypertrophy and cardiomyopathy, which results in expansion or dilatation of the left ventricle.
The danger of this condition lies in the fact that increasing heart failure becomes the cause of the functional failure of the heart muscle. Damaged myocardium is not capable of full reduction, therefore, a person develops circulatory insufficiency and acute hypoxia of all organs and systems.
An asymptomatic course is characteristic of the early stage of atherosclerotic cardiosclerosis. If we are talking about patients of middle and old age, they are characterized by vivid clinical manifestations of atherosclerotic changes. If a person has previously suffered a myocardial infarction, then without additional diagnostic methods, one can be sure that multiple foci of scarring have formed on the surface of the heart muscle of this patient, as well as atherosclerotic cardiosclerosis of the coronary arteries (coronary sclerosis).
For the clinical picture of this disease, such manifestations are characteristic:
- In the initial stages of the disease, a person may complain of shortness of breath on exertion. As the disease progresses, a feeling of shortness of breath appears during intense and slow walking. Another characteristic feature is an increase in feelings of weakness and general malaise when performing any actions,
- Headache and feeling of dizziness. This characteristic symptom is often accompanied by tinnitus, and indicates oxygen starvation of brain tissue,
- Pain in the heart of the whining character. Ischemic heart pain in atherosclerotic cardiosclerosis can last from a few minutes to several hours. Also, coronarocardiosclerosis is characterized by typical signs of angina (pain in the heart, radiating to the left shoulder blade, arm and collarbone),
- Heart rhythm disorders, which manifest themselves in the form of tachycardia, extrasystole or atrial fibrillation. In people suffering from atherosclerotic cardiosclerosis, the heart rate may exceed 120 beats per minute,
- Edematous syndrome in the legs and feet, manifested in the evening time of day. This symptom indicates circulatory failure.
As the progression of heart failure and angina, the clinical symptoms of congestion in the lungs, hepatomegaly, ascites and pleurisy join the above symptoms. People with such a diagnosis are prone to atrial ventricular and intraventricular blockade. In the initial stages, these disorders are paroxysmal or paroxysmal. Atherosclerotic lesions of the coronary vessels of the heart are characterized by a combination with atherosclerosis of the cerebral arteries, aorta and peripheral arteries.
One of the potential reasons for the formation of atherosclerotic cardiosclerosis is an incorrect lifestyle, contributing to the accumulation of harmful lipids in the body and damage to the walls of blood vessels.
The general plan for the correction of lifestyle in this disease includes the following items:
- Waiver of alcohol and tobacco,
- Prevention of physical inactivity, which is to comply with the optimal motor mode. People suffering from cardio sclerosis, moderate exercise is beneficial. For these purposes, walking in the fresh air, visiting the swimming pool, morning exercises and breathing exercises,
- Avoiding excessive consumption of fatty and fried foods. This event will regulate the amount of cholesterol in the systemic circulation,
- Avoiding excessive emotional overload and stress. Since no one can fully protect themselves from the influence of stressful situations, in order to preserve the functional well-being of the circulatory system, it is recommended to reduce the influence of the emotional factor on the body.
People over 40 and regardless of gender are recommended to pay attention to the daily diet. When diagnosing atherosclerotic lesions of the coronary arteries, it is necessary to make radical changes in the usual diet.
Disposable foods and foods containing large amounts of fats and carbohydrates are categorically banned. In addition, if atherosclerosis is diagnosed, it is not recommended to use such products:
- Various sauces and hot spices,
- Fatty and fried foods, as well as fast food,
- Fatty fish and meat
- Pastry and pastry,
- Strong tea and coffee
- Carbonated sweet drinks,
Eliminating these products from the diet, as a useful alternative, it is recommended to use fresh vegetables and fruits, lettuce, fresh greens, dairy products, wholemeal bread. Tea and coffee should be replaced with broth hips, infusion of lemon balm, mint or St. John's wort. In addition, it is recommended to pay attention to dishes from cereals, low-fat varieties of fish and poultry meat. Before eating fruits and vegetables with high sugar content, it is recommended to make sure that the blood glucose levels do not go beyond the physiological norm.
Therapy of atherosclerotic changes in this disease is recommended to begin only on the condition of reliable confirmation of the presence of pathological changes in the coronary vessels.
Therapy with drugs of atherosclerotic cardiosclerosis, includes the following groups of medicines:
- Statins. These medicinal drugs affect the lipid metabolism in the body, thereby reducing the concentration of cholesterol in the systemic circulation, and preventing atherosclerosis. Such drugs include Simvastatin, Rosuvastatin, and atorvastatin. The purpose of these funds is also for preventive purposes, when a person has an increase in the synthetic function of the liver in various diseases,
- Antiplatelet agents. This group of drugs affects the mechanism of the so-called platelet aggregation, preventing the accelerated blood coagulation. A prominent representatives of these drugs is acetylsalicylic acid or aspirin, as well as Cardiomagnyl. Medicinal disaggregants prevent the blockage of blood vessels and the formation of atheromatous plaques,
- Preparations from the group of nitrates. This group of drugs is effective in relieving attacks of coronary heart disease. Nitroglycerin in tablet form and spray form is particularly effective. The only caveat is that the action of nitroglycerin occurs over a short period of time. If a person is disturbed by frequent attacks of coronary heart disease, he is recommended to take prolonged nitrates, which lasts up to 12 hours. These drugs include mononitrate or isosorbide dinitrate,
- Diuretics (diuretics).To reduce the intensity of edema syndrome and combat hypertension in heart failure, patients are prescribed such diuretics as Veroshpiron, Furosemide or Spironolactone,
- Antihypertensives. If a person has a persistent increase in blood pressure (hypertension), then to reduce the load on the myocardium, he is prescribed Captopril, Enalapril or Lisinopril.
In case of rhythm disturbances and pain syndrome, people suffering from atherosclerotic cardiosclerosis are prescribed medicinal drugs with the following effect:
- Feeding the heart muscle and providing it with energy
- Expanding the lumen of the coronary vessels
- Reducing excitability in pathological foci of the myocardium.
In addition, as additional means of drug therapy, patients with atherosclerotic cardiosclerosis are prescribed the following drugs:
- Potassium and magnesium preparations (Asparkam and Panangin Magnesium B6),
- Multivitamin complexes,
If it is not possible to cure atherosclerosis with conservative methods, medical specialists resort to the use of surgical techniques to restore myocardial trophism. For the treatment of atherosclerotic cardiosclerosis, a small list of surgical techniques is used. Balloon angioplasty, shunting and stent placement are distinguished from the methods used.
Coronary artery bypass surgery is a dangerous and complex surgical technique that is performed on an open heart.
The technique of balloon angioplasty is the so-called initial stage of stenting, but in certain clinical cases it is used as an independent method. Balloon angioplasty is performed under the control of x-rays. The essence of this operation is the installation of a special catheter with a balloon in the coronary vessel, with its inflation, the patency of the arteries is restored.
When performing stenting, medical specialists introduce a special design (stent) into the lumen of the coronary vessel. The function of this metal structure is the expansion of the lumen of the coronary vessel. In order to gain access to the coronary vessels of the heart, patients undergo catheterization of the femoral artery.
Despite the fact that physiotherapeutic methods of treatment is not a panacea for cardiovascular pathologies, their use helps alleviate the general condition of patients and slow down the progression of the disease. In patients with atherosclerotic cardiosclerosis, a method of local electrophoresis using special medicines is applied. Electrophoresis with statins has become widespread, which allows increasing the accumulation of these drugs in the heart area.
In addition, people with a similar diagnosis are recommended sanatorium-resort treatment in mountainous conditions. The purpose of this treatment is to enrich the body with oxygen, improve the rheological properties of the blood and strengthen the whole body. In addition to climatotherapy, on the territory of sanatorium-resort institutions, patients receive individual recommendations regarding nutrition, daily routine and level of physical activity.
Micro and macroangiopathy in diabetes mellitus: what is it?
For many years, unsuccessfully struggling with cholesterol?
The head of the Institute: “You will be amazed how easy it is to lower cholesterol simply by taking it every day.
Diabetic macroangiopathy is a disorder of a generalized and atherosclerotic nature that develops in the middle or large arteries during long-term diabetes mellitus type 1 and 2.
Such a phenomenon is nothing but pathogenesis, it causes the appearance of coronary heart disease, and a person often has arterial hypertension, occlusive lesions of peripheral arteries, and cerebral circulation is impaired.
The disease is diagnosed by electrocardiogram, echocardiogram, Doppler ultrasound, kidneys, brain vessels, limb arteries are examined.
Treatment consists in controlling blood pressure, improving blood composition, correcting hyperglycemia.
Description of the disease
What is coronary atherosclerosis? This is a chronic pathology that leads to the gradual consolidation and narrowing of the coronary arteries due to the development of plaques on the vascular endothelium. The disease develops over several decades.
Usually, the first signs of atherosclerotic vascular lesions appear at a young age, but the disease begins to progress in middle-aged people. The first symptoms of atherosclerosis of the coronary arteries usually appear after 45-55 years.
The development of atherosclerotic plaques occurs against the background of the accumulation of low-density lipoproteins, which contain cholesterol.
Pathological neoplasms gradually grow, begin to bulge into the lumen of the coronary artery. This leads to impaired blood flow until it stops completely. The narrowing of the lumen of the arteries causes oxygen starvation of the heart muscle, impairment of its function, development of ischemic damage.
Atherosclerosis of the coronary arteries has the following stages:
- At the initial stages of the pathology, slow blood flow and the appearance of microcracks in the vascular endothelium are noted. Such changes lead to a gradual deposition of lipids on the intima of the arteries, as a fat stain develops. The weakening of the defense mechanisms causes an increase in the proliferation of the vascular wall, the growth of tumors, their fusion into lipid strips.
- In the second stage, the growth of fat formations is noted. As a result, atherosclerotic plaques appear on the intima of the coronary arteries. At this stage, the development of blood clots is possible, which are able to come off and close the lumen of the artery.
- At the last stage, the plaque is compacted due to the deposition of calcium salts. This provokes a narrowing of the lumen of the artery, its deformation.
Pathogenesis of atherosclerotic cardiosclerosis
Stenosing atherosclerosis of the coronary arteries is accompanied by ischemia and metabolic disorders in the myocardium, and, as a result, by gradual and slowly developing dystrophy, atrophy and death of muscle fibers, in the place of which necrosis and microscopic ribs are formed. The death of receptors helps to reduce the sensitivity of myocardial tissues to oxygen, which leads to further progression of coronary artery disease.
Atherosclerotic cardiosclerosis is diffuse and prolonged. With the progression of atherosclerotic cardiosclerosis, compensatory hypertrophy develops, and then dilatation of the left ventricle, signs of heart failure increase.
Taking into account the pathogenetic mechanisms, ischemic, post-infarction and mixed variants of atherosclerotic cardiosclerosis are distinguished. Ischemic cardiosclerosis develops due to prolonged circulatory failure, progresses slowly, diffusely affecting the heart muscle. Postinfarction (postnecrotic) cardiosclerosis is formed at the site of the former site of necrosis. Mixed (transient) atherosclerotic cardiosclerosis combines both of the above mechanisms and is characterized by a slow diffuse development of fibrous tissue, against the background of which necrotic foci are periodically formed after repeated myocardial infarctions.
The main causes of atherosclerosis
Atherosclerosis of the coronary vessels of the heart is able to develop under the influence of exogenous and endogenous causes. Doctors emit about 200 different provocative factors that increase the risk of developing pathology.
However, the most common reasons are:
- Increase the level of "bad" cholesterol in the bloodstream. This substance is the main component of atherosclerotic plaques, therefore, at high concentrations it can settle on the walls of blood vessels,
- Smoking. A harmful habit provokes the synthesis of nitric oxide, which disrupts blood flow, accelerates the development of atherosclerosis of the coronary arteries,
- Arterial hypertension,
- Hypodynamia. A sedentary lifestyle leads to slower metabolism, impaired metabolism of fats and proteins,
- Abuse of foods that are rich in saturated fats,
- Hereditary predisposition
- Gender. Women of reproductive age rarely develop atherosclerosis of the coronary vessels. This is due to the synthesis of estrogens that protect the arteries. However, after the onset of menopause in women, the risk of developing the disease increases significantly.
- Age. People over 35 are susceptible to the development of atherosclerosis,
- Obesity. Overweight patients are 3 times more likely to experience atherosclerotic vascular disease,
- Alcoholism. Alcohol abuse leads to impaired blood flow, provokes the development of atherosclerosis,
- Diabetes. The disease leads to impaired metabolic processes in the body, therefore, significantly increases the risk of developing coronary atherosclerosis.
Diagnosis of atherosclerotic cardiosclerosis
The diagnosis of atherosclerotic cardiosclerosis is based on anamnesis (IHD, atherosclerosis, arrhythmias, myocardial infarction, etc.) and subjective symptoms. Biochemical blood test revealed hypercholesterolemia, an increase in beta-lipoproteins. On an ECG, signs of coronary insufficiency, post-infarction scars, rhythm disturbances and intracardiac conduction, moderate left ventricular hypertrophy are determined. The data of echocardiography in atherosclerotic cardiosclerosis are characterized by impaired myocardial contractility (hypokinesia, dyskinesia, akinesia of the corresponding segment). Veloergometry allows you to specify the degree of myocardial dysfunction and functional reserves of the heart.
The performance of pharmacological tests, daily ECG monitoring, polycardiography, rhythmocardiography, ventriculography, coronary angiography, MRI of the heart, and other studies can contribute to the solution of diagnostic problems in atherosclerotic cardiosclerosis. To clarify the presence of effusion, ultrasound of the pleural cavity, chest x-ray, and abdominal ultrasound are performed.
How to check the vessels of the heart and abdominal cavity for atherosclerosis? In order to find out the extent and area of damage, the following diagnostic methods are prescribed:
- Ultrasound of the heart and abdomen,
- invasive techniques
- chest x-ray,
- blood biochemistry
- vascular scan.
The diagnosis of atherosclerotic cardiosclerosis is made if the scar connective tissue in the myocardium begins to grow, and the muscular atrophy. This is due to atherosclerotic lesions of the coronary arteries.
Essence of pathology
What is atherosclerotic cardiosclerosis? This is a pathological process in which myocardial muscle fibers are replaced by connective tissue fibers. Cardiosclerosis can vary in the etiology of the pathological process, it can be myocardial, atherosclerotic, primary and post-infarction.
In cardiology, this pathology is considered as atherosclerosis of the coronary vessels and as a manifestation of coronary artery disease, atherosclerotic cardiosclerosis in most cases is observed in middle-aged and elderly men.
In the early stages of atherosclerosis of the coronary arteries of the heart occurs in a latent form. Usually, the first signs of the disease are noted by middle-aged people.
Therefore, doctors recommend to pass annual examinations to all people who have crossed the 35-year-old milestone. However, smoking, hypertension, hypercholesterolemia can lead to an earlier development of symptoms of atherosclerosis of the coronary arteries.
The first symptoms of the disease include the following symptoms:
- Chest tenderness radiating to the back or left shoulder,
- The appearance of shortness of breath at the beginning of pain. Sometimes patients are not able to be in a horizontal position due to respiratory failure,
- Nausea and vomiting.
These symptoms of atherosclerosis of the coronary arteries are not specific, and therefore they are often confused with other pathologies of the cardiovascular system. This greatly complicates the diagnosis and treatment of the disease.
With further progression of atherosclerosis, the symptoms of the coronary vessels cause the following:
- Angina pectoris The condition is characterized by a rare pain behind the sternum, which develops after intense physical exertion or emotional overstrain,
- Cardiosclerosis. Acute myocardial ischemia leads to the formation of fibrosis sites throughout the heart muscle. The condition causes a violation of the contractile function of the heart,
- Arrhythmia. Pathology develops due to myocardial damage, impaired conduction impulses,
- Heart attack. If a cholesterol plaque ruptures, a thrombus appears on its surface. This clot interferes with normal blood flow, provokes the development of cardiomyocyte necrosis. Heart attacks usually develop from 4 to 10 am, when adrenaline rises in the bloodstream. About 50% note the onset of symptoms, precursors before an attack.
There are three stages of the disease:
- ischemic stage - angina, limping, abdominal cramps,
- trombonekroticheskaya stage - stroke, myocardial infarction, gangrene of the foot, caused by the separation of a blood clot,
- fibrous - the last stage of the disease, when there are areas of atherosclerotic cardiosclerosis, and fibrous tissue appears instead of myocardial tissue.
There are such forms of atherosclerosis of the aorta and valves:
- preclinical period without characteristic manifestations. Diagnosis of the disease at this stage is carried out with the help of hypercholesterolemia and the beta-lipoprotein fraction.
- latent clinical period. Violations can be identified by instrumental means, but the symptoms have not yet manifested.
- stage of specific symptoms, ischemia and the first heart attacks. Only a specialist can distinguish atherosclerosis from hypertension.
- arterial chronic occlusion. Fibrous changes and ischemic disorders in the affected vessels begin.
Signs of atherosclerotic vascular lesions depend on many factors - the severity of the disease, the area of spread, and general health.
Symptoms of atherosclerosis in the thoracic aorta include:
- heaviness in the chest
- dizziness and headache
- lipoma on the face and pallor,
- fatigue and memory loss
- loss of consciousness.
Aortic atherosclerosis (code according to MKB 10 I70.0) and coronary arteries of the heart (code according to MKB 10 I25.1) are often diagnosed. The blood flow in this area worsens, which leads to the appearance of chest pain lasting several hours or even days.
The aorta is compressed, which increases the load on the heart, which causes choking and heart failure.Atherosclerosis of the heart vessels is evidenced by an increase in the upper pressure with a normal lower pressure.
Atherosclerosis of the aortic arch leads to a hoarse voice and a violation of swallowing. The spread of atherosclerosis in the aorta and coronary arteries causes angina in the chest, with recoil in the left arm, shortness of breath, ischemic heart disease, and increased heart rate.
Impaired circulation of blood vessels leading to the intestine, cause the following symptoms:
- bloating and constipation
- losing weighing
- severe pain in the navel,
- bowel disorders.
In addition, there will be an increase in pressure, numbness of the extremities, renal failure, impotence, loss of sensation of the legs, limping.
Atherosclerosis of the aortic arch provokes the accumulation of cholesterol inside or on the walls of the vessels. With the appearance of plaques inside the arteries, stenosing atherosclerosis of the coronary arteries is diagnosed.
What is aortic atherosclerosis? Impaired blood supply to the muscles of the heart, as well as damage to or blockage of the coronary arteries leads to atherosclerosis of the coronary arteries of the heart.
Atherosclerosis of the coronary vessels of the heart is characterized from mild angina to heart failure. Atherosclerosis affects not only blood vessels, but also valves and ventricles of the heart.
Two forms of pathology are determined: preclinical and clinical. In the first case, patients rarely face painful sensations in the heart area, deterioration of performance, headaches, and fatigue.
|Ischemic||Accompanied by a narrowing of blood vessels and destabilization of the work of the associated organs. As a result, dystrophic changes are noted in these systems.|
|Trombo necrotic||It implies the development of small or large-focal formations, as well as vascular thrombosis. In some cases, thrombosis may not be.|
|Sclerotic (fibrous)||Accompanied by atrophic processes in organs and the formation of scar tissue in them.|
The symptomatology of pathology is variable and is directly dependent on the stage of its development and location. Patients may experience headaches, bouts of dizziness, pain in the heart area.
Visual inspection reveals the following deviations:
- skin with multiple wrinkles, atrophic, yellowing and characterized by dryness,
- in the area of the cornea next to the pupil - the appearance of lipids, which is expressed by the senile arch, dull eyes,
- early gray hair, baldness.
Causes of macroangiopathy in diabetes mellitus
When a person is ill with diabetes mellitus for a long time, small capillaries, artery walls and veins when exposed to an increased amount of glucose begin to break down.
So there is a strong thinning, deformation or, on the contrary, it is already a thickening of the blood vessels.
For this reason, the blood flow and metabolism between the tissues of the internal organs are disturbed, which leads to hypoxia or oxygen starvation of the surrounding tissues, and damage to many diabetic organs.
- Most often, large vessels of the lower extremities and the heart are affected, this occurs in 70 percent of cases. These parts of the body receive the greatest load, so the vessels are most affected by the change. In diabetic microangiopathy, the ocular fundus is usually affected, which is diagnosed in the form of retinopathy, these are also frequent cases.
- Typically, diabetic macroangiopathy affects cerebral, coronary, renal, peripheral arteries. This is accompanied by angina pectoris, myocardial infarction, ischemic stroke, diabetic gangrene, and renovascular hypertension. With diffuse lesion of blood vessels, the risk of developing coronary heart disease, stroke increases threefold.
- Many diabetic disorders lead to atherosclerosis.This disease is diagnosed in people with diabetes mellitus type 1 and type 2 15 years earlier than in healthy patients. Also, the disease in diabetics is able to progress much faster.
- The disease thickens the basal membranes of the middle and large arteries, which later form atherosclerotic plaques. Due to the calcification, expression and plaque necrosis, thrombi are locally formed, the lumen of the blood vessels is closed, as a result, the diabetic has impaired blood circulation in the affected area.
As a rule, diabetic macroangiopathy affects the coronary, cerebral, visceral, peripheral arteries, so doctors do everything to prevent such changes by applying preventive measures.
Particularly high risk of pathogenesis of hyperglycemia, dyslipidemia, insulin resistance, obesity, arterial hypertension, increased blood clotting, endothelial dysfunction, oxidative stress, systemic inflammation.
Also, atherosclerosis often develops in people who smoke, in the presence of physical inactivity, professional intoxication. At risk are men over 45 years and women from 55.
Often the cause of the disease becomes hereditary predisposition.
Diabetic angiopathy and its types
Diabetic angiopathy is a collective concept that represents pathogenesis and implies a disorder of the blood vessels - small, large, and medium.
Such a phenomenon is considered the result of a late complication of diabetes mellitus, which develops approximately 15 years after the onset of the disease.
Diabetic macroangiopathy is accompanied by syndromes such as atherosclerosis of the aorta and coronary arteries, peripheral or cerebral arteries.
- During microangiopathy in diabetes mellitus, retinopathy, nephropathy, and diabetic lower limb microangiopathy are observed.
- Sometimes with the defeat of blood vessels, universal angiopathy is diagnosed; its concept includes diabetic micro-macroangiopathy.
Endoneural diabetic microangiopathy causes a violation of peripheral nerves, which in turn causes diabetic neuropathy.
Diabetic macroangiopathy and its symptoms
In atherosclerosis of the aorta and coronary arteries, which causes diabetic macroangiopathy of the lower extremities and other parts of the body, ischemic heart disease, myocardial infarction, angina pectoris, and cardiosclerosis can be diagnosed in a diabetic.
Coronary heart disease in this case proceeds in an atypical form, without pain and accompanied by arrhythmias. This condition is very risky, as it can cause sudden coronary death.
Pathogenesis in diabetics often includes such post-infarction complications as aneurysms, arrhythmias, thromboembolism, cardiogenic shock, heart failure. If doctors have found that diabetic macroangiopathy is the cause of myocardial infarction, everything must be done so that the infarction does not recur, since the risk is very high.
- According to statistics, diabetics 1 and 2 types of the disease are twice as likely to die in myocardial infarction than in people who do not have diabetes. About 10 percent of patients suffer from atherosclerosis of cerebral arteries due to diabetic macroangiopathy.
- Diabetic atherosclerosis makes itself felt through the development of ischemic stroke or chronic cerebral ischemia. If a patient has arterial hypertension, the risk of developing cerebrovascular complications increases threefold.
- In 10 percent of patients, obliterating atherosclerotic lesion of peripheral vessels is diagnosed as obliterating atherosclerosis. Diabetic macroangiopathy is accompanied by numbness, cold feet, intermittent claudication, hypostatic edema of the extremities.
- The patient's frequent pain in the muscle tissues of the buttocks, thighs, legs, which are aggravated by any physical activity. If the blood flow in the distal extremity is sharply disturbed, this leads to critical ischemia, which in the end often becomes the cause of necrosis of the tissues of the feet and lower leg in the form of gangrene.
- Skin and subcutaneous tissue can necrotic independently, without additional mechanical damage. But, as a rule, necrosis occurs with a previous violation of the skin - the appearance of cracks, fungal lesions, wounds.
When impaired blood flow is less pronounced, diabetic macroangiopathy causes the appearance of chronic trophic ulcers in diabetes mellitus on the legs.
How is diabetic macroangiopathy diagnosed?
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Diagnostics is performed to find out how severely coronary, cerebral and peripheral vessels are affected.
To determine the required method of examination, the patient must consult a doctor.
The examination is carried out by an endocrinologist, a diabetologist, a cardiologist, a vascular surgeon, a cardiac surgeon, a neurologist.
In diabetes type 1 and 2, the following types of diagnostics are prescribed to identify the pathogenesis:
- A biochemical blood test is performed to identify the level of glucose, triglycerides, cholesterol, platelets, lipoproteins. A blood clotting test is also performed.
- It is necessary to examine the cardiovascular system using an electrocardiogram, daily blood pressure monitoring, exercise tests, echocardiograms, aortic ultrasound dopplerography, myocardial perfusion scintigraphy, coronary angiography, computed tomography angiography.
- The patient's neurological condition is refined using cerebral vascular Doppler sonography, duplex scanning and angiography of cerebral vessels are also performed.
- To assess the state of the peripheral blood vessels, the limbs are examined using duplex scanning, Doppler ultrasound, peripheral arteriography, rheovasography, capillaroscopy, arterial oscillography.
Treatment of diabetic microangiopathy
Therapy of the disease in diabetics is primarily to provide measures to slow down the progress of a dangerous vascular complication that could threaten the patient with disability or even death.
Trophic ulcers of the upper and lower extremities are treated under the supervision of a surgeon. In the case of an acute vascular catastrophe, appropriate intensive therapy is carried out. The doctor may also refer to surgical treatment, which consists in endarterectomy, elimination of cerebrovascular insufficiency, amputation of the affected limb, if it is already gangrene in diabetes mellitus.
The basic principles of therapy are associated with the correction of dangerous syndromes, which include hyperglycemia, dyslipidemia, hypercoagulation, arterial hypertension.
- To compensate for carbohydrate metabolism in diabetics, the doctor prescribes insulin therapy and regular monitoring of blood sugar levels. To do this, the patient takes lipid-lowering drugs - statins, antioxidants, fibrates. Additionally, you must follow a special therapeutic diet and limit the use of foods with a high content of animal fat.
- When there is a risk of thromboembolic complications, antiplatelet drugs are prescribed - acetylsalicylic acid, dipyridamole, pentoxifylline, heparin.
- Hypotensive therapy in case of detection of diabetic macroangiopathy is to achieve and maintain blood pressure indicators at the level of 130/85 mm Hg. Art. To this end, the patient takes ACE inhibitors, diuretics.If a person has suffered a myocardial infarction, beta-blockers are assigned to him.
According to statistical data, in patients with diabetes mellitus type 1 and type 2, due to cardiovascular complications in patients, death rates range from 35 to 75 percent. In half of these patients, death occurs with myocardial infarction, in 15 percent of cases acute brain ischemia is the cause.
To avoid the development of diabetic macroangiopathy, it is necessary to take all preventive measures. The patient should regularly monitor the level of sugar in the blood, measure blood pressure, follow a therapeutic diet, monitor their own weight, follow all medical recommendations and to abandon bad habits as much as possible.
The video in this article discusses the treatment of diabetic macroangiopathy of the extremities.
Symptoms of the disease
The main problem associated with atherosclerosis of the coronary arteries is due to the inability to diagnose pathology in the early stages of development. It is established that atherosclerotic plaques form in the body by the age of 10 years. Initially, these are simply deposits of lipids - excess cholesterol and triglycerides. They appear in the form of stripes or spots on the endothelium of the arteries. Since blood flow disorders are not observed, the initial form of the pathology passes without symptoms.
The next stage of atherosclerosis is associated with the formation of connective tissue on sediments and their penetration into the walls of blood vessels. They kind of "take root." This is how an atherosclerotic plaque forms. In case of a lesion of the coronary arteries, this leads to the following symptoms:
- pain in the region of the heart, chest,
- shortness of breath during physical exertion,
- general weakness, aggravated by fatigue.
Most symptoms are characteristic of other forms of atherosclerosis. Select the lesion of the coronary arteries can be on the nature and localization of pain. Their relationship with physical activity is observed, due to the fact that the lack of oxygen in the myocardium is increasing. The patient may feel both squeezing pain and burning. Localization of sensations spreads along the left side of the chest, can go to the scapula.
Causes and pathogenesis
The causes of the disease may be as follows:
- excess weight,
- high cholesterol
- bad habits,
- sedentary lifestyle,
- diabetes and other endocrine disorders
- coronary heart disease.
Atherosclerotic factors in the cardiovascular system lead to the fact that necrosis occurs on the heart tissue, the receptors as a result of this pathology perish, which leads to a decrease in the heart's sensitivity to oxygen.
The disease is characterized by a long and actively developing course, as a result of which the left ventricle significantly increases in volume, which is accompanied by heart failure and all the signs accompanying it (heart rhythm disturbance, angina, etc.).
Symptoms of atherosclerotic cardiosclerosis have different intensity, it depends on the localization process and its prevalence. At the initial stages of the disease, the patient is worried about shortness of breath, and it occurs with such physical activities that previously did not cause any symptoms. With the development of the disease, shortness of breath begins to appear at rest. In addition, atherosclerotic cardiosclerosis is manifested as follows:
- arrhythmia develops,
- there is pain in the heart, and its intensity can be very variable - from a slight discomfort to severe attacks, often pain is given to the left side of the body,
- blood pressure takes an abrupt nature
- there may be dizziness and ear congestion,
- swelling appear.
If the post-infarction cardiosclerosis has all these symptoms in a bright and permanent form, then atherosclerotic is characterized by a wave-like course, since pathological processes in the myocardium occur gradually.
Diagnosis of the disease
Diagnosis is based on hardware research, as the symptoms described above can be observed in other diseases that are not related to cardiology, such as asthma. The most up-to-date hardware diagnostic option is ECG. It is very important to save all ECG results so that the doctor can follow the dynamics and chronology of the disease. Pathology on the ECG can only decipher specialist.
If there are signs of a heart rhythm disturbance, single extrasystoles will be visible on the cardiogram, in case of conduction disturbances, the doctor will see blockades, and teeth may also appear in the cardiogram, which the patient did not have before.
Ultrasound of the heart can also give information about poor blood circulation. Other methods of investigation, such as echocardiography and veloergometry, are used to diagnose pathology. These studies provide highly accurate information about the state of the heart at rest and during exercise.
What is the danger of the disease and what can be complications
Atherosclerotic cardiosclerosis is a hidden disease, and since it is associated with the heart, the danger speaks for itself. Cardiosclerosis is dangerous due to its irreversible changes. As a result of poor circulation in the myocardium, oxygen starvation occurs, and the heart is not able to work in the desired mode. As a result, the walls of the heart thicken, and it increases in size. Due to excessive muscle tension, the vessel may be damaged (or completely ruptured), myocardial infarction occurs.
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Complications of atherosclerotic cardiosclerosis are various heart diseases that can be fatal.
Types and stages of cardiosclerosis
There are several stages of development of the pathology, each of them has its own symptoms, and treatment at different stages also has differences:
- Stage 1 - tachycardia and shortness of breath, occur only during exercise,
- Stage 2 with left ventricular failure - symptoms occur with moderate exertion,
- Stage 2 with right ventricular insufficiency - edema occurs in the legs, palpitations, moderate acrocyanosis of the extremities,
- Stage 2 B - stagnation is observed in both circles of blood circulation, the liver increases, swelling does not subside,
- Stage 3 - the symptoms are permanent, the work of all systems and organs is disturbed.
Cardiosclerosis can be of the following types:
- atherosclerotic - develops as a result of deposition of atherosclerotic plaques on coronary vessels,
- diffuse cardiosclerosis - the heart muscle is completely covered by the pathological process,
- post myocardial inflammation in the myocardium.
Treatment of the disease
The first thing that is recommended to the patient is diet food. It is necessary to stop eating fatty, fried, flour, salty and smoked dishes. It is advisable to limit to cereals, dietary meats, such as chicken, turkey, veal, to consume more fruits and vegetables.
It also shows a change in lifestyle - feasible exercise (swimming, unhurried jogging, walking), gradually the load should be increased. All these activities are ancillary therapy for medical treatment, without which improvement for patients with atherosclerosis is impossible.
What medications should be used to treat atherosclerotic cardiosclerosis, the doctor should recommend, you cannot take medicines yourself, in order to avoid serious consequences.
Appointed drugs that reduce blood viscosity - Cardiomagnyl or Aspirin. Their reception is necessary so that the formation of plaques will slow down and no blockage of the vessel will occur. Long and regular use of these drugs is a good prevention of myocardial infarction.
Prepared drugs that reduce blood lipids: Simvastatin, Atorvastatin, Rosuvastatin. Nitroglycerin is indicated for bouts of coronary artery disease, but its effect is short, if seizures occur frequently, you should use drugs that have a longer effect.
When strong edema prescribed diuretics Spironolactone, Veroshpiron, if these funds are ineffective, then prescribe furosemide. In addition, medications that reduce blood pressure and relieve symptoms of heart failure are prescribed: Enalapril, Captopril, Lisinopril.
If necessary, other medical agents are added to the treatment regimen. With the ineffectiveness of drug treatment, surgical intervention is proposed, which is aimed at improving the blood supply to the myocardium.
Forecast and preventive measures
The prognosis can be given only after a complete diagnosis of the patient, assessment of his general condition and the presence of concomitant diseases. According to statistics, if atherosclerotic cardiosclerosis did not give serious and life-threatening complications and if the treatment is started on time and successfully completed, then we can talk about 100% survival.
It must be said that almost all the complications that affect the survival rate are due to the fact that the patient is late in contacting the doctor for help, as well as with the failure to follow all the recommendations that the specialist has appointed.
The treatment of diseases of the heart and blood vessels, including atherosclerosis, is long and rather complicated, so if a person has a predisposition to these pathologies, it is necessary to start prevention in a timely manner. Knowing the causes of the disease, it is easy to understand what is the prevention of atherosclerotic cardiosclerosis:
- Proper nutrition. Food should only be carried to the body, it should be cooked with a minimum amount of oil, that is, it is necessary to use gentle cooking methods. Fatty and smoked products should be drastically reduced; salt intake should be reduced.
- Normalization of weight. Premature aging and many problems in the body are associated with overweight. You do not need to adhere to strict and debilitating diets, it is enough to eat properly and balanced, and the weight is normalized without harm and stress to the body.
- Be sure to give up bad habits. This is a key point in the treatment of diseases of the heart and blood vessels. Smoking and alcohol abuse adversely affect the state of all systems and organs of a person, destructive habits destroy blood vessels and impair metabolic processes.
- An active lifestyle is very important for maintaining tonus and strengthening the body as a whole. However, overly zealous in sports is also not worth it, physical exertion must be feasible and bring joy to a person. If there is no desire to run and swim, then you can choose walking or some other active activity.
Prevention of heart ailments and vascular pathologies is a healthy lifestyle. Unfortunately, recently less and less people care about their health and listen to the advice of doctors, they need to remember that atherosclerotic cardiosclerosis is a disease that develops for many years, it can not be quickly cured, but it can be prevented.
Cardiosclerosis after heart attack: classification, causes and treatment
One of the most terrible, often resulting in the death of the patient, manifestations of coronary heart disease (CHD) can be considered an acute emergency condition of myocardial infarction and post-infarction cardiosclerosis.
Independently recognize these diseases is almost impossible, we can only assume the development of seizures or sclerotic pathology.
Quite often, the main manifestations of such pathologists as postinfarction atherosclerosis can be changes in heart rhythm, as well as the preservation of pain.
To understand how to deal with various manifestations of coronary artery disease, to learn to behave correctly (if post-infarction atherosclerosis has appeared in your life) it is important to understand what the described condition is.
- What is this condition?
- Classification of pathology
- What is caused by?
- Symptoms and manifestations of pathology
- Possible complications
- Treatment problems
- Forecasts and preventive measures
What is this condition?
Under the concept of post-infarction cardiosclerosis it is customary to imply such a form of ischemic pathology of the heart (or IHD), which may manifest itself by replacing individual sections of the myocardium (its muscle fibers) with scar connective tissues.
It should be understood that after the acute form of IHD and the emergency condition of myocardial infarction, scarring of muscle tissue occurs necessarily, and an atherosclerotic scar occurs always at the sites of primary necrosis.
In other words, post-infarction cardiosclerosis is always the logical outcome of such manifestations of coronary artery disease, as myocardial infarction. Sometimes it can take about three or even four weeks to fully heal the areas of myocardium affected by necrosis.
That is why all patients without a condition of a heart attack will automatically be diagnosed with post-infarction cardiosclerosis of one degree or another, while physicians can often describe the quality and size of the existing atherosclerotic scar.
Unfortunately, the atherosclerotic scar on the heart muscle obtained after myocardial infarction does not have sufficient elasticity, does not possess contractile ability, it tightens and deforms the nearby myocardial tissues, significantly worsening the quality of the heart’s work.
Classification of pathology
Modern clinical medicine describes the following forms of cardiosclerosis (as the most frequent manifestation of primary ischemic heart disease or coronary artery disease):
- focal form,
- diffuse form:
- pathology with lesions of the valve apparatus.
Postinfarction atherosclerotic changes of myocardial focal type occur most often.
The same damage to the muscle tissue can occur after a localized form of myocarditis. The essence of focal post-infarction cardiosclerosis lies in the formation of a clearly limited area of connective scar tissue.
The severity of this disease depends on such post-infarction factors:
- The depth of the necrotic lesion of the myocardium, which largely depends on the type of heart attack. Pathology can be superficial or transmural, when necrosis has been able to spread throughout the entire thickness of the muscular wall.
- The size of the necrotic focus. We are talking about large-focal or small focal sclerotic lesions. The greater the area of cicatricial damage, the more pronounced the symptoms of cardiosclerosis will be, the less optimistic will be the prognosis for further survival.
- Localization of the outbreak. For example, lesions located in the walls of the atria or interventricular septa are not as dangerous as cicatricial inclusions on the walls of the left ventricle.
- Of the total number of lesions formed necrosis. With this risk of complications and subsequent survival projections directly depend on the number of primary foci of necrosis.
- From the defeat of the conducting system. Atherosclerotic foci affecting the conduction heart bundles, as a rule, lead to the most severe disturbances in the functioning of the heart, in general.
Speaking of the diffuse form of cardiosclerosis, it should be noted that with this type of pathology, cicatricial myocardial lesions are distributed evenly, everywhere.This form of cardiosclerosis can develop not only in acute heart attack, but also in chronic form of coronary artery disease.
Cardiosclerosis, affecting the valvular apparatus of the heart, is most rare, since the valves initially have a connective tissue structure.
Nevertheless, doctors distinguish two types of such lesions of the heart valves: valve insufficiency or its stenosis.
What is caused by?
It must be said that every disease has certain origins. The main cause of the development of cardiosclerosis is itself coronary heart disease (or CHD).
From the point of view of the mechanism of development of cardiosclerosis, the causes of scarring of the tissue can be:
- narrowing of the large coronary vessels, which lead to insufficient blood supply to the heart muscle, hypoxia and necrosis,
- acute inflammatory processes that can change the structure of the myocardium,
- a sharp increase in the size of the myocardium, its stretching, say, due to the cardiomyopatidilation type.
In addition, the development of cardiosclerosis, or rather its progression, may be influenced by heredity and characteristics of a particular lifestyle.
Complicate the course of cardiosclerosis can:
- lack of adequate physical exertion, which is urgently needed during rehabilitation after a heart attack or other forms of ips,
- maintaining bad habits
- poor nutrition,
- constant stress
- rejection of proper prophylactic treatment.
Unfortunately, due to the influence of these factors, cardiosclerosis annually causes the death of a huge number of people.
Symptoms and manifestations of pathology
Due to the fact that post-infarction cardiosclerosis forms scar lesions on the heart tissues that cannot fully contract, the clinical manifestations of chronic heart failure can be considered the main manifestations of this disease.
Most often, patients with this ailment may complain of:
- severe dyspnea, even in the absence of exercise,
- a sharp increase in heart rate, as the appearance of a response to a decrease in ejection fractions,
- the bluish color of the lips, limbs, the area around the nose,
- various types of arrhythmias - say, atrial fibrillation, or extrasystole, in more complex cases, recurrent ventricular tachycardia, which can often become the cause of death of the patient,
- conditions of abrupt fluid accumulation in the body - the development of hydrothorax, hydropericardium, ascites, which can also lead to the death of the patient.
Also, post-infarction cardiosclerosis quite often leads to changes in the structure of previously healthy myocardial areas.
Cardiac muscle tissues become more friable, heart cavities can increase in size, all this leads to remodeling of the entire organ.
As a result, the problem provokes only an increase in the symptoms of heart failure.
It should be understood that both myocardial infarction and post-infarction cardiosclerosis, these diseases can lead to the death of the patient.
But, among the less serious complications of this condition, doctors call:
- development of cardiac arrhythmias,
- appearance of atrial fibrillation
- extrasystoles - the so-called extraordinary contractions of the myocardium,
- heart block, in which the “pumping” functions of the myocardium can be disturbed,
- vascular aneurysm — dangerous enlargements or protrusions of certain sections of heart tissue that increase the risks of hemorrhage,
- chronic heart failure.
At the same time, medical statistics confirms that any complications of the primary problem (IHD, myocardial infarction or post-infarction cardiosclerosis) increase the risk of death of patients.
Classification of disease forms
In medicine, there is an alternative view of what is aortic atherosclerosis. In fact, this is coronary artery disease. Pathology is classified according to the forms and stages of the disease:
- proceeding without pain,
- angina of three kinds,
- heart rhythm disorders
- primary cardiac arrest
- myocardial infarction.
Each of the forms is characterized by its own course and symptoms.
The popular name for the disease is angina pectoris. In atherosclerosis, the aorta of the coronary arteries, depending on the nature of the flow, distinguish the following types of angina:
- first arisen
- stable - the disease proceeds without noticeable changes over a long period of time,
- unstable - the disease progresses, with the risks of myocardial infarction or primary cardiac arrest.
Even with stable angina, complications can occur, since the pathology with frequent manifestations can turn into an unstable variety.
It should be understood that the function of myocardial areas affected by cardiosclerosis is completely impossible to restore.
That is why the treatment of post-infarction cardiosclerosis, most often, is aimed at preventing the progression of pathological sclerotic processes, at preventing the development of complications, at reducing the unpleasant symptoms of the problem.
Drug treatment of cardiosclerosis is very similar to the therapeutic methods used in IHD, with the addition of drugs to correct heart failure.
As a rule, with this pathology can be assigned:
- diuretic drugs
- drugs from the group of ACE inhibitors, which allow slowing down the process of rebuilding the structure of the myocardium,
- agents from the group of anticoagulants to prevent the formation of blood clots,
- metabolic drugs to improve myocyte nutrition,
- various beta-blockers, as a preventive measure for the development of arrhythmias.
Upon detection of post-infarction aneurysms, significantly impairing the pumping function of the myocardium, treatment can be surgical, removing the aneurysm surgically. Often, they can simultaneously carry out the procedure of coronary artery bypass surgery.
In order to improve the functions of viable myocardial areas, patients may be recommended to perform balloon angioplasty or stenting.
Forecasts and preventive measures
In most cases, prognoses of survival of patients who are faced with the problem of post-infarction cardiosclerosis can be determined:
- the percentage of diseased and healthy myocardial tissue,
- the severity of pathological changes in the heart muscle,
- real state of all coronary arteries.
For example, with the development of multifocal postinfarction atherosclerosis, with an ejection fraction of less than twenty-five percent, the overall life expectancy of patients usually cannot exceed three years.
Postinfarction cardiosclerosis, (as well as the heart attack itself) is a deadly disease, and therefore, physicians insist on the urgent need for the patient to observe all sorts of secondary prevention measures to avoid the recurrence of the problem.
In the described pathologies, physicians try to maximize the remission period, since any aggravation will contribute to the formation of new cicatricial lesions.
For the prevention of recurrence of the pathology it is necessary:
- eat right (avoid harmful foods, give preference to healthy, fortified food),
- avoid stress and nervous shocks
- try to eliminate excessive physical exertion, but not abandon the correct therapeutic gymnastics,
- walk in the open air as often as possible,
monitor the usefulness of sleep and rest. It is imperative to get rid of snoring and insomnia, for example, with the help of such a simple and affordable means as a medical pillow "Healthy."
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In conclusion, I would like to note that post-infarction cardiosclerosis is a disease that cannot be completely cured.
Important! Indeed, it is impossible to eliminate all the existing post-infarction scars on the walls of the heart. But this does not mean that this diagnosis leads to the imminent death of the patient.
With appropriate prevention of recurrence, with adequate treatment of the problem, patients can significantly prolong their lives. And this, you see, is important!
- Do you often have unpleasant feelings in the heart area (pain, tingling, squeezing)?
- Suddenly you may feel weak and tired ...
- Increased pressure is constantly felt ...
- About dyspnea after the slightest physical exertion and nothing to say ...
- And you have been taking a bunch of drugs for a long time, dieting and watching the weight ...