Author Ольга Кияница
Disormonal cardiomyopathy (DDCP) is still known as climacteric, as it is often detected in women during menopause. Far from immediately, doctors managed to determine the relationship between cardiovascular disorders and hormonal changes in the body. Only in 1874 Dr. Kirsch managed to prove the independence of the DHA and distinguished pathology as a separate nosological unit.
Cardiomyopathy is considered in the International Classification of Disease Controls 10 (ICD-0), but a separate dishormonal form is not isolated, so the disease is most often correlated with code 142 "Cardiomyopathy."
The disease is often accompanied by hormonal disorders, although it can develop independently. In women, the disease occurs more often and basically proceeds favorably, whereas the definition of DHHM in men often indicates a tumor of the prostate.
Video cardiomyopathy is a general characteristic
At the transition stage of a person from the middle age to the elderly, various hormonal alterations occur, resulting in a slowing down of many reactions in the body. This process is not one-time. It stretches for a year or two, which depends on the individual characteristics of a particular person. Both women and men are exposed to such changes, but the high degree of perestroika is characteristic of female representatives.
Climax (from Greek Climacter - step, staircase) is a physiological period in human life, but in some cases, with the associated hormonal changes, damage to the heart muscle occurs.
Climacteric cardiomyopathy is an atypical form of menopausal syndrome, manifested by pain in the cardiac region and nephrocardiary pathology of the myocardium.Characterized by marked violations of the period of electrocardiographic repolarization, and especially by the change in the automatic, excitability and conduction of the cardiac muscle.
Disormonal cardiomyopathy is most often associated with a metabolic disorder in the body. One of the main roles in this is played by the endocrine system. Such disorders are expressed by the development of various diseases:
- diabetes mellitus;
- adrenal dysfunction;
- lack or excess of thyroid hormones;
- disorder of regulation of the prostate gland.
Climax is the most common cause of DHA.It is precisely against the background of the onset of menopause that various hormonal alterations are developed, which are subsequently expressed in cardiomyopathy.
Video How to find out that I have a climax
Hormones refer to the biologically active substances produced by the glands of the internal secretion. With their participation there are various metabolic processes, therefore, in the event of a violation of protein, carbohydrate or fat metabolism suffer various organs, including the heart. Since cardiomyopathy is a non-inflammatory disease, its development is most often associated with disturbances of metabolic mechanisms, including hormonal processes.
The similarity of clinical signs of dyshormonal cardiomyopathy with other diseases of the heart and blood vessels is strongly expressed. In particular, with DHCM, pain in the heart is often observed in the type of false angina, which leads to difficulty in setting the correct diagnosis.
Pain in the heart with dyshormonal cardiomyopathy is localized on its vertex, characterized by varying area of distribution - from the small (in the left shoulder) to the extensive (covers the entire left half of the chest). It has a different intensity (from nose to strong and unbearable).
Characteristics of emotional staining of pain:
- "Piercing nail"
- "Piercing long needles";
- "The heart is filled with boiling water."
In each third case (32.6%) there is a combination of dyshormonal cardiomyopathy with initial manifestations of coronary heart disease (combined forms of the disease). The pain syndrome of the heart in such cases is difficult due to the combination of false angina with true. IBS, which occurs in patients at a later age (after about 50 years) compared to dyshormonal cardiomyopathy (47 years) and in most cases in postmenopausal women.
"Tides" in patients with climacteric cardiopathy, in contrast to patients with typical forms, menopausal symptoms are less pronounced, although their incidence is usually less than 10 per day.
In addition to cardialgia and "tides," other symptoms may be determined in patients with DHCM:
- feeling of lack of air;
- pronounced autonomic disorder;
- oscillation of arterial pressure;
- general neuroticism of the patient.
The "haters" of the DCMC in women can be considered:
- Late start of menarche (average 14.5 years)
- Inhibition of the generative function (about 3 pregnancies and the ratio of births to abortions 1: 2)
- A large number of diseases in terms of gynecology (uterine fibroids, chronic inflammatory processes of internal genitals, dysfunctional uterine bleeding)
- Early onset of menopause (mean age 46.5 years).
Men tolerate the development of DCMCs not so brightly. As a rule, the pathological process affects the prostate gland, therefore, patients often notice a rapid urination, alternating with appeals. In some cases, on the contrary, there is an oliguria (a decrease in the amount of daily urine) that may be accompanied by a reduced libido. Such disorders are often the cause of erectile dysfunction, another sign of DHA in men.
In the course of the examination of patients with suspicion of dyshormonal cardiomyopathy, inderal (obsidian), ergotamine and potassium tests are often used, as indicated by MS Kusakovsky. KM N. Medvedev in 1972; T. V. Shishkov and others in 1972 and Makarov in 1973.
Conducting the test:
- Patients with a suspicion of cardiomyopathy take 40-60 mg of ozidane or 6-8 g of potassium (together with 100 ml of water). It is also possible to administer intramuscularly 1 ml of a 0.05% solution of ergotamine. Data on ECG normalization are analyzed after 1-1.5 hours after tablet ingestion or after 45-60 minutes. after injection.
A positive test is considered if normalization of the ECG is observed after the specified time. Its confirmation is one of the criteria for cardiomyopathy.
However, a slight positive dynamics of the changes in the T wave and the RS-T segment can also be observed in cases of use of tests with obsidian and potassium in patients with coronary insufficiency. In such cases, only an accurate positive test is used in a patient with a clinic characteristic of dyshormonal cardiomyopathy. In some cases, these tests can not confirm the diagnosis of DHA
In addition, the patient can appoint:
- General urine analysis
- Ultrasound of the heart
- X-ray of OGK
- MRI and CT
If dyshormonal cardiomyopathy is a secondary pathology then treatment of the underlying disease is first and foremost. Additionally corrected:
- electrolytic disorder (potassium chloride, panangin);
- the metabolic state of the patient (inosine, ATP, essential oil, anabolic hormones).
In the presence of arrhythmias, beta-blockers are used, whereas the pronounced autonomic disorder is stopped with sedatives. In case of heart failure, glycosides or non-glycoside inotropic agents, vasodilator, diuretics are prescribed.
Forecast and prevention
Dyshormonal cardiomyopathy often occurs favorably and is not accompanied by the development of complications. In some cases, cardiac insufficiency and hypertrophy of the ventricles are determined, but this is mainly due to the presence of cardiovascular diseases other than DHHM in a patient.
Prevention of DHHW is associated with the prevention of the development of hormonal disorders and endocrine diseases. It is also good to adhere to the general recommendations of a healthy lifestyle.
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