CHD and cardiosclerosis
Author Ольга Кияница
Cardiosclerosis is a heart disease in which myocardial blood supply is impaired. Occurs due to blockage of the coronary arteries, most often against the background of atherosclerosis. According to the clinical manifestations may occur in the form of angina or ischemic heart disease.For this reason, ischemic heart disease and cardiosclerosis are often diagnosed together.
Cardiosclerosis is considered an irreversible disease, so it is extremely important to undergo appropriate treatment in time.
To diagnose the disease, electrocardiography is used primarily, which, if necessary, is supplemented by imaging techniques. Cardiosclerosis can occur in different ways, but in any case, it is important to undergo an examination and appropriate therapy in time to avoid serious complications.
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Cardiosclerosis and its relationship with coronary artery disease
The heart consists of three types of membranes - the endocardium, myocardium and epicardium. The middle sphere, the myocardium, is also known as the heart muscle. Reduction of the body is carried out precisely by the controlled and orderly work of cardiomyocytes. For their proper functioning, proper nutrition is required, which enters through the system of coronary (coronary) vessels. If for some reason the arteries are completely or partially blocked, myocardial ischemia develops. It is then that they talk about coronary heart disease, since the first clinical signs appear at the initial stages of its development.
Metabolic and ischemic disorders underlie the development of coronary heart disease (CHD), which with further development turns into myocardial infarction.
Myocardial infarction is a form of IHD and is characterized by the death of heart muscle cells, that is, myocardial necrosis. Even a small necrosis should be replaced by another type of tissue - connective, which allows to some extent compensate for the work of the organ and to delay the likelihood of heart failure.
It is important to know that the more extensive myocardial infarction, which means necrosis of the heart muscle, the weaker the organ will be and the worse it will be able to cope with its function of pumping blood throughout the body.
About the development of cardiosclerosis speak in the case when a significant number of foci or diffuse formations of connective tissue have formed in the myocardium. With total myocardial damage with cardio sclerosis, the patient often dies very quickly, when even the ambulance does not have time to get there. Thus, the lack of treatment for coronary heart disease, and subsequently cardiosclerosis, can lead to the following disorders:
- Vivid manifestations of angina or ischemic heart disease occur.
- To compensate for the contraction force, the heart begins to increase its mass and myocardial hypertrophy develops.
- Further disruption of the normal blood supply to the myocardium leads to the death of a significant part of the cardiomyocytes and the growth of connective tissue in their place, leading to the formation of cardiosclerosis.
- As a complication of cardiosclerosis, cardiomyopathy is most often used, which contributes to an even greater increase in cardiac muscle, usually in the region of the left ventricle.
- Due to serious violations of the structure of the myocardium, atrophy of the heart muscle occurs, which, in turn, leads to all kinds of arrhythmias.
Against the background of pathological changes in the myocardium, concomitant disorders occur in various organs and tissues. This is due to chronic hypoxia, that is, insufficient oxygen supply, because the heart cannot pump the proper amount of blood. First of all, the brain suffers, so there are also various disorders on the part of the nervous system.
The main characteristics of cardiosclerosis
The progression of the disease may differ due to the cause of the above violations. Depending on this, the following types of cardiosclerosis can be distinguished:
Atherosclerotic cardiosclerosis is most common, since many factors predispose people to its development. Most often, the appearance of the disease is associated with blockage of the coronary artery (or several vessels) with an atherosclerotic plaque, which causes hypoxia and myocardial necrosis.
Postinfarction cardiosclerosis is the result of damage to the muscle tissue of the heart. Especially often occurs after a large-focal myocardial infarction or frequently repeated microinfarction.
Myocarditis cardiosclerosis is the result of structural changes in the myocardium due to the development of rheumatism or myocarditis. In the latter case, the infectious agent is often the damaging element; therefore, appropriate treatment is required to eliminate it.
Sometimes a person develops without any apparent cause of fibroelastosis. Against this background, focal or diffuse proliferation of connective tissue is often observed. As a result, they speak of primary cardiosclerosis , which is the most difficult to treat.
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There are certain factors contributing to the development of both coronary heart disease and cardiosclerosis:
- Hypertension - high blood pressure itself has a negative effect on the condition of the blood vessels, and in combination with atherosclerosis, myocarditis or rheumatism, the risk of IHD and cardiosclerosis is further increased.
- Diabetes and other endocrinological disorders - often lead to secondary vascular damage, which also increases the likelihood of blockage of the arteries of the heart.
- Bad habits of smoking and alcohol use are serious factors that affect not only the heart, but the whole body. Vessels with different localization suffer from nicotine and alcohol, but most of all the heart and brain.
- Hypodynamia and excess weight - these two reasons are often interrelated, although overweight can be transmitted by heredity, and a person with a slender figure leads a low-active lifestyle. It is important to know that even in the case of exposure to only one factor, overweight or physical inactivity, the risk of CHD and cardiosclerosis increases markedly.
Studies show that older men are more likely to develop CHD and cardiosclerosis. After 50 years, physiological changes begin to occur, and in combination with predisposing factors that are more often defined in men, the disease develops more actively.
Additionally, you should indicate that the patient can conduct self-treatment or delay with a visit to the doctor. In such cases, the disease progresses more actively, and after prescribing the necessary treatment, the result may not be as expected.
Clinical manifestations and diagnosis
At the initial stages, the disease may not be expressed at all, indicating a rather effective work of compensatory mechanisms. The progression of ischemia or the addition of necrosis contributes to the following symptoms:
- Shortness of breath - mainly occurs during physical activity, but with the progression of the disease, the symptom occurs even when walking slowly or even at rest.
- Pain in the heart - often worried because of oxygen starvation of the heart muscle.
- Malaise and weakness - often concern patients with heart disease, because the organs do not receive enough oxygen and nutrients.
- Coordination of movement is disturbed , and sometimes occurs together with a headache.
- Heart rhythm is disturbed , that is, arrhythmia occurs. The reason for this is often a disorder of the electrical activity of the heart or the formation of pathological foci generating impulses. Against the background of arrhythmia, the heart rate often reaches 120 beats / min.
- Edema - insufficient ventricular contractility leads to stagnation of blood in the venous system, which is why the liquid fraction of the blood - the cytoplasm - infiltrates into the surrounding tissues, often in the area of the feet and legs.
Severe disease is indicated in cases when the patient has signs of pulmonary edema (severe shortness of breath, coughing with foam, heavy, noisy breathing) or ascites (accumulation of fluid in the abdominal cavity).
To clarify the diagnosis can be used additional diagnostic methods . In particular, after a physical examination of a patient, the doctor prescribes:
- Ultrasound of the heart - can be used to determine the foci of growth of connective tissue, as well as their size and degree of impairment of cardiac function.
- Electrocardiography is the very first method for determining various types of cardiac arrhythmias. Also, an experienced doctor can determine the location of foci of cardiosclerosis and severity of myocardial ischemia using an electrocardiogram.
- Coronary angiography is performed using a radiopaque substance. With the help of a special catheter inserted through the femoral artery and advanced to the heart vessels, images are taken that measure the degree of complexity of the pathology.
If necessary, laboratory tests can be made by which it is possible to determine the presence of an inflammatory reaction, myocardial damage, cholesterol, glucose and other important indicators.
Treatment of cardiosclerosis with ischemic heart disease
A thorough examination of the patient allows the doctor to prescribe the most effective treatment. Depending on the severity of the clinic and the condition of the patient, various methods of exposure and drugs can be used, while therapy has the following goals:
- To slow down or stop the development of the disease.
- Reduce the likelihood of myocardial infarction.
- Improve the quality of life of the patient by reducing the severity of symptoms.
Practically all patients with heart diseases, including cardiosclerosis and ischemic heart disease, are recommended to adhere to the rules of a healthy lifestyle. Without them, even drugs may not be as effective as they should have been.Despite the fact that physical exercises should be limited, they should not be abandoned altogether, since the heart muscle functions better with a permissible load.
Drug treatment often includes drugs from the group of statins, diuretics, nitrates, antiplatelet agents, antihypertensive drugs. All drugs should be prescribed only by a doctor, because if used improperly, a serious deterioration of the patient’s condition is possible.
Surgical therapy is performed as a last resort, when a conservative effect did not produce the desired result. To restore the trophism of the heart muscle, the following types of surgery can be performed: stenting, bypass surgery or balloon angioplasty.
Depending on the indications and the condition of the patient, physiotherapy may additionally be prescribed. With its help, health is strengthened, and the cardiovascular system in particular. Also, if necessary, drugs are introduced directly into the region of the heart - these can be statins or nonsteroidal anti-inflammatory drugs. If necessary, the doctor directs the patient to the procedure of saturation of the body with oxygen, local electrophoresis or sanatorium-resort treatment.
Cardiosclerosis in combination with ischemic heart disease can seriously undermine health. Patients may not feel any changes at first, but later they will definitely manifest and then, if untreated, serious complications develop very quickly.In particular, the risk of heart failure increases dramatically, and a long course of the disease can lead to the damage of all organs and systems. Therefore, it is extremely important to undergo the appropriate treatment prescribed by the doctor.
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