The main reason for IBS. Ischemic heart disease - symptoms and treatment

In the presence of such a symptom as pain behind the sternum, the correct diagnosis is very important. The fact is that similar symptoms can be observed in several types of diseases of the internal organs. This applies to the lungs and gastrointestinal tract.

The cause of pain in the thoracic region may be neuralgia, osteochondrosis, a history of chest trauma.

Ischemic heart disease is a condition characterized by acute or chronic damage to the myocardium due to insufficient supply of blood to it.

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The diagnosis of coronary artery disease is not one specific disease, but a number of pathological conditions that differ in symptoms and methods of treatment.

The term "ischemic disease" combines several diseases:

• stable
• unstable;
• rest angina;
• heart attack;
• painless ischemia.

Correctly diagnosing the disease is an extremely important task, since myocardial pathology is dangerous for human life.

General diagnostic measures

The accuracy of IHD diagnostics is achieved by an integrated approach in conducting various types of research.

Questioning and examining the patient

This is the first stage of diagnostic studies. The main complaints are identified, the presence of concomitant diseases is clarified.

An examination is carried out: listening to the heart and lungs, measuring blood pressure and pulse.

Laboratory research

Instrumental Research

Examples of the formulation of the diagnosis of coronary artery disease

For the correct formulation of the diagnosis of coronary heart disease, it is necessary to strictly follow the classification of the disease currently used.

IHD is classified as follows:

According to the above classification, the formulation of the diagnosis of coronary artery disease is built. For example: stable angina pectoris IV f. class; or: coronary syndrome X, stable angina III f. class, paroxysmal AF, stage I heart failure.

Symptoms

Symptoms of coronary artery disease are often similar to those of other diseases. It is especially difficult to differentiate between ischemia and lung lesions. These are diseases such as pleurisy, bronchial asthma, bronchitis and others. The fact is that with these diseases, the same symptoms occur as with heart problems.

Ischemic disease can develop over decades. She can change. Therefore, the symptoms and signs of coronary artery disease also vary, depending on the form of the disease:

Under IHD (in deciphering the definition - ischemic heart disease) a complex of diseases is grouped. They are characterized by unstable blood circulation in the arteries that supply the myocardium.

Ischemia - insufficient blood supply - is caused by narrowing of the coronary vessels. Pathogenesis is formed under the influence of external and internal factors.

IHD leads to death and disability of people of working age around the world. WHO experts have calculated that the disease is becoming the cause of the annual death of more than 7 million people. By 2020, mortality could double. It is most common among men aged 40-62.

The combination of the processes discussed below increases the risk of morbidity.

Main causative factors:

• Atherosclerosis. A chronic disease that affects the arteries that go to the heart muscle. The vascular walls thicken and lose their elasticity. Plaques formed by a mixture of fats and calcium narrow the lumen, the deterioration of the blood supply to the heart progresses.
• Spasm of the coronary vessels. The disease is caused or formed without it (under the influence of external negative factors, such as stress). The spasm changes the activity of the arteries.
• Hypertonic disease- The heart has to fight high pressure in the aorta, which disrupts its circulation and causes angina and heart attack.
• Thrombosis/thromboembolism. In the artery (coronary), as a result of the collapse of an atherosclerotic plaque, a thrombus is formed. There is a high risk of blockage of the vessel by a thrombus, which formed in another part of the circulatory system and got here with the bloodstream.
• or .

Atherosclerosis is the main cause of coronary artery disease.

The risk factors are considered to be:

• hereditary factor - the disease is transmitted from parents to children;
• steadily elevated "bad" cholesterol, causing the accumulation of HDL - high density lipoprotein;
• smoking;
• obesity of any degree, disorders of fat metabolism;
• arterial hypertension - a high level of pressure;
• diabetes (metabolic syndrome) - a disease caused by a violation of the production of the pancreatic hormone - insulin, which leads to malfunctions of carbohydrate metabolism;
• lifestyle deprived of physical activity;
• frequent psycho-emotional disorders, character and personality traits;
• adherence to an unhealthy fatty diet;
• age - risks increase after 40 years;
• gender - men suffer from coronary artery disease more often than women.

Classification: forms of coronary heart disease

IHD is divided into several forms. It is customary to distinguish between acute and chronic conditions.

Cardiologists manipulate such a thing as acute coronary syndrome. It combines some forms of coronary artery disease: myocardial infarction, angina pectoris, etc. Sometimes this includes sudden coronary death.

What is dangerous, complications, consequences

Ischemic heart disease indicates the presence of changes in the myocardium, which leads to the formation of progressive insufficiency. Contractility weakens, the heart does not provide the body with the required amount of blood. people with coronary artery disease get tired quickly and experience constant weakness. Lack of treatment increases the risk of death.

Clinic of the disease

Manifestations can emerge in a complex or separately, depending on the form of the disease. There is a clear relationship between development pain localized in the region of the heart, and physical activity. There is a stereotype of their occurrence - after a plentiful meal, under adverse weather conditions.

Description of pain complaints:

• character - pressing or squeezing, the patient feels a lack of air and a feeling of increasing heaviness in the chest;
• localization - in the precordial zone (along the left edge of the sternum);
• negative sensations can spread along the left shoulder, arm, shoulder blades or in both hands, in the left pre-scapular zone, in the cervical region, jaw;
• pain attacks last no more than ten minutes, after taking nitrates they subside within five minutes.

We talked in more detail about, including differences in signs in men and women and risk groups, in a separate article.

If the patient does not seek treatment and the disease proceeds for a long time, the picture is supplemented by the development of swelling in the legs. The patient suffers from severe shortness of breath, which forces him to take a sitting position.

A specialist who can help with the development of all the conditions considered is a cardiologist. Timely medical attention can save lives.

Diagnostic methods

Diagnosis of IHD is based on the following examinations:

To clarify the diagnosis and exclude the development of other diseases, a number of additional studies are being implemented.

According to the plan, the patient receives a complex of stress tests (physical, radioisotope, pharmacological), undergoes examinations using the X-ray contrast method, computed tomography of the heart, electrophysiological examination, dopplerography.

How and what to treat

The tactics of complex therapy for coronary artery disease is developed based on the patient's condition and an accurate diagnosis.

Therapy without medication

Principles of IHD treatment:

• daily cardio training in dynamics (swimming, walking, gymnastics), the degree and duration of the load is determined by the cardiologist;
• emotional peace;
• the formation of a healthy diet (a ban on salty, fatty).

Pharmacological support

The following drugs may be included in the treatment plan:

Anti-ischemic- reduce myocardial oxygen demand:

• Calcium antagonists are effective in the presence of contraindications to beta-blockers and are used with low effectiveness of therapy with their participation.
• beta-blockers - relieve pain, improve rhythm, dilate blood vessels.
• nitrates - stop angina attacks.
• Antiplatelet agents- Pharmacological drugs that reduce blood clotting.
• ACE inhibitors- drugs of complex action to reduce pressure.
• Hypocholesterolemic medicines (fibrators, statins) - eliminate bad cholesterol.

As additional support and according to indications, the therapy plan may include:

• diuretics- diuretics to relieve swelling in patients with coronary artery disease.
• antiarrhythmics- maintain a healthy rhythm.

Learn more about in a separate post.

Operations

Surgical regulation of myocardial blood supply. A new vascular bed is brought to the site of ischemia. The intervention is implemented in case of multiple vascular lesions, with low efficiency of pharmacotherapy and in a number of concomitant diseases.

Coronary angioplasty. In this surgical treatment of IHD, a special stent is introduced into the affected vessel, which keeps the lumen normal. The blood flow of the heart is restored.

Forecast and prevention

Cardiologists point out that IHD has a poor prognosis. If the patient complies with all prescriptions, the course of the disease becomes not so severe, but it does not disappear completely. Among preventive measures, maintaining a healthy lifestyle (proper nutrition, absence of bad habits, physical activity) is effective.

All persons who are predisposed to the development of the disease are recommended to visit a cardiologist regularly. This will help maintain a full quality of life and improve the prognosis.

A useful video about what kind of diagnosis it is - "coronary heart disease", all the details about the causes, symptoms and treatment of coronary artery disease are given:

Ischemic heart disease (CHD) is a condition resulting from a mismatch between the supply of oxygen to the heart and myocardial demand for oxygen and nutrients.

This discrepancy can be both primary, arising from narrowing of the lumen of the coronary vessels (their spasm, blockage of the lumen atherosclerotic deposits), and secondary (with inadequate physical activity predominantly in the elderly).

ICD-10 codes

I20-I25 Ischemic heart disease:
I20 Angina pectoris
I21 Acute myocardial infarction
I22 Recurrent myocardial infarction
I23 Some current complications of acute myocardial infarction
I24 Other forms of acute ischemic heart disease
I25 Chronic ischemic heart disease

Causes of coronary heart disease (CHD)

The most common cause of myocardial ischemia is coronary atherosclerosis, short-term or persistent narrowing, thrombosis of the coronary arteries or their embolism. Thrombosis leads to damage and defects that occur on the wall of blood vessels or on the surface atherosclerotic plaques.

Risk factors : hyperlipidemia with increased levels of low - density lipoproteins , total cholesterol , triglycerides ; obesity concomitant, aggravated heredity, diabetes mellitus, smoking, physical inactivity - a sedentary lifestyle - sedentary, with a minimum of physical activity.

To assess overall cardiovascular risk, it is recommended to useSCORE scale (Systematic Coronary Risk Evaluation - systematic assessment of coronaryrisk), which was prepared on the basis of the results of large prospectiveEuropean studies. The SCORE scale predicts the risk of death innext 10 years. Moreover, by multiplying the resulting individual risk on a scaleSCORE of 3 in men and 4 in women, it is possible to establish the overall risk of developing coronary artery disease andother cardiovascular diseases within 10 years.

Classification of coronary heart disease (CHD)

1. Sudden coronary death (or primary cardiac arrest) is a sudden onset, unforeseen condition, which is presumably based on electrical instability of the myocardium. Sudden coronary death is understood as instantaneous death or death occurring no later than 6 hours after a heart attack in the presence of witnesses. Allocate sudden coronary death with successful resuscitation and death.

2. Angina:

• angina pectoris (load):

1. stable (I-IV functional classes);
2. unstable: first appeared, progressive, early postoperative or postinfarction angina pectoris;

• spontaneous angina (Prinzmetal's angina, variant)

3. Painless form of myocardial ischemia.

4. Myocardial infarction:

• macrofocal (transmural, Q-infarction);
• small-focal (not Q-infarction);

5. Postinfarction cardiosclerosis.

6. Violations of cardiac conduction and rhythm (form).

7. Heart failure (form and stages).

In cardiology, such a generalized concept is distinguished as "acute coronary syndrome", which combines various forms of coronary heart disease: unstable angina, myocardial infarction (Q- and without Q-wave, with or without ST segment elevation). These acute conditions can turn into one another: for example, unstable angina with a prolonged attack - into myocardial infarction, and the latter is accompanied by the development of early post-infarction angina pectoris. Sometimes this group also includes sudden coronary death caused by coronary artery disease.

Symptoms of coronary heart disease (CHD)

Clinical manifestations of IHD are determined by the specific form of the disease listed in the above classification.

In general, ischemic heart disease has an undulating course: periods of stable normal state of health alternate with episodes of exacerbation of ischemia. About a third of patients, especially with a painless form of myocardial ischemia, do not feel the presence of coronary artery disease at all, or the manifestations of the disease consist in periods of general weakness and malaise. The progression of coronary heart disease can develop slowly, with a change in the forms of the disease, and hence the symptoms.

Common manifestations of coronary artery disease include retrosternal pain associated with physical exertion or stress, pain in the back, arm, lower jaw; shortness of breath, palpitations, or a feeling of interruption; weakness, nausea, dizziness, clouding of consciousness and fainting, excessive sweating. Often, coronary artery disease is detected already at the stage of development of chronic heart failure with the appearance of edema in the lower extremities, severe shortness of breath, forcing the patient to take a forced sitting position.

The listed symptoms of coronary heart disease usually do not occur simultaneously, with a certain form of the disease, there is a predominance of certain manifestations of ischemia.

One of the manifestations of IHD is acute myocardial infarction, angina: unstable, exertional angina. Angina pectoris is clinically manifested by severe compressive pain, localized in the chest area. Pain can give away (radiate) in the left half of the body: under the shoulder blade, in the left arm, in the neck, lower jaw, etc. Fear of death, shortness of breath, anxiety, a feeling of lack of air, severe palpitations are symptoms that are also very characteristic of an angina attack.

Complications of coronary heart disease (CHD)

Hemodynamic disorders in the heart muscle and its ischemic damage cause numerous morphological and functional changes that determine the forms and prognosis of coronary artery disease. The result of myocardial ischemia are the following mechanisms of decompensation:

• insufficiency of energy metabolism of myocardial cells - cardiomyocytes;
• "stunned" and "sleeping" (or hibernating) myocardium - forms of impaired contractility of the left ventricle in patients with coronary artery disease, which are transient;
• development of diffuse atherosclerotic and focal post-infarction cardiosclerosis - a decrease in the number of functioning cardiomyocytes and the development of connective tissue in their place;
• violation of systolic and diastolic functions of the myocardium;
• disorder of the functions of excitability, conduction, automatism and contractility of the myocardium.

The listed morphological and functional changes in the myocardium in IHD lead to the development of a persistent decrease in coronary circulation, i.e., heart failure.

Diagnosis of coronary heart disease (CHD)

Diagnosis of coronary artery disease is carried out by cardiologists in a cardiological hospital or dispensary using specific instrumental techniques.

When questioning the patient, complaints and the presence of symptoms characteristic of coronary heart disease are clarified. On examination, the presence of edema, cyanosis of the skin, heart murmurs, rhythm disturbances are determined.

Laboratory diagnostic tests involve the study of specific enzymes that increase with unstable angina and heart attack (creatine phosphokinase (during the first 4-8 hours), troponin-I (on days 7-10), troponin-T (on days 10-14), aminotransferase , lactate dehydrogenase, myoglobin (on the first day)). These intracellular protein enzymes are released into the blood during the destruction of cardiomyocytes (resorption-necrotic syndrome).

Also, a study of the level of total cholesterol, low (atherogenic) and high (antiatherogenic) density lipoproteins, triglycerides, blood sugar, ALT and AST (nonspecific markers of cytolysis) is carried out.

The most important method for diagnosing cardiac diseases, including coronary heart disease, is ECG - registration of the electrical activity of the heart, which makes it possible to detect violations of the normal operation of the myocardium.

EchoCG - a method of ultrasound of the heart allows you to visualize the size of the heart, the condition of the cavities and valves, assess myocardial contractility, acoustic noise. In some cases, with IHD, stress echocardiography is performed - ultrasound diagnostics using dosed physical activity, which registers myocardial ischemia.

Functional stress tests are widely used in the diagnosis of coronary heart disease. They are used to detect early stages of coronary artery disease, when disorders cannot yet be determined at rest. Walking, climbing stairs, exercise equipment (exercise bike, treadmill) are used as stress tests, accompanied by ECG recording of heart performance indicators. The limited use of functional tests in some cases is caused by the inability of patients to perform the required amount of load.

Holter 24-hour ECG monitoring involves recording an ECG performed during the day and revealing periodically occurring disturbances in the work of the heart. For the study, a portable device (Holter monitor) is used, which is fixed on the patient’s shoulder or belt and takes readings, as well as a self-observation diary in which the patient notes his actions and ongoing changes in well-being by the hour. The data obtained during monitoring is processed on a computer. ECG monitoring allows not only to identify manifestations of coronary heart disease, but also the causes and conditions of their occurrence, which is especially important in the diagnosis of angina pectoris.

Transesophageal electrocardiography (TECG) allows a detailed assessment of the electrical excitability and conduction of the myocardium. The essence of the method consists in introducing a sensor into the esophagus and recording the performance of the heart, bypassing the interference created by the skin, subcutaneous fat, and chest.

Carrying out coronary angiography in the diagnosis of coronary heart disease allows you to contrast myocardial vessels and determine violations of their patency, the degree of stenosis or occlusion. Coronary angiography is used to resolve the issue of surgery on the vessels of the heart. With the introduction of a contrast agent, allergic phenomena are possible, including anaphylaxis.

Treatment of coronary heart disease (CHD)

Treatment of coronary heart disease includes conservative therapy and surgical (invasive) treatment.

Non-drug therapy includes measures to correct lifestyle and nutrition. With various manifestations of coronary artery disease, a restriction of the activity regimen is shown, since during physical activity there is an increase in myocardial demand for blood supply and oxygen. Dissatisfaction with this need of the heart muscle actually causes manifestations of coronary artery disease. Therefore, in any form of coronary heart disease, the patient's activity mode is limited, followed by its gradual expansion during rehabilitation.

The diet for coronary heart disease (CHD) (treatment table No. 10 according to Pevzner) provides for limiting the intake of water and salt with food to reduce the load on the heart muscle. In order to slow the progression of atherosclerosis and fight obesity, a low-fat diet is also prescribed. The following food groups are limited, and, if possible, excluded: animal fats (butter, lard, fatty meat), smoked and fried foods, quickly absorbed carbohydrates (baking pastries, chocolate, cakes, sweets). To maintain a normal weight, it is necessary to maintain a balance between consumed and expended energy. If it is necessary to reduce weight, the deficit between consumed and expended energy reserves should be at least 300 kcal daily, given that a person spends about 2000-2500 kcal per day during normal physical activity.

Drug treatment of coronary heart disease (CHD)

Drug therapy for IHD is prescribed according to the formula "A-B-C": antiplatelet agents, β-blockers and hypocholesterolemic drugs. In the absence of contraindications, it is possible to prescribe nitrates, diuretics, antiarrhythmic drugs, etc.

Basic drugs for treatment of acute forms IHD, namely the above-mentioned acute coronary syndrome: nitrates (mainly in angina pectoris), beta - blockers, antiplatelet drugs, statins, calcium channel blockers, in myocardial infarction - thrombolytics, incl. enzyme preparations (streptokinase, etc.), painkillers, most often narcotic drugs. Trimetazidine (preductal) is a drug that effectively improves metabolic processes in myocardial cells.

Main groups of nitrates:

one . Nitroglycerin group (in the form of tablets, lozenges, spray, preparations for parenteral applications). Nitroglycerin tablets decompose easily in the light, so they must be stored in the dark.

2. Group of isosorbide dinitrate (isoket, isomax spray, cardiquet).

3 . Isosorbide-5-mononitrate group (pectrol, monocinque, monomak). Their main difference is that they are used for basic therapy (prevention, prevention of angina attacks).

During an attack, it is most advisable to take nitrospray or nitroglycerin. Long-acting drugs (such as kardiket) are not used to stop angina attacks. Main side effects nitroglycerins: strong head pain (increased intracranial pressure), decrease in systemic pressure and, as a result, compensatory tachycardia. All nitrates are best taken in the supine position, in order to avoid the possibility of fainting with sudden onset hypotension.

The molsidomine group - do not contain nitrates in their composition, but the strength of the action of these drugs is less.

Actively used in IHD means that affect the coagulation processes blood (blood thinners):

one . Direct acting anticoagulants. The drugs in this group include predominantly heparin and others low-fractionated heparin preparations (fraxiparin).

2. Anticoagulants with indirect action can be either derivatives of oxycoumarin (syncumar, neodicoumarin), or phenylindanedione(phenylin).

3 . Antiplatelet drugs (deaggregants) of different groups.

• Acetylsalicylic acid and its derivatives (Trombo-AS, Aspirin cardio, Acecardol, Cardiomagnyl, Aspicor, CardiASK) and others.
• ADP receptor blockers (Clopidogrel, Ticlopidin).
• Phosphodiestase inhibitors (Triflusal, Dipyridamole).
• Glycoprotein receptor blockers (Lamifiban, Eptifibatide, Tirofiban, Abciximab).
• Arachidonic acid metabolism inhibitors (Indobufen, Picotamide).
• Medicines based on the plant Ginkgo Biloba (Bilobil, Ginos, Ginkio).

Plants with antiplatelet properties (horse chestnut, blueberry, licorice, green tea) 4 means an increased risk of bleeding, a decrease in value less than 0.8 - the risk of thrombosis. Taking anticoagulants and antiplatelet agents, the INR indicator is used to monitor the effectiveness of therapy. If interventions related to risk of bleeding, warfarin and other anticoagulants are canceled 5 days before manipulation.

Means that affect lipid metabolism are also used ( hypolipidemic drugs - statins - atorvastatin, simvastatin, etc.) - are aimed at slowing down the progression of atherosclerosis of the vessels, lowering the level of cholesterol and atherogenic blood lipoproteins.

Surgical (infasive) methods of treatment of coronary heart disease (CHD)

1. Minimally invasive surgical techniques for IHD include percutaneous transluminal coronary angioplasty (PTCA) - first, a catheter is inserted through the arterial access (femoral or radial artery), reaching the heart and coronary vessels are contrasted. Under x-ray control, a place of narrowing of the cardiac artery by an atherosclerotic plaque is found, it is expanded by inflating a special balloon, and a stent with a mesh structure is installed here. Due to the artificial formation of a framework in the affected artery, blood flow is restored in the ischemic area of ​​the affected myocardium.

2. If it is impossible to perform PTCA (for example, with a multivessel lesion) or resistance to drug treatment, they resort to major cardiac surgery on the open heart - myocardial revascularization by coronary artery bypass grafting, or CABG for short. During the operation, a vascular anastomosis is applied between the aorta and the affected artery of the heart below the occluded area. As a transplant, the patient's own vessels are used - the internal thoracic artery or the great saphenous vein.

Prevention of coronary heart disease (CHD)

Prevention of coronary heart disease (CHD) includes:

• exclusion of bad habits, such as smoking and drinking alcohol (especially beer and strong drinks),
• adherence to a diet with the restriction of animal fats, the inclusion of fish, vegetables, fruits, greens in the diet,
• normalization of blood glucose, cholesterol and triglyceride levels,
• blood pressure control,
• weight loss,
• regular individually metered physical activity (walking in the fresh air, swimming, skiing, cycling). Heavy loads are excluded.
• sufficient sleep, if necessary, 2-3-hour rest during the daytime.

IHD symptoms and treatment is a serious topic, very necessary for those who have already been diagnosed in a medical card - coronary heart disease, doctors - this disease is reduced for convenience - (CHD). It does not hurt to study this topic for those who have crossed the threshold for 40 years.

IHD symptoms and treatment of the disease:

The disease is very serious, associated with a change in cholesterol in the blood (low and very low density), but it is not only the culprit. Problems with blood vessels begin, which means that the heart will suffer.

Ischemic disease is a large group of disorders in the work of the heart. The most important thing is a violation of the oxygen supply of the myocardium (heart muscle) of the heart.

The reason for this is very serious - the narrowing of the coronary vessels, sometimes their complete blockage. They strictly supply blood to our heart, the main organ that pumps blood throughout our body.

To put it simply, the heart is a muscle the size of your fist. From the heart, blood is pumped to our lungs, accumulating oxygen there. The oxygen-rich blood is pumped back to the heart and then throughout the body through the arteries.

Already through our veins, the blood returns back to the heart and back to the lungs. Blood continuously circulates in our body - we are healthy.

Coronary vessels are located on the surface of the heart, so they supply the heart with oxygen. If we are not narrowed, we are healthy, with deviations, ischemia begins. This is especially noticeable during physical labor or any load.

What can IBS lead to:

Otherwise, myocardial infarction, stroke, cardiac arrest develops.

• An ordinary citizen, ignoring his health, will not notice any manifestation of up to 50% narrowing of the coronary vessels of the heart.
• That's when the narrowing reaches 70 - 80%, the patient begins to feel acute attacks - angina pectoris. Such patients are prone to heart attacks.
• The culprit is, and its development provokes the notorious bad cholesterol of high and very high density.
• The patient experiences pain behind his chest, in his left arm, back, throat, neck, or lower jaw. Behind the sternum burns, presses.
• The appearance of nausea, heartburn, dyspepsia.
• Strong weakness, fear.
• Sometimes even my teeth hurt.
• Heartbeat begins, heart rhythm disturbance.
• Strong sweating.

What happens at the same time in the vessels:

• Inside the vessel on its walls, various salts begin to grow: calcium, fat. They are called plaques. The elastic tissue inside the vessel becomes rigid. From muscular, it turns into a connective one.
• Vessels are sealed, they can no longer pass blood as before.
• The heart begins to experience the entire lack of oxygen.
• Not only narrowing of the coronary vessels develops, but also thrombosis, spasm of the arteries.
• Ischemia provokes tachycardia (rapid heartbeat), hypertension, myocardial hypertrophy.

Types of angina:

Stable: appears under load.

Unstable: manifestation already at rest, from cold, stress, certain drugs.

In addition to the above-mentioned culprit - bad cholesterol, there are many more reasons to get this disease.

• Especially dangerous is the craze for alcoholic beverages, the "enjoyment" of a cigarette.
• Endless TV shows, football in the evenings, computer games, lead to immobility of a person more and more. The blood does not move, hence all the delights of such a life, which turns a healthy person into a ruin.
• Naturally, everything is aggravated with age - the body is aging.
• It is worth paying attention to the hereditary transmission of the disease.
• You can't miss the stress.
• Constant fatigue.
• Ignoring rest.
• Increased blood clotting. It is observed in almost everyone after 40. With age, the blood thickens, start taking action.

Diagnosis of coronary artery disease with symptoms and treatment:

• ECG (electrocardiography): will show deviations in the rhythm of the heart, its work. Its electrical activity is checked.
• Echocardiogram: the same ultrasound that checks the myocardium, blood vessels.
• Exercise bike test: check the load on the heart.
• Chest X-ray.
• CT scan: CT can check for deposits on vessel walls.
• Blood tests: on the content of cholesterol and the alignment of its fractions (total cholesterol, high-density cholesterol, low, very low density, triglycerides, atherogenic index). According to these indicators, you can immediately see which cholesterol you should correct.
• Blood for sugar.
• Holter monitor connection: a device that records the work of your heart for two or three days.
• Measure pressure at the ankle and shoulders. Compare blood flow.

Coronary angiography:

• Coronary angiography (vascular patency) may be needed. This is what they call x-rays of the vessels of your heart. The defeat of the coronary arteries will be visible: in which place and how far the process has gone. This will help you choose a method for treatment more accurately.
• This procedure is absolutely safe. It will take only 20 minutes. You need local anesthesia in the laboratory (angiographic).
• A special X-ray unit is used. A thin tube will be inserted into an artery in your leg or arm and passed through to your heart. A contrast agent is then injected through the catheter to make the coronary arteries visible under x-rays.
• The patient is connected to a heart monitor. Everything is done sterile. The catheter is passed to the heart. The patient does not feel anything. Only when it reaches the heart can your heartbeat slow down or, on the contrary, become more frequent.
• This is the norm. The patient is conscious, follows the doctor's command: take a deep breath or move.

IHD symptoms and treatment drugs:

It is impossible to cure this disease, but you need to control it in order to prolong your active life.

Before treatment, be sure to go through all the examinations prescribed specifically for you, so accurately establish the process of the disease. IHD is a chronic disease, it needs to be treated for life.

Statins are prescribed to stabilize blood cholesterol levels. There is no replacement for them in our time, although side effects are observed.

Statins:

• Simvastatins.
• Parvastatins.
• Lovastatins.
• Rosuvastatins.
• Atorvastatins.

Fibrates:

• Bezalip.
• Lipanor.
• Fenofibrate.
• Lipantil.

A nicotinic acid:

Assign courses, continuous use is contraindicated due to abnormalities in the liver.

Sometimes the patient does not tolerate treatment, but he also needs to be treated with something. This group of drugs is prescribed.

Appointment only with the consent of the doctor. Usually taken at night, starting with a dose of 10 mg at dinner. Then monthly you need to donate blood for cholesterol and dose adjustment.

Blood-thinning drugs (antiplatelet agents):

• Acetylsalicylic acid.

Usually taken for life in small doses of 50 - 75 mg / day.

Anticoagulants:

To slow down blood clotting. In an emergency in a hospital, you may be given Heparin for this purpose. It is impossible to use this drug on its own (it has a direct effect).

There are also direct-acting drugs:

• Flaxiparin.
• Klevarin.
• Flagmin.

Antiplatelet drugs:

• Fenilin.
• Warfarin.

The drugs are very strong in action, independent use can lead to bleeding. Only on prescription from your doctor! Assign with atrial fibrillation.

Nitrates:

Nitroglycerin: for the rapid expansion of the coronary vessels. There are capsules, tablets, sprays. Application for seizures.

Beta blockers:

• Anaprilin.
• Atenolol.
• Besoprolol.
• Metoprolol.

Calcium channel blockers:

• Verapamil (decrease in the number of heartbeats).
• Nifedipine (dilates the arteries).

Beta-agonists:

The use is rare, to enhance the supply of oxygen to the body.

• Papaverine.
• Carbocromen.
• Dipyridamon.

Harness the heart rate, lower blood pressure, prevent angina pectoris.

Drugs to reduce pressure:

• Lisinopril.
• Captopril.
• Enalapril.

In addition to lowering pressure, they help stop the development of coronary artery disease.

Diuretics:

Remove excess fluid, reduce pressure.

• Hypothiazide.
• Indapamide.
• Furosemide.
• Veropshiron.

cardiac glycosides:

Their appointment occurs already with serious deviations in the work of the heart. A lot of side effects. Treat atrial fibrillation.

• Korglikon.
• Digoxin.

Antioxidants:

• Mexidol.
• Emoxipin.
• Ubiquinone.

Antihypoxants:

Improve cell respiration.

• Hypoxen.
• Actovegin.
• Cytochrome.

Surgical methods of treatment:

Angioplasty (stent):

Then the balloon is inflated, it straightens, compressing the fat deposits on the wall. A special mesh (stent) is left at this place in order to fix the expanded area.

Coronary bypass:

A blood vessel is taken from the patient from any part of the body (leg, chest wall), suitable for bypassing the blocked, affected area of ​​the artery during the operation.

Laser surgery:

With this intervention, several small holes are made in the myocardium. They will form new blood vessels.

Carotid endarterectomy:

Means carotid surgery to prevent stroke.

IHD symptoms and treatment with folk remedies:

1. Eat more foods containing potassium, magnesium: dried apricots, raisins, prunes, carrots, beets, rosehip decoctions, nuts, cabbage, oatmeal, rice.
2. Include garlic, cranberries, lemons in your diet to clean blood vessels.
3. Good help is marsh cudweed, valerian, hawthorn, horse chestnut, white willow (bark), fennel decoction (similar to dill), knotweed, motherwort.

The most active herbs:

Elderberry, spring adonis, tricolor violet, blue cornflower, blueberries (berries), peppermint.

1. Give up all bad habits immediately. I know it's hard, but you want to be healthy, right?
2. Give up cigarettes, excess alcohol. There are more enjoyable things in life.
3. Eat healthy foods: vegetables, greens, fruits, nuts, whole grains, poultry, fish.
4. Remove smoked meats, pickles, red meat, white flour, preservatives from the diet.
5. In women, the risk increases significantly after the onset. If the doctor allows, take estrogens (replacement, hormone therapy).
6. There is evidence that the disease is inherited.
7. Be sure to treat all chronic sores: high blood pressure, high weight. With their presence, the blood becomes very thick, the blood flow decreases.
8. Engage in feasible movements, move more, sit less.
9. Constantly maintain the norm of content, donate blood for analysis.

1. Be less upset, don't freak out. This greatly affects the vessels.
2. A very common cause of high cholesterol is the production of homocysteine ​​(an amino acid) by the body. Taking vitamin B 12, B 6 in combination will help.
3. Donate blood once a year for fibrinogen (the norm is up to 4000). It is a protein involved in blood clotting. When it rises, aspirin is needed.

IHD symptoms and treatment is an unpleasant, serious, chronic disease. But, people live with her for many years, which I wish for YOU too.

Come visit more often. I look forward to.

I suggest watching a video, prevention of coronary artery disease:

Ischemic heart disease is a lack of blood supply to the myocardium (heart muscle). The disease is very dangerous - for example, in acute development, coronary heart disease immediately leads to myocardial infarction, which causes death in middle-aged and elderly people.

Causes of coronary heart disease

The main cause of the development of the disease in question is atherosclerosis of the coronary arteries, which is accompanied by the deposition of cholesterol plaques in the vessels and narrowing of their lumen.

Of course, atherosclerosis of the coronary arteries does not occur on its own - it is caused by malnutrition, bad habits, and a sedentary lifestyle.

It is noteworthy that coronary heart disease can occur acutely - in this case, we will talk about saving the patient's life. But quite often the disease under consideration has a gradual development - at first there is practically no narrowing of the lumen of the coronary artery, and the patient will experience only mild, non-intense symptoms during physical exertion, and after some time the disease will make itself felt even in absolute rest.

With coronary heart disease, there is an insufficient supply of oxygen to the heart muscle, which can affect the patient's well-being in different ways: it all depends on the form of coronary artery disease.

Silent coronary heart disease

It is also called asymptomatic, because the patient does not experience any inconvenience, cannot identify the exact symptoms, and generally considers himself to be absolutely healthy. This form of IHD is quite insidious - it can turn into an acute one at any time and then it will be difficult to save a person.

To prevent the most severe development of the clinical picture, doctors recommend visiting a cardiologist at least once every 6 months and undergoing a preventive examination - this will help identify incipient coronary heart disease and provide timely assistance.

angina pectoris

Regular attacks, chest pain, shortness of breath are characteristics of angina pectoris. This form of coronary heart disease can last for a long period, the patient will complain only of discomfort and deterioration of health during exercise.

Unstable angina

A dangerous condition that may indicate the onset of myocardial infarction - at least doctors place a patient with signs of unstable angina in a medical institution and carry out not only treatment, but also round-the-clock monitoring of the work of the heart muscle.

Unstable angina is manifested by frequent attacks, each subsequent one will differ in the intensity of pain and the addition of unusual symptoms.

Arrhythmic form of coronary artery disease

It proceeds in the form of atrial fibrillation, is characterized by cardiac arrhythmias, can quickly and suddenly turn into a chronic form of leakage.

The arrhythmic form of coronary heart disease is often perceived by doctors as a signal for urgent action - the patient is placed in a medical institution, he is prescribed a full examination and competent treatment.

myocardial infarction

This form of coronary heart disease is the most dangerous for the normal life of the patient - myocardial infarction is the process of death of a section of the heart muscle, which always proceeds in an acute form. Myocardial infarction develops due to the separation of a plaque or thrombus from the wall of the coronary artery, which leads to blockage of its lumen.

In this case, only professionals can help.

With a sharp decrease in the amount of blood supplied to the heart muscle due to complete blockage of the coronary artery, the heart stops and clinical death occurs.

Note:all these forms of coronary disease can occur/develop independently, but most often there is a combination. For example, angina pectoris and arrhythmia are often diagnosed at the same time, which, if left untreated, necessarily leads to myocardial infarction.

Symptoms of coronary heart disease

The disease under consideration can proceed quite secretly, therefore it is recommended to pay attention to even minor changes in the work of the heart. Warning symptoms are:

• intermittent chest pain that may radiate to the arm, shoulder blade, or neck;
• feeling of tightness in the chest;
• burning sensation or heaviness in the chest;
• intermittent feeling of lack of air;
• feeling anxious for no apparent reason;
• general weakness;
• nausea and vomiting of unknown etiology.

Treatment of coronary heart disease

When the first symptoms of the disease in question appear, after visiting a cardiologist and clarifying the diagnosis, the patient will be offered, first of all, to radically change his life - to adjust both his lifestyle and diet. Of course, both drug therapy and regular monitoring of the work of the heart will be prescribed, some folk remedies will also be effective in the treatment of coronary heart disease - therapy should be carried out in a complex manner.

Nutrition for IHD

The menu of a patient with diagnosed coronary heart disease should be based on the principle of rational nutrition, balanced consumption of foods with a low content of cholesterol, fat and salt.

It is necessary to exclude or significantly reduce the use of:

• meat and fish dishes, including broths and soups;
• rich and confectionery products;
• Sahara;
• semolina and rice dishes;
• animal by-products (brains, kidneys, etc.);
• spicy and salty snacks;
• chocolate
• cocoa;
• coffee.

It is very important to include the following products in the menu:

Note:you need to eat with diagnosed coronary heart disease fractionally - 5-7 times a day, but in small portions. If there is excess weight, then you must definitely get rid of it - this is a heavy burden on the kidneys, liver and heart.

We change the way of life

To prevent the development of the most severe forms of coronary heart disease, you need to follow only three rules:

1. move more. Nobody says that you need to set Olympic records, but it is necessary to abandon the car, public transport and the elevator in favor of walking. You can’t immediately load your body with kilometers of roads traveled - let everything be within reason. In order for physical activity not to cause a deterioration in the condition (and this happens with ischemia!), be sure to get advice from your doctor about the correctness of the exercises.
2. Leave your bad habits in the past. Smoking and drinking alcohol is like a blow that will definitely lead to a worsening of the condition. Even an absolutely healthy person does not get anything good from smoking and drinking alcohol, to say nothing of a sick heart.
3. Take care of your nerves. Try to avoid stressful situations, learn to calmly respond to troubles, do not succumb to emotional outbursts. Yes, it's hard, but it is this tactic that can save a life. Talk to your doctor about taking sedatives or herbal teas with a calming effect.

Medical therapy

As a rule, patients with diagnosed coronary heart disease are prescribed nitroglycerin and its derivatives - drugs that promote vasodilation. As a result, the blood flow through the coronary artery is significantly accelerated and improved, the heart muscle is fully supplied with oxygen.

The intake of acetylsalicylic acid will also be effective - it prevents vascular thrombosis and improves blood composition. As part of therapy, medications that reduce cholesterol levels can also be prescribed.

note: there can be no question of any self-treatment! Any, even the most harmless at first glance, drugs should be prescribed by a specialist.

ethnoscience

Do not forget that to support the work of the heart muscle, increase the lumen in the vessels and prevent thrombosis of the latter can be means belonging to the category of "traditional medicine". Of course, you need to consult with your doctor and get his approval in principle for the use of various decoctions and infusions from medicinal plants - this is an indispensable condition for achieving a therapeutic effect.

The most popular prescription drugs to take with coronary heart disease:

Take 1 tablespoon of dried fruits, pour 250-300 ml of boiling water and insist for 2-3 hours. It is better to cook everything in a thermos. Ready infusion is filtered through 2-3 layers of gauze.

How to apply: 2 tablespoons of infusion three times a day 20 minutes before eating. Duration of admission - 30 days, then you need to take a break for 2-3 weeks.

Hawthorn is excellent for angina pectoris and in combination with motherwort herb - they are taken in 6 tablespoons, poured with 7 cups of boiling water and insisted for 10-12 hours. You need to take this decoction 1 glass 3 times a day before meals.

Herbal preparations

Mix white mistletoe leaves (1 tablespoon) and buckwheat flowers (2 tablespoons), pour all 300 ml of boiling water and leave to infuse for 10-12 hours (preferably overnight). You need to consume 2 tablespoons of infusion three times a day before meals.

Mix jaundice grass, sunflower reed flowers, dill seeds (2 tablespoons each) and coltsfoot leaves (1 tablespoon). 1 tablespoon of the mixture is poured with a glass of boiling water and infused for 60 minutes. Take an infusion of ½ cup 3-5 times a day before meals.

Grind the corn root (40 grams), add lovage herb officinalis to it in the same amount, pour water so that the mass is completely immersed in it, cook for 8-10 minutes. Then the decoction is infused for 40-60 minutes and taken 1/3 cup three times a day after meals.

Mix horsetail, hawthorn flowers and herb mountaineer bird (each 20 g) and pour a glass of boiling water, leave for 20-30 minutes, strain. The resulting amount should be drunk during the day in small sips.

Note:all listed herbal preparations can be taken no more than 30 days in a row. Then you need to take a break, undergo a preventive examination and consult with your doctor about the advisability of further use.

Horseradish

With its help, inhalations are made, which will be useful for coronary heart disease and other diseases of the main organ in the body.

Grate 5 g of horseradish root on a fine grater, pour a glass of boiling water and leave for 1 hour. Then inhalations are done either over a wide and shallow basin (bowl) or over the spout of a teapot.

Diagnosis of coronary heart disease is the main thing in the whole process of treating this insidious disease. It is impossible at the very first pain in the chest to independently decide that the disease in question is developing. The most reasonable thing is to immediately contact a specialist to conduct a full examination and make an accurate diagnosis.