Ischemic heart disease - symptoms and treatment. Ischemic heart disease: symptoms and treatment

Signs of coronary disease in men are often hidden: a person may not suspect that he is developing a pathology. You need to be attentive to your own health, pay attention to the signals of the body. Cardiovascular disease is life threatening. Coronary heart disease is common among men: they suffer 2 times more often than women. IHD manifests itself in different ways: some people have alarming symptoms, while others have mild or absent symptoms. If coronary disease is asymptomatic, it means that it progresses and will give complications in the future. With untimely treatment, a fatal outcome is possible.

Pathology is divided into several types depending on the symptoms. There are many factors that provoke coronary disease. IHD is divided into stable and unstable angina, primary and recurrent myocardial infarction, and it can also manifest itself in the form of postinfarction cardiosclerosis and heart failure. Symptoms of coronary heart disease occur due to the fact that the heart muscle (myocardium) is poorly saturated with oxygen. Oxygen starvation of the myocardium occurs with atherosclerosis of the coronary arteries: in this case, the lumen of the veins narrows. It is associated with spasm of arteries not affected by atherosclerosis.

Also, the disease occurs due to impaired blood circulation in the myocardium. Another reason for oxygen starvation of the myocardium is a violation of blood clotting. Atherosclerosis has an undulating course, in connection with this, the symptoms of coronary disease are unstable: they can increase and subside. As we have already said, coronary heart disease may be asymptomatic, but alarming signals may appear during physical and psycho-emotional stress.

Risk factors and causes of pathology

Symptoms of coronary artery disease are more common in men, so gender is a predisposing factor. In the female body there are special hormones: they block atherosclerosis. IHD and atherosclerosis often develop in people over 45 years of age. In the development of ischemia, heredity plays a role. It is worth noting that if a man smokes a lot, the functioning of the organs is disrupted. Due to bad habits, the heart muscle can suffer.

Ischemia develops in men who smoke 15 cigarettes a day.

The next predisposing factor is high cholesterol. To avoid this problem, you need to regularly take tests, and, if necessary, start treatment. If the body has high cholesterol, serious diseases can develop. In some men, ischemia appears due to excess weight. A sedentary lifestyle also predisposes to the disease. Factors of development of ischemia can be isolated or superimposed on each other.

Manifestations of ischemia

Consider the signs of the disease. The prognosis of coronary artery disease depends on its stage and severity of symptoms. If ischemia occurs in an asymptomatic form, the person seeks help late. In this regard, the forecast is not as favorable as it could be. The latent form of ischemia entails the appearance of plaques on the vascular walls, but the lumen of the vessels will narrow gradually.

A form of ischemia is angina pectoris: with such a pathology, pressure is felt in the chest, pain can radiate to the arm, radiate to the back, shoulders.

With this pathology, shortness of breath appears, in particular, when walking fast.
Some men have high blood pressure.
If ischemia is latent, there is a high probability of plaque growth in the veins. In the future, the venous lumen will be half closed. If coronary disease is manifested by symptoms, a person feels pain in the heart, the functioning of the organ itself is disrupted. Gradually, the heart muscle becomes thinner. If we consider the narrowing of the arteries, it occurs abruptly, the lumen of the vessels closes completely.
With myocardial infarction, pain in the sternum is felt. The pressure rises, atrial fibrillation appears. At any stage of ischemia, a heart attack can occur. Even if symptoms do not appear, the disease still progresses, and the symptoms intensify.
With ischemia of the heart, seizures appear. If we consider seizures separately, it is worth noting that they are more common in men, since they have an increased pain threshold. Ischemia develops in those who work hard, overstrain physically. In order to avoid cardiovascular pathologies, including ischemia, you need to fully relax, allocate enough time for sleep.
The development of ischemia contributes to smoking, alcohol abuse.

Clinical picture of the disease

An important sign of ischemia: chest discomfort. With such a pathology, a man quickly gets tired, as a rule, he cannot do hard work. Ischemia is characterized by increased pressure, palpitations, pain in the chest and heart. With such a disease, shortness of breath appears, jumps in blood pressure are observed (it is worth noting that pressure can drop sharply). If a man has severe ischemia, he often feels dizzy. Some patients experience visual disturbances, heartburn, and it hurts to swallow. He is nauseous and has regular urge to vomit. If the pathology is asymptomatic, the person quickly gets tired. It is important to pay attention to shortness of breath. In most cases, a man cannot explain what caused it.

The peculiarity of ischemia is that it gives symptoms characteristic of indigestion. Discomfort during exercise is possible. After it stops, the symptoms disappear. As the disease progresses, the symptoms become more pronounced. There is cardiac obstruction. It is important to identify ischemia at the asymptomatic stage, then it will be possible to start treatment in a timely manner and improve the prognosis. Latent ischemia is detected during a medical examination. If the pathology is diagnosed in a timely manner, it will be possible to avoid progression. Treatment in advanced stages is difficult. In this case, the doctor prescribes a lot of medicines and, if necessary, prescribes an operation.

Symptoms of progressive ischemia

The most common form of ischemia in men is angina pectoris. Previously, this disease was called "angina pectoris". Symptoms of angina pectoris appear depending on what caused it. If a person has stable angina pectoris, he is disturbed by pressing pains in the heart. Unpleasant sensations can be given to the arm, left forearm.

Hypothermia may be the cause of angina pectoris. The disease develops as a result of intense physical exertion. Unpleasant sensations with angina are given to the back, shoulder blade. A man may experience shortness of breath, in which there will be a lack of air. Pain is localized in the left side of the sternum. With progressive angina, mental health is disturbed: a person is often nervous, breaks down. This disease occurs in people who abuse alcohol and spend a lot of time in conditions of heavy physical exertion. The predisposing factor is hypertension. If we talk about shortness of breath, it may be accompanied by suffocation.

Against the background of angina pectoris, tachycardia often occurs. Unstable angina is dangerous because it can be asymptomatic. In this case, the patient will feel tired, unwell. It is worth noting that the progression of unstable angina is dangerous. Learn to recognize the symptoms of ischemia and cardiac obstruction. It is important not to confuse cardiovascular diseases with pathologies associated with the gastrointestinal tract. Despite the forms and stages of ischemia, a person must feel the state of his body.

stable angina

The stable form of the disease has the same type of symptoms. If the symptoms are rapidly increasing, the development of unstable angina pectoris, a pathology that is life-threatening, occurs. You need to start treatment as soon as possible. Attacks of pathology are difficult to stop with medicines. If the signs of the disease grow in waves and last 1-2 hours, blood pressure begins to jump, the heart rate changes. In this case, we can judge the progression of unstable angina. A dangerous condition can turn into a myocardial infarction. In the acute form of the ischemic process, blood circulation in the vessels is disturbed. Tissue hypoxia develops gradually.

Symptoms of ischemia can pass within 10 minutes, in other cases they last more than an hour. With this disease, blood clots of the heart vessels can appear. Hypoxic starvation causes vital cells to die. If a person feels severe pain in the sternum, you need to see a doctor. Common symptoms of ischemia are heart pain, dizziness, and nausea. Spasmodic abdominal pain may also be present. In some patients, respiratory functions are disturbed, suffocation appears.

Symptoms of ischemia develop in different ways: they may appear once and not remind of themselves in the future. The disease leads to excessive sweating. On the ECG, a specialist can diagnose post-infarction changes: they are a sign that there is an accreting scar in the heart. Angina requires immediate treatment. If shortness of breath and spasm are detected, resembling gastrointestinal disorders, you should consult a doctor. It is worth noting that against the background of such symptoms, pain in the extremities may be present.

About prevention

Ischemia may occur due to oxygen starvation of the myocardium. The cause of the disease is coronary insufficiency: the disease develops due to the fact that the coronary vessels undergo deformation. To prevent ischemia, you should stop smoking and drinking alcohol. It is important to control blood pressure, treat diseases associated with high cholesterol. Ischemic disease can occur against the background of diabetes mellitus, in connection with this, competent treatment of this disease is necessary. It is recommended to lead a mobile lifestyle.

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 finds the greatest distribution among men 40 — 62 years.

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 X-ray contrast examinations, 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:

We are talking about the absolute leader among cardiovascular diseases and the main killer of mankind (more than 7 million deaths per year according to official WHO statistics, exceeding the death rate from stroke, respiratory infections and oncology).

Since any person is at risk of getting a diagnosis of coronary artery disease, everyone should know: cardiac ischemia - what it is and why an untimely reaction to the onset of the disease is dangerous.

This is a pathological disorder caused by a decrease in the sufficient level of blood circulation (hence, oxygen filling) in the heart muscle. Only two transport channels carry blood to the myocardium - paired coronary arteries (branching of the aorta) and the slightest difficulty in their path stimulates abundant oxygen starvation.

How cardiac ischemia manifests itself in patients depends on the specific form of development of the pathology - malfunctions in the work of the myocardium can develop into chronic tachycardia and arrhythmia, heart failure, create preconditions for a heart attack and even sudden cardiac arrest.

According to the standards of the current ICD-10, several forms of the course of the disease can be distinguished:

Painless (also known as silent). The initial stage is characterized by the absence of pronounced pain, except for slight discomfort and heaviness in the chest. What exactly are the symptoms of ischemia, at this stage can only be determined by professional diagnostics.
voltage. It manifests itself with an increased need of the heart for oxygen (during physical exertion, stress, hypothermia, a single intake of an excessive amount of food), which the coronary vessels are unable to provide in the required volume.
Unstable angina. A period of threatening changes in the nature of the work of the heart. This is an alarming bell - such a manifestation of ischemia precedes the most severe complications.
Myocardial infarction. With a particularly acute lack of oxygen, the muscle tissue in the heart gradually begins to die. At a certain stage, the destruction reaches a critical point and an acute painful muscle spasm begins, which is fraught with a fatal outcome without the provision of qualified and urgent medical care.
Cardiosclerosis. Myocardial necrosis does not always increase rapidly enough to cause a heart attack. The process of replacing healthy cells with connective scar tissue, under certain conditions, stretches over time and proceeds without noticeable manifestations. It occurs regularly as a complication of many cardiovascular diseases, diabetes, the consequences of a heart attack, severe injuries and operations, in the elderly.
Sudden coronary death (aka primary cardiac arrest). A severe necrotic process that has gone deep into the tissues causes a sharp loss in the electrical activity of the myocardium. Cardiac activity stops, and there is a direct threat to life - even immediate resuscitation may be unsuccessful.

Forms of coronary heart disease

The reduced capacity of the main arteries is caused, on the one hand, by the heaps of atherosclerotic plaques of cholesterol on the walls (). The lumen narrows, the vessels become thicker and less flexible - blood is transferred with significant difficulty.

Thrombosis - the spontaneous formation of solid blood clots (emboli) in the bloodstream - is the second most important cause of cardiac ischemia. Together, this combination generates the most devastating effects on the body.

As the disease progresses, the problems increase - the oxygen-depleted tissue gradually dies, is replaced by scar tissue, and loses its ability to contract. As a result, the pathology goes so deep that the further functioning of the entire organ is extremely problematic.

In the early stages, signs of cardiac ischemia are almost invisible, which significantly complicates timely diagnosis. The patient has:

squeezing spasmodic pain in the chest, radiating to the left shoulder - at first only during heavy physical exertion, then for no apparent reason;
pains are aggravated, combined with nausea, heartburn, swelling of the lower extremities, a change in the rhythm of the heart (,), general weakness.

A patient with similar complaints and at risk. At the slightest suspicion that these are symptoms of ischemia, the doctor should undergo electrocardiography, which allows you to draw a fairly accurate conclusion and verify the presence of the disease and its dynamics.

The interpretation of the indications of electrocardiodiagnostics should be entrusted to specialists who thoroughly know what it is - cardiac ischemia - and how to treat its consequences. Pathological teeth Q, QS, QR and negative T wave are considered weighty grounds for making a diagnosis.

Along with the ECG are actively used:

ultrasound examination;
echocardiography;
blood chemistry;
functional tests (registration of the body's response to physical activity);
angiography of the walls of blood vessels.

ECG signs of myocardial ischemia

A huge number of methods of combating the disease are known. All methods of how to treat cardiac ischemia can be divided into three interrelated groups:

Preventive measures - aimed at eliminating factors contributing to the further development of pathologies. This includes:

special diet;
adjustment of the level of physical tension;
drugs that reduce the load on the myocardium (thrombolytics, anticoagulants and antiplatelet agents for blood thinning, diuretics - diuretics).

Pharmacological preparations to eliminate the symptoms of cardiac ischemia and increase the body's resistance:

blockers (reduce oxygen consumption by the heart);
hypolipidemics;
statins and fibrates (regulate blood cholesterol),
nitrates to neutralize spasmodic exacerbations.

Non-drug intervention - primarily surgical methods:

shunting;
X-ray endovascular dilatation;
other methods of artificial expansion of the lumen of the artery.

The fact that cardiac ischemia is such a continuation and its treatment requires similar actions unites all risk groups for cardiovascular diseases according to similar criteria:

genetic predisposition;
age;
bad habits;
malnutrition;
lifestyle: insufficient or vice versa - excessively exhausting physical activity;
diseases and chronic metabolic disorders: high blood pressure, diabetes, obesity, dyslipidemia.

The older a person gets, the more likely they will need medication for ischemia of the heart, regardless of other circumstances.

Alcohol and tobacco, the predominance of fatty, fried, salted foods in the diet are the key drivers of the development of pathology and the key cause of the problem.

It is worth remembering that excessive mental stress also causes irreparable harm to blood vessels and the heart.

Risk Factors for Coronary Heart Disease

More than a third of women over 65 years of age have signs of cardiac ischemia, the most common form being stable angina. In addition to the usual risks of developing pathology, a metabolic disorder due to menopause is added. The features include a more aggressive course of the disease and a higher percentage of deaths compared to men. The predominant manifestation of symptoms of coronary artery disease at night is characteristic.

Men are more susceptible to various forms of ischemia and experience the disease at an earlier age (average 45–60 years). A separate alarm signal about predisposition to cardiovascular diseases can be early impotence.

One of the fundamental factors in the treatment of cardiac ischemia is the maintenance of a balanced and healthy diet, from which the following should be completely excluded or severely limited:

fats, mainly of animal origin;
fried, smoked, dried food;
salt;
foods with a high content of fast carbohydrates (sweet and starchy foods).

It is much easier to prevent the disease in advance than to find out later what is ischemia of the heart and how to treat it on your own experience. It is obviously impossible to completely protect yourself, since vascular pathologies, as a rule, are hereditary, but minimizing the risks is more than realistic. Supporting a healthy lifestyle, a balanced level of physical activity, and preventing severe mental stress will help reduce the risk of coronary artery disease to zero.

Any form of cardiac ischemia manifests itself as a chronic disease, specific forms of its expression rest on the rate of clogging of blood vessels and the development of necrotic processes. Periods of long-term stagnation of the pathology are characterized by symptoms of stable angina pectoris or cardiosclerosis.

But with an increase in negative external factors, for example, after increased physical or emotional stress, a transition to an acute form is possible.

The chronic variant of the course of IHD has an extremely negative effect on the patient's performance and well-being, making it difficult for any vigorous activity, and at any time can develop into more serious complications - circulatory disorders of the extremities (obliterating atherosclerosis, venous thrombosis, etc.).

What is dangerous ischemia of the heart?

This deadly disease with the highest percentage of deaths, claims the lives of millions of people around the world every year. In fact, a complete cure is impossible, but competent treatment can significantly reduce the damage to health and prolong the patient's life.

Useful video

You can learn more about the causes, methods of diagnosis and treatment of coronary heart disease from the following video:

Conclusion

The modern way of life of the majority of the population can hardly be called healthy - almost everyone is in one or another risk group for developing coronary artery disease.
Symptoms of the disease are difficult to distinguish in the early stages; in more serious stages, serious damage is done to the body and human performance.
Modern therapeutic methods can prevent the onset of serious consequences and restore the full functioning of the heart and blood vessels, but the disease is characterized by a high mortality rate and the risks only increase with age.
Careful prevention and a balanced attitude to your lifestyle are effective methods for preventing pathology and guaranteeing a healthy and fulfilling life.

When the vessels that feed the heart begin to narrow, the blood flow to the myocardium is disrupted, which leads to the emergence of various cardiovascular pathologies, united under the concept of "ischemic heart disease".

Causes of ischemia

The most common cause of coronary heart disease (CHD) is the development of atherosclerosis. When the disease occurs, damage to the arteries occurs: the walls of the vessels become denser, the gaps in the arteries are greatly narrowed, and the general blood flow is disturbed. Oxygen starvation occurs in the heart muscle, which leads to the appearance of diseases of the cardiovascular system.

There are more than 30 causes that trigger the processes of atherosclerotic lesions of the arteries. Main reasons:

Smoking. In the vessels, nicotine provokes a spasm. Contained in tobacco, carbon monoxide causes damage to the walls of blood vessels, and this increases the risk of atherosclerosis.
Age. With age, the arterial walls become thinner, irreversible processes begin in the body, the risk of developing and developing various ailments increases significantly. Dangerous for coronary heart disease is considered to be over 55 years old (for women) and over 45 years old (for men).
Hypertension. The constant increase in pressure, if left untreated, leads to rapid wear of the walls of the arteries and accelerates the aging process.
Heredity. A certain contingent of people whose relatives suffered from diseases of the cardiovascular system have a high risk of developing coronary heart disease.
Constant and chronic stressful situations. In the process of stress, arteries are destroyed. Often people try to "relieve stress" through alcohol, smoking, or overeating. All these factors together lead to the destruction of the walls of blood vessels.
Sedentary lifestyle and obesity. Physical inactivity and overeating put a strain on the heart and blood vessels.
The presence of cholesterol in the blood. The formation of cholesterol plaques is one of the main factors in the development of atherosclerosis.

Taking hormonal contraceptives, chronic infections, and increased blood clotting can also trigger coronary disease.

In men, the risk of atherosclerosis and ischemia is several times higher than in women (usually the risk occurs during menopause). This is due to hormonal factors, differences in lifestyle and some genetic characteristics.

There are cases that coronary heart disease occurs in people without bad habits, thin build, with normal pressure and fairly high physical activity. Here, the causes of the disease lie in a change in the composition of the blood: blood test indicators can indicate the risk of developing coronary disease, and the doctor will prescribe preventive measures to prevent it.

Symptoms of coronary artery disease

The disease goes through several stages, depending on this, the symptoms of coronary heart disease are classified as follows:

1. Asymptomatic stage. The disease does not make itself felt, although cholesterol plaques are already beginning to appear in the vessels, which are still too small to clog the passage.

2. First manifestations. The sizes of plaques increase, the artery is already closed almost by half. Heart failure begins to develop, symptoms appear:

Pain in the sternum (radiating to the back, left arm, etc.);
Dyspnea;
severe dizziness;
Frequent unstable heartbeats;
excessive sweating;
Clouding of consciousness (pre-fainting state) or fainting.

3. Progression of the disease. The gaps in the artery are getting smaller, the work of the heart is deteriorating. Against the background of pain behind the sternum, swelling occurs, shortness of breath bothers even at rest, tachycardia attacks appear more often, unreasonable anxiety and fear of death begin to appear.

4. The final stage. At this stage, the likelihood of critical conditions (myocardial infarction or sudden cardiac arrest) increases. Manifestations:

Sudden uncontrolled pressure surges;
Severe pain in the sternum (manifested in any condition);
Atrial fibrillation.

All of the above symptoms of coronary heart disease do not manifest themselves simultaneously - in a certain form of coronary heart disease, one or the other signs may predominate.

Classification of coronary heart disease

Ischemic disease includes several clinical forms that manifest themselves in different ways:

In women, the manifestations of ischemia are more vague and not permanent. There is weakness and frequent fatigue, which can cause the disease to be confused with the usual flu or indisposition from overwork. Therefore, in women, coronary artery disease is diagnosed more often already in the later stages, when immediate treatment is required.

Often, forms of coronary disease can pass one into another (acute coronary syndrome): angina attacks, for example, can be replaced by a heart attack or even sudden death.

Diagnosis

Before treating IHD, a cardiologist prescribes a number of diagnostic measures aimed at identifying the form and stage of the disease.

How is ischemia diagnosed?

Drawing up an anamnesis: clarification of complaints and determination of the causes leading to the onset of the disease, the presence of cardiovascular diseases in relatives.
Initial examination: heart murmurs are heard, the presence of wheezing in the lungs is determined, the presence of edema is checked, pressure is measured.
Ordering blood and urine tests. Studies of indicators make it possible to establish signs of coronary heart disease, to detect probable complications and prerequisites for the onset of the disease.
Electrocardiogram: determines the electrical activity of the heart, reveals disturbances in the functioning of the myocardium. If ischemia manifests itself exclusively during stress, an ECG with stress is prescribed: the patient performs certain physical efforts, and the device simultaneously records the performance of the heart.
Echocardiogram. Ultrasonic waves help to study the work of the heart muscle in real time: to study blood flows inside the heart, assess the state of blood vessels, and identify a possible heart attack. An echocardiogram, just like an ECG, can be done with exercise.
Coronary angiography: evaluates the state of the myocardium and vascular patency by introducing a special dye into the vessels. The procedure can cause complications, so it is usually performed when there are indications for surgery.
MRI and computed tomography: allows you to more accurately assess the condition in which the coronary arteries are located.
Holter monitoring: detects violations of the heart muscle in dynamics. The patient during the day wears a special device that records changes in the work of the heart in vivo, which allows you to quickly identify the prerequisites for the onset of pathology.

After the examination, the diagnosis of "ischemic heart disease" is not made - there must be a decoding of the disease: IHD: exertional angina, IHD: myocardial infarction, etc.

Treatment of the disease

Treatment of coronary heart disease is a set of specific measures, the purpose of which is to regulate the necessary blood flow to the myocardium in order to prevent the development of additional pathologies.

There are the following directions of treatment of ischemic disease:

Non-drug therapy.
Therapy with medications.
Operative (surgical) intervention.

All these measures are aimed at alleviating the symptoms of the disease, eliminating the factors that cause the disease, and reducing mortality from ischemia.

Non-drug therapy

These include activities aimed at adjusting lifestyle:

Regular physical activity (cardio training, gymnastics, swimming).
Change in nutrition. The transition from junk food (fatty, salty, smoked) to the introduction of more fruits, vegetables, fish, grains into the diet. In heart failure, water intake should be limited to reduce the load on the heart muscles.
Rejection of bad habits.
Stress management. You should reduce as much as possible the number of stressful situations (at work and in the family). Meditation, yoga, and taking sedatives will help.

In various forms of coronary heart disease, the activity regimen should be limited, because. with strong physical exertion, there is an increase in the need of the heart muscle for blood supply, which can increase the manifestations of coronary disease. Physical exercises should be carried out under the supervision of a physician, and the load should be increased gradually in the process of rehabilitation measures.

Therapy with drugs

Drugs that carry out therapy for coronary artery disease are divided into 3 main groups:

Antiplatelet agents (drugs that reduce clotting and prevent the development of blood clots): aspirin, ticlopedin, dipyridamole, pentoxifylline, iloprost.
Anti-ischemic drugs (reduce oxygen demand in the heart muscle): β-blockers (relieve pain, dilate blood vessels, restore heart rhythm) or calcium antagonists (used if there are contraindications to taking beta-blockers or if they are not effective enough). The drugs in this group include: nebivolol, bisoprolol, carvedilol.
Hypocholesterolemic drugs (cholesterol-lowering drugs): statins, bile acid sequestrants, fibrates, etc.

Additionally, diuretics, nitrates, antiarrhythmics can be prescribed - in the absence of contraindications to admission.

Popular drugs for ischemia:

Thrombo ASS;
Cardiomagnyl;
bisoprolol;
Aspirin Cardio;
Nebivolol;
Carvedilol;
Aspigrel;
Agrenox.

It is advisable for a patient with ischemia to have nitroglycerin tablets in the medicine cabinet - they have the ability to relax blood vessels, relieve angina attacks and pain syndrome.

Surgical intervention

If drug therapy fails and there is a risk of developing a heart attack, surgery is prescribed:

Coronary angioplasty (or PTCA). The procedure is both diagnostic and therapeutic. A special frame-stent is installed in the blocked artery, which keeps the walls of the vessel from re-narrowing.
Aorto-coronary bypass. With the help of a surgical operation, the blood supply to the heart muscle is restored by creating a bypass channel through which blood will be delivered to the myocardium.

Depending on the indications, stage and form of coronary artery disease, other surgical measures can be used: minimally invasive coronary artery bypass grafting, brachytherapy, transmyocardinal laser revascularization, etc.

Measures to prevent ischemia

Prevention of ischemia is a set of measures that eliminate risk factors for the onset of the disease and prevent complications. First of all, this is a change in lifestyle and compliance with simple rules:

You can not drink alcohol in large quantities, and cigarettes should be abandoned altogether.
You can’t worry and get annoyed over trifles - stress and excessive emotional stress should be avoided.
Physical activity cannot be avoided - they must be strictly dosed and include regular cardio training, swimming, gymnastics, etc.
You can not eat junk food (fried, spicy, salty) - you should include more cereals, fish, fruits and vegetables in the diet.
You can not overeat - it is necessary to maintain optimal body weight and prevent obesity.

Ischemia is very dangerous and can lead to serious complications. However, if the patient complies with all the doctor's instructions regarding treatment and preventive measures, this will definitely protect him from myocardial infarction and other serious consequences. Not a single remedy can protect against ischemia if the patient does not change his habits and does not choose a healthy lifestyle.

Ischemia, the symptoms of which are manifested not only by pain in the chest area, is a disorder of the coronary circulation, which leads to insufficient blood supply to the myocardium, metabolic disorders and inadequate supply of oxygen to the heart muscle. Recently, a fairly common disease of the cardiovascular system, which leads to severe irreparable deterioration in health and even death. The risk group includes mainly men, women during the period, as well as after menopause, which, with a change in hormonal levels, brings with it a weakening of the body and provokes many diseases.

There are several forms of cardiac ischemia:

The initial one is painless. There is a decrease in blood pressure, discomfort in the chest, shortness of breath.
Primary arrest - characterized by cardiac arrest. In this case, without immediate professional help, it leads to death.
Angina. There is a blockage of the coronary arteries with plaques that cause pain in the chest, arm, neck, and facial part.
Heart attack. Termination of the full flow of blood to the heart.
Heart failure or cardiosclerosis. Scarring of areas of the heart, violation of the shape of the valves.

If you do not seek medical help in a timely manner, serious complications are possible. At the first sign, you should immediately consult a doctor. The cardiovascular system is involved in the process of blood circulation of the whole organism, and the heart, as its independent organ, also needs blood supply. Coronary vessels or arteries feed the myocardium and heart muscle.

But there are reasons that lead to disruption of this process and the development of coronary disease:

Atherosclerosis. The formation of cholesterol on the walls of blood vessels.
Arterial hypertension. Due to the constant increase in blood pressure, there is an increase in the left ventricle and a violation of the full blood supply.
Diabetes. It leads to the formation of cholesterol plaques, which impede blood circulation.
Thrombosis. The mechanism of rapid blood clotting makes it impossible for it to enter the organs through the vessels.

These diseases often not only provoke ischemia, but are subsequently concomitant diseases. Much complicate the treatment and recovery of patients.

Provoke violations and improper functioning of the organs of the cardiovascular system can not only diseases, but also the characteristics of the body and the life of the person himself:

Stress, nervous strain. They lead to constant arrhythmia, disruption of the supply of nutrients and oxygen to the organs.
genetic predisposition. It is inherited along with the genetic code.
Gender identity. In men, ischemia is more common.
Excess weight. Exceeding normal body weight leads to an increase in the volume of blood that the heart must push out in one contraction. The tone of the walls gradually worsens, the load on the vessels increases.
Having bad habits. Smoking provokes an excessive amount of carbon monoxide and a lack of oxygen in the blood.

Gradually and with age, the vessels lose their elasticity, so after 45-50 years there is a high probability that ischemia will appear. Symptoms in the stronger sex are more pronounced, as they are more vulnerable to ischemia. This is due not only to physiological characteristics. The reasons are difficult working conditions, bad habits and stressful situations.

Untimely visit to the doctor, when there are complaints of coronary artery disease, leads to coronary heart disease, which manifests itself in men with characteristic symptoms:

severe pain in the chest;
lack of air, shortness of breath;
fainting, darkening in the eyes;
dizziness and migraine;
bouts of nausea;
increased sweating;
arrhythmias.

The prerequisites for the appearance of cardiac ischemia in this case are atherosclerosis, the formation of blood clots in the vessels, elevated cholesterol levels and spasms of the coronary vessels. All this contributes to a lack of nutrients in the body and disruption of the full process of blood circulation.

Signs of ischemia of the heart in women and children

Signs of cardiac ischemia in women are not as bright as in men, since for a long time only men were susceptible to cardiac ischemia. In women, this disease was observed quite rarely. Now it is considered age-related and manifests itself during menopause. Changes occurring in the body, lack of estrogen affects the work of the cardiovascular system in 20% of women.

Women still have individual signs of cardiac ischemia:

bouts of acute sharp pain in the back;
short angina - lasts no more than 15 minutes;
dyspnea;
indigestion;
swelling of the extremities may appear in the evening;
loss of consciousness or frequent dizziness.

In women, the cause for ischemia of the heart can be stress, hard mental work, age from 55 years. Then, as in men, the disease begins by the age of 40.

Diseases of the cardiovascular system affect even young children. There are several reasons for their occurrence. These include heredity, overwork during the educational process, congenital pathologies.

In a child, ischemia shows its characteristic symptoms:

Pain, feeling of constriction of the chest. The duration reaches 30 minutes.
Numbness and sharp pain in the left side of the face, arm and forearm.
Lack of oxygen, shortness of breath, signs of suffocation.

In most cases, even the drug "Nitroglycerin" is not able to alleviate the condition. In childhood, mortality from coronary disease is much higher. Therefore, at the first even the slightest suspicion of a violation of the heart, it is urgently required to call an ambulance.

An ischemic attack usually begins after heavy physical exertion or a strong emotional shock. A person feels squeezing pain in the chest, there is profuse sweating.

In such cases, it is necessary to know exactly the rules of how to provide first aid for angina pectoris:

immediately call an ambulance;
it is convenient to put the patient on the bed, raising his head and loosening the belt and collar of the clothes;
try to calm and distract;
open windows, turn on a fan or air conditioner in the summer;
pour warm water into a heating pad and place it at the feet of the patient.

You can also give the drug "Nitroglycerin", depending on the severity, you can give from 1 to 4 tablets. A person should put them under the tongue and dissolve.

It is impossible for angina pectoris to cause excitement, give unfamiliar drugs and force a person to move. Until the ambulance arrives, it is better to keep quiet and, in case of severe anxiety, apply valerian tincture.

The best way to avoid ischemia is to constantly monitor your health and undergo a medical examination. In the case when symptoms suddenly appear in the chest or left side of the body, contact a specialist.

The main measures for the prevention of coronary disease are simple daily rules that must be observed:

Stick to a healthy nutritious diet. Control weight, avoid obesity.
Move more and accustom the body to walks in the fresh air.
Don't forget about physical activity.
Get rid of bad habits.
With a hereditary predisposition, spend more time visiting doctors.
Take, on the advice of a specialist, drugs that strengthen the heart and blood vessels, for example, Entresto (you can read about the drug) or Kordanum medicine.

Many diseases are the result of the wrong way of life of the person himself. It is necessary to take into account environmental problems, which also play a large role in the deterioration of health. In every possible way avoid stressful situations and excessive loads.