Diseases of the cardiovascular system occupy the first place in the frequency of occurrence throughout the world. At one of the first places is coronary heart disease and its complications.
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- What is CHD?
- Clinic of the disease
- What you need to know about atherosclerotic cardiosclerosis
- What is CHD?
- Aortocardiosclerosis. Clinical manifestations
- Conservative treatment
- Surgical intervention
- Cardiosclerosis Prevention
- In conclusion
What is CHD?
Coronary heart disease is understood as a condition that develops as a result of a decrease in blood flow in the coronary arteries, the main system of blood vessels in the heart. As a result of this, the myocardium of the heart lacks oxygen and experiences oxygen starvation. For this reason, the heart cannot properly perform its function, as it works at the limit of its own capabilities.
Because of this, there is a thickening of the walls of the heart and its increase in size. At some point, in conditions of lack of blood and oxygen, excessive muscle tension appears, and as a result, either myocardial rupture or damage to the vessel with the development of hemorrhage (myocardial infarction) develops. Most often, this condition is fixed against the background of atherosclerotic lesions of the coronary vessels, but there can be many reasons for its appearance. It is worthwhile to understand why the most important and frequent condition develops in IHD – atherosclerotic cardiosclerosis.
Usually, cardiosclerosis is understood as an irreversible process that takes place in the thickness of the heart muscle. When it is present, the replacement of normal cardiomyocytes with connective tissue, which significantly impairs the functioning of the heart.
There are two main forms into which cardiosclerosis is divided – atherosclerotic and postinfarction.
As the name implies, post-infarction cardiosclerosis develops at the site of the former cardiomyocyte necrosis – infarction. When it replacing damaged tissue is a physiological process, the body’s attempt to restore the affected organ. In its activation lie the complex mechanisms of interaction between the cells of the myocardium, connective tissue and cells of the immune system.
In atherosclerotic cardiosclerosis, the process is usually pathological and proceeds somewhat differently than post-infarction sclerosis. The basis of complex reactions of accumulation and consumption of fatty molecules.
The disease is also mentioned in the international classification of diseases. If there is atherosclerotic cardiosclerosis – the ICD code, which is set in the diagnosis – I24. By the way. This diagnosis is made to all, without exception, patients older than 55 years. What is characteristic of him?
How does atherosclerotic cardiosclerosis develop? The causes of this pathology are metabolic disorders, primarily associated with fat metabolism.
It all starts with an imbalance of lipoproteins in the body. An important role is played by low density lipoproteins (recognized as the most atherogenic – capable of forming atherosclerotic plaques). Another, no less important factor is the local damage to the vascular endothelium. Normally, the endothelium is covered with special substances that prevent lipoproteins and blood clots from settling on them.
Since it is affected, conditions are created for the accumulation of lipoproteins at the site of the violation. As a result, an atherosclerotic plaque develops at the site of the vascular defect. As it grows, a gradual narrowing of the coronary vessel occurs, which creates the conditions for oxygen starvation. As a result of an almost total decrease in the lumen of the vessel, the blood stops passing to the myocardium, and its heart attack develops.
This form of coronary heart disease – atherosclerotic cardiosclerosis – is the main cause of heart failure. As a result of a violation of the supply of myocardium with oxygen and the development of sclerosis of the coronary vessels, the process goes to the heart muscles. Because of this, it becomes total and captures the entire thickness of the organ.
It develops over a long period of time. Disorders are growing gradually, because of which it is impossible to establish the diagnosis of atherosclerotic lesion without conducting relevant research. What are the manifestations of this disease and how they manifest themselves in different people?
Clinic of the disease
Any clinical signs do not manifest themselves until the whole myocardium, as well as other membranes of the heart, are involved in the process. Especially important is the narrowing of the lumen of the coronary vessels. The clinic does not appear until the diameter of the heart arteries is reduced by at least 70 percent and atherosclerotic cardiosclerosis of the heart develops.
The initial manifestations of the disease are shortness of breath, pain in the heart, periodic rises in blood pressure.
Shortness of breath manifests itself gradually. Initially, its development is characteristic of excessive physical exertion, but over time, its appearance may be at rest.
As for heart pain, they are aching in nature and usually appear when the heart is overloaded. It cannot be said that they are of a stenocardic nature (squeezing pain, extending to the arms or back). With the progression of pain become permanent and poorly respond to taking vasodilators.
If such a patient comes to you, and the above-described clinic and medical history are observed, atherosclerotic cardiosclerosis is what a competent specialist should think about.
In order to reach a verdict and answer the question of what happened to the person and why he makes such complaints, it is necessary to conduct an additional examination of the patient. The diagnosis of atherosclerotic cardiosclerosis can be identified in the presence of all these symptoms and risk factors. Additional components of the latter, affecting the development of the process, are the age of patients older than 55 years, the male sex, a sedentary lifestyle, and poor nutrition.
To clarify the diagnosis should conduct some more research. Among them, biochemical blood tests for cholesterol, an electrocardiogram and coronary angiography come out on top.
Changes in the cardiogram, characteristic of atherosclerosis of the heart – a decrease in the voltage of the teeth (a decrease in their normal size), while the teeth are quite normal in width and character.
Coronary angiography reveals a narrowing of the lumen of the coronary vessels and suggests a lack of oxygen in the myocardium.
Given the complexity of the pathogenesis of the disease, it should be understood that the therapy should be comprehensive. The balance of non-drug interventions, as well as medicinal and surgical interventions allow to achieve significant success in the treatment of coronary heart disease.
First of all, you should promote a healthy lifestyle. As is known, the violation of proper nutrition is the main cause of damage to the heart vessels and the heart. In addition, competent physical exertion allows you to properly prepare the heart for subsequent overstrain in work.
Compliance with these simple rules (nutrition and physical education) make it possible to delay the development of coronary heart disease for some time. The use of drugs will eliminate the cause of the disease and restore normal metabolism.
The main thing you should pay attention to if you want to cure atherosclerotic cardiosclerosis – the pathogenesis of the disease. Influencing on its basic links, it is possible to achieve considerable success in the treatment of ailment.
Treatment of atherosclerotic cardiosclerosis with drugs should be initiated only in case of reliable and confirmed presence of heart failure and vascular lesions. To do this, use such groups of drugs as antihypertensive drugs, means to combat heart failure, statins, fibrates and metabolites.
Antihypertensive therapy includes the use of angiotensin-converting enzyme inhibitors (Enalapril, Captopril), diuretics (Indap, Furosemide). Diuretics are also used in the presence of heart failure and are one of those drugs that are prescribed in the first place.
To improve heart function, it is recommended to use metabolic preparations (Mildronate, Cardiomagnyl). They can improve the blood supply to the heart muscle, and also contribute to the launch of regenerative processes.
In addition, with increased heart rate and impaired functioning, it is best to use cardiac glycosides (Digoxin, Strofantin).
Statins are the main drugs in the treatment of atherosclerosis. The essence of their action is to reduce the level of atherogenic lipoproteins in the blood plasma, their cleavage and elimination, as well as to saturate the blood with anti-atherogenic lipoproteins (HDL – high density proteins). By increasing their concentration, the protective properties of the vascular endothelium are improved, it is strengthened, which prevents the development of new plaques.
Fibrates have a similar effect, but using them together with statins is strictly prohibited due to the development of side effects.
For treatment, drugs such as Lovastatin, Simvastatin, and Rosuvastatin are used. Of fibrates, clofibrate, bezafibrat, and gemfibrozil were widely used.
These drugs should be used only as prescribed by a doctor and with mandatory monitoring of health status, since not all patients tolerate these drugs well.
With the ineffectiveness of non-drug methods and prescribed drug therapy resort to the use of surgical intervention. The spectrum of operations performed in this pathology is small, and all of them are aimed mainly at expanding the narrowed coronary vessels and restoring blood flow. Shunting, stenting, and balloon angioplasty are most common.
Shunting is usually performed on an open heart and is a rather complicated and dangerous operation.
Stenting is the introduction into the cavity of a vessel of a metal structure, the purpose of which is the mechanical expansion of constricted vessels.
Balloon angioplasty is formally the initial stage of stenting, but sometimes it can be used independently. It is carried out under the control of X-rays. A catheter with a balloon is placed in the vessel. When reaching the narrowing point, the balloon inflates, thereby flattening the plaque and expanding the vessel.
- Diana Hysi, MD. Atherosclerotic cardiosclerosis, 2018
- L.M. Attack, Yu.O. Otaman. Clinical electrocardiography, 2011
Higher medical education. Kirov State Medical Academy (KSMA). The local therapist.
More about the author
Last Updated: October 2, 2019
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Doctors divide the disease into two forms:
- Diffuse small focal. It is characterized by a uniform death of the cells of the heart tissue in small flaps. Often accompanied by angina attacks.
- Diffuse large focal. It is characterized by the formation of large pathologically altered areas. It develops, as a rule, after a heart attack.
Depending on the causes, atherosclerotic cardiosclerosis can be:
- Ischemic type. In this case, the ailment is the result of prolonged oxygen starvation.
- Postinfarction type. The formation of connective tissue (scar) occurs in areas of necrosis.
- Mixed type. The disease combines both of the above symptoms.
Against the background of treatment, the pathology progresses slowly. If therapeutic measures are not carried out, the disease develops very quickly.
There are several approaches to classification. According to the characteristics of the development of the disease, ischemic, post-infarction, combined atherosclerotic atherosclerosis is distinguished. Ischemic develops with prolonged oxygen starvation of cells. It is characterized by slow progression. Post-infarction differs from ischemic rate of development.
In appearance, there are two forms of cardiosclerosis:
- focal – single scars of a small size;
- diffuse – multiple lesions having significant dimensions.
The focal form leads to a mild form of heart failure, and the diffuse form to moderate or severe.
Cardiosclerosis does not have its own index for mcb-10. The disease is classified according to the underlying disease – chronic coronary heart disease (I25).
What you need to know about atherosclerotic cardiosclerosis
The insidiousness of this pathology lies in the absence of pronounced symptoms. The patient seeks help even when the disease is in an advanced stage. What is cardiosclerosis?
The disease is diffuse or focal in nature, in the process of its development the muscle tissue of the heart is replaced by connective, forming the so-called scars, which lead to impaired blood flow. In the process of the disease, the heart perceives foreign tissue as its own fibers, and tries to function in the usual way. Here the failures in the work of the myocardium, and indeed the whole organism, begin.
The cause of the disease can be:
- coronary heart disease (CHD);
- coronary arteriosclerosis;
- age-related changes in the body;
- violation of cholesterol metabolism;
Experts note that the presence of arterial hypertension in a patient significantly increases the progression of the disease, in other words, increased blood pressure, increases the rate of formation and the number of scars.
At risk are men from 55 – 70 years old.
Symptoms of the disease in the initial stage resemble ordinary exhaustion – physical fatigue, distracted thoughts, decreased performance. In this connection, many patients believe that a short rest and unloading of the body will give a positive result and will remove this symptomatology without taking medications. As a rule, this does not happen, but more serious deviations begin, such as shortness of breath and swelling of the lower extremities.
As the number of scars increases, it becomes harder for the heart to pump blood and saturate it with oxygen. The organ increases in volume on the left, heart sounds are muffled, characteristic wheezing on exhalation is observed. Arterial cardiosclerosis, manifests itself as arrhythmia and angina pectoris. The disease is accompanied by heart failure, cardiac asthma, pulmonary edema, enlarged liver and subcutaneous edema of the whole organism.
As a rule, atherosclerotic cardiosclerosis has a long course, without obvious sharp manifestations. But cases have already been recorded when this diagnosis caused the death of patients.
When contacting a specialist, you must completely describe your own feelings and the symptoms present. Based on the examination of the patient, and analysis data, the specialist makes this diagnosis.
An interesting fact: Some experts consider atherosclerotic cardiosclerosis a mythical disease, a collective name for a number of symptoms of cardiac pathology, but this term does not exist in the official medical classification. Rather, it exists, but as a manifestation of the aging of the heart and its age-related change, inherent in everyone without exception, starting from 55 years old.
To diagnose the disease, prescribe:
- Ultrasound of the heart;
- electrocardiogram (ECG);
- echocardiogram (echocardiography);
The treatment of this cardiac pathology is aimed at:
- Identification and treatment of the underlying disease – coronary heart disease or atherosclerosis, as a result of which atherosclerotic cardiosclerosis started.
- Restoring normal heart rhythm (taking drugs that reduce arrhythmia or surgery).
- Angina treatment.
- Improving metabolic processes in the myocardium (taking medications that improve metabolism in the heart muscle).
- Treatment of coronary insufficiency and circulatory failure.
As a rule, a cardiologist recommends adhering to the basics of a healthy diet, to lower blood cholesterol. It is necessary to reduce physical activity. Constant monitoring of the level of arterial hypertension, taking appropriate medications and diuretics. Control over the amount of fluid consumed.
The treatment of the disease, as a rule, depends on the symptoms present in the patient. In most cases, a cardiologist prescribes nitroglycerin to improve coronary circulation. In small doses, aspirin is prescribed for a month. It will be advisable to take statins, drugs that slow down the processes of atherosclerosis.
Patients with such a diagnosis are shown spa treatment and special therapeutic exercises.
Atherosclerotic cardiosclerosis is a disease that can occur for a long time. If you do not carry out appropriate therapy, then the pathological process will be aggravated.
At the initial stages of development, the patient does not have any manifestations. The diagnosis is usually made by chance during electrocardiography.
Over the years, the likelihood of atherosclerotic changes in the vessels increases significantly. Therefore, even if there has never been a heart attack, scars still appear in the heart due to oxygen deficiency.
Pathological processes with development are supplemented by new manifestations:
- Initially, the patient often has a feeling of lack of air during exercise. Gradually, it becomes difficult for a person to breathe, even if he walks slowly. The patient begins to tire quickly, suffers from weakness and cannot fully perform the usual work.
- Pain in the left chest in the chest. At night, they begin to intensify. Symptoms similar to angina attacks may be observed. Unpleasant sensations spread to the shoulder blade, the entire arm and to other parts of the body.
- Often, a headache, stuffy ears and noise. This indicates an insufficient supply of oxygen to the brain.
- The rhythm of the contractions of the heart is disturbed. The frequency of strokes increases, signs of atrial fibrillation appear.
All these symptoms appear even in the presence of serious malfunctions in the heart. Therefore, it is important to be examined regularly to identify disorders at the beginning of development.
The initial stage of the disease is not accompanied by the occurrence of alarming signs. As angina progresses, the following symptoms of atherosclerotic cardiosclerosis appear:
- Dyspnea. Initially, it occurs only after the commission of any motor activity. Over time, she begins to bother the patient even at rest.
- Pain in the heart. As a rule, the severity of their manifestation is enhanced at night. Often worried about angina attacks. The pain radiates to the left half of the body: arm, collarbone or shoulder blade.
- Increased fatigue.
- Rapid decline in performance.
- Muscle weakness.
- Noise and a feeling of stuffiness in the ears.
- Violation of the heart rate.
The progression of atherosclerotic cardiosclerosis of the heart is accompanied by the occurrence of cough, dizziness and severe swelling of the lower extremities. It becomes extremely difficult for the patient to perform any domestic actions. Even the slightest physical exertion leads to severe weakness and fatigue.
If the lumen of the vessels narrows by 70% or more, the process of formation of scar tissue is accelerated. At this stage, signs of the following pathologies appear:
- acute heart failure;
- expansion of the cavities of the main muscle of the body;
- myocardial infarction;
- atrial fibrillation;
- conduction disturbances (blockade);
- pulmonary edema;
- rupture of the aorta;
If these complications of atherosclerotic cardiosclerosis develop, the probability of a fatal outcome is 85%.
What is CHD?
Cardiosclerosis is a condition in which cicatricial connective tissue grows in the heart muscle. This condition can be the outcome of various pathological processes in the heart: inflammatory and dystrophic, usually developing with coronary atherosclerosis. Therefore, at least two forms of cardiosclerosis are distinguished: myocarditis and atherosclerotic. In this case, we will talk about the latter.
The reasons for the development of atherosclerotic cardiosclerosis are the same as those that underlie atherosclerosis in general and coronary in particular (see Causes of Atherosclerosis). There are cardiosclerosis, which developed during prolonged myocardial ischemia and after large and small myocardial infarction; often the development of the disease is affected simultaneously by both factors.
The first include attacks of religious pain, acute myocardial infarction in the past and recurring. The second – shortness of breath, sometimes in the form of cardiac asthma, an increase in heart size, tendency to cyanosis, congestion in the lungs, swelling in the legs, enlarged liver, and in more severe forms and advanced stages – accumulation of transudate in the abdominal and pleural cavities.
Symptoms of the third kind include a tendency to extrasystole and especially to atrial fibrillation. At first, these rhythm disturbances appear only periodically, but later on they become more and more frequent. Atrial fibrillation is first paroxysmal in nature, and later becomes permanent.
Atherosclerotic cardiosclerosis usually has a progressive course, although periods of relative improvement, sometimes lasting several years, are possible. New acute disorders of coronary circulation, especially repeated myocardial infarction, cause deterioration.
Treatment of atherosclerotic cardiosclerosis should take place in several directions. The main efforts of the doctor are aimed at:
- elimination or mitigation of coronary insufficiency – for this purpose, vasodilators and, periodically, anticoagulants are used;
- heart failure treatment;
- the elimination of conduction and rhythm disturbances, in particular the elimination of atrial fibrillation.
Of particular note is the question of the possibility of using cardiac glycosides in cardiosclerosis. With diffuse forms and with a sharp tendency to angina pectoris, such drugs as digitalis are not suitable, since it in some cases contributes to spasms of the coronary arteries. However, strafantin or korglikon are used if necessary.
With focal forms, when hypertrophy of some parts of the myocardium is observed, and therefore, their overstrain, as well as with a frequent form of atrial fibrillation, digitalis is indicated. With decompensation, not amenable to cardiac agents, potassium salts are prescribed, against the background of which digitalis is more effective.
In the same cases, methylthiouracil is used, which suppresses the function of the thyroid gland and thereby reduces the main metabolism. Under such conditions, the heart works with less load and decompensation may weaken. This also includes attempts to treat with anabolic hormones, which are transformed testosterone with a missing component that is related to sexual function. These drugs reduce protein metabolism and contribute to the retention of certain electrolytes (potassium and calcium) in the body and heart muscle.
The treatment of atrial fibrillation (quinidine, procainamide, etc.) is important. With cardiosclerosis, it often gives a positive effect, at least temporary.
With aneurysm of the heart, surgery is important. It consists in excising an aneurysm, if it is saccular in nature. With a flatter aneurysm with a thinning of the ventricular wall, any elastic tissue such as a flap cut from the diaphragm is sutured to this area.
With heart block, treatment is very difficult; from drugs, cocarboxylase and potassium salts are used. It also practices the connection to the heart of an electric pacemaker.
A patient with cardiosclerosis should avoid strong physical stress. But an immobile lifestyle is also not very suitable, because it does not contribute to the improvement of vascularization, the development of compensatory hypertrophy and at the same time leads to obesity, poorly tolerated by patients with cardiosclerosis. Physiotherapy exercises are useful to a certain extent under the supervision of specialists.
It is necessary to consult a doctor when the first alarming signs occur. The diagnosis of atherosclerotic cardiosclerosis is made on the basis of medical history, examination of the patient, symptoms and research results. The doctor must provide the most complete information regarding which heart diseases a person suffered from, which of the pathologies turned into a chronic form. In addition, it is important to indicate the severity of the signs available at the time of contacting the specialist.
For the diagnosis of atherosclerotic cardiosclerosis, the results of the following studies are sufficient:
- Biochemical blood test. Allows you to evaluate the level of high and low density lipoproteins, as well as triglycerides.
- Electrocardiograms. Atherosclerotic cardiosclerosis on the ECG is manifested by impaired conduction and heart rhythm, signs of coronary insufficiency, moderate left ventricular hypertrophy, scars formed after a heart attack.
- Echocardiography. During the study, violations of the contractile function of the myocardium are detected.
- Bicycle ergometry. Using this method, the degree of myocardial damage is assessed, and the functional reserves of the heart muscle are determined.
In some cases, additional methods of diagnosing atherosclerotic cardiosclerosis are prescribed, for example, daily ECG monitoring, coronary angiography, MRI, X-ray examination, ultrasound, etc.
When examining the patient and to establish the picture of the disease, the following complaints are considered:
- For pain in the area of the heart that is associated with circulatory problems;
- Increased heart rate;
- Cardiac arrhythmia and blockade, which indicate the spread of the sclerotic focal process in the main pathways of the central nervous system.
Laboratory diagnostic methods begin with a biochemical blood test. He is needed to identify:
- Glucose level for assessing the state of the endocrine system, liver and susceptibility to diabetes;
- The level of total bilirubin, which indicates the condition of the gallbladder, circulatory system and liver;
- Aspartate AT level;
- Alanine AT level;
- LDL and VLDL levels.
In addition, pay attention to the indicators of albumin and creatinine in the blood, the level of C-reactive protein and the amount of uric acid.
Based on the data of biological analyzes, the patient is additionally assigned instrumental diagnostics.
Electrocardiography is based on the ability of the heart to produce small electrical impulses. The ECG registers weak electrical potentials that occur during contraction and relaxation of the myocardium during a given time period. The device generates changes in the rhythm in graphical form. According to them, doctors are able to determine:
- The constancy of cardiac impulses, their conduction along the myocardial tissues and the reaction of tissues to them;
- Myocardial ejection of blood;
- The ability of the heart chambers to maintain shape after contractions.
EchoCG basically uses waves that propagate through the body and change the frequency and amplitude depending on the state of the heart. The sensor converts the reflected waves into an electromagnetic signal. The procedure allows you to determine the stability of the pulsation, the presence of arrhythmias and indicators of heartbeat. In the presence of atherosclerosis, echocardiography is repeated at regular intervals to assess the effectiveness of the chosen course of treatment and the dynamics of the disease.
MRI is a complex and more complete method, which is based on the use of radio frequency pulses and a magnetic field. For diagnostic purposes, the patient is placed inside the tomogrof chamber. Using MRI, a three-dimensional image of organs with their layered sections is obtained. To study blood flow in the brain tissue, MR perfusion, which also refers to MRI, is used.
Bicycle ergometry is used to establish latent coronary insufficiency. VEM refers to electrographic methods, which are carried out using an exercise bike – a bicycle ergometer. It provides a dosed load and transmits data via sensors to the on-board computer. According to them, the doctor can assess the condition of the heart and blood vessels.
Diagnostic criteria for atherosclerotic cardiosclerosis are determined in the course of collecting an anamnesis, a survey for the presence of symptoms and information obtained in the process of laboratory studies.
Examination of the patient consists of:
- Electrocardiography It will show if there is scar tissue, how rhythm is disturbed, whether there are manifestations of hypertrophy and coronary insufficiency.
- Biochemical blood test. It is needed to determine blood cholesterol. With atherosclerosis, its level is elevated.
- Echocardiography. It confirms a violation of the contractile properties of the heart muscle.
- Bicycle ergometry to detect the degree of myocardial dysfunction.
To obtain more detailed information about the state of the heart, they resort to magnetic resonance imaging, radiography, ventriculography and other diagnostic procedures.
Diagnosis of atherosclerotic cardiosclerosis begins with a medical history, auscultation – listening to heart sounds. Symptoms, as well as specific noises allow the doctor to establish a preliminary diagnosis. To clarify it, determine the severity of the disease, the patient is asked to undergo a number of additional studies:
- Electrocardiogram – allows you to evaluate the conductivity of the heart muscle, heart rate, detect arrhythmias;
- Ultrasound of the heart – gives the doctor an understanding of the structure of the heart: the thickness of the myocardium, the size of the heart chambers, and the condition of the valves. If the device has a special sensor, the uzist is able to determine the speed of blood flow, the presence of “leakage” of valves;
- Computed tomography, MRI or radiography. Assigned to obtain an organ image. If a patient is injected with a medical dye before an image, the doctor can assess the condition of the vessels, the degree of narrowing, the number of plaques;
- Laboratory blood test. It evaluates the functioning of the most important internal organs: pancreas, heart, liver, kidneys.
How to diagnose vascular atherosclerosis? The diagnosis of atherosclerosis can only be made by a doctor based on a diverse examination of the patient. Depending on the area of damage to the circulatory system with atherosclerotic changes, examination by different specialists will be required. For example, in order to learn how to cure atherosclerosis of the blood vessels of the heart, you need to contact a cardiologist.
Diagnosis of vascular atherosclerosis is as follows:
- Visual examination of the patient for signs of atherosclerosis.
- Clarification of his disturbing symptoms.
- Palpation of arteries.
- Determination of the density of arterial walls.
- Blood sampling for tests for atherosclerosis of blood vessels, including clarification:
- cholesterol level;
- triglyceride content;
- indicators of lipid metabolism;
- atherogenic coefficient.
- Auscultation of the heart vessels reveals systolic murmurs.
Atherosclerosis diagnosis by instrumental methods:
- Dopplerography (ultrasound) and rheovasography of the veins of the lower extremities.
- Ultrasound of the abdominal region and heart zone.
- Coronography and aortography.
- Magnetic resonance therapy (MRI) will allow you to view in great detail the walls of the arteries to detect atherosclerotic lesions and determine the stage of the pathological process.
- Chest x-ray and other doctor-recommended studies.
Diagnosis of atherosclerosis of the vascular system is not an easy event, as the disease often proceeds without symptoms and does not bother a person. The insidiousness of atherosclerotic pathology consists precisely in the fact that it is detected even when the characteristic indicators of vascular atherosclerosis are evident. At this point, it is often in the patient’s body that irreversible processes are already developing that require either drastic measures, that is, surgical intervention.
Aortocardiosclerosis. Clinical manifestations
Over time, the symptoms of the disease worsen:
- shortness of breath appears in a calm state;
- at night, the patient suffers from “cardiac asthma” – nocturnal suffocating attacks overtaking him in a prone position;
- a chest pain, a strong irregular heartbeat is observed;
- the patient feels pain in the right hypochondrium, because the liver is full of blood. For the same reason, the abdomen, lower back of the patient are swollen;
- extremities swell strongly.
The basis of all the symptoms is a dysfunction of contractile function, insufficient supply of heart muscle (coronary insufficiency), loss of susceptibility of myocardial cells to electrical impulses (decreased conductivity), and violation of the frequency and regularity of heart rhythms (arrhythmia).
Considering the issue of aortocardiosclerosis, what is it, it should be noted that this ailment, despite quite serious myocardial transformations, does not have acute, threatening conditions and can develop for years.
For reference. The risk of developing an ailment increases with age. In men, the age of the disease is on average 10 years ahead of women. After 50 years, the statistics of patients is equalized in both sexes. This is due to a sharp restructuring of the hormonal background in the weaker sex. It is believed that aortocardiosclerosis indicates intense aging of the body.
It is important to understand that it is impossible to get rid of scars on the heart muscle. In this regard, patients need to visit a doctor regularly throughout their remaining lives, who will, if necessary, make adjustments to the maintenance therapy regimen. Information on how to treat atherosclerotic cardiosclerosis and what it is should be provided by a specialist. This is due to the high risk of complications, which in most cases ends in death.
Supportive care is based on medication and diet. If the patient is diagnosed with severe heart failure, the cardiologist individually calculates the optimal intensity of physical activity for the patient, daily routine and drinking regimen.
Medication includes taking the following drugs:
- Cardiac Glycosides. Designed to normalize heart rate and blood pressure, improve blood circulation to the organ. As a rule, doctors prescribe Digoxin or Korglikon.
- Nitro drugs. Active substances improve blood microcirculation, stimulate the contractile function of the myocardium, and promote vasodilation. Examples of funds: Nitrosorbide, Sustak.
- Vasodilators. Preparations of this group increase the elasticity of the walls of blood vessels and strengthen them. In most cases, doctors recommend taking Molsidomin.
- Calcium antagonists. Designed to normalize the frequency of contractions of the heart muscle and vasodilation. The most commonly prescribed is Amlodipine.
- Cytoprotectors and metabolic enhancers in the heart. Against the background of their intake, metabolic processes are accelerated, the functioning of myocardial cells is restored. Examples of drugs: Mildronate, Preductal.
- Activators of potassium channels. Active components help lower blood pressure, dilate blood vessels and increase their elasticity. The most commonly prescribed is Nicorandil.
- Beta blockers. Designed to normalize heart rate and increase the duration of periods of relaxation of the myocardium. Examples of drugs: Metoprolol, Atenolol.
- Antithrombotic agents. Prevent the formation of blood clots. As a rule, Aspirin or Ticlopidine is prescribed.
- Statins. The active ingredients reduce the level of “bad” cholesterol and prevent the formation of new plaques on the walls of blood vessels. Examples of drugs: Atorvastatin, Lovastatin.
In the presence of concomitant diseases, agents are prescribed that prevent their development.
In the treatment of pathology, dietary compliance plays an important role. Since the cause of atherosclerotic cardiosclerosis is vascular blockage with cholesterol plaques, it is important to normalize lipid metabolism.
The principles of a therapeutic diet:
- It is necessary to exclude or limit to a minimum the use of foods high in animal fats. These include: lard, margarine, butter, offal, hard cheeses, egg yolk.
- It is forbidden to eat sausages, fast food, fried and smoked dishes, canned food, confectionery and buns. It is not recommended to drink coffee and black tea.
- You need to give preference to boiled or steamed dishes.
- The menu must include: cereals, legumes, vegetables, fruits, vegetable oil, cottage cheese with a low percentage of fat content, fish, grain bread, dairy products.
- Dishes are allowed to season with garlic, ginger, horseradish, red pepper and turmeric.
- You need to eat 5 or 6 times a day, while the size of each serving should not exceed 200 g.
- The amount of salt must be limited. The norm is 4,5 g per day.
In addition, patients must completely abandon smoking and drinking alcohol-containing drinks.
Surgical treatment of atherosclerotic cardiosclerosis is indicated with the ineffectiveness of conservative methods.
Currently, the following surgical procedures are used in practice:
- Coronary artery bypass grafting. With its help, full blood supply to the heart is restored. The method consists in creating an artificial (additional) vessel.
- Closed angioplasty. In the process, the doctor expands the lumen of the affected vessel, due to which normal blood supply is restored. This effect is achieved by introducing a special balloon into the artery.
- Stenting. The essence of the method is as follows: the so-called frame is installed in the lumen of the affected vessel. Due to this, stenosis is eliminated.
- Removal of aneurysm. The objective of the operation is to eliminate the defect, which prevents the full blood supply.
The technique of surgical intervention is determined by the doctor on the basis of research results and taking into account the individual characteristics of the patient’s health.
It is impossible to completely cure atherosclerotic cardiosclerosis. Scarred tissue is not able to repair.
If the heart muscle is weakly or moderately affected, the patient’s condition can be normalized with medication. If the patient strictly follows the medication regimen and follows a diet, he has every chance to live to a very old age.
After surgery, the prognosis is usually favorable. The patient’s condition improves, painful symptoms recede. But at the same time, high-intensity physical activity should be avoided.
If the foci of the pathology in the heart muscle are very extensive, complications develop, most of which are fatal.
IHD and atherosclerotic cardiosclerosis are very serious disorders. Therefore, it is important to pay more attention to the state of your health. This is especially important for those people whose close relatives suffered from similar problems.
The prognosis for such a diagnosis will depend on the severity of the lesions, the stage of circulatory failure.
Secondary prevention should consist of rational therapy, which helps to avoid pain in the heart, rhythm disturbances and heart failure. Patients need to undergo a systematic observation by a cardiologist, regularly examine the cardiovascular system.
In order to prevent the development of coronary heart disease, which is the cause of atherosclerotic cardiosclerosis, it is necessary to follow the principles of proper nutrition and regularly subject the body to moderate physical exertion. In the presence of coronary heart disease, it is important to visit your doctor regularly and follow all his recommendations.
Prevention of heart and vascular diseases consists of maintaining a healthy lifestyle. It is necessary to give up smoking and alcohol, maintain a constant diet and reduce weight, engage in physical exercises and cardio exercises, control emotions and avoid a negative psychological climate. If there is a genetic predisposition, it is recommended to visit a doctor to examine the heart 1-2 times a year.
Proper nutrition implies a rejection or a significant decrease in the diet:
- Products that provoke excitation of the central nervous system and CVS;
- Greasy, fried, salty, spicy foods;
- Canned, sausage and smoked products.
It is also necessary to maintain a water-salt balance and drink more clean water. If you need to reduce weight, then you should follow simple rules:
- Do not overeat: servings should be small;
- Control the calorie content of dishes;
- Refuse sweet, flour, fast food, convenience foods, alcohol;
- Divide the daily diet into 4-5 receptions;
- Exclude heavy food from dinner;
- Introduce more vegetables, fruits, low-fat fish, nuts, seeds into the diet.
Feasible physical activity will help lower blood pressure, improve tissue oxygen saturation, and stop the development of diabetes. Long walks in the fresh air, swimming, cycling and light jogging, dancing, yoga, aero yoga, horse riding and skiing are useful. The main rule of sports is that they should bring joy, not cause overwork and physical fatigue, and not provoke a rise in blood pressure. Otherwise, it is necessary to limit physical activity and consult a doctor to prescribe a course of physiotherapy exercises.
Atherosclerotic cardiosclerosis is a dangerous disease of the cardiovascular system, which, if improperly treated, can lead to sudden death from cardiac arrest. Symptoms in the early stages of the disease are mild, and are often confused with fatigue and overwork. With the development of the disease, such characteristic sensations as pressing chest pain, shortness of breath even with minor exertion, insomnia, dizziness, accompanied by nausea and vomiting begin to appear.
Diagnosis of cardiosclerosis is complex, and consists of laboratory and hardware studies. According to the results of the tests, doctors prescribe treatment. Usually it includes drug therapy with a mandatory diet, taking traditional medicine to strengthen immunity and control blood pressure, physiotherapy exercises. Non-compliance with the doctor’s prescriptions or self-medication with cardiosclerosis is unacceptable and can result in a sharp deterioration in well-being and myocardial infarction.
Even in the early stages of cardiosclerosis is incurable, irreversible changes can only be suspended. The most effective way to prevent cardiosclerosis is to prevent the development of coronary atherosclerosis. You can achieve the goal by adhering to the following rules:
- no smoking;
- do not abuse alcohol;
- play sports, move more;
- Healthy food;
- control blood pressure.
An important component of prevention is the control of cholesterol. Biochemical changes are several years ahead of clinical symptoms. Hypercholesterolemia noticed in time allows taking measures to prevent the development of atherosclerosis. Healthy adults are advised to check sterol levels every 4-6 years.
Atherosclerotic cardiosclerosis is a pathology characterized by scarring in the myocardium. The cause of the disease is coronary heart disease, in which the lumen of the vessels that deliver vital substances to the body narrows against the background of deposition of cholesterol plaques on their walls.
The danger of the disease lies in the fact that at the initial stage it may not manifest itself in any way. The progression of the pathology can lead to the development of complications that pose a threat to the patient’s life. In order to avoid this, you need to contact a cardiologist if you experience any, even slightly expressed, alarming signs.