Diagnosis of coronary heart disease, classification, symptoms and treatment

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2018-11-14 21:00:52

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Ischemia, accompanied by disruption of normal blood supply to the heart muscle, is today considered a very serious problem. This pathology is the most common cause of sudden death. Moreover, as a rule, from the disease affects patients of working age. Diagnosis of coronary heart disease is sometimes difficult. That is why you should familiarize yourself with basic information about this disease.

What is a coronary heart disease? Symptoms, diagnosis, treatment, possible complications — it's those moments which are worth exploring in more detail. After all, the sooner people will notice the symptoms and consult a doctor, the higher the probability of a favorable outcome.

What is a disease? General information

diagnosis of ischemic heart disease

What is a coronary heart disease? Symptoms, diagnosis, treatment — is that of interest to many patients. But first, let's understand the basic facts.

Ischemic heart disease (IHD) is a pathology which is accompanied by functional and/or organic lesions of the heart muscle. Disorders of the myocardium in this disease associated with insufficient blood supply to the organ or complete termination.

It is Worth noting that such a diagnosis “coronary heart disease" often put men active age (55 to 64 years). Of course, it is possible the development of the disease in patients of female gender or of boys of younger age.

This pathology is associated with an imbalance between the demand of myocardial blood flow and actual blood flow. If the heart muscle, for whatever reason, does not get enough oxygen and nutrients, which inevitably occurs when the circulatory disturbance, the possible pathologic changes, including sclerosis, dystrophy and necrosis.

According to statistics, about 60-70% of cases of acute form of ischemic heart disease leads to sudden death of the patient. It is therefore correct and, most importantly, a modern diagnosis of coronary heart disease is so important.

The reasons for the development of the disease. Description of the risk factors

How and why developing coronary heart disease? Diagnosis, treatment, rehabilitation — are important issues. But first, let's learn more about the causes of disease.

coronary heart disease diagnosis and treatment

Approximately 97-98% of cases the disease is associated with atherosclerosis of the coronary arteries. These vessels provide nutrition of the myocardium. Accordingly, even a small narrowing of the lumen of the coronary arteries adversely affects the condition of the muscles of the heart. Complete occlusion of the vessel leads to the development of acute ischemia, angina, heart attack and sometimes sudden death. List other causes include thromboembolism (blockage of the lumen of the vessel from a blood clot).

Of Course, the above pathology by themselves do not develop. Their creation results in exposure to certain risk factors. Diagnosis of ischemic heart disease should be aimed at determining the causes of the condition.

  • First and foremost, it is worth mentioning Hyperlipidemia. This condition is accompanied by a sharp increase in the level of lipids and lipoproteins in the blood. An abnormal increase in the number of fat in the blood promotes atherosclerosis. It is proved that the risk of CHD in people with hyperlipidemia is increased 2-5 times.
  • One of the main risk factors is Hypertension. According to the research, the risk of developing coronary heart disease patients with high blood pressure (we are talking about chronic disease, not an accidental, temporary pressure jumps) above 2-8 times.
  • Not to mention Inheritance. If among the relatives of men suffering from coronary artery disease, then the likelihood of the pathology a lot more.
  • According to statistics, coronary heart disease (symptoms, diagnosis of disease will be described below) is much more frequently diagnosed in older men. Therefore, the risk factors can be attributed to Half and The age the patient.
  • Patients with Diabetes mellitus (including the latent form of the disease) are more likely to suffer from CHD.
  • Risk factors include a Physical inactivity and Obesity. Proven cases of coronary heart disease three times more often diagnosed in people leading a sedentary lifestyle. As you know, lack of exercise often combined with obesity. Having more weight also increases the chances of developing the disease.
  • Negative impact on the cardiovascular system is affected by Smoking because the nicotine causes a spasm of small vessels, including coronary arteries.

Properly conducted diagnostics of ischemic heart disease allows not only to determine the stage and severity of the disease but also its causes. Based on these data, the physician can create an effective treatment plan. It is understood that in most cases CHD develops under the influence of severalfactors.

Ischemic heart disease: classification

The term IBS unite various pathological conditions associated with impaired blood supply to the myocardium:

  • Sudden coronary death. In this case we are talking about primary cardiac arrest which was caused by electrical instability of the heart muscle. People in this condition can be successfully resuscitated (of course, if the patient will receive timely assistance).
  • Angina. In this case, pathology may acquire different forms. Produce stable, unstable, spontaneous and some other types of angina. Pathology is accompanied by pain behind the breastbone, which often spreads to the left shoulder and shoulder blade.
  • Myocardial Infarction. The condition that is accompanied by necrosis of a certain portion of heart muscle arising on the background of insufficient blood supply.
  • Cardio. In most cases such pathology develops as a result of previous infarction. Areas of heart muscle that have undergone necrosis, start to change — the muscle fibers are replaced by connective tissue, causing the myocardium loses its contractile properties.
  • Heart rhythm abnormalities. The pathology is almost inevitably caused by the narrowing of blood vessels, because the blood begins to pass “shock”.
  • Heart failure. Chronic violation of the trophic infarction may be accompanied by violation of physiological activity and anatomical structure of the heart.

What symptoms should pay attention to?

coronary heart disease symptoms diagnosis

What is a coronary heart disease? Diagnosis, treatment — this is definitely important information. However, many patients are interested in symptoms. What are the first symptoms of IBS? What breaches need to pay attention?

  • Heart failure is often accompanied by shortness of breath. First, problems with breathing appear during physical activity such as fast walking, climbing stairs etc. But as the progression of the disease shortness of breath occurs even at rest.
  • To the list of symptoms include arrhythmias. Patients complain of increased and rapid heartbeat.
  • Coronary artery disease is often accompanied by changes in blood pressure — patients diagnosed Hypo - or hypertension.
  • Angina accompanied by pain in the chest. Some patients report a feeling of pressure and burning in the chest. The pain may radiate to shoulder, neck, scapula. Sometimes the pain syndrome is very intensive and not amenable to relief drugs.

Regrettably, diagnosis and treatment of chronic ischemic heart disease is often fraught with difficulties, because in most cases people ignore small shortness of breath and weak, intermittent, stabbing pain in the heart area. To the doctor treated already in the late stages of the disease.

Tests for suspected ischemia

If the patient goes to a specialist with complaints of intermittent chest pain and dyspnea, the physician first collects a full medical history. It is important to know exactly when there symptoms, is there heart disease in your family, whether at the patient of harmful habits, etc.

Further tests are performed. For example, determine the level of troponin, myoglobin and aminotransferases in the blood — it is these protein compounds are released during the destruction of cardiomyocytes.

In addition, the patient's blood is tested for the presence of increased quantities of glucose, lipoproteins and cholesterol — that helps to diagnose comorbidities, and sometimes to determine the cause of coronary heart disease (e.g., atherosclerosis).

Diagnostics

diagnosis of ischemic heart disease

Decisive in the diagnosis of coronary heart disease is such a simple and affordable study like an electrocardiogram. During the procedure, the doctor may check the electrical activity of the heart, to detect certain arrhythmias of the myocardium.

It is Mandatory and the Echo. This study allows to determine the heart size, to evaluate its contractile activity, to visualize the condition of the valves and cavities of the myocardium, to study specific acoustic noise. Additionally performed stress-echocardiography, because the symptoms of ischemia are sometimes found only during physical activity.

Informativeis daily monitoring of ECG. The patient to shoulder attach a special device that measures the heart's activity during the day. In addition, the patient must be recorded in a special diary of their actions, changes in well-being.

Often performed transesophageal electrocardiography. The patient entered a special sensor that registers the performance of the heart. Thus, the doctor can assess the electrical conductivity and excitability of the myocardium.

Quite often the patients are positron emission tomography (PET). Diagnosis of coronary heart disease involves the study of blood flow of the myocardium. This technique allows also to measure the rate of glucose utilization in a particular area of the myocardium, to evaluate the metabolic activity of fatty acids to measure the amount of oxygen consumed. PET diagnosis of ischemic heart disease is appropriate, if any segment of the heart muscle looks like a scar.

A Lot of useful information can be obtained after carrying out coronary angiography. Introduced into the coronary arteries, a contrast agent, and then tracking its movement. Using this procedure, the specialist can determine the existence of violations of vascular permeability, and the degree of occlusion and stenosis.

Important is the differential diagnosis of coronary heart disease, because symptoms such as pain behind the breastbone and shoulder, and shortness of breath develop on the background of other diseases, including vegetative neurosis, pathology of the peripheral nervous system, paraneoplastic syndrome, lesions of the pleura, etc.

How to treat ischemic heart disease?

remedies for the treatment of coronary heart disease

In fact, therapy in this disease have to be integrated.

Treatment of coronary heart disease selects only the doctor, as much depends on the General condition of the patient, other medical conditions, etc. Sometimes, specialists prescribe the intake of beta-blockers that help reduce blood pressure. Preparations containing nitroglycerin to expand the blood vessels, including coronary arteries. Proper intake of ACE-inhibitors improves the flow of blood. In atherosclerosis patients, prescribe medication, which consists of a statin, as they help to adjust the level of cholesterol in the blood. Thrombosis prophylaxis may be used acetylsalicylic acid. In the presence of oedema diuretics are sometimes used.

It is also Worth noting that the patient needs to change a little the way of life, in particular, to eat right. Shown and the limitation of physical activity. If the severity of coronary artery disease is small, the patients are recommended to feasible load, for example, swimming, walking, Cycling. Such lessons help to strengthen blood vessels. But if we are talking about severe forms of the disease and severe shortness of breath, from sports and physical activity will have to decline.

Proper nutrition during ischemia

The Diet for coronary heart disease is extremely important. Doctors recommend patients to follow some rules:

  • It Is necessary to drastically reduce the amount of salt. Furthermore, it is not recommended to use too much liquid. This will help to relieve the load on the heart muscle.
  • In order to slow the development of atherosclerosis, it is important to limit the number of products containing animal fats and cholesterol. The list of prohibited carry lard, fatty meats, butter. Doctors recommend to refrain from fried, too spicy and smoked food. Negatively on the health impact of foods rich in simple, easily digestible carbohydrates. It is therefore important to limit the amount of candy, sweet pastries, chocolate and other sweets in the diet.
  • If the patient has ischemic heart disease developed on the background of obesity, it is important to fight obesity. Of course, you need to lose weight slowly and carefully, as too strict a diet is a stress to the body. Doctors recommend to eat right, to do as much physical labor (unless contraindicated), to keep the correct energy balance (energy expenditure must be greater than the amount consumed along with food calories by about 300).

Surgery

how to treat ischemic heart disease

Unfortunately, in most cases, it is difficult to do without surgical intervention, as the medication only helps to relieve the symptoms and to prevent complications.

  • Coronary artery bypass-surgery in which the surgeon takes a private vessel of the patient and sutured to the coronary artery in such a way as to create a detour for blood flow. The heart again begins to receive oxygen and nutrients in sufficient quantities, which leads to the elimination of ischemia.
  • At the time, was widely used this technique as balloon angioplasty. During the procedure, the lumen of a vessel is introduced a special balloon, through which the surgeon literally inflates the artery, restoring its normal size and normalizing the flow of blood. Unfortunately, the treatment gives only a temporary effect.
  • More effective is stenting. The point is the same — to expand the vessel. But during the procedure into the lumen of the affected artery injected metal meshframe (stent) — so the vessel maintains its natural shape permanently.

Possible complications

diagnosis and treatment of chronic ischemic heart disease

Unfortunately, many patients are faced with this problem, as ischemic heart disease. Therapy helps to slow down the progression of the disease and prevent complications. But when the wrong treatment or the absence of possible:

  • Failure of energy metabolism of cardiomyocytes;
  • Various forms of disorders of left ventricular contractility;
  • The development of cardiosclerosis (the number of functioning cardiomyocytes is significantly reduced, they replace the connective-tissue elements that are not capable of Contracting);
  • Violations of systolic and diastolic myocardial function;
  • Violations conductivity, contractility and excitability of the myocardium, partial loss of autoreguljatsii.

Preventive measures and forecasts

Not immediately say that the prognosis for patients with this diagnosis depend on the General state of the organism, extent of coronary vessels, presence of other diseases. If we are talking about mild ischemia, it's pretty well to therapy. The forecasts are not so favorable for patients along with coronary artery disease suffer from diabetes and hypertension.

As for prevention, any specific funds does not exist. People at risk, is to maintain a healthy lifestyle. It is important to eat right, and limit the amount of fatty, fried and overly spicy foods rich in bad cholesterol.

Negatively on the state of the vessels affected by Smoking. It is important to maintain physical fitness, regularly working out feasible exercise,such as workout in a gym and walking outdoors. Patients with hypertension need to constantly monitor the blood pressure.

These simple rules will not only help to prevent the development of ischemia, but also significantly improve the whole body.


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Alin Trodden - author of the article, editor
"Hi, I'm Alin Trodden. I write texts, read books, and look for impressions. And I'm not bad at telling you about it. I am always happy to participate in interesting projects."

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