Cardiac ischemia



Ischemic heart disease

(ischemia) – this concept includes a whole group of diseases. For them, a violation of blood circulation in those arteries that feed myocardium (cardiac muscle) – coronary arteries. In connection with the latter, ischemic heart disease is often called coronary atherosclerosis or coronary heart disease.

Chronic (whose symptoms are arrhythmia, heart failure, etc.) and acute (the manifestation of which can be myocardial infarction) forms the course of this disease. Ischemia is a threat not only to the heart, but to many other organs and systems of organs. Ischemic heart disease is directly related to anemia.


Cardiac ischemia

One of the forms of coronary heart disease is angina. The main symptoms of angina are a pulling pain behind the sternum, which, however, can extend to both the left shoulder and the left arm. Among other symptoms of angina pectoris: a feeling of heaviness and consternation, a feeling of discomfort and shortness of breath.

Among the methods for diagnosing coronary heart disease: a detailed questioning of the patient, an electrocardiogram (at rest and after a dosed load), ultrasound, laboratory test data.

Treatment of coronary heart disease is complex and is aimed at minimizing risk factors for the development of complications, as well as eliminating the symptoms of the disease and ensuring normal life of the patient. In complicated cases, surgical treatment is indicated.

Coronary heart disease, in particular angina pectoris, can in no case be treated independently, as this many times increases the risk of developing such a serious complication of coronary heart disease as myocardial infarction.

Ischemic heart disease is one of the most common diseases of this body.

There is no border for this disease. It is often found in both developing countries and economically developed. However, statistics indicate that the male population is more affected by coronary heart disease than the female.

Ischemic disease is associated with anemia.

Because of this relationship, the disease got its name, because anemia and ischemia are synonyms. In the case of coronary heart disease, ischemia is directly related to an insufficient amount of blood entering the heart muscle.

Ischemia can occur even in a healthy person.

In this case, they speak of a transient ischemia of the heart. This form can take place as a reaction of the body to physical stress, cold or stressful situation.

Ischemia is a threat to the heart.

Practice shows that not only this organ. In some cases, cerebral ischemia is diagnosed. In this case, there is a lack of blood circulation in the brain. Sometimes limb ischemia is diagnosed. To a greater extent, ischemia affects the cardiovascular and nervous systems of the human body.

Atherosclerosis – ischemia of the heart muscle (myocardium).

The cause of myocardial ischemia is associated with high cholesterol, resulting in the accumulation of atherosclerotic plaques in the vessels. The latter leads to a narrowing of the lumen of the vessels. Because of this narrowing, the blood can not enter the organ in the former – sufficient for normal work – the amount.

For periods of myocardial ischemia, there are periods of exacerbation and remission.

In this case, we can say that the course of ischemia of the cardiac muscle goes along the sinusoid – periods of exacerbation of the disease alternate with periods when ischemia does not manifest itself at all. But it should be understood that such “asymptomatic” periods are not an excuse to refuse treatment of the disease – if the diagnosis is made, then the ischemic disease must be treated in any case.

Physical stress provokes the appearance of signs of coronary disease.

You can also say about mental stress on the human body. To exacerbate the disease, the appearance of paroxysmal pain in the region of the heart is characteristic.Such attacks as the progression of coronary heart disease may appear even at rest. The further development of coronary disease can provoke the development of myocardial infarction.

Diagnosis of coronary heart disease is based on modern methods.

A cardiologist can diagnose this disease. Naturally, the diagnosis of any disease at the initial stage is connected with the patient’s questioning – on the basis of this poll, an experienced cardiologist can say a lot, without even resorting to the help of instrumental techniques, although they, of course, are very necessary. Examination of the patient can give a lot of meaningful information.
First, the specialist listens to the existing noises in the heart.
Secondly, the cardiologist determines the patient’s edema. Often, the examination helps to establish the presence of arrhythmia in the patient.
During laboratory tests, blood cholesterol and blood sugar levels are determined, as well as enzymes that appear in the blood in case of a heart attack and unstable angina. The main method of diagnosing ischemic heart disease is electrocardiography (ECG). This type of study is effective in diagnosing all diseases of the cardiovascular system. ECG is often used in combination with exercise. Electrocardiography allows to see the existing deviations from the normal functioning of the myocardium, which is very important for diagnosing coronary heart disease. In addition, the data of laboratory studies, in particular the level of cholesterol and blood sugar, are of great importance.

Holter monitoring of an electrocardiogram is an effective method of investigation.

As a rule, this is an electrocardiogram that lasts for a day. This study is carried out either in a hospital or outpatient setting. Of great importance is the fact that carrying out such a survey should be as much as possible connected with the ordinary life of the patient. Holter monitoring of the electrocardiogram makes it possible to trace the causes of the onset of symptoms of coronary heart disease – to fix when they occur (during physical exertion or at rest).
Especially important during the Holter monitoring of the electrocardiogram is the diary of the patient’s self-observation. This diary should contain detailed information about what happens during the day (the one in which the study is being conducted) with the patient – when he takes medication, experiences any pain, etc. Thanks to this, a fairly reliable picture of a person’s condition is created.

Timely diagnosis of coronary heart disease is impossible without the initiative of the patient himself.

Symptoms of coronary heart disease often reveal themselves as individual sensations in each patient. The earlier a person pays close attention to them, the more likely that the treatment of the disease will begin on time. In connection with the aforesaid, the patient should, as much as possible, tell the cardiologist about those sensations that he noted recently in the region of the heart and which he experienced earlier. The patient should say with certainty whether he has symptoms such as dizziness, the appearance of dyspnoea, increased heart rate, and so on.

Mortality from coronary heart disease is great.

This is more relevant for the twentieth century. The explanation for this is that in the last century there were no such effective methods of diagnosing coronary disease as they are now, and the course of coronary heart disease itself is full of a large number of symptoms or the symptoms are generally absent.

Angina is one form of ischemic heart disease.

Angina is also called angina pectoris, the reason for this is simple – the main symptom of this disease are attacks of pressing compressive pain, which are localized behind the sternum (in this case they say that the “toad strangles”).With angina pectoris pain can be felt in the left shoulder and in the left arm, there are cases when they are accompanied by a sharp sense of fear.
The cause of angina pectoris can be called arteriosclerosis of the coronary arteries. Risk factors include more than thirty factors, including increased cholesterol levels in the blood (which can lead to atherosclerosis), overweight, bad habits (in particular, smoking and alcohol abuse), sedentary lifestyle, concomitant diabetes, and others. The combination of risk factors dramatically increases the chance of developing angina pectoris.

Myocardial infarction is a form of ischemic heart disease.

Myocardial infarction is associated with an acute deficiency of blood supply to the heart muscle. The result of this insufficiency is the emergence of tissue necrosis (necrosis). As the main cause of the development of myocardial infarction is the complete blockage of the coronary arteries with a plaque or thrombus. Of course, this form of coronary heart disease to treat at home is meaningless and dangerous. Therefore, if an attack of angina is not removed by nitroglycerin, you should immediately call an ambulance.


Postinfarction cardiosclerosis is another manifestation of ischemic heart disease.

It is a direct consequence of myocardial infarction and is a lesion of the myocardium (and often of the heart valves). Such a defeat is due to the development of the scar tissue in the heart muscle and valvular heart valves, which replaces the heart muscle, that is, the necrotic parts of the myocardium are not restored.

There is a difference in the angina of rest and angina of tension.

An indication of this classification is the dependence of an attack on the circumstances that cause it. The angina of rest does not have any connection with physical stress, in this case the pain most often reveals itself in the night and early morning time. Thus patients often complain of sensation of shortage of air. With stenocardia, seizures appear after physical exertion on the patient’s body. This can be a normal climb up the stairs, walking after meals, brisk walking and so on. In addition, attacks of angina pectoris may occur and in stressful situations, may occur after smoking.
It should be noted that for angina pectoris is characterized by seizures. This means that a person can accurately indicate the time when the pain appeared, and the time when it disappeared (as a rule, the attack is removed by taking nitroglycerin – under the tongue, this drug relieves pain usually within two to three minutes). If the first tablet of nitroglycerin pain is not removed, then the second one is taken. If the positive effect is absent in this case, then there is a probability of development of the development of the pre-infarction state. Therefore, frivolous attitude to a similar situation is by no means possible and it is necessary to call an ambulance as soon as possible.

In the diagnosis of angina pectoris, electrocardiographic exercise tests are of great importance.

This method consists in recording an electrocardiogram during a period of time when the patient receives a physical load – it is selected strictly individually. In this case, the patient is provided with such conditions, under which a sufficiently high supply of cardiac muscle with oxygen is created. Such conditions make it possible to determine the existing discrepancy between the ability of the coronary arteries to supply the heart with sufficient blood volume and the metabolic needs of the cardiac muscle. Similar methods are used to recognize coronary heart disease at the initial stage of the development of this disease.

Ultrasound examination of the heart (cardiac echocardiogram) is another method of diagnosing coronary heart disease.

This examination allows us to understand the acoustic phenomena of a working heart.In addition, the ultrasound examination of the organ makes it possible to recognize the signs of a significant number of diseases associated with cardiac dysfunction – for example, this study can determine the extent to which the correct functioning of the heart is disturbed, and also to reveal the condition of the heart valves and the cavity dimensions (in particular, to determine them change).

Of great importance for every person is the prevention of coronary heart disease.

This, of course, is true, but people who are part of the so-called risk group should think the most about such prevention. For such people, the prevention of coronary heart disease is not just prophylaxis (no matter how strange it sounds), but also a vital necessity.
What is this risk group? First, these are patients who are diagnosed with coronary heart disease – prevention in this case is reduced to preventing the development of various complications of coronary heart disease. Secondly, they are healthy people, but they are at risk of developing coronary disease. The degree of this risk is due to the presence of one or more factors of development of coronary heart disease (this is an increased level of cholesterol, high blood pressure, overweight, etc., they were mentioned above).

Increased physical activity is a significant point in the prevention of coronary heart disease.

But not the only one. Prevention of coronary heart disease is reduced to zero in the factors of the development of this disease. That is, if a person moves little, then for his own health he should start moving much more. According to the advice of experts, any citizen should give at least half an hour a day to engage in sports and physical education – these classes should go not out of the stick, but give pleasure.
In addition, a sensible person should give up smoking, switch to a healthy eating system, etc. It should be noted that “passive” smoking has an almost identical negative impact on the cardiovascular system, as well as the active. Therefore, do not wait for the words of the doctor – about these: “Every smoked cigarette in your case may be the last” – and think about getting rid of this habit as quickly as possible. As for proper nutrition, it should contain fewer animal fats. The goal is to prevent the formation of cholesterol plaques on the walls of the arteries. It is worth eating more vegetables and fruits, limiting the use of alcohol, coffee and strong tea.
In short, a healthy lifestyle should not become something transcendental, which can only be read in newspapers and heard on radio and television, but the most real and real.

Emotional background plays an important role in the prevention of coronary heart disease.

It is, of course, a favorable and benevolent emotional background. After all, it is known that people who call themselves happy, rarely get sick of any disease.

Coronary heart disease requires comprehensive treatment.

It involves the mutual work of both the doctor and the patient.
First, the patient should pay attention to his lifestyle and try to minimize risk factors for the development of coronary heart disease and its complications (quitting smoking, increasing motor activity, normalizing body weight, etc.).
Secondly, the mandatory component is drug treatment, the goal of which in a significant number of cases is getting rid of signs of angina pectoris, preventing the development of complications (myocardial infarction, unstable angina, etc.), providing the patient with an opportunity for normal life activity, and increasing life expectancy. Medicines that are prescribed to a patient with coronary heart disease, contribute to an increase in the volume of the coronary bed, and also affect the decrease in the need for cardiac muscle in oxygen.
Third, it is recommended that patients with coronary heart disease adhere to a certain diet. The diet of the patient should include fruits and vegetables, fish and seafood dishes.
In addition, if coronary heart disease develops against other diseases – diabetes mellitus or hypertension – then an effective result is treatment for these diseases.

In ischemic heart disease, surgical treatment is necessary.

Not always. The point is that the medicines can not cope with the main task in the treatment of coronary heart disease. The latter consists in the release of already closed vessels.
In serious cases of coronary heart disease, surgical treatment is necessary. A method of surgical treatment is aortocoronary shunting. The essence of this treatment is that the artery, the blood flow through which is difficult as a result of overlapping its thrombus or plaque, is replaced by an “artificial vessel”.
Last and assumes the function of conducting blood flow. However, this operation is rather complicated, because, firstly, it is performed on a non-functioning heart (the patient’s blood circulation is artificial), and secondly, the postoperative period for the patient is rather complicated. This complexity is caused by the need to recover from a vast surgical wound. In addition, this wound limits the possibility of another operation, if necessary.
If aortocoronary bypass surgery is successful, the effect of this surgery is very favorable.

Endovascular surgery is the most promising method for treating ischemic heart disease.

Verbatim translation of the word “endovascular” means “inside the vessel”. It is this concept that determines the specificity of endovascular surgery. With this type of treatment, cuts are not required. Endovascular surgery is performed through punctures in the skin under local anesthesia. All this is done under X-ray surveillance.
The importance of this method is increased for those patients who can not perform traditional surgical treatment, for example, because of the general weakening of the body.
Endovascular surgery is usually performed with balloon angioplasty and stenting. The goal of the treatment is to restore patency in the coronary arteries affected by the disease. The bottom line is that a balloon is injected into the affected vessel, which “spreads” the plaques on the walls of the vessels, after which a stent is inserted into the artery, which preserves the shape attached to the vessel.

Self-treatment of ischemic heart disease is possible.

This is not true. Those medicines that can now be bought at the pharmacy must be prescribed by a doctor, since different ones are aimed at treating different forms of coronary heart disease. In addition, and apply these medications can only be controlled by a cardiologist.
Everyone should know that most potent drugs that a patient can take as a self-medication can give very serious side effects. Urgent medical assistance will be required to eliminate them.



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