Development mechanism and symptoms
Coronary heart disease (CHD) is a disease that develops when insufficient flow of oxygen to the heart muscle on the coronary arteries. The most common cause is atherosclerosis of the coronary arteries with plaque formation and narrowing the clearance. May be acute and chronic (long-term). Manifestations of CHD can be: stenocardia, myocardial infarction, arrhythmia of the heart, as well as sudden cardiac death.
The prevalence of
In developed countries, ischemic heart disease was the most frequent cause of death and disability — at its accounts for about 30 per cent of deaths. She is far ahead of other diseases as the cause of sudden death and meets every third women and half of men. This difference is due to the fact that female sex hormones are a means of protection from atherosclerotic vessels. Due to changes in hormonal levels during menopause the likelihood of heart attack in women after menopause are considerably on increasing.
Depending on how oxygen deprivation expressed heart, how long it lasts, and how quickly, distinguish several forms of ischemic heart disease.
- Asymptomatic, or "dumb" form of IBS-causes no complaints on the part of the patient.
- Angina-chronic form manifesting shortness of breath and pain in the sternum during physical exertion and stressunder the action of some other factors.
- Unstable angina-any attack of angina, significantly surpassing the prior or with new symptoms. Such increasing attacks showed a deterioration of disease and may be harbingers of a myocardial infarction.
- Form Aritmičeskaâ-manifest violations of heart rhythm, most commonly atrial fibrillation. Occurs acutely and can go into a chronic.
- Myocardial infarction-acute form, plot the demise of the heart muscle, most often called margin plaque from the wall of a coronary artery or a blood clot and complete occlusion of its lumen.
- Sudden cardiac deathis cardiac arrest, in most cases, caused by sharp decrease in delivered to him the blood as a result of full blockage of large arteries.
These forms can be combined and overlap one another. For example, strokes often joins the arrhythmia, and then a heart attack.
Causes and mechanism of development
Despite the fact that the heart pumps blood in the body, it needs a blood supply. The heart muscle (myocardium) gets blood on two arteries, which depart from the root of the aorta and are called coronary (because they Flex the heart as though Crown). These arteries are divided into several smaller branches, each of which nourishes its section of the heart.
More of the arteries that bring blood to the heart, no. Therefore, when narrowing the lumen or blockage of one of them, the plot lacks the heart muscle of oxygen and nutrients, develops the disease.
The main cause of IBS is now considered atherosclerosis of the coronary arteries with deposition of cholesterin plaques in them and the narrowing of the lumen of arteries (coronary disease). As a result, blood may not be sufficient flow to the heart.
Initially, the lack of oxygen is manifested only during high loads, for example when running or fast walking. Appearing with this pain in the sternum are called strokes voltage. As narrowing the lumen of the coronary arteries and the deterioration of the metabolism of heart muscle pain begin to appear in all lower stress, and eventually alone.
Simultaneously with exertional angina can develop chronic heart failure, swelling and shortness of breath.
The sudden rupture of plaques can be full overlap lumen of the artery, myocardial infarction, cardiac arrest and death. The degree of affection of cardiac muscle with this depends on what artery or branch obstruction has occurred-the bigger the artery, the worse the consequences.
To developed myocardial infarction, the lumen of the artery should be reduced to not less than 75%. The slower and postepennee this happens, the heart is easier to adapt. Sudden blockage in the most dangerous and often leads to death.
Depending on the form of the disease:
- Asymptomatic form -manifestation of the disease is not detected during the examination only.
- Angina -pain in the sternum oppressive character (as if put a brick), in the left arm, neck. Shortness of breath when walking, climbing stairs.
- Aritmičeskaâ form -shortness of breath, palpitations, disruption of the heart.
- Myocardial infarction is severe pain in the sternum resembling stroke, but more intense and not removable by normal means.
Current and forecast
For ischemic heart disease, irreversible. This means that there are no tools that completely izlečivaûŝih it. All current treatments allow, to a greater or lesser extent, to monitor the progress of the disease and slow down its development, but the turn they cannot reverse.
The defeat of the heart goes continuously and concurrently with other organs: kidneys, brain, pancreas. This process is called "cardiovascular continuum, it includes diseases such as ischemic heart disease, arteriosclerosis, hypertension, stroke, atrial fibrillation, metabolic syndrome, and others. All these diseases are interrelated and arise from common causes.
Briefly the main stages of the cardiovascular continuum can be described that way.
- Asymptomatic stage-risk factors have a negative effect, in cardiac vessels appear deposits of cholesterol, but their lumen is still quite wide.
- The appearance of the first harbingers of- high blood pressure, blood sugar, cholesterol. At this stage of cholesterol plaques in the blood vessels expand and may close before the 50% clearance. In the heart muscle begins remodeling processes, that is, changes in its structure, which lead to heart failure.
- The emergence and increase of symptoms-dizziness, disruption of the heart, pain in the sternum. The ULTRASOUND of the heart at this point becomes visible extension of the cavities of the heart, thinning of the heart muscle. The lumen of arteries narrowed even more.
- The final stage is the emergence of congestive heart failure, the sharp deterioration of the heart, the appearance of edema, pulmonary standstill, sharply increasing pressure, atrial fibrillation. Pain in the sternum at the slightest exertion or even at rest.
For any of these stages, but usually on third or fourth, can happen myocardial infarction or sudden cardiac arrest. Infa CT did not necessarily lead to death but after ischemic always speeds up its course.