Atherosclerosis confidently takes the lead among cardiovascular diseases leading to death. The main reasons for this dynamics: a passive lifestyle provokes its development, the disease is difficult to detect on early stages and cure later. The main threat among the different types of atherosclerosis is coronary atherosclerosis, which is we'll talk below.
The coronary (coronary) artery is the artery that delivers oxygenated blood to the “central” muscle of the heart, the myocardium. The latter is responsible for the rhythmic contractions of the heart, which form the basis of blood circulation and do not stop throughout a person’s life.
Atherosclerosis – chronic illness arteries, in which cholesterol plaques form in them, blocking the lumen of the artery and interfering with normal blood flow.
Atherosclerosis coronary arteries- These are plugs inside the coronary arteries, which lead to a lack of oxygen in the tissues of the heart.
Why does the lumen of the artery narrow?
It's all about cholesterol. Its high concentration leads to the formation of plaques from it on the inner walls of the arteries. The walls become narrower, there is less oxygen in important organs, tissues become hypoxic and die.
High cholesterol levels can have several causes. The most obvious is poor nutrition. The more fried potatoes enter the stomach, the more harmful (if in excess) substance enters the blood. Less obvious is poor metabolism, including lipoproteins, which are responsible for removing cholesterol from the body. High-density lipoproteins cope with their task, but similar proteins of low and very low density can themselves be deposited in plaques along with cholesterol.
Plugs initially appear as deposits on the inner walls of blood vessels. Over time, the growths become larger due to the arrival of new portions of “building material” and the appearance of connective tissue. This is how coronary sclerosis develops. Subsequently, one of two things happens: either the vessel slowly but surely closes to the point of complete blockage, or the clot ruptures, releasing its contents and immediately blocking the artery.
In case of slow development of the disease in the coronary vessels, the patient begins to detect IHD (coronary heart disease) in chronic form. This diagnosis means that the heart does not have enough oxygen, and is accompanied by pain in the heart area, shortness of breath, dizziness, and fatigue. When a blood clot ruptures, ischemic heart disease occurs acute form– myocardial infarction. In this case, the oxygen supply to the heart muscle abruptly stops, and the myocardium begins to undergo necrosis or, in other words, die. In this case, the issue of a person’s life is decided in the next few hours or even minutes.
Thus, the narrowing of the lumen of the artery is caused by the deposition of cholesterol on the walls of blood vessels, leading to their blockage and can be the cause of both serious chronic diseases and sudden death.
Who is predisposed to the disease?
- Increased blood cholesterol levels. More cholesterol means more chances for a blood clot.
- Sedentary lifestyle. Stagnation of blood in the body helps cholesterol settle on the walls of the arteries.
- Obesity. Excess weight puts a strain on the entire body, including the cardiovascular system.
- Hypertension. High blood pressure increases the chance of damage to the walls of blood vessels.
- Diabetes. Metabolic disorders can have unpredictable effects on the entire body.
- Poor nutrition. Especially dangerous is a large amount of animal fats, cholesterol and salt.
- Smoking. It narrows and dilates blood vessels, increasing the load on them, and also spoils internal structure arteries and veins.
Those who have several of these factors in their lives should think about their future, since the chance of developing atherosclerosis is quite high for them.
Symptoms of atherosclerosis
All symptoms of insufficient blood circulation in the heart can be divided into two categories: general and ischemic. General are associated with a deterioration in blood flow throughout the body, ischemic are associated specifically with the heart.
General symptoms:
- Shortness of breath, poor exercise tolerance. The lungs have to supply more oxygen to the body to make up for the deficiency.
- Dizziness. If there is insufficient blood pressure, the brain cannot function normally.
- Coldness in hands and feet. Blood does not flow to distant areas of the body in sufficient volume, as a result of which the temperature decreases.
- Nausea, vomiting, poor health, clouding of consciousness. Everything that accompanies illness of cardio-vascular system.
These symptoms are a sure sign that the disease has not yet reached full strength, but is already approaching.
Among the ischemic symptoms, it is worth highlighting the following:
- Attacks of angina. Sharp chest pain, usually from behind. It appears during physical activity and is associated with the fact that the heart cannot receive enough oxygen.
- Wrong heartbeat. With a lack of blood, the heart can work “idlely”.
- Hypertension. Blockages in the coronary arteries increase blood pressure.
- Coronary heart disease in chronic or acute form. As noted above, lack of nutrition for the myocardium can result in a number of problems, including fatal ones.
- Cardiophobia. Simply put, it is the fear of death when any heart problem occurs. It is dangerous because any fear increases the flow of testosterone and heart rate, and these changes can aggravate a heart attack or heart attack.
These symptoms indicate that there is a problem and it needs to be addressed urgently. Therefore, if you notice several of these cardiac symptoms or coronary artery disease, the main thing is not to panic and immediately consult a doctor.
Medical diagnosis of the disease
The basis for diagnosing almost any disease, including atherosclerosis, is asking the patient about his health (history) and various tests.
In addition to medical history and tests, cardiac ultrasound and echocardiography are used. An ultrasound picture of the heart makes it possible to assess the extent of the lesion: changes in the internal shape, wall thickness, and the level of contractility of the chambers. Carrying out the procedure during physical activity allows you to see areas that receive less oxygen. 24-hour ECG monitoring is often used, in which a recording device is attached to the body and remains with the person for a long time.
Computed tomography (CT), multislice CT, and electron beam tomography make it possible to expand the picture and learn more about the patient’s heart condition. The administration of contrast agents during examinations shows a detailed drawing of arteries, veins and vessels. Based on this information, the doctor can choose the type of treatment.
Intravascular ultrasound, radionuclide studies, treadmill test, scintigraphy and bicycle ergometry are prescribed if it is necessary to clarify the details of the diagnosis.
In general, the diagnosis of coronary atherosclerosis is quite extensive in its methods and depends on the individual patient, his capabilities and the capabilities of the hospital in which he is located.
How to treat coronary arteries?
First and foremost important rule in treatment - no self-medication! At best, it will have no effect, and the disease will develop further. At worst, the disease can worsen.
In mild and moderate cases, drug therapy and lifestyle changes are sufficient. The drugs are aimed at two goals: combating further narrowing of the lumen of the vessel and eliminating the consequences coronary atherosclerosis. The first point is achieved by reducing cholesterol in the blood, the second is achieved by strengthening and protecting the heart muscle.
Improving lifestyle plays even more important role here important role than tablets. Adequate diet, moderate exercise under the guidance of a cardiologist, refusal bad habits, treatment of obesity and other diseases such as diabetes will put the patient on his feet as quickly as medical intervention. And in general there is not a single disease that would be adversely affected by a healthy lifestyle.
In severe cases, if there is no other option, the doctor may prescribe surgery. A common option is the implantation of a stent, which can be used to expand the damaged vessel and ensure normal blood flow. If this is not enough, coronary artery bypass grafting may be required. This method creates a healthy bypass for the blood, bypassing the atherosclerotic vessel.
Regardless of which method the doctor prescribes to the patient, you need to start treatment as soon as possible - take pills, run in the morning or sign up for surgery, because in atherosclerosis, lost time can cost further well-being or even life.
Prognosis for atherosclerosis
If treatment is started in time, the progression of the disease can be stopped. It is almost impossible to completely restore damaged arteries, but with timely measures taken and competent medical intervention sclerotic plaques will decrease, blood flow will increase and the patient’s condition will improve.
But you need to come to terms with the fact that atherosclerosis of the coronary arteries of the heart is a disease that you have to live with. You can’t take pills for a week, run, eat vegetables and get better. Those who are faced with this disease need to change their lifestyle, adapting it to new conditions, if they do not want to spend the remaining time in hospitals and intensive care units.
Disease Prevention
If the reader feels well and does not plan to devote 10-20 years of his life to fighting a serious chronic disease, he should think about his health now. Adding fuel to the fire is the fact that atherosclerosis of the coronary vessels of the heart does not manifest itself in any way at an early stage, and it can only be detected upon the appearance of symptoms. That is, it's too late.
Prevention is simple: you need to give up bad habits, play sports or physical labor, eat well, treat diseases in a timely manner and visit a cardiologist for examination every few years. Naturally, following this list is not so easy, but following it will improve the quality of life and greatly prolong it.
As a result, atherosclerosis of the coronary arteries is a dangerous chronic disease that manifests itself in late stages and if not handled carefully can lead to death. It affects the central arteries of the heart and is reluctant to treat, although it can be stopped and even achieve positive dynamics. In order not to find yourself lying in intensive care after a heart attack, you need to consult a doctor in time when symptoms appear, and even better, take care of your health and not get sick at all.
According to doctors cardiovascular diseases cause 17,000,000 deaths annually. About half of them are atherosclerosis of the heart vessels. In Europe alone, it kills 1,950,000 people every year.
Let's figure out what the diagnosis of atherosclerosis of the coronary arteries indicates, what the danger of this disease is, symptoms, treatment options, and what complications can arise.
Physiology of the disease
The development of atherosclerosis begins early. It has been proven that the first protoplaques can appear as early as childhood. Typically, the formation of an atherosclerotic plaque takes more than 10 years. At first it is too small to affect blood flow. As the deposit grows, it occupies an increasing part of the lumen of the vessel, significantly narrowing it - stenosing atherosclerosis of the cardiac arteries develops. If the formation of atherosclerotic plaque continues, it can clog the vessel. This condition is called obliterating atherosclerosis.
Coronary vessels are a system of arteries and veins that supply the heart muscle. Their vascular pattern resembles a branched tree, whose smallest branches are capillaries. Only one capillary approaches each heart cell. If blood does not reach it, myocytes stop receiving oxygen. After some time they die (myocardial infarction). The blood supply to the cells of other organs is always carried out by several vessels, so they tolerate the narrowing of the lumen of the arteries without such serious consequences.
According to ICD-10, atherosclerosis of the coronary arteries of the heart is classified as atherosclerotic heart disease (group I25.1).
Main causes, risk factors
For the development of atherosclerosis, 2 components are necessary:
- artery damage;
- metabolic disorders, especially fat metabolism.
Throughout life, the walls of blood vessels are susceptible to a wide variety of damaging factors. It is not possible to determine which one caused serious damage.
According to modern concepts, disturbances in fat metabolism play an important role in the development of atherosclerosis. High levels of cholesterol, low-density lipoprotein LDL, neutral fats, low concentrations of high-density lipoprotein HDL, and abnormal size of lipid fractions contribute to the formation of deposits.
Therefore, doctors do not name the exact cause of atherosclerosis, but identify risk factors for its development. 80-90% of people who die from complications coronary disease, had at least one of the following factors:
- High blood pressure in people over 50 years of age. It is considered one of the most significant risk indicators. Under the influence of hypertension, the artery wall becomes thin and inelastic. It is easily damaged, which provokes the formation of plaques.
- Age. Women after menopause, as well as men over 50 years of age, are more prone to atherosclerosis.
- Hereditary predisposition. If the patient has relatives who had cardiovascular problems under the age of 55 (men) or 65 (women), he is at risk;
- High cholesterol, LDL. About 60% of people with coronary atherosclerosis have abnormally high concentrations of them.
- Smoking. Smoking people have very high risk development of the disease. Passive smokers are also prone to developing it. Cigarettes increase levels of fibrinogen, a protein involved in blood clotting reactions. This increases the risk of blood clots. Nicotine also increases blood pressure and speeds up the pulse.
- Diabetes. The presence of diabetes increases the risk of coronary atherosclerosis by 2-4 times in men, 3-5 in women. The disease worsens Negative influence on the body of smoking, obesity.
- Diet. People whose diet is rich in saturated fats, cholesterol, salt, and poor in vegetables and fruits have an increased risk of narrowing the lumen of blood vessels with atherosclerotic plaque.
- Sedentary lifestyle. Increases the likelihood of heart disease by 50%, increases complications of diabetes, hypertension, and obesity.
- Obesity. In addition to the fact that excess weight is associated with increased risk development coronary disease heart, it is also accompanied by triglycerides, LDL, low HDL.
- Other factors. Stress, alcohol abuse, blood homocysteine deficiency, excess iron, inflammatory diseases, taking some oral contraceptives, hormonal drugs.
Symptoms of coronary atherosclerosis
In the initial stages of atherosclerosis, the deposit is too small to significantly affect the blood supply to the heart muscle. Because of this, there are no symptoms of atherosclerosis of the coronary arteries at this stage.
As atherosclerosis progresses, oxygen deficiency develops in the myocardium. This condition is called coronary heart disease. The first symptoms usually do not appear constantly, but with significant physical exertion and stress. These may include:
- Attack of angina (angina pectoris). It manifests itself as a feeling of pain, compression in the central or left half chest as if someone is standing on it. Usually the discomfort disappears after a few minutes or after stopping physical activity. For some people, especially women, the pain may be fleeting or sharp, radiating to the neck, arm, or back;
- Dyspnea. Myocardial cells begin to work worse due to which the heart pumps less blood than the body needs. The body tries to compensate for the lack of oxygen by breathing more frequently, which causes shortness of breath;
- General weakness, chronic fatigue.
If a cholesterol plaque blocks the lumen of a vessel, myocardial infarction develops. Typical symptom compression of the chest, acute savage pain that radiates to the shoulder, arm, less often the jaw, neck. Sometimes the development of a heart attack is accompanied by shortness of breath and intense sweating.
Some people may have a heart attack without symptoms.
Modern diagnostics
In the early stages of coronary atherosclerosis, there are no symptoms. At the appointment, the doctor first questions the patient, conducts a general examination, and listens to the heart. Then the patient gives biochemical analysis blood so that the doctor has an idea of the functioning of the internal organs. If, based on the results of a general examination and blood biochemistry, the doctor suspects the possibility of developing atherosclerosis, the patient is referred for further examination.
To diagnose atherosclerosis of the coronary vessels, the following methods are used:
- Electrocardiogram. Records the passage of electrical signals through the heart. At suffered a heart attack it will be difficult for the impulse to pass through scar tissue, which will be reflected on the ECG. This type of test is used to detect previous heart attacks. Daily ECG monitoring is indicated for some patients. To do this, a person puts on a small device that he wears for 24 hours.
- Echocardiogram. A subtype of ultrasound examination that helps to obtain an image of the heart, assess the wall thickness, size of the chambers, and condition of the valves. These indicators change with heart disease.
- Stress test. Prescribed to patients whose symptoms appear only during exercise. Such patients are asked to walk on a treadmill or pedal an exercise bike. The doctor monitors the patient’s ECG changes all this time. Sometimes, instead of physical activity, a person is given medications that make the heart work harder. Then the doctor can examine the functioning of the heart using MRI.
- Angiogram. The doctor injects a small amount of dye into the coronary artery. After some time, he takes a picture of the heart (using X-ray/MRI). The dye makes the vessels visible, so areas of narrowing are clearly visible in the image.
- CT scan. Allows the doctor to identify the most dangerous atherosclerotic plaques which contain calcium. May be combined with angiography.
Features of treatment
Therapy for coronary atherosclerosis begins with lifestyle changes (quit smoking, move more), diet, treatment concomitant diseases. The majority of the diet should consist of plant products; animals are allowed to include poultry, fish, eggs, and low-fat milk. Red meat consumption should be limited. It is recommended to avoid obviously unhealthy foods - fast foods, snacks, street shawarma, chebureks.
If the listed measures are not enough or at the time of admission the person’s health condition raises concerns, for the treatment of coronary artery atherosclerosis drug therapy, surgical procedures.
Conservative therapy
Atherosclerosis of the coronary vessels in the initial or middle stages can be treated with medications. In fact, the disease itself cannot be cured. It is within the power of the doctor to slow down its progression and remove some symptoms. Objectives of therapeutic treatment:
- reduce the load on the heart;
- relieve vascular spasm;
- reduce ;
- prevent thrombosis;
- reduce the risk of heart attack;
- normalize blood pressure.
To achieve these goals, the following groups of drugs are used. Most pills must be taken for life.
Lipid-lowering drugs
Medicines of this class normalize fat metabolism indicators: cholesterol, LDL, HDL, triglycerides. These include:
- Statins (simvastatin, atorvastatin, rosuvastatin, pitavastatin). The most powerful representatives of the group. They block the synthesis of liver cholesterol, reduce the concentration of LDL, triglycerides, slightly. Prescribed for the treatment of atherosclerosis and prevention for people at risk.
- Fibrates (fenofibrate, gemfibrozil). Before the invention of statins, they were widely used in the treatment of patients with atherosclerosis. They most effectively reduce the concentration of triglycerides, increase HDL, and have a lesser effect on cholesterol and VLDL levels.
- A nicotinic acid. High doses of the drug, better known as vitamin B3(PP), are prescribed to lower triglycerides, LDL. But since the medicine must be used in doses that exceed the daily requirement by 50-300 times, taking niacin is almost always accompanied by adverse reactions. Because of this, the use of nicotinic acid is greatly limited.
- Bile acid sequestrants (colestyramine, colestipol). Medicines that don't give bile acids reabsorbed, which forces the body to use cholesterol for their synthesis;
- Cholesterol absorption inhibitors (ezetimibe). Prevents the absorption of dietary cholesterol.
Blood thinners
Necessary at any stage of development of coronary atherosclerosis. Reducing blood viscosity prevents the likelihood of blood clots. The most popular drug is acetylsalicylic acid(aspirin). It is indicated at the initial stage of the disease. For more severe forms of atherosclerosis, warfarin is recommended.
Antihypertensive medications
High blood pressure is considered one of the most significant factors damaging the artery wall. A decrease in indicators by 35-40% inhibits the progression of atherosclerosis. To correct blood pressure, the drugs bisoprolol, valsartan, lisinopril, and amlodipine are prescribed.
Surgery
For atherosclerosis of the coronary arteries, surgical intervention is necessary if the size of the deposits is significant. The two most common techniques are bypass surgery and stenting.
Bypass involves creating a bypass path. To do this, an artificial or transplant vessel is sewn above, below the atherosclerotic plaque, through which blood can flow freely.
Stenting - restoration of blood flow is achieved by installing a metal frame - a stent - in the narrowed area. To do this, a catheter with a deflated balloon is inserted through a large vessel. The surgeon, under computer control, moves it towards the atherosclerotic plaque and then inflates it. The lumen of the vessel expands, the plaque becomes flatter. To secure the result, the catheter delivers a folded spring (stent) to the site of narrowing and unfolds it. A rigid frame is formed that keeps the artery open.
Folk remedies
At the very initial stages of atherosclerosis, when the first symptoms have not yet appeared, you can try treatment herbal infusions, although this is ineffective.
- Heart grass, yarrow, chestnut bark - 100 g each, rue grass, knotweed, lemongrass leaves, caraway seeds, sunflower petals - 50 g each. Prepare a mixture from the listed plants. 1 tbsp. l. Place in a thermos, pour a glass of boiling water, let it brew for 20-30 minutes. Drink the strained infusion 100 ml 3 times a day before meals.
- 20 g of caraway seeds, Japanese sophora pods, 30 g of valerian root, lemongrass leaves, 40 g of hawthorn flowers, nettle leaves. Pour boiling water over 1 tablespoon, leave for half an hour, strain. Drink 150 ml of infusion 2 times a day before breakfast and dinner.
- Herbs in equal proportions: birch leaf, nettle leaves, sage, horsetail grass, knotweed, hawthorn inflorescences, caraway seeds, rose hips, kelp, yarrow. 3 tbsp. l. place in a saucepan, pour three cups of boiling water. Cover with a lid and leave for 3 hours. Take a glass before meals 3 times a day. For patients over 70 years of age, the dose is reduced to half a glass.
- Mix equal quantities of hawthorn flowers, knotweed grass, goldenrod, St. John's wort, and yarrow. Place a tablespoon of the mixture in a saucepan, pour a glass of boiling water, and place on low heat. Cook for 3 minutes. Set aside and let sit for 10 minutes. Drink warm, a glass 3 times a day before meals. A portion of the infusion must be prepared for each dose.
- Mix equal amounts of rue, cinquefoil, mistletoe, horsetail, and yarrow. Pour a tablespoon of the mixture into a glass of water and let stand for 3 hours. Put on fire, cook for 5 minutes. Let stand for 30 minutes, strain. For 2-3 months, drink half a glass of infusion 2 times a day. The fifth collection contains potent herbs. Consult your physician for safe use.
Many biologically active ingredients plants are capable of interacting with medications. Therefore treatment traditional methods should be discussed with a therapist.
Complications
Atherosclerosis of the coronary arteries can significantly impair the functioning of the heart. Possible complications diseases:
- angina pectoris;
- myocardial infarction;
- heart failure;
- arrhythmia.
The patient's death can occur after a cholesterol plaque ruptures, fragments of which block the arteries. Most of these cases occur in the morning hours of the cold season. Severe stress or physical exertion can provoke fatal complications.
The heart is the most important organ in the human body. Rhythmic heart contractions help circulate oxygenated blood throughout the body. This natural process. And through which vessels does the myocardium itself (this is the name of the middle layer of the heart muscle, which makes up most of its mass) receive the necessary amount of oxygen to function normally? Through the coronary vessels (also called coronary vessels).
Important! The coronary arteries are the only source of blood supply to the heart. Therefore, it is so important that they are in “working condition” and function normally.
Atherosclerosis of the coronary vessels of the heart is a chronic pathology characterized by the formation cholesterol plaques, significantly blocking the lumen of the arteries and preventing normal blood flow. Statistics say that this disease occupies one of the first places among diseases of the cardiovascular system. Moreover, the pathology is difficult to diagnose at the initial stage; and when it is detected late, it is difficult to treat. What provokes the development of pathology? How to deal with it? What are its symptoms? What preventive measures can prevent the development of atherosclerosis of the coronary vessels? Let's figure it out. Useful information there is never too much.
Reasons for the development of atherosclerosis
The main reason for the development of atherosclerosis of the coronary vessels is the presence of elevated cholesterol levels (about 6 mmol/l or more) in the blood. What could lead to this state of affairs:
- Consumption of animal fats in large quantities.
- Decreased metabolic activity.
- Failure of the intestines to eliminate fat-containing substances.
- The presence of a hereditary predisposition to atherosclerosis of the coronary vessels.
- Psycho-emotional overstrain and stressful situations.
- Diabetes.
- Hormonal imbalance.
- Speed dial body weight, that is, obesity.
- Disturbances in the functioning of the central nervous system.
- Inactive lifestyle (i.e. physical inactivity).
- We should not forget about the age of the patients and the gender factor. It’s no secret that the older a person is, the slower the metabolism occurs. Up to 60 years of age, the disease is more often diagnosed in men; In women, the risk of developing the disease increases after menopause.
- High blood pressure (ie hypertension).
On a note! Atherosclerosis of the aorta of the coronary vessels can be provoked by the same factors that were described above. We remind you: the aorta is called the largest blood vessel, located above It is from it that the two main arteries (right and left) of the coronary blood supply depart.
The mechanism of development of vascular atherosclerosis
The starting point for the development of atherosclerosis of the aorta, coronary vessels and arteries is damage to the endothelium as a result of autoimmune pathologies, exposure to viruses and bacteria, as well as allergic reactions. It is in these places that fatty deposits (plaques) form. Over time, they become larger and larger, as there is a constant supply of new volumes of “building material”. As a result, connective tissue is formed in the lesions, which is the cause of narrowing of the lumen of the aorta and coronary vessels; their blockages; failure of the local circulatory process and, as a consequence, serious illnesses chronic (for example, coronary heart disease or myocardial infarction) and even fatal outcome. That is, in the presence of cholesterol plaques, there are two options for the development of pathology: the first - the vessel slowly but surely becomes clogged until it is completely blocked; the second - the blood clot, having reached its maximum in volume, simply ruptures and thereby blocks any movement of blood through the artery. Both are very bad.
Who is at risk
Who is predisposed to atherosclerosis of the coronary aorta? cerebral vessels and arteries? There is a certain group of people who have every chance of such a pathology developing in their body. This category includes those who:
- Leads a sedentary lifestyle, that is, he constantly either sits or lies down. As a result, blood stagnation occurs in the body and, as a result, cholesterol settles on the walls of the arteries.
- Has elevated cholesterol levels.
Remember! The more cholesterol in the blood, the greater the risk of blood clots.
- Suffering from diabetes. Metabolic disorders are one of the main causes of pathology.
- Is overweight.
- Doesn't eat right. That is, the diet contains a large amount of salt and animal fats.
- Has high blood pressure (this contributes to damage to the walls of blood vessels).
- He smokes a lot and often.
Symptoms of the disease
All signs that blood circulation in the heart is not at the proper level are divided into two categories - ischemic and general. The former are directly related to the work of the heart muscle, and the latter are related to the deterioration of blood flow to various parts bodies.
Among the ischemic symptoms, it is worth highlighting the following:
- The presence of a heart muscle rhythm that is somewhat different from normal. This happens as a result of the fact that when there is not enough blood, the heart begins to work “idle”.
- There is an increase blood pressure due to blockages in the coronary arteries.
- Attacks of fear in a patient caused by problems with the heart muscle. The pulse quickens and the influx of testosterone increases, which only makes the situation worse.
General symptoms of atherosclerosis of the coronary vessels:
- Shortness of breath, which is observed at the initial stage of the attack.
- Dizziness resulting from insufficient blood pressure.
- Malfunction of the central nervous system.
- The presence of pain (burning and pressing in nature) in the sternum, which can radiate to the left shoulder or back. As a rule, they occur during physical exertion and are associated with a lack of oxygen in the heart.
- Increased nervousness.
- Loss of consciousness.
- Coldness felt in the extremities (legs and arms).
- Swelling.
- Lethargy and weakness.
- A nauseating state, sometimes turning into vomiting.
- Redness of the skin.
Important! At the initial stage of development, atherosclerosis of the coronary arteries does not manifest itself in any way. The first symptoms appear only at the moment when the plaques begin to increase and obscure part of the lumen of the blood vessels. Therefore, it is necessary to undergo regular examinations, especially for people at risk.
Main stages of atherosclerosis
The main phases of the development of the disease can take decades to form and, in the absence of any fight against the disease, can lead to serious consequences. There are five stages of atherosclerosis:
- Prelipid phase. It is characterized by some accumulation of protein compounds and lipids in the smooth muscles. During this period, deformation of intercellular membranes occurs, formation of blood clots (soft in structure), loss of elasticity by muscles, as well as production of collagen in the body. At this stage, it is possible to return to normal if you adhere to proper nutrition and a healthy lifestyle.
- Lipoid phase. The patient does not show any concern, despite the fact that further growth of connective tissue occurs. During this period, there is a rapid increase in body weight.
- Liposclerosis phase. Full-fledged fibrous plaques are formed.
- Atheromatosis phase. At this stage, destruction of atherosclerotic plaques, blood vessels, muscle tissue and connective tissue occurs. As a result, disruptions occur in the functioning of the central nervous system. Brain hemorrhages are possible.
- Calcification phase. A hard coating is observed on the plaques, and the vessels become brittle and completely lose their elasticity and shape.
Atherosclerosis of the coronary cerebral vessels
The disease can develop for a long time completely asymptomatically or with some mildly expressed manifestations. The clinic begins to be observed only when plaques of an atherosclerotic nature already interfere cerebral circulation, causing ischemia and vascular damage to the brain (that is, discirculatory encephalopathy). The result is either temporary dysfunction or severe tissue damage.
There are three aortic coronary cerebral vessels:
- First. This is the initial stage, which is characterized by symptoms such as general weakness, fast fatiguability, lethargy, headaches, inability to concentrate, tinnitus, decreased mental activity and irritability.
- Second. This is a progressive phase, which is characterized by an increase in psycho-emotional disorders. The patient develops depressive state tremor of the fingers or head is observed; problems with memory, hearing and vision; headaches, constant tinnitus, uncoordination of movements, unclear speech, suspiciousness and anxiety.
- Third. At this stage, the patient experiences persistent impairment of speech function, complete indifference to his appearance(i.e., apathy), memory lapses, and loss of self-care skills.
Treatment of cerebral atherosclerosis is a long process and cannot lead to complete healing. True, as a result of regular and complex therapy, it is possible to achieve some slowdown in the development of pathology.
There are several surgical techniques to treat the disease:
- Shunting (that is, plastic abdominal surgery), which allows blood flow to bypass the affected area of the vessel.
- Endarterectomy, during which the atherosclerotic plaque and altered tissue of the vessel wall are removed.
- Extra-intracranial anastomosis (i.e. connection internal system carotid artery with its external component).
- Removal of the affected area of the artery (that is, blocked by an atherosclerotic plaque) and its restoration by installing an artificial prosthesis (that is, prosthetics of the brachiocephalic trunk).
- As a result of surgical measures, resection of the inner surface of the carotid artery occurs.
Diagnosis of atherosclerosis
When a patient comes to a medical facility, first of all, a specialist listens carefully to him. Moreover, all the smallest details are important, since it is they and clinical tests that make it possible to determine accurate diagnosis. In addition to collecting anamnesis and visual examination, the doctor prescribes the following laboratory and instrumental studies:
- Complete blood test to determine cholesterol levels.
- Determination of the ankle-brachial index, that is, measurement of pressure in the ankle and shoulder area.
- Electrocardiogram. Sometimes, to make a diagnosis, daily ECG monitoring is necessary, in which a recording device that records all readings is attached with belts to the person’s body and remains with him throughout the entire examination.
- Examination on a special analyzer called a cardiovisor.
- Radionuclide research.
- Bicycle ergometry. This method allows you to identify a hidden form of coronary insufficiency.
- Treadmill test. In the process of this diagnosis, the state of the heart muscle is examined at the time of a certain physical activity.
- Intravascular ultrasound. Using it you can get a clear picture of the lumen of blood vessels.
- Duplex scanning. A non-invasive ultrasound examination that can be used to evaluate the characteristics of blood flow.
- Ultrasound of the heart. Using this method, you can determine the extent of organ damage.
- Stress echocardiography. This method using ultrasound allows you to evaluate anatomical structure and the functioning of the heart muscle during physical activity, as well as the pericardial space.
- CT scan.
Only after complex diagnostics For atherosclerosis of the coronary vessels, the specialist prescribes adequate treatment.
Important! Do not self-medicate: at best, it will not give any results, and at worst, it will simply worsen the situation with your health.
Treatment of vascular atherosclerosis
In many ways, the treatment of atherosclerosis of the coronary vessels of the heart depends on the stage of the disease. If the disease has just begun to develop, then sometimes it is enough:
- Taking certain cholesterol-lowering drugs (that is, statins). The doctor may also prescribe beta blockers, diuretics, antiplatelet agents, and others that help eliminate the symptoms of atherosclerosis.
Remember! Only a specialist can prescribe medications and determine their dosage.
- Lifestyle changes. Balanced diet, moderate physical activity under the supervision of a cardiologist, abstraction from stressful situations, as well as giving up bad habits such as smoking and drinking “hot” drinks will help you quickly cope with the disease.
On a note! You can use the tips traditional medicine, after consulting with your doctor. For example, eating garlic has a good effect in the fight against atherosclerosis. True, if it causes a rapid heartbeat in the patient, then it is better to purchase garlic-based products at the pharmacy chain.
How to treat atherosclerosis of the coronary vessels in severe cases? Most likely, without surgical intervention not enough:
- The most common option is to install a stent, which is used to expand the affected vessel, thereby ensuring normal blood flow.
Important! A patient who has undergone stenting will have to take statins and other drugs for life, since if this is not done, the vessels will again be affected by atherosclerosis.
- Another option is coronary artery bypass grafting. Using this method, you can allow blood flow to bypass the affected area of the vessel.
Prevention
In order not to subsequently treat atherosclerosis of the coronary vessels, it is necessary to implement a number of preventive measures:
- Regularly engage your body in moderate physical activity (for example, walking, swimming, doing morning exercises or simply dig up beds on your own plot). The most important thing is more movement.
- Treat any pathologies you have in a timely manner. It would be a good idea if you visited a cardiologist once every few years.
- Try to avoid stressful situations or at least abstract yourself from them. Any psycho-emotional stress is harmful to health.
- If you are overweight, be sure to fight it.
- Try to alternate physical activity with rest.
- Proper nutrition is the key to health. What need to do? Avoid animal fats, eggs, butter, high-fat dairy products, sour cream, as well as fatty meats and fish. Vegetables and fruits are encouraged.
- Quit smoking and drinking hard drinks.
- Go for walks regularly fresh air.
- Use traditional medicine recipes.
On a note! If atherosclerosis has already developed, then try to slow down its progress. Follow your doctor's recommendations regarding both medications and lifestyle choices. If surgery inevitably, then don’t delay with him.
Finally
Take more care of your health, especially your heart. Moreover, such a pathology as atherosclerosis of the coronary arteries manifests itself in all its glory exclusively in the later stages. This disease is difficult to treat, but it can be stopped, and sometimes positive dynamics can be achieved. Remember: the main thing is to start treatment of coronary atherosclerosis on time. Health to you and your loved ones!
Among the heart diseases, there is coronary heart disease. The reason for its development is atherosclerosis of the heart vessels. Complicating the problem is that development initial stages diseases are practically not accompanied by symptoms.
If atherosclerosis can be detected in the early stages, this will have a positive effect on treatment: significant changes in the vessels can be achieved and the likelihood of complications can be reduced.
Until recently, atherosclerosis was detected only in people over 45 years of age. Now there is a tendency towards “rejuvenation” of the disease.
- All information on the site is for informational purposes only and is NOT a guide to action!
- Can give you an ACCURATE DIAGNOSIS only DOCTOR!
- We kindly ask you NOT to self-medicate, but make an appointment with a specialist!
- Health to you and your loved ones!
What is pathology
Atherosclerosis of the coronary vessels of the heart (ICD code - 10) is a disease chronic course, accompanied by the formation and growth of fatty plaques. The latter arise due to the accumulation of cholesterol on the walls of blood vessels, as well as low-density lipoproteins. The more of these “helpers”, the more the plaques grow.
Over time, they begin to close the lumen in the arteries. This leads to the fact that the blood flow in them decreases and may eventually stop altogether.
As a result, problems arise with the organs that receive oxygen and nutrients. This leads to ischemia of organs, their oxygen starvation and impaired performance.
Atherosclerosis does not occur in one minute. This takes years. Initially, atherosclerosis begins to occur in adolescence.
At first it develops slowly, but during the transition to the second half of life, the disease begins to progress and makes itself felt after 45 years.
Plaques of deposited cholesterol can “infect” arteries in absolutely any part of the body. Arteries may be affected lower limbs, renal, brain, mesenteric vessels, aorta. But the most affected are the coronary vessels, which supply blood to the heart.
The seriousness of the problem is that the coronary vessels are tortuous, highly branched and rather narrow. They are the ones who are primarily “attacked” by plaques and “overgrow”.
But the development of atherosclerosis is not always accompanied by obvious symptoms. There are cases when a patient suffers from a disease for a long time, but does not feel any symptoms. This can be explained by the fact that the brain and kidneys are in dire need of oxygen.
But the heart does not, since the need for oxygen arises during physical activity of the body. So, at rest, 5 liters of blood flows through the heart, while during physical activity - 30 liters/min. In proportion to the increase in the amount of blood, the need for oxygen arises.
In the case of atherosclerosis, the vessels underlying the heart become “clogged” with plaques and do not allow the required volume of blood to flow into the heart. In this case, plaques compact the walls of blood vessels and prevent them from expanding normally. All this leads to a failure of myocardial blood circulation.
The resulting myocardial ischemia due to developing atherosclerosis is called coronary heart disease (otherwise IHD).
Causes
Atherosclerosis is damage to the arterial vessels of the entire body. Therefore, atherosclerosis of the coronary and cerebral vessels has the same.
The disease occurs for the following reasons:
- the presence of diseases such as diabetes and obesity;
- bad habits such as smoking and excessive drinking;
- increased levels of cholesterol in the blood;
- inactivity;
- arterial hypertension;
- poor nutrition, accompanied by the consumption of large amounts of carbohydrates, animal fats, salt and ignoring or small consumption of fish, vegetables, oils plant origin and fruits.
Symptoms
Since coronary heart disease and atherosclerosis of the coronary vessels are one and the same, their symptoms are the same. There are two types of IHD:
Angina pectoris is closely related to atherosclerosis and its clinical manifestations. This disease is accompanied by pain in the chest caused by a lack of blood supply to the myocardium due to narrowing of blood vessels by plaques.
Such painful attacks usually last no more than 15 minutes, are observed during physical activity and stop after its completion.
Put away painful sensations You can use nitroglycerin, which leads to dilation of the coronary vessels, due to which blood begins to flow to the heart in the right quantity.
Depending on how severe the atherosclerosis of the aorta of the coronary vessels, angina pectoris and myocardial ischemia can manifest themselves to an equal degree of severity.
In addition, the symptoms and their strength directly depend on what type of physical activity the body undergoes.
Angina pectoris is divided into several functional classes:
Diagnostics
Initially, atherosclerosis of the coronary vessels can be suspected by ECG, which clearly shows signs of myocardial ischemia. You can suspect the presence of plaques using following methods research:
| Myocardial stress scintigraphy | This method allows you to determine not only the location of atherosclerotic plaques, but also in which vessel the most dangerous ones are located. |
| Intravascular ultrasound | Doppler is also used. |
| Ultrasound of the heart and DEHO-CG | Using this method, it is possible to determine structural changes: wall thickness, chamber size, identify the presence of sections with absent or reduced contractility, hemodynamics and valve morphology. |
| Coronary angiography | This is nothing more than an X-ray examination with preliminary contrast. This makes it possible to identify where the affected vessels are located, what is the length of the affected area and what is the narrowing of the vessel. |
Treatment of atherosclerosis of coronary vessels
Treatment of the disease is prescribed to each patient individually. As a rule, drug therapy and a variety of procedures are prescribed to help eliminate excess cholesterol in the blood.
Drug treatment is prescribed to eliminate metabolic syndrome, correct various disorders accompanying the disease, and normalize heat metabolism. As a rule, the following medications are prescribed:
- Drugs that can increase energy metabolism.
- Medicines that prevent cholesterol from being absorbed into the blood.
- Medicines that prevent the production of triglycerides and cholesterol, as well as lower their levels in the blood plasma.
Additionally, the following may be prescribed: Anginin, Aevit, Vasoprostan, etc.
Folk remedies
For the treatment of aortic atherosclerosis is also used alternative medicine. Only in this case you need to remember that such treatment cannot be used in any way in place of the prescribed treatment by a doctor. But at the same time, it is possible, since herbs help eliminate symptoms, break down fat cells in the blood, and normalize metabolic processes.
To clean vessels, you can use the following recipes:
| Medicinal mixture of pre-crushed licorice, wheatgrass and dandelion roots (10g, 20g and 10g respectively) |
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| Nutrition correction |
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| (leech treatment) |
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Regardless of which method of alternative treatment you choose, it should only be carried out with the permission and under the supervision of your attending physician.
Diet
In order to prevent the development of atherosclerosis of the coronary vessels and reduce symptoms, it is necessary to follow a diet. To do this, exclude foods rich in cholesterol from the diet, namely:
- egg yolks;
- salo;
- fatty meats;
- kidneys;
- solid animal fats;
- brain.
Add to your diet foods that can cleanse the body of cholesterol, namely: oatmeal, cabbage, low-fat cottage cheese, potatoes.
Use vegetable oils instead of animal fats. Don't forget vegetables, whole grains and fruits.
Prevention
If the patient has already been diagnosed with even initial atherosclerosis, then it is necessary to immediately prescribe treatment, followed by long-term recovery of the whole organism and in order to avoid development into a more serious stage.
Atherosclerosis is a chronic disease, so the patient is prescribed medications that must be taken for life. To reduce atherosclerotic plaques it is recommended:
- Follow a special diet that reduces the intake of cholesterol in the body.
- Do physical therapy.
- Completely give up bad habits.
The most terrible enemy of any inhabitant of the planet over 50 years old, an insidious enemy, overtaking unexpectedly and changing life once and for all. An enemy you need to know by sight. Meet atherosclerosis of the coronary arteries.
Provides truly frightening data medical statistics– every second death in the world occurs due to coronary heart disease. The cause of which is atherosclerosis of the coronary arteries. This has always been the case, except during times of total military battles. The saddest thing is that from year to year these readings change for the worse. This is despite the fact that medicine continues to develop, regional vascular centers are opening to resolve the current situation, and new medications are being produced. Let's try to figure out what kind of disease this is and how to defeat it.
With a significant narrowing of the arteries and arterioles (the smallest vessels) of the heart, their damage by the atherosclerotic process, the heart performs its job worse and worse. At rest, pain most often does not bother you, but when walking, running, lifting heavy objects or strong experiences, the heart begins to work faster. That's when the patient appears characteristic pains. As a rule, a person complains of a compressive sensation, similar to a feeling of heaviness, and points his hand to the center of the chest or the left side. With rest the pain goes away. This condition is medically called angina. In more severe cases, when atherosclerosis of the coronary vessels of the heart is even more widespread, similar pain occurs even with the slightest movement.
Why does my heart hurt?
At the beginning of the disease, a person usually does not feel sick - he has no complaints, discomfort. For a long time atherosclerosis of the coronary arteries of the heart proceeds painlessly, without making itself felt. As a rule, when an atherosclerotic plaque enlarges and bulges into the lumen of the vessel, the first symptoms appear. The vessel that supplies blood to the heart muscle becomes narrow. Blood flows through it worse. There is a lack of oxygen and the heart begins to cope poorly with the load. The organ suffers, roughly speaking, from malnutrition. There is a well-known expression in medicine: “pain in the heart is its cry for help.”
Development of the disease
Angina pectoris is a disease that can bother a person for decades in a row. However, more often the disease progresses. If proper attention is not paid to treatment, atherosclerosis continues to grow and a heart attack develops.
At the molecular level, the cause of a heart attack is stenotic atherosclerosis of the coronary arteries . That is, a huge, total damage to the blood vessels of the heart. It happens something like this: the covering of the plaque ruptures and blood particles begin to “stick” to the liquid core, creating a clot. The already narrow vessel closes completely. Inflammation begins in its lumen. And in that part of the muscle that was supplied from this vessel, a catastrophe occurs. When the muscle stops receiving nutrition, it dies. At this moment, the patient feels a sharp, unbearable pain in the chest, fear, and shortness of breath may appear. This moment is critical for life. Some survive, some don't. This depends primarily on how extensive the affected area is. Of course, the age, condition of the patient, and his other chronic diseases play a role.
How to fight
The very first question patients ask is whether atherosclerosis can be cured. Definitely not. There is no medicine that would reverse the process, reduce or disappear the plaque. Treatment is to stabilize the situation. Slow down the growth of atherosclerosis, and in the most successful case, stop it altogether. Ideally, you need to think about this before symptoms appear. However, later this literally becomes a vital necessity.
No matter how trite it sounds, you should start with changing your lifestyle. Namely, with proper nutrition. The fats that make up the plaque mostly come from the fats we eat. It should be borne in mind that only animal fats should be considered “to blame” for the formation of atherosclerosis - they are the ones that are dangerous. Vegetable fats do not cause the growth of atherosclerosis. Butter, cream, fatty meat - these are the foods that need to be strictly limited. On the contrary, vegetables, fruits, and grains are extremely healthy products. Their content should make up the majority of the diet. Vegetable oils is given great attention, they should, if possible, replace butter.
Beyond nutrition great value has a metabolism. A person with increased body weight is at much greater risk of developing coronary heart disease. In addition, diabetes mellitus, especially poorly treated, increases the tendency to atherosclerosis, with high level blood sugar
Heredity makes a significant contribution to morbidity. Atherosclerosis of the aorta and coronary arteries can develop even at a young age and be very aggressive if the patient has genetic predisposition. It can be detected by tests that show the content of total cholesterol and its fractions in the blood. The fact is that one of the types of blood fats is the most dangerous. Therefore, it is very important to do a detailed analysis. With a serious disorder of lipid metabolism, an increase in “bad” cholesterol - LDL (more than 3) and an increase in total cholesterol (more than 5) are detected.
Drug treatment
There are medications that can affect fat metabolism. They are called statins, and they suppress the increase in “bad” cholesterol, which causes an increase in atherosclerosis. Statins also reduce general content blood cholesterol. According to some scientific data, these drugs can even slightly reduce the size of atherosclerotic plaques, but you should not seriously count on this.
Prescription and dose selection of medications of this kind should only be carried out by a doctor. Like any other medicines, they have a number of side effects, for example, affect liver function. For this reason, they are prescribed strictly according to indications, focusing on tests and the severity of the disease. Timely intake of statins in appropriate dosages is one of the most powerful means of preventing atherosclerosis.
Operation
It would seem that the size of the affected vessels in coronary heart disease is quite small for surgery. But fortunately, modern medicine maybe even that. In case of severe angina or acute heart attack, a special intervention is performed - coronary angiography. A microscopic probe is inserted into the heart vessel and contrast is injected. Under high magnification, doctors can see where blood flow is obstructed and correct the problem. Using a special balloon, the narrowing site is expanded and a stent is installed - a mesh-shaped structure that increases the lumen. This operation is performed under local anesthesia. Moreover, opening the chest is not required, only a small puncture on the arm or thigh.
Stenting could have been considered a salvation, if not for one thing. The vessels on which the intervention occurred are again affected by atherosclerosis if statins and a number of other medications are not taken. After the operation, the patient is simply obliged to take medications for life, according to a certain scheme.
To summarize, we can say that atherosclerosis is really enemy number one. But having looked at it from all sides, we can successfully repel attacks. The main thing is to act on time and wisely.
