IBS treatment. Treatment of coronary artery disease: how to stop the disease and save life from a heart attack

This is the middle muscular layer of the organ, which makes up the bulk of its mass. As a result of the development of pathological symptoms without their treatment, various complications may occur.

Coronary heart disease (symptoms and treatment are taken into account during diagnosis) is a pathology in which the blood supply to the myocardium is disrupted. The disease is abbreviated as ischemic heart disease. The coronary vessels are affected, blood flows to the heart is limited or does not flow to the organ at all.

The myocardium is the thickest muscle of the heart, which is located in the middle. It is involved in pumping blood.

Thanks to the myocardium, the heart has the following properties:

• automatic operation without external stimulation - the heart contracts rhythmically;
• impulse conduction;
• response to external and internal factors.

Forms of cardiac ischemia

Ischemic disease has a classification. The table shows the forms of IHD.

Name	Description
Sudden coronary death	Other names are primary cardiac arrest, VCS. A lethal outcome that occurs as a result of the cessation of organ activity. A type of ischemic heart disease occurs in adults aged 45–75 years. Sudden death is the cessation of the body's vital functions, which occurs within 6 hours from the onset of cardiac disorders. A type of ischemic heart disease always appears unexpectedly and does not depend on the presence of cardiovascular pathologies. The condition does not always lead to death. It is possible to normalize the functioning of the heart if resuscitation measures are provided in a timely manner.
Angina pectoris	Another name is angina pectoris. A person experiences paroxysmal pain in the heart area. Unpleasant sensations arise as a result of insufficient blood supply to the myocardium. There are several types of angina:
Myocardial infarction	Muscle necrosis, which develops as a result of acute impaired circulation. Stages of heart attack: 1. Initial. Another name is the damage period. The stage lasts up to 3 days. The fibers are damaged, resulting in impaired blood circulation. 2. Acute. The duration of the stage is from 1 to 21 days. Gradually, the area of ​​damage decreases, as one section of the fibers dies, and the other tries to recover and reduces blood circulation. 3. Subacute. The duration of the stage is from 3 to 12 months. Deeply damaged fibers die. And others are restored and move into the ischemia zone (reduced blood circulation). 4. Scar. Another name is the final stage. The fibers scar throughout a person's life. Healthy areas unite at the site of necrosis.
Post-infarction cardiosclerosis	Scarring of dead tissue occurs. A type of ischemic heart disease appears not only as a result of myocardial infarction, but also in infectious diseases.
Violation heart rate	Another name is arrhythmia. This is a type of coronary artery disease in which the frequency, rhythm, and sequence of contraction and excitation of the heart are disrupted. Classification: sinus bradycardia - rare heart rhythm; sinus tachycardia - a sharp increase in heart rate more than 90 beats/min.; sinus arrhythmia - an abnormal heart rhythm, which is accompanied by a decrease and increase in frequency (heart rate is within normal limits); paroxysmal tachycardia is a sudden change in heart rate, but the correct rhythm is maintained for a long time.
Heart failure	A condition that develops as a result of weakened contractile activity of the myocardium. Heart failure is not an independent disease. The disorder appears as a result of ischemic heart disease, arterial hypertension. There are several types of heart failure:
Silent cardiac ischemia	The blood supply to the myocardium is temporarily disrupted. Pain does not appear as symptoms, but disturbances in the functioning of the heart can be seen on the cardiogram. A type of ischemic heart disease manifests itself as an independent deviation or combined with other forms of ischemia.

In addition to international qualifications, new types of IHD have emerged.

Namely:

• Hibernating myocardium. Another name is sleeper. The condition is a long-term impairment of myocardial functionality due to chronic ischemic heart disease or repeated episodes of ischemia.
• Stunned myocardium. Decreased myocardial contractility, which occurs against the background of impaired blood flow. The muscle is affected, but its cells do not die.
• Syndrome X. The arteries change, their lumen decreases. The symptoms of the disease are similar to atherosclerosis of the coronary vessels.

Causes of IHD

Coronary heart disease (symptoms and treatment are interrelated in the choice of treatment tactics) occurs for various reasons.

These include the following factors:

Coronary heart disease is an inadequate supply of blood, oxygen and nutrients to the myocardium.

This develops for the following reasons:

• damage to the coronary vessels;
• Heart disease is combined with impaired metabolism.

Risk factors

Coronary heart disease can occur in the presence of risk factors. That is, the likelihood of the disease increasing. This must be taken into account when symptoms occur, as well as when prescribing treatment.

Risk factors that increase the likelihood of CAD:

Pain due to ischemic heart disease

Pain caused by ischemic heart disease depends on the type of disease. detailed information indicated in the table.

Type of IHD	Description of pain
Sudden coronary death	Unpleasant sensations arise behind the sternum. The nature of the pain is pressing or squeezing.
Angina pectoris	Angina pain has specific symptoms. First there is discomfort in the chest. Then pain appears, which has the following features:
Myocardial infarction	Most often, myocardial infarction can be judged by the appearance of pain behind the sternum, which has a sharp, burning, pressing character. Discomfort may be localized in upper limb, neck, back. The pain also radiates to the lower jaw. But the discomfort is not always typical. During myocardial infarction, pain may be masked. There is an abdominal type of discomfort. Unpleasant sensations in the abdominal cavity, which are not typical for a heart attack. Discomfort acute nature, is localized in the right side, but then can spread throughout the abdomen.
Post-infarction cardiosclerosis	The condition is characterized by chest pain; it has a burning and pressing character. Discomfort radiates to the shoulder or upper limb.
Abnormal heart rhythm	With arrhythmia, pain in the heart area may be observed, which is aching or stabbing in nature. Sometimes the discomfort is so strong that it leads to fainting. If your heart rhythm is abnormal, you may experience back pain.
Heart failure	The pain in the heart squeezes, squeezes. Additionally, it can manifest itself as piercing and cutting.
Silent ischemia	There is no pain.

Signs of illness

Coronary heart disease exhibits various symptoms. Signs depend on the classification of IHD. Detailed information is shown in the table.

Name of the type of IHD	Symptoms
Sudden coronary death	A symptom that a person himself can notice is a sudden decrease in previously tolerated loads. For example, if before it was possible to climb to the 5th floor without problems, now it is difficult to walk 200 m. Further symptoms of coronary death: cessation of heart activity; blood pumping disorder; loss of consciousness; lack of pulse and breathing; pupil dilation. Precursors may appear before this type of IHD. For example, increased heart rate, dizziness.
Angina pectoris	In addition to pain, with angina pectoris, the emotional background is disturbed. The person is afraid of death and is constantly nervous. Additionally, shortness of breath and fatigue occur with minimal exertion.
Myocardial infarction	In addition to pain, the following symptoms appear during myocardial infarction: shortness of breath with minimal exertion; weakness; feeling of heartbeat; dizziness; cold, sticky sweat; emotional instability – fear, anxiety; nausea and vomiting; change blood pressure; pale skin; impaired coordination of movements; vision problems; cough; enlarged veins in the neck; blueness and swelling of the limbs. But a heart attack can be masked. Additional symptoms: Gastralgic form. Symptoms characteristic of an attack of pancreatitis appear - high fever, loose stools, hiccups. Asthmatic form. Signs disguised as diseases respiratory system. Symptoms include difficulty breathing and severe shortness of breath. But asthma medications do not relieve symptoms. Cerebral form. Possible loss of consciousness. A person’s speech is impaired and becomes slurred. Painless form. Symptoms include weakness and shortness of breath. In rare cases, the little finger on the left hand becomes numb.
Post-infarction cardiosclerosis	Symptoms: fatigue with minimal exertion; frequent heartbeat when playing sports; pastiness of the legs - a condition that precedes edema; swelling lower limbs(in serious cases); suffocation at night; impaired heart function.
Heart rhythm disturbance	Signs of the condition: interruptions in heart function; abnormal heart rate; weakness with minimal exertion; feeling of heat; coldness in the extremities; mental disorders - fear, anxiety. If the case is severe, then fainting is added.
Heart failure	Symptoms acute failure in the right ventricle: increased heart rate; enlarged veins in the neck; swelling of the lower extremities; reduced blood pressure. Signs of acute failure in the left ventricle: With chronic deficiency, the following symptoms appear: dyspnea; fatigue with minimal exertion; pale skin; discoloration of the skin in a bluish color; swelling of the lower extremities.
Silent ischemia	According to symptoms, the disease may be similar to other pathologies - diabetes, thrombosis. Signs: headache; constant thirst; impaired urination; swelling of the lower extremities; lameness; decreased sensitivity of the skin.

Complications

Coronary heart disease (symptoms and treatment are interrelated factors) provokes complications. The most serious consequences of IHD are coma and death.

When should you see a doctor? Diagnostics

Treatment of coronary artery disease is within the competence of a cardiologist. Therefore, if you suspect a disease, you should visit a doctor. He will conduct a survey and study the medical history. Additionally, an examination of the person’s body will be required. After this, you may need to consult a heart surgeon.

Symptoms that require calling your doctor or an ambulance:

To clarify the diagnosis, a complete examination of the body is necessary. It includes:

• taking a general blood and urine test - the value is determined based on the results important indicators(erythrocytes, hemoglobin, etc.);
• biochemical analysis - determine the value of glucose, cholesterol and other indicators;
• electrocardiogram (ECG) – the procedure helps to identify abnormalities in the functioning of the heart;
• Ultrasound examination (ultrasound) – the results can reveal the size of the heart and abnormalities in the development of the organ;
• magnetic resonance imaging (MRI) is a highly informative study, the results of which can determine the size of an organ and assess its functionality;
• heart biopsy - a small myocardial tissue is removed and sent to the laboratory;
• load test;
• Holter study;
• EchoCG;
• coronary angiography.

Load tests

Another name for loading methods is a stress test. They come in several types. But the principle is the same - the heart is examined during physical activity. This helps to fully examine the organ. At rest, there may not be a complete picture of cardiac dysfunction.

Positive qualities of load tests:

• identifying abnormalities in the functioning of the heart at an early stage;
• the ability to study abnormalities in the functioning of the heart that are not visible at rest;
• the body's tolerance can be determined.

Therefore, stress tests are often used in people whose professions involve increased stress - firefighters, drivers. This diagnostic method is also used by athletes to calculate the permissible load and conduct training more effectively.

Popular tests:

Load test combined with imaging techniques

The following procedures are used as stress tests with imaging techniques:

• Single photon emission computed tomography (SPECT). The drug is injected into the human body. Then a CT scan is done. If myocardial blood flow is normal, the drug is distributed evenly. When the blood supply to the muscle is reduced, defects can be noticed.
• Positron emission tomography (PET). A radioactive isotope is injected into the body. Using tomography, the nutrition of the myocardium is monitored. Based on the results, we can conclude about the supply to the heart.
• Coronary perfusion magnetic resonance imaging (PMRI). A substance is introduced into the human body that stains blood vessels. After PMRI, we can draw a conclusion about the work of the myocardium.

Holter monitoring

The abbreviated name used by cardiologists is Holter.

Based on the results of the procedure, we can conclude the following points:

The skin in the chest area is degreased using a special alcohol solution. A small device whose weight does not exceed 500 g is attached to the human body. Next, electrodes are attached.

The standard procedure time is 24 hours. But, if a longer diagnosis is needed, the duration can be increased to 2–7 days.

When installing a holter, the doctor will tell you what actions it is better not to do. For example, it is prohibited to physical activity, as the device may turn off or the result will be incorrect. Also, due to increased sweating, the electrodes will not stay in place. Otherwise, you need to stick to your usual lifestyle.

When the required period of time has passed, the device is removed and the device is connected to the computer. The digital system analyzes the received data.

EchoCG

The full name of the procedure is echocardiography. For this purpose, a special device is used that emits ultrasound. Passing through the heart, the waves are reflected by the tissues of the organ.

The duration of the procedure varies from 30 to 40 minutes. The sensor is applied to several areas of the skin. During echocardiography, attention is paid to myocardial contractility, valve activity, and heart function.

Coronary angiography

Based on the results of the procedure, it is possible to identify the structural features of the circulatory system. Coronary angiography is a surgical diagnostic intervention. Therefore, the procedure is performed only in the clinic.

An incision is made in the skin through which a probe (a long, thin tube) is inserted. The process of advancing the catheter to the heart is controlled using a camera. A contrast agent is injected through the probe. Next, an x-ray is performed. The person's pulse is monitored throughout the procedure.

Drug treatment

Coronary heart disease (symptoms and treatment are interrelated factors) is a pathology for which drug therapy can be used. Medicines reduce the manifestation of negative symptoms and make a person feel better.

B-blockers

A group of drugs reduces myocardial oxygen demand, reduces heart rate and blood pressure. When taking B-blockers, the life expectancy of a person with coronary artery disease increases.

Mechanism of action of beta blockers

The most commonly prescribed drugs are:

• Metoprolol.
• Atenolol.
• Bisoprolol.
• Concor.
• Betalok.

Antiplatelet agents

Medicines that reduce the likelihood of blood clots.

For IHD, the following are often prescribed:

• Acetylsalicylic acid.
• Cardiomagnyl.
• Thrombo ACC.
• Acecardole.

Statins and fibrates

Statins speed up the elimination of bad cholesterol. As a result, the general condition of the blood vessels improves and the elasticity of their walls improves. Additionally, the drugs eliminate the symptoms of high cholesterol.

For IHD, the following medications are prescribed:

• Atorvastatin.
• Atoris.
• Crestor.
• Rosuvastatin.

Fibrates reduce the production of triglycerides, high and low density lipoproteins. The drugs also increase the synthesis of good cholesterol.

Medicines:

• Clofibrate.
• Fenofibrate.
• Lipantil.

Anticoagulants

Medicines help thin the blood. As a result, the likelihood of blood clots is reduced. The group includes Heparin, Warfarin, Xarelto.

Nitrates

Medicines relieve an attack of angina. Nitrates are also used to prevent complications in the event of acute myocardial infarction. A group of drugs dilates blood vessels, blood flows faster to the myocardium and supplies it with oxygen.

As a result, you can get rid of pain in the chest. Additionally, nitrates improve blood fluidity and prevent blood clots. The group includes Nitroglycerin, Nitrospray, Nitromint.

Antiarrhythmics

The drugs normalize heart rhythm. The group includes Verapamil, Digoxin, Amiodarone.

Diuretics

Medicines speed up the removal of excess fluid from the body. As a result, swelling decreases and the load on the heart decreases. The group includes Veroshpiron, Diuver, Hydrochlorothiazide.

Other methods

Besides medicines, for ischemic heart disease, other methods of therapy can be used. The most commonly used are coronary angioplasty and stenting, and coronary artery bypass grafting.

Coronary angioplasty and stenting

The operation is used to open the vessel (if it is blocked by cholesterol plaque) and restore blood flow. Before the procedure, the person is given local anesthesia.

In the femoral (about groin area) or radial (wrist) artery is punctured. The skin is pre-treated alcohol solution. Next, a catheter is inserted into the artery, at the end of which there is a balloon.

The tube is advanced to the site of the blockage. The balloon is slowly inflated, pressing the plaque into the artery wall. Then deflation occurs. The actions with the balloon are repeated several times. Next, all instruments are removed from the vessel.

If the artery diameter is more than 3 mm, stenting is necessary. A special device (stent) is inserted into the vessel. Thanks to the lattice design, the artery expands. Thus the effect is more lasting. After the procedure, the stand remains in the vessel forever.

Coronary artery bypass grafting

During the operation, a new vascular pathway is created for blood movement. The surgeon places it to bypass the artery, which is blocked by cholesterol plaque. The results of the procedure can improve blood supply to the myocardium. The patient's blood vessels are used for bypass surgery. This could be part radial artery upper limb, saphenous vein legs.

On one side, the shunt is connected to the aorta, and on the other, to the cardiac branch, which is blocked by a blood clot. During the operation, the person is connected to a cardiopulmonary bypass system. The device will carry out blood flow throughout the body instead of the heart. But intervention is possible without fulfilling this point; the main organ will work.

The importance of nutrition in ischemic heart disease

If you have IHD, you need to eat right. This can reduce the load on the heart and improve a person’s well-being.

Nutrition principles:

• Frequent meals – up to 6 times a day. It is necessary to observe breaks between meals - from 3 to 4 hours. Serving size – up to 300 g.
• Remove fatty, fried, smoked foods from your diet.
• Reduce the amount of sweets and starchy foods.
• Replace fatty meat with low-calorie meat - instead of pork and lamb, it is better to buy chicken and turkey;
• Dairy products should be low in calories.
• The diet should be dominated by vegetable soups and cereals.
• It is better to cook food by steaming, boiling or baking in the oven.
• You need to remember about the drinking regime - at least 1 liter of clean still water per day. It is recommended to exclude sweet drinks, strong coffee and tea.

The importance of physical activity

Exercise for coronary artery disease helps reduce symptoms and make a person feel better. But you don’t need to engage in professional sports or put a lot of stress on your body. At first, charging in the morning is enough. Then you can increase the load and choose your favorite activity - cycling, walking.

Forecast

The prognosis for IHD depends on the type of disease and stage. Concomitant pathologies are also taken into account. But IHD is an incurable condition. You cannot completely get rid of the disease.

But with such a pathology, a person’s life can be increased by another 20 to 50 years, if you follow all the specialist’s recommendations. With help therapeutic measures it is possible to stop the progression of the disease.

Coronary heart disease means a disorder of the myocardial circulation. This is a muscle that is involved in pumping blood. There are different forms of IHD - myocardial infarction, angina pectoris, cardiosclerosis. Each variety has its own symptoms.

Treatments include medications and surgery (angioplasty, bypass surgery). The most important thing is to visit a cardiologist in a timely manner or call an ambulance. If you follow all the doctor’s recommendations, you can stop the progression of the disease and reduce the likelihood of complications.

Article format: Vladimir the Great

Video about coronary heart disease

What is the danger of cardiac ischemia:

Coronary heart disease is a disease in which a person’s blood supply to the myocardium is disrupted due to pathologies coronary arteries.

IHD is a fairly common disease. That is why, probably, almost everyone has an idea of ​​what kind of disease this is. It is one of the main causes of mortality and loss of productivity. It is for this reason that modern doctors pay so much attention to this disease.

In European countries, ischemic heart disease and cerebral stroke account for about 90% of all pathologies of the heart and blood vessels. IHD accounts for 30% of all deaths. Coronary heart disease is present in 30% of women and 50% of men. This difference is explained by certain hormonal characteristics (female sex hormones prevent vascular atherosclerosis). However, if you consider that during menopause a woman’s hormonal background changes, then their risk of developing IHD also increases.

Etiology and pathogenesis of IHD

Among the main factors causing IHD are:

• atherosclerosis of the coronary vessels. Most often, the pathological process affects the anterior branch of the vessels of the left coronary artery. In more rare cases, the disease affects the right branch of the arteries;
• spasm of the coronary arteries, changing their reactivity and increasing their sensitivity to various unfavorable factors;
• various diseases of the coronary arteries.

The very mechanism of development of IHD is that the vessels cannot fully supply blood, and therefore oxygen and nutrients, to the myocardium.

This phenomenon develops for the following reasons:

• damage to the coronary arteries, resulting in circulatory disorders;
• increasing the load on the heart to satisfy its metabolic needs;
• a combination of vascular pathologies and metabolic disorders. IN normal conditions Human coronary vessels can increase up to 5 times in size so that more blood flows to the myocardium.

Risk factors for coronary heart disease

Many factors can cause the development of coronary heart disease. And while some of them can still be influenced, others cannot be eliminated.

Unavoidable factors. These may include a person's race, age, genetic predisposition and gender. For example, Africans are much less likely to experience this disease than Europeans (especially those who live in the northern part of the continent). The risk of developing coronary heart disease increases significantly in people whose family had relatives who died of a myocardial infarction before age 55.

Eliminated factors. Although a person cannot change his race and age, he can still eliminate other factors and thus reduce the risk of pathology. Often they are interconnected, that is, by eliminating one of them, the others can be eliminated in the same way. For example, reducing consumption fatty foods will lead to a decrease in the amount of cholesterol in the blood, which will lead to weight loss and, as a result, lower blood pressure. All this together can significantly reduce the risk of coronary artery disease.

Avoidable factors:

• Obesity manifests itself as an excess amount of fatty tissue in the body. According to statistics, 1/2 of people over 45 years old are overweight. As a rule, obesity is caused by nutritional reasons. That is, a person’s weight increases significantly as a result of consuming high-calorie foods in excess quantities, as well as a decrease in physical activity;
• Smoking is one of the most common causes of coronary heart disease. Moreover, the negative impact of a bad habit on the body increases many times over if it is combined with an increase in cholesterol in the blood. According to scientific research, smoking can shorten a person's life by 7 years. This is due to the fact that this bad habit reduces the level of oxygen in the blood. It provokes vasospasm and thus increases blood pressure;
• Diabetes mellitus is one of the most dangerous risk factors for coronary heart disease. Diabetics are several times more likely to suffer from coronary artery disease than others. They often experience a decrease in coronary blood flow, and they suffer myocardial infarction much more severely. Moreover, doctors claim that almost all patients with diabetes, whose disease duration is 10 years or more, have a severe form of vascular atherosclerosis - the cause of the development of coronary heart disease. Myocardial infarction is the leading cause of death in diabetics;
• mental stress can also cause ischemic heart disease. This is explained by the fact that during stress the heart works faster, as a result of which the pressure in the blood vessels increases, and the delivery of oxygen and vitamins to the heart worsens;
• low physical activity is one of the most important problems of humanity in the 21st century. After all, it often leads to various diseases of the heart and blood vessels, including coronary heart disease. It has been noted that men under 40-50 years of age who engage in mental work are 5 times more likely to have IHD. The risk of developing the disease also greatly increases in athletes who have finished their careers and stopped playing sports;
• hypertension can also cause problems with the heart and blood vessels. Increased volume of the left ventricle of the heart and hypertension are likely to lead to death;
• increased blood clotting. Blockage of blood vessels by blood clots often results in a heart attack and circulatory disorders, causing the formation of atherosclerotic plaques in the vessels.

Types of disease

IHD differs from other diseases in a huge number of symptoms, which sometimes differ slightly depending on what caused the disease. In addition, doctors' opinions regarding the mechanism of development of the pathological process change from time to time. This is due to the fact that every year cardiologists learn more and more facts about this disease.

The classification of IHD is very complex, and it is almost impossible to establish it correctly, since quite often different types of IHD are combined with each other and spontaneously change from one form to another. However, there is still a special classification of IHD.

So, doctors distinguish 2 forms of the disease:

• acute ischemic heart disease. It is accompanied by acute circulatory disorders and often causes instant death;
• chronic ischemic heart disease. It is combined with chest discomfort, some types of arrhythmia and disturbances in the functioning of the heart. Moreover, all these unpleasant symptoms can be present either all at once or separately.

Myocardial infarction

Myocardial infarction is serious disease heart, which leads to prolonged angina. With this disease, as a result of insufficient blood supply to the heart, areas of necrosis form on it.

The most common cause of myocardial infarction is blockage of blood vessels with atherosclerotic plaques or blood clots.

If a patient has a complete blockage of a vessel, he eventually develops a large-focal infarction. With this type of infarction, patients develop one, but very large area of ​​necrosis. If the blockage of the blood vessels is not complete, then the foci of necrosis on the heart will be small, but there will be quite a lot of them.

Do not treat a heart attack under any circumstances. folk remedies. The treatment of this pathology should be carried out exclusively by a doctor.

Sudden death

This is the most severe and most dangerous type of IHD. IN in this case the patient feels quite normal throughout the entire time, after which he suddenly experiences cardiac arrest.

Sudden death from coronary heart disease can happen even if a person is sitting quietly or even sleeping. With this form of coronary heart disease, the percentage of deaths is the highest, since it develops sharply and, as a rule, outside the hospital.

Asymptomatic IHD

This form of coronary heart disease is different from others complete absence pain and many others unpleasant symptoms. This is why the disease is usually detected late or not detected at all. As a result, patients often die. Only an experienced cardiologist can diagnose asymptomatic ischemic heart disease after conducting numerous studies.

It is important to say that with timely consultation with a doctor, this form of coronary heart disease can be treated.

Post-infarction cardiosclerosis

This form of coronary heart disease occurs in people who have had a previous myocardial infarction. With it, rough scars appear on the affected heart muscles, which can have different sizes and be present in different quantities.

Arrhythmia

Arrhythmia is a combination of various cardiac pathologies vascular system leading to disruptions in heart rhythm. Most often, arrhythmia develops as a result of damage to various parts of the heart, endocrine diseases and some neurological pathologies.

Sports for coronary heart disease

Some patients, after they have been diagnosed with coronary artery disease, wonder if they can play sports?

Need to! Light physical activity for coronary heart disease is the main component in the treatment of this pathology.

Thanks to sports, patients can strengthen the heart muscles, blood vessels and improve blood circulation. To achieve maximum results, it is recommended to engage in sports for several years. Most often in this case, doctors recommend walking and swimming.

Symptoms

Coronary heart disease, the symptoms of which are very diverse, ranks first among the main causes of mortality and disability in the working population. And although these figures are gradually decreasing every year, this is only due to timely detection of the disease and adequate treatment.

Sex differences in patients with coronary artery disease

Signs of coronary artery disease in men and women have no gender (sex) differences and depend only on the form of the disease itself. That is: pain, shortness of breath, interruptions manifest themselves in the same way. The differences are associated with age, types of pathology and subjective experiences. Although, of course, there are exceptions.

Symptoms of coronary artery disease in men are first detected after the age of 55 years. It has been noted that in them the first manifestation of IHD is myocardial infarction, in the fairer sex - angina pectoris. Also, the latter are more likely to develop syndrome X.

Symptoms of coronary heart disease in women occur over the age of 65. This is due to physiological characteristics, namely, with the protective properties of estrogens - female sex hormones. Only after the onset of menopause and their sharp reduction, the vessels are susceptible to the atherosclerotic process - the main cause of IHD.

Women are also more predisposed to the development of hysteroid reactions such as various phobias and panic attacks, clinically reminiscent of cardiovascular pathology. In this connection, a more thorough history taking and a special approach to its assessment and interpretation are required.

Clinical features of types of coronary artery disease

IHD consists of 9 acute and chronic clinical forms. And each specific case will have its own characteristic differences in symptoms.

Sudden coronary death

Sudden coronary death is manifested by cardiac arrest. Outwardly, the person immediately loses consciousness. Moreover, there are practically no harbingers of it.

In “full health” a person dies if resuscitation techniques ( indirect massage heart, mechanical ventilation or defibrillator) will be ineffective.

Myocardial infarction

Pain in coronary heart disease is most typical for myocardial infarction and angina pectoris. There is a typical pain syndrome with the development of these pathologies. Already during a survey at the patient’s bedside, a preliminary diagnosis can be made with a high percentage of confidence.

Pain or discomfort has the following several defining signs:

• Localization (the place where it hurts) is most often behind the sternum, from the upper abdomen to the lower jaw along the midline. The heart area does not hurt. If the pain is there, you need to look for another pathology. Unusual places are the teeth, the interscapular space, as well as the shoulders, wrists and fingers (usually on the left side).
• Character - from a feeling of heaviness and discomfort to pressure and an unbearable burning sensation.
• Duration – more than 15 minutes. Sometimes it lasts up to several days, and its intensity increases.
• The connection with the load is direct. Typically, the patient has recently, or at the time of the onset of pain, been physically engaged in some kind of work or suffered a serious emotional stress. It also occurs after eating a large meal or going out into cold air.
• The reaction to nitrates is negative. Pain or discomfort does not disappear even with large doses of nitroglycerin or its analogues when taken under the tongue.

Common signs will also be weakness, profuse sweating, and a drop in blood pressure.

Symptoms of myocardial infarction and coronary heart disease, in general, are peculiar, sometimes with their complete absence at the initial stages of development, and depend on the location and parameters of the focus of dead cardiomyocytes.

Atypical forms of heart attack are:

• dyspnea; feeling that there is not enough air, cough (with asthma)
• dizziness, loss of consciousness, darkening of the eyes (with collaptoid)
• speech impairment, paresis or passing weakness in the limbs (with cerebral)
• abdominal pain, nausea, diarrhea, vomiting (with gastralgia)
• palpitations and interruptions (with arrhythmic)
• the appearance of swelling of the legs, enlargement of the liver and abdomen due to the accumulation of fluid in it (with edema)
• weakness, sweating (if asymptomatic)
• combined – can combine characteristics of different forms

Angina pectoris

With this type of ischemic heart disease, the most common symptom is pain. It is similar to those during a heart attack, but has differences that directly indicate the diagnosis of angina pectoris.

The localization and its nature may be the same, however, a positive reaction to nitrates is noted - pain or discomfort in the chest disappears immediately or within 2-3 minutes when taking nitroglycerin or its analogues under the tongue. It also usually disappears after stopping the load.

In the interictal period, and when there are no provoking influences, there are no other symptoms.

Post-infarction cardiosclerosis

This diagnosis is made 28 days after the onset of myocardial infarction and is manifested by general symptoms characteristic of the clinical picture of heart failure. These include shortness of breath on exertion, irregular heartbeats, swelling of the legs, as well as weakness and sweating. Whenever pain syndrome The development of a second or recurrent infarction cannot be ruled out, which requires immediate help.

Arrhythmias and blockades

This form of coronary heart disease is classified as chronic, where the pulse in coronary heart disease is its characteristic and indicative sign.

The feeling of a rapid or slow heartbeat, “fading” and interruptions in its work are the main symptoms of IHD in this case.

In addition, a feeling of lack of air appears when the pulse and heart contractions increase against the background of the tachyarrhythmic form of coronary artery disease.

Nonspecific complaints of general malaise and sweating may also be of concern.

Chronic heart failure

Edema in coronary heart disease (as a symptom) appears with the development of weakness of the heart muscle. It can be primary or considered as a consequence of acute forms of coronary artery disease (after a heart attack).

Fluid retention syndrome begins with the appearance of symmetrical swelling in both legs in the evening. This distinguishes them from renal edema that appears on the face and in the morning, as well as from edema in chronic venous insufficiency when only one leg swells more often.

As the disease progresses, swelling may rise and reach the anterior abdominal wall.

With CHF, the patient experiences increased fatigue and severe weakness. Ordinary physical activity becomes a burden.

Shortness of breath with coronary heart disease also occurs with severe heart failure (cardiac asthma). It worsens when lying down, so to ease breathing, many patients sleep with the head end elevated (placing 2-3 pillows under their heads).

Also, CHF is characterized by signs of an underlying disease that has led to the development of weakness of the heart muscle.

Special forms of IHD

These include vasospastic and refractory angina, cardiac X syndrome. The symptoms are similar to the clinical picture of ordinary exertional angina, however, they are accompanied by the phenomenon of peripheral vasospasm, as well as a negative reaction to standard treatment of angina.

Silent myocardial ischemia is detected only when additional examination methods are performed. There is no typical pain (as with other forms of IHD).

If you discover that you have a similar clinical picture of the disease, it is recommended that you immediately contact a specialist.

A family practice doctor, therapist and cardiologist will help in this matter. Therefore, you should not delay a visit to the doctor and self-medicate by taking some medications yourself or using traditional methods on the advice of relatives or neighbors.

Only timely diagnosis and treatment of IHD can prolong the patient’s life.

Diagnostics

Diagnosis of coronary heart disease (CHD) is necessary to determine the exact form of the disease, since the term itself combines several pathologies into one group. This is necessary to determine further tactics for managing the patient, because treatment directly depends on the timely making of the correct diagnosis.

The examination includes the collection of complaints, medical history, general examination, laboratory and instrumental methods.

How to suspect IHD?

A preliminary diagnosis is established when initial examination patient by a therapist or cardiologist. These specialists know how to diagnose coronary heart disease.

In addition to the characteristic symptoms and complaints presented by patients, even during examination it is possible to identify signs of coronary heart disease.

In acute pathology, which includes myocardial infarction, an attack of angina pectoris, or a sudden disturbance in heart rhythm, the patient’s condition can be extremely severe, including loss of consciousness. In this case, his accompanying persons are questioned.

During the inspection, special emphasis is placed on the examination of cardio-vascular system.

Pale or bluish skin, swelling of the legs and legs may be signs of coronary pathology.

In the area of ​​the heart, congenital or acquired deformities of the chest, similar to a cardiac hump, can be detected.

When percussing the boundaries, cardiac dullness can be displaced. Additional noises and interruptions may be heard on auscultation.

The pulse in coronary heart disease can be either slowed or increased (depending on the form of the disease). That is, it is not very indicative.

Blood pressure with concomitant hypertension may be increased. With the development of acute heart failure, for example, against the background of myocardial infarction, the pressure, on the contrary, can be reduced.

Laboratory research methods

Tests for coronary heart disease can help make the correct diagnosis. General analysis and biochemical blood markers are assessed.

General analysis blood reflects the quantitative characteristics of red blood cells, hemoglobin, leukocyte formula and erythrocyte sedimentation rate (ESR).

The main indication for this analysis is to identify concomitant pathology that can imitate or distort the main symptoms of cardiovascular diseases.

With extensive myocardial infarction, leukocytosis and acceleration of ESR are possible in the first few days. They reflect the processes of necrosis (disintegration) of the heart muscle.

Test results are interpreted in accordance with the duration of the disease.

A general urinalysis, a blood test for glucose are required, and biochemical indicators of kidney function are assessed in order to identify underlying metabolic diseases and diabetes mellitus.

The diagnosis of coronary heart disease, namely myocardial infarction, can be confirmed with great certainty after testing the blood for enzymes. These include:

• CPK (creatine phosphokinase),
• ACaT (aspartate aminotransferase),
• ALaT (alanine aminotransferase).

Normally, they are present in the blood in small quantities, since they are mainly intracellular substances. With acute destruction of cardiomyocytes as a result of myocardial infarction, their massive release into the bloodstream is observed, which is reflected in biochemical analysis in the form of an increase in their concentration above accepted norms.

Such an increase may be associated not only with a heart attack. To others common reasons include liver disease, severe heart failure or skeletal muscle pathology.

An important indicator is also the detection of troponins in the blood - protein components of the heart muscle. Their detection is more specific only in the first hours of myocardial cell death. Taking blood for this indicator does not make sense if a heart attack has already developed for two to three days.

A blood electrolyte test determines potassium and sodium levels. Their concentration affects the rhythm of heart contractions and can cause arrhythmias.

And of course, an important step in establishing the diagnosis of coronary artery disease is determining lipid spectrum blood.

The concentration of total cholesterol and its fractions reflects a person’s predisposition to the development of atherosclerosis, which is the main factor in the development of such pathology of the cardiovascular system as coronary heart disease.

Diagnosis of ischemic heart disease using instrumental methods.

The main procedures that make it possible to reliably determine the diagnosis of IHD in a patient include:

• Electrocardiography (ECG)
• Coronary angiography (CAG)
• Carrying out functional tests
• Echocardiography

Patients also undergo a chest x-ray to exclude respiratory pathologies.

Electrocardiography

The main study that is carried out first when there is a suspicion of sharp forms pathology such as coronary heart disease - ECG.

It is a procedure for capturing and recording the bioelectric fields of the heart. To conduct the study, special equipment is required in the form of an electrocardiograph and electrodes. The first is a receiver with a writing element (specially tuned for voltage) and graph paper. And special electrodes like plates with wires are applied to the chest and all limbs. As a result of conducting electrical signals from the heart muscle into the electrocardiograph, curves in the form of teeth are drawn on a millimeter film - a graphic representation of the contractions of various parts of the heart - the atria and ventricles. With all forms of IHD, a peculiar picture is observed on the ECG.

In acute infarction of different locations, the most typical appearance is the appearance of a pathological Q wave or ST segment elevation above the isoline in the corresponding leads. During the scarring stage, these changes may disappear completely.

With angina pectoris, at the time of the attack, it is also possible to record similar ischemic changes that disappear without a trace after the episode stops.

In the arrhythmic form of IHD, rhythm disturbances with both rare (bradysystole) and rapid (tachyarrhythmia) heartbeats can be detected. Extraordinary contractions may also appear - extrasystoles.

In heart failure related to chronic ischemic heart disease, the ECG can show lengthening of the main segments and deformed ventricular complexes due to slowing of impulse conduction or hypertrophy (enlargement) of the chambers.

Functional diagnostic doctors interpret the results obtained.

But even in the presence of pathological changes on the film, a comprehensive assessment of the data obtained in conjunction with the clinic and other research methods is necessary.

Since there are frequent cases of overdiagnosis of the disease.

Angiography

Refers to the gold standard for diagnosing coronary vessel pathology. Thanks to it, it is possible to visually assess the degree of narrowing of the lumen blood vessels heart with the help of a contrast agent injected there.

The examination itself is recorded using a series of x-rays.

Often, diagnostic coronary angiography turns into a therapeutic one, when a stent (a hollow mesh tube) is immediately installed in the area of ​​the narrowed vessel to expand the lumen and improve coronary blood flow.

Holter ECG monitoring

It is a long-term (from several hours to 7 days) ECG registration, since a single ECG may not have time to register the pathology.

It is mainly performed for patients with complex heart rhythm disturbances, nocturnal pain episodes in the heart, as well as for unclear diagnosis or to monitor treatment in order to correct it.

The design of the device is similar to an electrocardiograph, but it is only more portable, and instead of paper there is a special magnetic tape for recording.

The conclusion is also issued by a functional diagnostician.

Load tests

They are carried out either using a treadmill or exercise bike, or using a 6-minute walk test.

The need for such tests is due to the fact that some forms of IHD manifest themselves clinically only during physical stress. It is at this moment that myocardial ischemia (lack of oxygen) develops due to a discrepancy between the needs of the heart muscle and the amount of blood supplied through the narrowed vessels.

Such altered heart function is recorded on an ECG.

An indication for testing is also the need to clarify the diagnosis, form and severity of coronary artery disease, selection and monitoring of the effectiveness of treatment.

The technique is associated with a certain risk, so it must be carried out only in the presence of a specialist doctor who knows how to perform cardiac resuscitation.

The test is stopped immediately if the subject's well-being worsens or if serious abnormalities appear on the ECG.

Echocardiography

Allows you to visually assess in real time the size of the chambers and the thickness of the walls of the heart, the contractility (ejection fraction) of various parts of the myocardium, as well as the presence additional education(thrombus, tumor) in the cavity of the atria or ventricles.

It is carried out using a special ultrasound machine by a diagnostician.

During the study, you can clearly see the work of the heart and valve apparatus, as well as observe the rhythm and frequency of contractions.

It is more indicated in chronic forms of coronary artery disease, namely in heart failure and the formation of an aneurysm in the post-infarction period.

Signs of coronary heart disease in men and women are practically no different. However, in the former, the disease occurs at an earlier age. Unfortunately, IHD is constantly getting younger. Therefore, at the slightest suspicion, an urgent request for medical care. Timely diagnosis can not only save lives, but also prevent serious complications. This will improve your prognosis, quality of life and well-being in the future.

Treatment

The diagnosis of ischemia sometimes sounds like a death sentence, because, unfortunately, this disease is incurable and leaves an unpleasant imprint on the life of the patient. Therefore, to the question whether coronary heart disease can be cured, any cardiologist will give a negative answer. But in this case, you cannot do without medications, since properly selected treatment for coronary heart disease in combination with a healthy lifestyle will help to significantly prolong the patient’s life, avoid serious complications and alleviate the course of ischemia.

Rules for the treatment of coronary heart disease

How to avoid coronary heart disease? To successfully combat ischemia and avoid its development, it is necessary to follow a number of important rules:

• Blood pressure control. A sharp and prolonged increase in blood pressure should not be allowed. To monitor, you need to independently measure your blood pressure every day so that if it increases, you can take timely measures. Normally, blood pressure should not exceed 140 per 90 units.
• Healthy eating. The first thing the doctor will do after diagnosing coronary heart disease is prescribe a low-cholesterol diet. The diet and list of recommended and prohibited foods are selected individually depending on the severity of the disease, the patient’s age and his individual characteristics.
• Controlling cholesterol levels. Blood tests for cholesterol levels are performed regularly as prescribed by your doctor. In case of any deviations from the norm, drug treatment and nutrition are adjusted. In this case, the total amount of cholesterol in the blood should not exceed 5 mmol/l. Part of this volume is high-density cholesterol, which is considered healthy and necessary. It should be at least 1 mmol/l. The rest of the mass is allocated to harmful low-density cholesterol. But it should not be more than 3 mmol/l. To understand how to treat coronary heart disease, you need to understand what cholesterol level the patient was admitted with and monitor this level throughout the entire therapeutic process.
• Maintaining a sleep schedule. In order for the heart to work in comfortable conditions, the body must not be overloaded, including by disrupting sleep patterns. You must go to bed at the same time: the most comfortable time for your biological clock. You also need to sleep at least 7 and no more than 10 hours a day. Deviations from this norm, up or down, negatively affect the functioning of the heart muscle.
• Fresh air. It is very important to prevent oxygen starvation of the body. If possible, you should devote 30-40 minutes a day to walking fresh air. If walks or long walks are contraindicated during the rehabilitation of patients with coronary heart disease, and the patient does not have the opportunity to be outside often and for a long time, it is necessary to ventilate the room daily after waking up and before going to bed. This will have a beneficial effect on the quality of sleep, and will also allow you to saturate the blood with sufficient oxygen.
• Rejection of bad habits. You should forget about such bad habits as drinking alcohol and smoking. They intoxicate the body, change the composition of the blood for the worse and deplete the heart muscle.

These rules must be followed not only during treatment, but also for the prevention of coronary heart disease.

Medicines for the treatment of coronary heart disease

For coronary heart disease, therapy is primarily carried out with medication. For this purpose a complex is used various groups drugs such as ACE inhibitors (Enapril, Lisinopril), beta blockers (Anaprilin), nitrates (Nitroglycerin), statins (Atorvastatin), antiplatelet agents (Aspirin), anticoagulants (Warfarin). Together, these drugs help maintain normal blood pressure, relieve heart attacks, maintain blood viscosity in a thin form, reduce the level of bad low-density cholesterol and prevent blood clots. Such assistance for coronary heart disease will help to avoid more radical treatments and complications.

In addition to the listed drugs, patients are often prescribed various multivitamin complexes to support the body and immune system, non-steroidal anti-inflammatory drugs, antihypoxants, and diuretics. These drugs are prescribed to improve the effectiveness of complex therapy.

Do not forget about treatment with folk remedies and herbs. There are a large number of plants that can provide auxiliary effects. For example, hawthorn, garlic, horseradish, valerian and motherwort. Hawthorn has a beneficial effect on the heart and blood composition, garlic is an anti-inflammatory agent, horseradish improves blood circulation, valerian and motherwort help normalize blood pressure with concomitant hypertension.

The medications described above form a combination of drugs for the treatment of coronary heart disease. Specific treatment methods, medications and their dosage should be prescribed directly by the attending physician after all necessary tests. Is coronary heart disease curable? At the moment no. But the body needs to be supported and complications avoided. With this type of disease, you cannot self-medicate and uncontrolled treatment, as this is fraught with serious complications and even the possibility of death.

Surgical treatment of coronary heart disease

If other methods are ineffective, surgical treatment of coronary heart disease is used. This is a complex and dangerous procedure characterized by long rehabilitation. For coronary heart disease, bypass surgery is performed in the event of a heart attack. In case of coronary heart disease, surgery is sometimes the only option (if a high risk of complications is identified).

After bypass surgery, high blood flow to the heart is ensured due to the formation of a new channel, which reduces the load on the affected vessels. For example, if coronary artery disease occurs as a result of coronary artery thrombosis, bypass surgery is performed. As a result, the lumen necessary for blood flow increases and the blood supply to the heart muscle returns to normal.

Bypass surgery usually involves long-term rehabilitation: at least 6 months. During this period it is necessary:

• Limit physical activity;
• Do not lift heavy objects;
• Avoid stress and emotional stress;
• Follow a low-cholesterol diet;
• Do not drink alcohol;
• Stop smoking.

The duration of operation of shunts is about 6 years. Once they wear out, a repeat operation may be scheduled to replace them. Immediately after surgery, the patient's movements should not be limited. The first weeks need to be done light gymnastics, stretching the joints of the hands, feet and neck. It is also necessary to walk. It is recommended to walk at least 50 meters per day (depending on how you feel). This will help prevent complications such as pneumonia caused by stagnation of fluid in the bronchi.

After discharge from the hospital, physical activity should be limited. But this does not mean that you do not need to move at all. Usually, before discharge, the doctor conducts examinations of the body to determine its readiness for further life activities and gives recommendations on a set of exercises that can help in this case. You also need to walk every day. The distance must be calculated individually so as not to overload the body. Walking in the fresh air should become a daily ritual.

An able-bodied person who has undergone bypass surgery may have to change his or her activity. To increase the lifespan of the valve, you should not put a lot of stress on the heart. If the work takes a lot of strength and energy, is associated with frequent stress or physical activity, then it needs to be changed to a more gentle type of activity.

So, when treating coronary heart disease, you can most often manage with medication and maintaining a healthy lifestyle. This should be done under the direct supervision of a doctor. If there is a risk of a heart attack or other complications, an operation is prescribed, which (thanks to an implanted shunt) will help improve blood supply to the heart and have a beneficial effect on the quality of life.

Medicines

Reducing the severity of symptoms and mortality, as well as improving the quality of life and prognosis of the disease, is pursued by pharmacotherapy of coronary heart disease.

In addition to anti-ischemic drugs, this is achieved by adjusting nutrition, lifestyle, physical activity, and in case of severe narrowing of the coronary arteries - revascularization with restoration of the patency of the vessel affected by atherosclerosis. Treatment with folk remedies does not have evidence base and, probably, can only be effective at the stage of pathology prevention.

Drugs for coronary heart disease are divided into several groups according to their mechanism of action. These include:

• nitrates,
• beta blockers,
• ACE inhibitors,
• statins,
• antiplatelet agents,
• calcium antagonists,
• diuretics,
• antiarrhythmics,
• cytoprotectors.

What to take for coronary heart disease is advised only by a qualified specialist after conducting diagnostic methods and establishing a diagnosis.

Nitrates

A group of drugs that help relieve the main symptom of coronary artery disease - pain - in angina pectoris. The antianginal mechanism of action is based on the release of nitric oxide, which dilates blood vessels, including cardiac ones. Due to this, more blood with oxygen and nutrients begins to flow to the heart, eliminating their deficiency, and the pain goes away. Refers to symptomatic therapy, does not affect the cause and prognosis of the disease.

The whole group is divided into short- and long-acting drugs. The first include nitroglycerin, nitrosorbide, erinite. They are suitable for relieving an attack of ischemia due to the quickly onset effect. For sudden anginal pain or to prevent it (prophylaxis), it is taken under the tongue (in the form of a spray and tablets). But their effect is also fleeting and ends within a few hours.

Prolonged (long-acting) ones include isosorbide di- and mononitrate (pectrol, monocinque). They are used as pain-preventing drugs for stable angina pectoris twice a day.

Main side effects are the development of resistance (addiction), severe headaches, as well as a sharp drop in pressure due to dilation of blood vessels. Therefore, they are the means of choice for frequent painful episodes of angina pectoris against the background of hypertension with high blood pressure numbers. Not recommended for use in patients with blood pressure values ​​below 110/70 mm Hg.

The problem of addiction is solved by taking a course of medications with alternating “rest” from them. The dosage regimen is prescribed by the attending physician.

Beta blockers

Medicines for the treatment of coronary heart disease also include a group of beta-blockers. Affect the prognosis. The mechanism of action differs from nitrates, as they directly affect the functioning of the heart muscle. The effect is associated with the effect on cell receptors that reduce heart rate and strength. The myocardium begins to work less intensely, the load decreases, and subsequently the need for oxygen decreases.

Tablets for coronary heart disease from this group are widely used to treat arrhythmias, reducing the excitability of cells and blocking the conduction of impulses.

The main drugs include metoprolol, bisoprolol, carvedilol, propranolol, atenolol, nebivolol and others.

Among the main indications for use are myocardial infarction, post-infarction cardiosclerosis, angina pectoris, chronic heart failure and arrhythmic form of coronary artery disease.

These drugs for the treatment of coronary heart disease are contraindicated in bronchial asthma and COPD, bradycardia (rare pulse less than 60 beats per minute), hypotension (blood pressure less than 90/60 mm Hg), including against the background of collapse or cardiogenic shock, atrioventricular blockades of 2-3 degrees (when the conduction of electrical impulses through the myocardium is disrupted) and individual intolerance. Not recommended for children under 18 years of age (no clinical studies), during pregnancy or breastfeeding.

The most common adverse reactions, in addition to allergies, include a decrease in heart rate of less than 56 beats per minute, a sharp drop in blood pressure, bronchospasm and dysfunction of the reproductive system.

All treatment of coronary heart disease requires an individual approach; drugs and doses are therefore selected in accordance with indications and contraindications.

ACE inhibitors

These include enalapril, perindopril, ramipril, lisinopril, fosinopril, captopril, etc.

The main indication for coronary artery disease is chronic heart failure, although the drugs are first-line drugs for the treatment of hypertension. It has been proven that the drugs have the property of remodeling the heart chambers, reducing the degree of myocardial hypertrophy (thickening). They have a positive effect on the prognosis, reducing the percentage of mortality from heart attack and decompensation of CHF, especially against the background of left ventricular myocardial dysfunction.

Contraindicated in case of individual intolerance, bilateral stenosis (narrowing) of the renal arteries, increased potassium levels in the blood, as well as during pregnancy and breastfeeding.

Basic side effects– sharp decrease in blood pressure, dry cough. Which serves as an indication for their replacement with a group of sartans similar in mechanism (valsartan, telmisartan).

Doses and dosage regimen are selected individually in accordance with blood pressure parameters, starting with starting doses.

Statins

Considering the cause of the development of IHD, which in 80% of cases is damage to the arteries by the atherosclerotic process, lipid-lowering drugs are prescribed to reduce and stabilize cholesterol plaques. The drugs of choice are statins. These include atorvastatin, rosuvastatin, simvastatin.

Indicated for altered lipid profile: total cholesterol levels above 4.5 mmol/l, low-density lipoprotein levels above 1.8 mmol/l.

They reduce the concentrations of lipid fractions due to their effects on the liver, namely due to the blockade of HMG-CoA reductase, which is responsible for the further formation of cholesterol.

Side effects – hyperenzymemia of ALaT and ACaT (internal enzymes of liver cells), myopathy, allergies.

Contraindicated for liver and kidney diseases, myopathies, pregnancy, lactation, individual intolerance and children.

Taken once a day. The usual starting dosage is 20 mg with a gradual increase until the desired lipid level is obtained under the control of blood enzymes.

The drug is taken for life, provided that the proper level of cholesterol and its fractions is achieved.

Antiplatelet agents and anticoagulants

They are used to prevent vascular complications such as thrombosis in the coronary arteries and “thinning” of the blood. These include aspirin and its analogues (Thrombo Ass, Cardiomagnyl), as well as clopidogrel. Indicated for all forms of IHD. The optimal daily dose of aspirin is 75-150 mg. Contraindicated if there is a high risk of bleeding.

Calcium antagonists

They are represented by two intragroup varieties: dihydropyridine (nifedipine, amlodipine) and non-dihydropyridine (verapamil, diltiazem) drugs. The latter are used to treat coronary artery disease.

The main effect is achieved through the influence on intracellular calcium channels, due to which vasodilation is observed, as well as a decrease in heart rate.

The most common adverse reactions are swelling of the legs and headaches.

The drugs are contraindicated in cases of hypotension, intracardiac blockade, and severe heart failure.

Diuretics

They help remove excess fluid from the body, thereby reducing the volume of circulating blood in the vessels and reducing the load on the heart muscle.

There are loop (furasemide, torsemide) and thiazide (indapamide, hypothiazide) diuretics.

There are different forms - tablets and injections. In ischemic disease, it is used to treat forms such as chronic heart failure with edema syndrome.

Contraindicated in cases of severe hypotension, coma, hypovolemia (dehydration), low potassium and sodium levels in the blood, children under 3 years of age, during pregnancy and lactation, as well as in case of individual intolerance.

The most common side effects include dizziness with decreased blood pressure, leg muscle cramps, and allergies.

Antiarrhythmics

The group includes a large number of different drugs, including beta blockers and calcium antagonists.

Potassium preparations, cordarone, lidocaine, cardiac glycosides. This is an incomplete list of drugs with antiarrhythmic activity.

Panangin, asparkam and other potassium-containing drugs are indicated as additional support for the myocardium after a heart attack or in heart failure, improving the metabolism of cardiomyocytes.

Contraindicated in case of hyperpotassium and magnesemia, cardiogenic shock, renal failure.

Cordarone is prescribed for supraventricular and ventricular arrhythmias, especially after a heart attack, as a prevention of sudden arrhythmic death.

Contraindicated for illnesses thyroid gland, heart block, pregnancy, lactation, intolerance to iodine preparations.

Lidocaine can be used for the development of arrhythmic syndrome in patients against the background of myocardial infarction in the acute period. Contraindicated in heart blockades and cardiogenic shock.

Cardiac glycosides are prescribed for various arrhythmias and congestive heart failure. Contraindicated in atrioventricular blockades. There is a danger in their overdose and the appearance of symptoms of glycoside intoxication in the form of the appearance of specific ventricular arrhythmias and AV blockades.

Cytoprotectors

Trimetazidine, Mexicor, mildronate and other drugs from this group have antianginal, metabolic effects, and also protect myocardial cells from lack of oxygen. Prescribed as maintenance therapy for any form of coronary artery disease, including progression of angina or in the acute phase of myocardial infarction.

Contraindicated in case of individual intolerance, as well as in pregnant and lactating women due to the lack of clinical data on their use in these categories of patients.

Despite the development of the modern pharmaceutical industry and the regular creation of new drugs for ischemic heart disease and other pathologies, a means has not yet been found that can completely get rid of atherosclerosis and its complications.

Folk remedies

IHD requires lifelong therapy and a healthy lifestyle. Folk remedies are widely used in the complex therapy of this disease. There are a huge number of herbs and plants that have a beneficial effect on the heart and arteries, increase blood circulation, lower cholesterol levels and blood viscosity. Here are the most popular folk remedies for herbal medicine for coronary artery disease:

Hawthorn

Traditional treatment of ischemic heart disease is unthinkable without hawthorn. This plant perfectly strengthens the heart muscle, helps reduce blood pressure and reduces heart rate. It should be taken with caution, as your blood pressure may drop significantly.

Hawthorn berry tea. The fruits are usually collected during their ripening season and dried. You can drink tea from such fruits all year round. For this purpose Art. pour 450 ml of boiling water over a spoonful of dried berries and brew for 15 minutes. Divide the resulting portion into 2 doses with a difference of at least 6 hours.

A decoction based on hawthorn with rose hips and motherwort. 100 gr. rose hips and hawthorn fruits and 50 gr. Add motherwort herbs to a liter of water and bring to a boil for 7 minutes. After this, the broth should be cooled, passed through a cloth or gauze and taken half a glass in the morning on an empty stomach.

Horseradish

The root of this plant improves blood circulation and blood supply to internal organs, this is very important for patients with coronary heart disease. Treatment with folk remedies using horseradish is useful and effective, but it is not recommended to use it orally for gastrointestinal diseases.

Inhalations with horseradish. Pour boiling water over a tablespoon of freshly grated horseradish and inhale for 15 minutes.

Horseradish with honey. Mix thoroughly 100 gr. horseradish and the same amount of honey and eat 1.5 teaspoons in the morning after meals, you can wash it down with water or tea. This treatment should be carried out intermittently. It is not recommended to use the mixture for more than a month; during treatment, you need to take a break of at least 3 weeks between courses.

Garlic

Garlic also has a beneficial effect on the blood circulation process, in addition, it stops inflammatory processes and promotes pain relief during attacks. Treatment of coronary artery disease with traditional methods involves the use of raw garlic. It is recommended to add it to ready-made dishes or eat a clove a day with meals.

Folk remedies for coronary artery disease are very effective, but you should not self-medicate without the knowledge of your doctor. The use of this or that recipe must be coordinated with it in order to avoid complications.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Ischemia is a local decrease in blood flow, which causes temporary disruption or permanent damage to organs and tissues.

This article described the main causes and symptoms of ischemia, as well as the principles of treatment, so that you can understand the nature of the problem, consult a doctor in a timely manner and avoid complications.

According to the form of the disease, ischemia is:

• Spicy. It occurs when there is a sudden blockage of a large vessel and develops rapidly.

Additional vessels do not have time to connect to the blood circulation of the affected area, which can lead to a life-threatening situation. For example, a sudden heart attack or stroke.

There are also cases when patients learned about a heart attack only during a heart examination, or when complications developed: arrhythmia, decreased cardiac contractility.

• Chronic. It forms gradually as atherosclerotic plaques accumulate on the walls of blood vessels or with prolonged compression of the artery. Auxiliary vessels have time to activate to supply tissues, so clinical manifestations of ischemia are not immediately diagnosed.

The danger is that it sharply reduces the performance of organs.

For example, chronic coronary heart disease can be complicated by arrhythmias and heart failure. Chronic ischemic disease of the brain leads to weakening of thinking and memory.

Causes and symptoms

Based on the reasons for its occurrence and the nature of its development, ischemia is divided into:

Coming due to prolonged compression of the artery leading to the organ. The cause may be a scar, tumor, foreign body, or accumulated fluid.

Arising as a result of arterial spasm. The cause may be the use of vasoconstrictor drugs, severe emotional or physical shock: panic, pain shock, hypothermia, mechanical irritation.

Occurring due to partial or complete blocking of the artery by a thrombus or embolus. Also, closure of the lumen is possible due to vascular diseases: atherosclerosis, obliterating endarteritis, periarteritis nodosa.

Also, ischemia can develop due to injury - due to mechanical rupture of blood vessels or blood loss, as well as due to blood diseases - an increase in its viscosity.

Any form of the disease is characterized by disruption of the normal functioning of organs - slowing blood flow and disruption metabolic processes, sometimes very difficult. Symptoms in the affected area include:

dystrophic changes and decreased tissue elasticity;

lowering temperature and blood pressure - for the extremities;

numbness, tingling and pain.

If these symptoms occur, we strongly recommend that you consult a doctor immediately.

But chronic cardiac ischemia may not manifest itself clinically, while remaining very dangerous. The appearance of the first symptoms may indicate an advanced process. They are:

Pain in the chest, which intensifies with physical activity and may subside as it continues.

Shortness of breath and a feeling of interruptions in the heart. If these symptoms appear, you must consult a doctor as soon as possible, and if an attack of pain occurs for the first time or its nature is unusual, you must immediately take nitroglycerin and call an ambulance.

Nowadays, it is possible to help a person in any situation and at any stage of the disease. Although, of course, the effectiveness of this help and the prognosis are much better if you consult a doctor in the early stages.

The doctor can identify ischemia or the risks of its manifestation in the initial stages of the disease. For this purpose it is used detailed analysis risk factors and exercise tests: treadmill test, bicycle ergometry, stress echocardiography. As well as vascular examination: coronary angiography, multislice computed tomography and ultrasound method - the most accessible, recommended as a screening or first-line study.

Consequences

The consequences of ischemia depend on external factors, the extent of the disease and the general condition of the body. These include:

• Duration of ischemia and oxygen starvation of the affected area - hypoxia.

The process of death of myocardial tissue develops within 12-18 hours from the moment the artery is damaged.

With complete restriction of blood access to the extremities - after 1.5-2 hours, this may be due to complete rupture of blood vessels, for example.

Localization - organs and tissues have different sensitivity to oxygen starvation. The organs of the cardiovascular and nervous systems are most sensitive to hypoxia.

Diameter of the affected arterial vessel- blockage of large arteries entails more extensive necrotic tissue damage compared to vessels of smaller diameter.

The development of a system of auxiliary vessels in the affected organ for additional blood access - collateral circulation.

For example, the lungs and limbs have an absolutely sufficient presence of auxiliary blood vessels, which helps to quickly provide the affected area with the necessary amount of blood, and with it oxygen and nutrients.

Organs with absolutely insufficient collateral circulation include the heart, brain, kidneys and spleen. The total diameter of the vessels and capillaries in them is less than the diameter of the main artery - with complete or significant blockage of the artery, blood enters critically insufficient volume or stops altogether. This can lead to heart attack, tissue necrosis, or death.

Common consequences are: development of oxygen starvation and disruption of delivery nutrients- cell damage and changes in the properties of the ischemic area.

Based on the structure of the body, the organs of the nervous system and cardiovascular system are most susceptible to ischemia. Unfortunately, the performance of these organs is critical for the life and normal functioning of the body.

If ischemia is so severe that some of the cells and tissues of the affected organ die, a heart attack develops. In case of damage to the heart, they speak of myocardial infarction; in case of damage to the brain, the term “ischemic stroke” is more often used.

To formulate a competent treatment program, it is necessary to determine the nature of the origin of the disease, the duration and extent of the lesion. The general steps in treatment are:

dilatation of arteries and elimination of spasm,

development of the functionality of auxiliary vessels,

correction of cholesterol levels,

elimination of atherosclerotic plaques,

reducing blood viscosity and preventing thrombosis,

correction of metabolism in affected tissues and increasing their resistance to hypoxia.

Treatment of ischemia can be either therapeutic or surgical. Currently, doctors have a fairly wide range of options at their disposal: medications and types of surgical interventions.

Doctors of the Cardiology Center " Black River» specialize in the treatment of coronary heart disease and rehabilitation of cardiac patients.

In this article we will learn:

According to the World Health Organization, coronary heart disease (CHD) is acute or chronic myocardial dysfunction due to a relative or absolute decrease in arterial blood supply to the myocardium, most often associated with a pathological process in the coronary artery system.

Thus, IHD is a chronic oxygen starvation heart muscle, which leads to disruption of its normal operation. Lack of oxygen leads to disruption of all functions of our heart. That is why coronary heart disease is a complex concept that includes angina pectoris, myocardial infarction And heart rhythm disturbances.

Why does IHD occur?

To function normally, our heart needs a constant supply of oxygen from the blood. The coronary arteries and their branches supply blood to our heart. As long as the lumen of the coronary vessels is clean and wide, the heart does not lack oxygen, which means it is able to work efficiently and rhythmically without drawing attention to itself under any conditions.

By the age of 35-40, it becomes increasingly difficult to have clean heart vessels. Our health is increasingly influenced by our usual lifestyle. High blood pressure and an abundance of fatty foods in the diet contribute to the accumulation of cholesterol deposits on the walls of the coronary vessels. This is how the lumen of the vessels begins to narrow, from which our lives directly depend. Regular stress and smoking, in turn, lead to spasm of the coronary arteries, which means they further reduce blood flow to the heart. Finally, a sedentary lifestyle and excessive body weight as a trigger inevitably lead to the earliest appearance of coronary heart disease.

Symptoms of IHD. How to distinguish from a heart attack?

Most often, the very first noticeable manifestations of coronary heart disease are paroxysmal pain in the sternum (heart)- angina pectoris. Painful sensations can “give” to left hand, collarbone, shoulder blade or jaw. These pains can be either in the form of sharp stabbing sensations or in the form of a feeling of pressure (“the heart is pressing”) or a burning sensation behind the sternum. Such pains often cause a person to freeze, stop all activities and even hold their breath until they pass. Heart pain with ischemic heart disease usually lasts at least 1 minute and no more than 15 minutes. Their occurrence may be preceded by severe stress or physical activity, but there may be no obvious reasons. An angina attack with ischemic heart disease is distinguished from a heart attack by less intense pain, its duration is no more than 15 minutes and disappearance after taking nitroglycerin.

What causes attacks of ischemic heart disease?

When we discussed the blood supply to the heart, we said that clean coronary vessels allow our heart to work efficiently under any conditions. Cholesterol plaques narrow the lumen of the coronary arteries and reduce blood flow to the myocardium (heart muscle). The more difficult the blood supply to the heart, the less load it can withstand without a painful attack. All this happens because any emotional and physical stress requires increased heart function. In order to cope with such a load, our heart needs more blood and oxygen. But the vessels are already clogged with fatty deposits and are spasmed - they do not allow the heart to receive the necessary nutrition. What happens is that the load on the heart increases, but it cannot receive any more blood. This is how oxygen starvation of the heart muscle develops, which, as a rule, manifests itself as an attack of stabbing or pressing pain behind the sternum.

It is known that the occurrence of IHD always leads to several harmful factors. Often they are related to each other. But why are they harmful?

Abundance of fatty foods in the diet– leads to increased cholesterol in the blood and its deposits on the walls of blood vessels. The lumen of the coronaries narrows - the blood supply to the heart decreases. Thus, distinct attacks of coronary artery disease become noticeable if cholesterol deposits narrow the lumen of the coronary vessels and their branches by more than 50%.

Diabetes – accelerates the process of atherosclerosis and deposits of cholesterol plaques on blood vessels. The presence of diabetes mellitus doubles the risk of coronary artery disease and significantly worsens the prognosis of patients. One of the most dangerous cardiac complications of diabetes is myocardial infarction.

Hypertension– increased blood pressure creates excessive stress on the heart and blood vessels. The heart works in an excessively high exhaustion mode. Blood vessels lose their elasticity - their ability to relax and allow more blood to pass through under stress. Traumatization of the vascular wall occurs - the most important factor accelerating the deposition of cholesterol plaques and narrowing of the lumen of blood vessels.

Sedentary lifestyle– constant sedentary work at a computer, traveling by car and lack of necessary physical activity lead to weakening of the heart muscle, venous congestion. It becomes increasingly difficult for a weak heart to pump stagnant blood. Under these conditions, it is impossible to adequately supply the heart muscle with oxygen - coronary artery disease develops.

Smoking, alcohol, frequent stress- all these factors lead to spasm of coronary vessels– which means they directly cut off the blood supply to the heart. Regular spasms of the heart vessels, already blocked by cholesterol plaques, are a dangerous harbinger of the rapid development of angina pectoris and myocardial infarction.

What does IHD lead to and why does it need to be treated?

Cardiac ischemia - progressive disease. Due to increasing atherosclerosis, uncontrolled blood pressure and lifestyle over the years, the blood supply to the heart deteriorates to critical quantities Uncontrolled and untreated IHD can progress to myocardial infarction, heart rhythm block and heart failure. What are these conditions and why are they dangerous?

Myocardial infarction- This is the death of a certain part of the heart muscle. It usually develops due to thrombosis of the arteries supplying the heart. Such thrombosis is the result of the progressive growth of cholesterol plaques. It is on them that blood clots form over time, which can cut off oxygen to our heart and pose a threat to life.

With myocardial infarction, a sudden attack of unbearable, tearing pain occurs behind the sternum or in the region of the heart. This pain may radiate to the left arm, shoulder blade, or jaw. In this state, the patient develops cold sweat, blood pressure may drop, nausea, weakness and a feeling of fear for his life appear. Myocardial infarction differs from angina attacks during ischemic heart disease by unbearable pain that lasts a long time, more than 20-30 minutes and is slightly reduced by taking nitroglycerin.

A heart attack is a life-threatening condition that can lead to cardiac arrest. That is why, if the above symptoms appear, you must immediately call an ambulance.

Heart rhythm disturbances - blockades and arrhythmias. Long-term disruption of adequate blood supply to the heart during ischemic heart disease leads to various heart rhythm disturbances. With arrhythmias, the pumping function of the heart can significantly decrease - it pumps blood ineffectively. In addition, in case of severe disturbance of heart rhythm and conduction possible cardiac arrest.

Heart rhythm disturbances in coronary heart disease can be asymptomatic and recorded only on an electrocardiogram. However, in some cases, patients feel them in the form of a rapid heartbeat behind the sternum (“heart pounding”), or, on the contrary, an obvious slowdown in the heartbeat. Such attacks are accompanied by weakness, dizziness and in severe cases can lead to loss of consciousness.

Development chronic heart failure– is the result of untreated coronary heart disease. Heart failure is inability of the heart to cope with physical activity and fully supply the body with blood. The heart becomes weak. In mild heart failure, severe shortness of breath occurs during exertion. In case of severe insufficiency, the patient is not able to endure the lightest household loads without heart pain and shortness of breath. This condition is accompanied by swelling of the limbs, a constant feeling of weakness and malaise.

Thus, heart failure is the result of the progression of coronary heart disease. The development of heart failure can significantly impair the quality of life and lead to complete loss of performance.

How is IHD diagnosed?

The diagnosis of coronary heart disease is made based on the results of instrumental and laboratory studies. Performed blood analysis, with a breakdown of the cholesterol and sugar profile. To assess the functioning of the heart (rhythm, excitability, contractility) ECG recording(electrocardiograms). To accurately assess the degree of narrowing of the vessels supplying the heart, a contrast agent is injected into the blood and an X-ray examination is performed - coronary angiography. The totality of these studies shows the current state of metabolism, heart muscle and coronary vessels. In combination with symptoms, this makes it possible to diagnose coronary artery disease and determine the prognosis of the disease.

Treatment of ischemic heart disease with medications. Prospects. What is important to know?

First of all, it is necessary to understand that medications do not treat the main cause of coronary heart disease - they temporarily dampen the symptoms of its course. As a rule, for the treatment of IHD, a whole complex of different drugs is prescribed, which must be taken every day from the moment of prescription for life. In the treatment of IHD, drugs of several main groups are prescribed. Medicines of each group have a number of fundamental restrictions on use in patients with ischemic heart disease. Thus, treatment becomes impossible or dangerous to health in the presence of certain diseases in different patients. Overlapping each other, these restrictions significantly narrow the possibilities of drug treatment of coronary heart disease. In addition, the totality side effects from different drugs, is essentially a disease separate from ischemic heart disease, which much reduces a person's quality of life.

For today for drug prophylaxis and treatment of coronary artery disease, the following groups of drugs are used:

• Antiplatelet agents
• B-blockers
• Statins
• ACE inhibitors
• Calcium antagonists
• Nitrates

Each group of these drugs has very specific limits of applicability and a number of associated side effects that are important to know about:

Antiplatelet agents- blood thinning drugs. The most commonly used drugs are aspirin-containing drugs. All drugs in this group contraindicated during pregnancy and breastfeeding. The drugs have irritant and ulcer-forming effect on the stomach and intestines. That is why taking these drugs poses a risk for patients who already have peptic ulcer stomach, duodenum or inflammatory bowel disease. With long-term use of aspirin-containing drugs, risk of developing an allergic reaction to the respiratory tract. This is especially important to consider if a patient with coronary artery disease already has bronchial asthma or bronchitis, because medications can cause an attack. It must be borne in mind that all drugs in this group place significant stress on the liver and therefore are extremely undesirable for use in liver diseases.

B-blockers– a huge group of drugs that occupy one of the main places in the drug treatment of coronary artery disease. All beta blockers have significant limitations for use. This group of drugs should not be taken by patients with bronchial asthma, bronchitis, COPD and diabetes mellitus. This is associated with side effects such as possible bronchospasm and spikes in blood sugar.

Statins– These drugs are used to lower blood cholesterol levels. The entire line of drugs prohibited during pregnancy and lactation, since statins may cause fetal developmental abnormalities. Drugs highly toxic to the liver, and therefore are not recommended for relevant diseases. If taken, regular laboratory monitoring of liver inflammatory parameters is necessary. Statins can cause skeletal muscle atrophy, as well as aggravate the course of an existing myopathies. For this reason, if muscle pain occurs while taking these medications, you should consult a doctor. Statins are strictly incompatible with alcohol intake.

Calcium channel blockers– are also used in combination with other drugs to lower blood pressure. The entire group of these drugs. When diabetes mellitus Taking this group of drugs in the treatment of coronary artery disease is extremely undesirable. This is associated with the risk of serious disturbances in the ion balance in the blood. In the case of old age and the presence of cerebral circulatory disorders, taking drugs of this group is associated with risk of stroke. The drugs are strictly incompatible with alcohol intake.

ACE inhibitors (angiotensin-converting enzyme)– most often used to lower blood pressure in the treatment of coronary artery disease. Reduce the concentration of essential ions in the blood. They have a detrimental effect on the cellular composition of the blood. Toxic to the liver and kidneys, and therefore not recommended for use in the corresponding diseases. Long-term use causes a constant dry cough.

Nitrates– most often used by patients to relieve attacks of pain in the heart (nitroglycerin tablet under the tongue); they can also be prescribed to prevent angina pectoris. This group of drugs prohibited for use during pregnancy and lactation. The drugs have a serious effect on vascular tone, and therefore their use causes headaches, weakness, and a decrease in blood pressure. For this reason, treatment with nitrates is dangerous for people with cerebrovascular accident, hypotension and intracranial pressure. With long-term use of nitrates, their effectiveness is significantly reduced due to addictive– the previous dosages no longer relieve angina attacks. Nitrates are strictly incompatible with alcohol intake.

Considering the above, it becomes obvious that treatment of coronary artery disease with drugs can only temporarily restrain the progress of the disease, causing significant side effects in the sick person. The main disadvantage of drug therapy is influencing the symptoms of a disease without eliminating the cause itself development of coronary heart disease.

The main reason for the development of ischemic heart disease. Why does this disease develop?

Coronary heart disease is a metabolic disease. It is because of a deep metabolic disorder in our body that cholesterol is deposited on the vessels, blood pressure rises and spasm of the heart vessels occurs. With the steady progress of IHD It’s impossible to cope without correcting your metabolism in organism.

How to correct the metabolism and stop the progression of IHD?

It is widely known that blood pressure must be monitored. It is no less known that there are strictly defined numbers for “healthy” blood pressure, which correspond to the norm. Everything higher and lower is a deviation leading to illness.

It is no less known that constant consumption of fatty and high-calorie foods leads to the deposition of cholesterol in blood vessels and obesity. Thus, it becomes clear that fats and calories in food also have a strictly defined norm, within which a person is healthy. Excessive fat consumption leads to disease.

But how often do sick people hear that their breathing is deeper than normal? Do patients with coronary heart disease know that excessively deep breathing every day plays a key role in the development of their disease? Do patients with coronary artery disease know that as long as they breathe deeper than the healthy physiological norm, no medications can stop the progression of the disease? Why is this happening?

Breathing is one of the most important vital functions in our body. Exactly our breathing plays a key role in metabolism. The work of thousands of enzymes, the activity of the heart, brain and blood vessels directly depends on it. Breathing, like blood pressure, has strictly defined standards at which a person is healthy. For years, patients with coronary heart disease have been breathing excessively deeply. Excessively deep breathing changes the gas composition of the blood, destroys metabolism and leads to the development of coronary heart disease. So when breathing deeply:

• There is a spasm of the vessels supplying the heart. Because Carbon dioxide is excessively washed out of our blood - natural factor relaxation of blood vessels
• Oxygen starvation of the heart muscle and internal organs develops– without enough carbon dioxide in the blood, oxygen cannot reach the heart and tissues
• Arterial hypertension develops– a rise in blood pressure is a reflexive protective reaction of our body to oxygen starvation of organs and tissues.
• The course of the most important metabolic processes is disrupted. Excessive breathing depth disrupts the healthy proportions of blood gases and its acid-base status. This entails disruption of the normal functioning of a whole cascade of proteins and enzymes. All this contributes to disruption of fat metabolism and accelerates the deposition of cholesterol in blood vessels.

Thus, excessively deep breathing is the most important factor in the development and progression of coronary heart disease. This is why taking whole handfuls of medications does not stop IHD. While taking medications, the patient continues to breathe deeply and destroy the metabolism. Dosages increase, the disease progresses, the prognosis becomes more and more serious - but deep breathing remains. Normalizing the breathing of a patient with coronary artery disease - bringing it to a healthy physiological norm can stop the progression of the disease, provide great assistance in treatment with medications and save a life from a heart attack.

How can you normalize breathing?

In 1952, the Soviet scientist-physiologist Konstantin Pavlovich Buteyko made revolutionary discovery in medecine - Discovery of deep breathing diseases. Based on it, he developed a cycle of special breathing training that allows you to restore healthy, normal breathing. As the practice of thousands of patients who have passed through the Buteyko Center has shown, the normalization of breathing itself forever eliminates the need for medications for patients with initial degrees diseases. In severe, advanced cases, breathing becomes a huge help, allowing, together with drug therapy, to save the body from the unstoppable progress of the disease.

In order to study Dr. Buteyko's method and achieve a significant result in treatment, the supervision of an experienced methodologist is necessary. Attempts to normalize breathing on your own using materials from unverified sources are, at best, unsuccessful. It is necessary to understand breathing - a vital function of the body. Establishing healthy physiological breathing is of great benefit; improper breathing is extremely harmful to health.

If you want to normalize your breathing, apply for a course distance learning via the Internet. Classes are held under the supervision of an experienced methodologist, which allows you to achieve the desired result in the treatment of the disease.

Chief Physician of the Center for Effective Training in the Buteyko Method,
Neurologist, chiropractor
Konstantin Sergeevich Altukhov