Cardiac ischemia. Why is it dangerous for a person?

Everyone knows that the purpose of the heart muscle (myocardium) is to supply the body with oxygenated blood. However, the heart itself needs blood circulation. The arteries that deliver oxygen to the heart are called coronary arteries. There are two such arteries in total, they depart from the aorta. Inside the heart, they branch into many small vessels.

However, the heart not only needs oxygen, but it also needs a lot of oxygen, more than any other organ. This situation is explained simply - because the heart is working constantly and with a very large load. And if a person may not particularly feel the manifestations of oxygen deficiency in other organs, then the lack of oxygen in the heart muscle immediately leads to negative consequences. Circulatory failure in the heart can occur for only one reason - if the coronary arteries drain less blood. This condition is called coronary heart disease (CHD).

The main cause of coronary artery disease is the gradual narrowing of one or more heart vessels by atherosclerotic plaque.

Cholesterol is a major component of atherosclerotic plaque. Gradually narrowing the lumen of the heart vessels, atherosclerotic plaques cause a lack of blood flow in various parts of the continuously working heart muscle. Usually, in the early stages of this long process, the disease does not show any symptoms, but in the intermediate stages, it manifests itself as pain in the chest during physical exertion and at rest. At a later stage, when the heart vessels close completely, a myocardial infarction can develop.

In clinical practice, several types of coronary heart disease are distinguished. In most cases, coronary artery disease manifests itself in the form of angina pectoris. Angina pectoris is an external manifestation of coronary heart disease, accompanied by severe pain in the chest. However, there are also forms of angina pectoris that are painless. With it, the only manifestations are fatigue and shortness of breath even after light physical exercise - for example, when walking or climbing stairs on several floors.

If attacks of pain appear during physical exertion, then this indicates the development of angina pectoris. However, in some people with coronary artery disease, chest pain occurs spontaneously, without anything to do with physical activity.

Also, the changing nature of angina symptoms can indicate whether the coronary disease is progressing or not. If coronary artery disease does not progress, then the condition is called stable angina. A person with stable angina, with proper behavior and appropriate supportive care, can live for decades.

What to do during an angina attack?

As mentioned above, angina pectoris is called chest pain caused by diseases of the heart vessels. In most cases, such pain occurs in the center of the chest, "under the spoon" or in the neck, may be accompanied by a lack of air. Sometimes angina pain radiates to the back, left shoulder, or left arm. Usually, the pain in the angina pectoris is pressing, burning, curving. May be accompanied by sweating. In most cases, angina pectoris occurs during activity, such as when walking or using physical exertion. But it can also appear at rest, as well as when exposed to cold - frost, strong winds, swimming in open water.

If an attack of angina pectoris occurs, then you should use nitroglycerin, but with caution and only lying horizontally and only if your doctor has recommended nitroglycerin. This drug dilates the vessels of the heart and thereby eliminates angina attacks. For ease of use, nitroglycerin is produced in tablet form to be taken under the tongue, and in aerosol form to be inhaled under the tongue. If within 3-5 minutes the pain has not disappeared or has not completely disappeared, you need to take a second dose of the drug. If, after the second dose of nitroglycerin, the pain does not go away or even increases, it is accompanied by severe weakness, suffocation, you should immediately call an ambulance to prevent the development of myocardial infarction.

An attack of angina pectoris at rest or at night is a worrying sign. In such cases, you should immediately take nitroglycerin, and call an ambulance immediately.

How to prevent angina attacks?

To prevent angina attacks, you must regularly take the recommended drugs in the prescribed doses. In some cases, you can also take nitroglycerin immediately before the expected physical or emotional stress - this is walking, physical work, sexual activity. If attacks of angina pectoris in daily life become more frequent, attacks that were not there before appear at rest and at night, if the patient begins to take nitroglycerin more often, consult a doctor immediately. An urgent change in treatment or hospitalization for follow-up may be necessary.

If the heart vessels close completely, a myocardial infarction can occur. How to prevent this disease?

A heart attack is a severe and life-threatening complication of coronary artery disease, but it can be prevented. For this, many drugs and various methods of surgical treatment are successfully used. Prevention of heart attacks is a very important task because each heart attack can be fatal, each repeated heart attack is more severe than the previous one and subsequently leads to a more severe form of disability. Careful monitoring of their condition, careful and precise compliance with medical prescriptions, timely contact with a cardiologist allows patients with coronary artery disease to delay the development of myocardial infarction for a long time, eliminate or relieve symptoms of the disease, and increase the level of activity in the heart. everyday life.

If someone has recently had a myocardial infarction, how often should I see a doctor?

Even with satisfactory health, it is necessary to visit the doctor at least once a year for a general examination, record a control ECG and evaluate the results of blood tests. If a person has recently had a myocardial infarction, you will need to see the doctor more often. It's helpful to keep a diary of how you're feeling, including your blood pressure, pulse, and medications you're taking. Show this diary to your doctor at your visit. If necessary, the doctor can prescribe additional instrumental and laboratory tests to the patient. If the condition worsens and the effectiveness of treatment decreases, consult a doctor for help more often. Do not self-medicate, this can cause irreparable harm to your health.

In what cases is a referral for surgical treatment of coronary heart disease given?

With properly selected treatment, careful implementation of medical recommendations regarding diet and lifestyle, IHD can continue in a stable form for a long time, and a person's ability to work will not be significantly limited. In cases where the disease progresses, angina attacks or symptoms of heart failure increase, and drug therapy becomes ineffective, the doctor may suggest surgical treatment. The modern method of surgical treatment is shunting or stenting of the coronary vessels. Such treatment can significantly improve the patient's condition, significantly reduce the risk of severe complications, including the risk of death, and in some cases reduce the need for medication. To choose the best surgical treatment method, the patient always undergoes a preliminary examination in the hospital. The decision about surgical treatment is always made by a medical specialist, with mandatory consideration of the patient's opinion.

Is there a single drug for the treatment of coronary artery disease?

There is no single drug for the treatment of coronary artery disease. Medicines for this disease are always prescribed in the complex.

Correctly selected drugs act on different disease mechanisms, complement each other, and, as a rule, are well tolerated with long-term use.

Intermittent treatment or IHD courses were not performed. Treatment of the disease is supportive and, if well tolerated, carried out indefinitely. If during treatment, the patient feels worse or symptoms of side effects appear, you should consult a doctor to find the cause of the deterioration and possibly change one or more drugs. Only the doctor should change the treatment regimen. It is impossible to cancel any drug for a long time on your own - this can be dangerous for the patient's health. If you come to the doctor, be sure to tell the doctor about all the medications you are taking for other ailments. This will help avoid side effects and unnecessary duplication of medication.

Do not forget to pay attention to the expiration date of the drug indicated by the manufacturer on the packaging and, of course, immediately replace the expired drug in your first aid kit with a new one.

Some co-morbidities can worsen, worsen symptoms, or complicate the treatment of CAD. What to do?

When making an appointment with a doctor, it is necessary to inform him of all known comorbidities. Especially important are previous myocardial infarction, any heart surgery, arterial hypertension, diabetes mellitus, and other endocrine diseases, as well as heart failure, anemia, other blood diseases, gastric and duodenal ulcers. And only after that treatment is prescribed.

Do I need to keep my medical records?

Of course. Keep at home all hospital extracts, electrocardiograms, copies of laboratory tests, and instrumental study protocols, if available. During scheduled visits to the clinic, during hospitalization, when calling an ambulance, be sure to show these documents to the doctor. Comparison of data with previous performance is very important and can be critical for improving diagnosis and treatment.

The main principle of IHD treatment is to apply a healthy lifestyle.

A healthy lifestyle will eliminate many risk factors and reduce the risk of severe complications. Of course, quit smoking and reduce excess weight. Increase the level of physical activity, taking into account the age of the person. It is important to continue to follow a low-fat diet, limit or completely avoid alcohol. Because coronary artery disease is the gradual narrowing of one or more heart vessels by atherosclerotic plaque, regular monitoring of blood pressure, pulse and cholesterol levels is necessary. Therefore, I advise you to follow medical recommendations that will not only reduce the risk of severe complications but also improve your well-being and increase your efficiency.