Scientific editor: Strokina OA, therapist, doctor of functional diagnostics. Practical experience since 2015.
October, 2018.
Cardiosclerosis - a progressive pathological condition characterized by the substitution process of normal muscle tissue in the myocardium inelastic and tough connective tissue.
As a result, the heart muscle loses its basic function - excitability and contractility. Also cardio partially exposed heart valves.
Causes
Cardio occurs in people of all ages.
However, the reasons which would lead to the replacement of normal tissue of the heart connection, depending on the age, are significantly different.
Children cardio usually the outcome of inflammatory or degenerative processes in the myocardium and is extremely rare.
In adults - is the result of heart disease, metabolic disorders, and to a lesser extent the changes are due to inflammation of the myocardium.
To lead the development of Cardiosclerosis:
myocarditis (Inflammation of the heart muscle) due mostly viral or bacterial infection. As a result, usually develops diffuse cardio.
cardiomyopathy (change of body structure) are hypertrophic (thick wall), dilated (expanded dramatically cavity) and restrictive (broken heart relaxation process). They may be the result of the progression of diabetes, thyroid disease, autoimmune processes, rheumatic fever. For cardiomyopathy is characterized by diffuse replacement of muscle connective tissue.
kardiodistrofii (muscle damage due to violation of its power). Since the process of eating disorders often reversible, and provoking factor can be eliminated, then the outcome is rarely formed diffuse cardio.
coronary heart disease (Damage due to loss of blood supply due to arteriosclerosis or myocardial spasm) and one of its Forms - myocardial infarction, after which the formed small- or large focal postinfarction cardio. The first can be "invisible" to the ordinary human life, but the second, macrofocal can badly impair the patient's life reduced ejection fraction (the amount of blood that the heart emits large and small circles of blood circulation), the development of an aneurysm (bulging of wall) with possible rupture or thrombus formation under the conditions which may come off and cause a blockage of the pulmonary artery (PE).
coronary atherosclerosis (due to chronic disorders of blood flow and myocardial nutrition).
Cardio on the background of degenerative processes formed
while excessive exercise professional athletes,
in endocrine diseases ( thyroid disease, obesity, diabetes ),
for violations of exchange of vitamins and chronic deficit,
at anemias severe and prolonged their flow,
with intoxication (alcohol, toxic production)
at amyloidosis (Accumulation in the tissues of the heart of a special substance - a gelatinous mass of amyloid)
in violation iron exchange with its accumulation in tissues (hemosiderosis).
cardio at coronary heart disease there:
at angina ,
at myocardial infarction .
The basis is a violation Cardiosclerosis atherosclerotic vascular lumen with chronic lack of oxygen and nutrients to the heart muscle.
development mechanism
All the reasons described above lead to oxygen deficiency in the tissue of the myocardium and the gradual replacement of normal muscle connective tissue. Portions of the tissue can not perform its functional load, and the work of the heart take on the adjacent normal sites.
In this form their hypertrophy (increase in muscle size due to active work). But long-term stress such heart can not stand - the muscles become fatigued, again replaced by connective tissue. This fabric stretches, and the cavity of the heart dilate, blood circulation is disturbed. Shaped heart failure.
types cardiosclerosis
According to the extent of the process is isolated:
focal lesions (only small areas have the connective tissue, in fact it's the scars on the heart)
diffuse lesions (connective tissue progressively replaces the vast areas of the myocardium).
Also cardio can be divided into certain forms:
post-infarction, occurs at the site of myocardial infarction, which forms a scar.
myocarditic occurs against a background of severe inflammation of the muscles, with no damage to the heart vessels.
substitutive kardiosklerosis called miofibrozom, the formation of scar tissue at the site chronically hungry muscle cells (in atherosclerotic vascular lesions with a gradual narrowing of their lumen). Connective tissue replaces the dying myocardial cells.
symptoms cardiosclerosis
The severity of manifestations Cardiosclerosis depends on the volume of defeat of the heart muscle and connective tissue localization of lesions. And often melkoochagovyj cardio asymptomatic. But more extensive lesions in the early stages of manifested:
chest pain under heavy braking,
health disorders, fatigue,
pressure fluctuations.
If the scar or area of the connective tissue is localized in the area of the pathways of the heart, can be formed arrhythmia .
In common, diffuse form Cardiosclerosis or large outbreak that arose after extensive myocardial infarction symptoms occur heart failure :
dyspnea resulting small physical exertion or in more severe cases, at rest,
heart "asthma" - the emergence of suffocation in a prone position,
heart swelling in the legs and feet,
cough at night because of the stagnation in the lungs,
tachycardia with pressure reduction,
accumulation of fluid in body cavities - the abdominal and thoracic,
development of persistent arrhythmias (atrial fibrillation, arrhythmia, cardiac conduction blockades different ways)
Pain in the right upper quadrant and enlargement of the liver due to excess blood supply to organs (heart can not cope with the pumping function).
Especially dangerous complications of far-gone as Cardiosclerosis
aneurysm in the places of the centers Cardiosclerosis - protrusion of tissue from thinning of the wall and the danger of a heart attack.
development of chronic heart failure with impaired blood pumping.
Diagnostics
Besides history with an indication of heart disease and other diseases, medical examination is important and typical complaints of patients. Then the doctor prescribes diagnostic methods to identify a possible cause Cardiosclerosis:
CBC: leukocytosis, elevated erythrocyte sedimentation rate - as signs of inflammation; anemia,
Urinalysis: white blood cells, red blood cells, protein, salt, density change - the result of kidney damage,
biochemical blood tests: ALT, AST indicate liver function; Creatinine. Urea - a kidney, the level of glucose is judged on diabetes;
blood analysis for thyroid hormones, adrenal hormones, and so on;
immunoassays to detect antibodies to viral, autoimmune diseases. rheumatic diseases;
Ultrasound of the internal organs and thyroid to detect structural changes.
But the main diagnostic methods Cardiosclerosis are:
ECG changes in the conduction system, the availability of fresh myocardial scar origin or stage of their localization.
Ultrasound of the heart (echocardiography) with an estimate of its contractility, structure, size and shape,
chest X-ray B2's projections for the visual assessment of heart size.
CT and MRI of the heart to detect changes myocardium.
cardiosclerosis treatment
Diagnosis and treatment takes Cardiosclerosis internists and cardiologists, sometimes they are joined by surgeons - if necessary correction of the changes of the operations.
Unfortunately, medications and treatment methods that would make the connective tissue re-transformed into muscle - does not exist. Therefore, treatment aims to maintain in working condition the remaining myocardium and stop proliferation of connective tissue.
In addition, in cardiosclerosis need treatment have heart disorders caused by a painful process:
myocarditis therapy, myocardial dystrophy,
lowering cholesterol (statins),
treatment aimed at eliminating myocardial ischemia (angina pectoris, myocardial infarction),
blood pressure control below 140/90 mmHg
administration of drugs for normalizing the heart rate (Cordarone, amiodarone, sotalol, and others)
preparations to activate and improve the metabolic processes in the myocardium (aktovegin, mildronat others).
dietary restrictions - reduced amount of salt and sugar, low-carb diet, a decrease in consumption of cholesterol-containing foods with a view to the prevention of atherosclerosis,
limit load overvoltage heart muscle,
regular exercise. adequate severity of the disease,
surgical repair of aneurysms, implantation of pacemakers with rhythm disorders, etc.
prevention
Basis of heart health and prevention Cardiosclerosis - is looking after your heart from a young age.
Need proper nutrition and regular load limiting toxic effects, and early treatment of colds, sore throats and inflammation.
In addition, the important control of blood pressure and vascular condition, the fight against excess weight and "bad" cholesterol .
sources:
- Acute myocardial infarction with ST elevation electrocardiogram segment. - Federal clinical guidelines 2016.
- Myocarditis. - Federal clinical guidelines 2016.
