Atherosclerosis of the coronary vessels symptoms. Complications and concomitant diseases of atherosclerosis

Diseases of the heart and associated vascular system in this moment have become a huge problem of modern human civilization. At the same time, the more prosperous the society is in terms of living standards, the more serious the situation is in terms of the number of people suffering from coronary heart disease.

What is coronary heart disease?

The human heart is a very complex, finely tuned and sensitive mechanism, the purpose of which can be reduced to one function - the delivery of substances necessary for proper functioning to each cell of the body.

In addition to the heart itself, blood vessels also participate in this activity, the system of which permeates the human body, which fully ensures the uninterrupted delivery of everything necessary to the cells of the organs most distant from the heart.

Crown

lar artery and its role in the human life support system

The full functioning of this system is ensured by the heart muscle, the rhythm and completeness of contractions of which also depend on the normal supply of blood - the carrier of everything necessary for normal life. human body. Blood flows to the heart muscle through vessels called coronary arteries.

Hence the names: artery, etc. And if the required blood flow in the coronary arteries is reduced, the heart muscle is deprived of nutrition, which leads to coronary diseases such as heart failure, abnormal heart rhythms and heart attacks. The reason for everything is coronary atherosclerosis.

What is it and why is it scary?

Over time and under the influence of many factors, which will be discussed later, fats and lipids settle on the walls of the arteries, forming constantly growing sticky plaques that create obstacles to normal blood flow.

Thus, the lumen of the artery gradually decreases, and less and less oxygen is supplied to the heart, which leads to the appearance of pain in the retrosternal region - angina pectoris. At first, these pains can disturb a person only when heavy loads, but gradually become a response to even small efforts, and subsequently may occur at rest.

Complications and concomitant diseases of atherosclerosis

Atherosclerosis coronary arteries inevitably leads to such a disease as the heart. It is worth noting that the so-called heart diseases claim incomparably more lives than oncological or infectious diseases- and it is in the most developed countries.

Damage to the coronary arteries naturally causes negative impact on the heart muscle, which in turn causes angina pectoris, heart attacks, heart attacks, disorders heart rate, heart failure and, worst of all, cardiac death.

Symptoms in coronary heart disease

The human body has an individual anatomical structure. And the anatomy of the heart, the arteries that feed it, each has its own characteristics. The heart is fed by two coronary arteries - right and left. And it is the left coronary artery that provides the heart muscle with oxygen in the amount required for its normal functioning.

With a decrease in blood flow in it, retrosternal pain occurs - symptoms of angina pectoris, and their appearance is often not associated with special loads. A person can experience them both while at rest, such as in sleep, and while walking, especially over rough terrain or stairs. Such pains can be provoked and weather conditions: in winter, in cold and windy weather, they can disturb more often than in summer.

What you need to know about angina pectoris

First of all, this disease is the result of acute heart failure, provoked by insufficient blood supply to the heart muscle due to the fact that the left coronary artery is affected. Another name for the disease, known to many from Russian classical literature, is angina pectoris.

A characteristic manifestation of this disease is the pain already described earlier. But it is also possible (most often on initial stages) sensations not of pain as such, but of pressure in the chest, burning. Moreover, the amplitude of pain has a fairly wide range: from almost insignificant to unbearably acute. Its distribution area is located mainly on the left side of the body and rarely on the right. Pain may appear in the arms, shoulders. Affect the neck and lower jaw.

Pain is not constant, but paroxysmal, and their duration is mainly from 10 to 15 minutes. Although there are up to half an hour - in this case, a heart attack is possible. Attacks can be repeated with an interval of 30 times a day to once a month or even years.

Factors Contributing to the Development of Coronary Heart Disease

As mentioned earlier, coronary heart disease is the result of damage to the coronary arteries. There are several generally recognized factors in which the coronary artery that feeds the heart muscle becomes unusable.

The first of these can rightfully be called an excessively high level of cholesterol in human blood, which, due to its viscosity, is the root cause of the formation of plaques on the walls of the artery.

Another risk factor contributing to the development of heart disease, namely a heart attack, is hypertension - excessive blood pressure.

Huge damage to the coronary arteries of the heart is obtained from smoking. The risk of damage to the walls of the arteries increases many times due to harmful effects on them the chemical compounds that make up tobacco smoke.

The next risk factor that increases the likelihood of injury coronary vessels, is a disease such as diabetes. With this disease, atherosclerosis is exposed to the entire vascular system a person, and significantly increases the likelihood of heart disease at an earlier age.

Heredity can also be attributed to risk factors affecting the occurrence of heart disease. Especially if the fathers of potential patients had heart attacks or died as a result of coronary diseases before the age of 55, and mothers before the age of 65.

Prevention and treatment of coronary heart disease

It is possible to avoid or reduce the risk of getting coronary heart disease if you perform, and strictly and continuously, several simple recommendations, which include healthy lifestyle life, rejection bad habits, reasonable physical activity and the passage of annual preventive examinations.

The treatment of coronary heart disease includes several options: drug therapy and cardio surgical intervention. The most common is coronary artery bypass grafting, in which blood is sent to the heart muscle along a bypass route: along a segment sewn parallel to the affected area of the aorta healthy vessel taken from the patient himself. The operation is complex, and after it the patient needs a long period rehabilitation.

Another type of treatment is angioplasty of the coronary artery using a laser. This option is more gentle and does not require dissection of large segments of the body. The affected area of the coronary artery is reached through the vessels of the shoulder, thigh or forearm.

Unfortunately, no matter what operations are performed, even the most successful of them do not get rid of atherosclerosis. Therefore, in the future it is necessary to comply with all medical prescriptions, this applies not only medical preparations but also the recommended diet.

Atherosclerosis is pathological process, which is characterized phased development. The intima of arterial vessels is overgrown cholesterol deposits, which leads to the formation of plaques and thickening of the arterial wall.

In turn, this causes a narrowing of the lumen and negatively affects the intensity of blood flow. Ischemization of the tissues feeding from these arteries develops.

Causes of the formation of coronary atherosclerosis

The main reason for the development of atherosclerosis is an increased content of low density lipoproteins in the blood. cholesterol level in medical practice measured in mmol/l. If the indicators are in the range of 4 mmol / l or less, then this is the norm.

Anything above this value is high.. The risk of coronary sclerosing changes increases from 4.2 to 4.9 mmol/l. The level of lipoproteins exceeding 4.9 mmol / l is a direct indication for the immediate hospitalization of the patient and subsequent treatment.

"Bad" cholesterol is formed for several reasons, the first of them is malnutrition when a person abuses fried, salty, spicy. The situation is aggravated when overuse alcohol, excessive production of cholesterol by the liver, slow digestion, disorders of fat metabolism.

Provoking factors should also include the habit of smoking, a passive lifestyle and physical inactivity.

Atherosclerosis often develops as a complication of diabetes mellitus, vessels are most often affected. lower extremities, which ultimately leads to the so-called diabetic feet and gangrene. The most dangerous form of the disease is expressed in the defeat of the cardiac coronary vessels.

Stenosis of the coronary arteries

Atherosclerosis is a process that begins its development in young age and it only gets better with time. At first, the changes are microscopic and this does not affect the functionality of the arterial wall in any way. Then a small elevation is formed, growing to.

If the formations do not block the lumen of the vessel by more than 50%, then they can be recognized by doctors as insignificant and the pathology falls under the definition of non-stenotic atherosclerosis. But in the case when plaques grow to large sizes and their growth does not stop, which leads to impaired blood flow in the heart, this is already classified as stenosing atherosclerosis of the coronary arteries.

These terms are used only to clarify the nature of the destructive process, and can rarely be part of an official diagnostic report. Since non-stenosing sclerosis is observed in almost all people over 45 years of age.

Pathological sclerosing process

Atherosclerosis of the coronary arteries, also called coronary arteries, leads to destruction of the myocardium. Clinically, this manifests itself in a heart attack, infarction, with typical pain in the sternum, and heart rhythm disturbance. Signs of cardiac decompensation cause sudden death person.

In particular cases, the surfaces of plaque-like formations are torn, and then blood clots are formed, which become a significant obstacle to blood flow. Clinical picture such a complication is coronary disease in one of its forms.

Considering angina pectoris, whether it is in a state of rest or tension, we can talk about more favorable prognosis. In a heart attack, the changes that occur in the heart muscle are irreversible and it dies.

Coronary atherosclerosis is very dangerous because heart attack overtakes the patient at any time, regardless of the state of sleep or wakefulness. But usually it happens early morning, from 4 to 10 o'clock.

It is at this time that the level of adrenaline increases in the peripheral blood, which provokes a rupture of the surface of the cholesterol plaque.

Classical symptoms of atherosclerotic blockade

Symptoms of atherosclerosis depend on which vessels are affected by the disease:

Atherosclerosis of the aorta of the coronary arteries manifests itself in coronary insufficiency and ischemic heart disease. This means that the patient complains of regular pain behind the sternum, characteristic of angina pectoris. And also for arrhythmia and constant swelling of the feet and legs.
characterized by headaches, dizziness, deterioration in the ability to memorize and concentrate. The patient complains of a decrease mental capacity, lack of working capacity, lowering of intellectual abilities, inhibition of the ability to think and uncontrolled personality changes.
Atherosclerosis of the extremities causes pain in the muscles while walking, intermittent lameness, chilliness in the legs. Sometimes appear convulsive syndrome and depigmentation of the skin of the lower extremities.

In especially neglected conditions, a person may experience signs of all three types of atherosclerosis. In this case, traditional drug treatment will not have any effect.

Methodology of treatment and preventive prevention

prevent development similar states is quite real. To this end, people at risk should seriously attend to issues primary prevention. First of all, atherosclerosis of the coronary vessels of the heart threatens those whose health is aggravated by a family history.

The disease is so insidious that a person, already having a vascular obstruction, still continues to feel well and is absolutely unaware of the possible danger. No measures are taken and the patient does not seek medical help for a long time.

If the problem is diagnosed in a neglected state, which happens most often, then doctors are forced to resort not only to drug treatment but also to cardiac surgery methods. Surgery refers to radical methods of cupping pathological conditions, however, is not indicated for all cardiological patients.

Operative methods in the treatment of coronary obstruction

Most effective method restoration of the vascular lumen and adequate blood supply to the myocardium is coronary artery bypass grafting. During the operation, new, bypass routes for the movement of blood are created. Manipulatively, this is a very complex intervention, and during bypass surgery there is always a risk of an unfavorable outcome.

The essence of the operation is to suture the autograft, which is located parallel to the narrowed sections of the coronary vessel.

Such a transplant is obtained from a segment of a healthy artery, excised in a different area of the bloodstream and removed from the patient himself. It is necessary to carry out such a procedure on open heart, and after the operation, the patient undergoes a long course of recovery.

No less effective is the second method - invasive endovascular surgery.

Its varieties include:

balloon dilatation;
stenting;
excimer laser angioplasty.

Patients endure such an intervention much easier, because these operations are not characterized by extensive trauma to the cardiac tissues and a large abdominal incision. The area where the coronary artery narrows is penetrated through the femoral or brachial vessels using X-ray control.

Atherosclerosis of the coronary arteries of the heart will annoy the patient even after a successful operation. Whatever the chosen treatment option, people with this diagnosis must adhere to a specific diet and take medications prescribed by their doctor for the rest of their lives. Atherosclerosis, as a pathology, will not disappear anywhere.

Many people know that atherosclerosis is the appearance on the walls of blood vessels. cholesterol plaques, which narrow, and in severe cases completely block the lumen of the vessels. This disease can affect different vessels, one of the most common and dangerous forms is atherosclerosis of the coronary arteries. As this disease progresses, the nutrition of the heart worsens.

Atherosclerosis of the coronary arteries develops gradually. For quite a long time, the symptoms do not manifest themselves in any way, and even during the usual diagnostic procedures significant violations does not show up on the cardiogram.

However, people who are attentive to themselves may already notice some changes at this time: irritability, increased fatigue, sensations of squeezing in the area chest.

Reasons for the appearance

And if internal causes, leading to the development of atherosclerosis, practically do not depend on a person, then external causes can be eliminated and the risk of the disease can be reduced.

External (removable factors) include:

smoking;
hypodynamia;
excess weight;
unbalanced diet with a predominance of animal fats.

To internal factors can be attributed:

age (the older the patient, the more likely disease development);

Advice! In men, atherosclerosis develops more often, but this is true only up to a certain age. After menopause, women's risk of developing the disease increases dramatically.

heredity;
Availability concomitant diseases(hypertension, diabetes, etc.).

Clinical picture

As atherosclerotic changes develop in the arteries, they begin to manifest clinical symptoms. The manifestations of the disease are usually divided into several stages:

Ischemia. The first signs of the disease develop at the stage when the heart begins to feel insufficient blood flow. At this stage, the patient may be diagnosed with angina pectoris and coronary artery disease.
necrotic changes. Due to the complete overlap of individual branches of the coronary vessels, foci with necrotic changes develop - a heart attack.
sclerotic changes. In place of foci of necrosis, a scar is formed.

angina pectoris

The main symptoms of angina pectoris are recurrent pain attacks in the chest area. This disease is considered the first stage of progressive coronary sclerosis.

How does a seizure happen? Under certain conditions, a spasm of the walls of the arteries occurs, that is, an attack occurs, during which a person feels a burning pain in the chest. This condition can be caused by factors such as:

stress, nervous strain;
physical fatigue;
long stay in the heat, in a stuffy room;
smoking;
alcohol abuse, etc.

ischemic heart disease

IHD (ischemic heart disease) is a condition caused by circulatory failure. As a result of the narrowing of the lumen of the coronary arteries, myocardial damage develops. In fact, the disease develops if the myocardium receives less oxygen than it needs for normal functioning.

Advice! IHD is one of the most common causes of disability and death, so this disease is considered a serious medical problem our time.

IHD can occur acutely: in this case, a heart attack develops or chronically (manifested periodic attacks angina).

Flow

As already mentioned, atherosclerosis of the coronary vessels develops gradually, the symptoms of the disease increase over time.

At the first stage, the so-called angina pectoris appears, that is, the symptoms begin to appear after physical effort. There are chest pains that radiate to left shoulder, hand, back of the head.

Sometimes it is enough to simply stop physical activity to relieve pain. For example, if pain occurs while walking, then when you stop, they disappear without taking medication.

As the disease progresses and blood circulation deteriorates, rest angina is diagnosed. At this stage of the disease, seizures occur without regard to exercise, often at night. The main symptoms of an attack:

pain in the chest;
feeling that the heart is constricting or "bursting" into pieces;
feeling of fear of death;
lack of air, shortness of breath;
pallor;
the appearance of cold sweat on the forehead.

The duration of an attack at this stage of the disease is usually short. After the pain stops, the patient feels healthy. The frequency of attacks is individual, in some patients they develop once every few years, while in others they occur several times a day.

The stage of angina pectoris can continue for many years. However, in some patients, the process continues to progress and the disease becomes more severe.

Advice! The occurrence of frequent seizures warning sign, it indicates that atherosclerosis continues to develop and passes into the next stage - necrotic.

heart attack

As you progress coronary atherosclerosis a heart attack develops, the symptoms of this condition:

sudden strong pain in the chest;
the attack is not relieved by taking conventional "heart" drugs;
duration pain attack during few hours.

Advice! A prolonged period of pain is a sign that necrotic changes affect more and more new areas of the heart muscle.

Pain during a heart attack can be varied. Most often, patients complain of burning pain in the chest. For others, pain may be concentrated in the abdomen, and this may lead to the fact that the patient takes the symptoms for manifestations of diseases of the digestive system.

Advice! In people with diabetes, often the pain during a heart attack is weak. This is explained by the fact that diabetes affects nerve fibers through which pain impulses are transmitted.

Along with the appearance of pain, the patient has the following symptoms:

shortness of breath;
severe weakness;
feeling of anxiety;
the appearance of cold sweat;
pallor;
a sharp decrease in blood pressure;
dizziness, sometimes there is a loss of consciousness.

How is the diagnosis established?

If you experience chest pain, you should immediately consult a doctor. Started on time and competent treatment help avoid complications. In order to diagnose atherosclerosis that has affected the coronary arteries, the following methods are used:

Coronary angiography;
Computed angiography;

It will definitely be necessary to do a detailed blood test in order not only to determine the level of cholesterol, but also to determine the concentration of this substance by fractions.

How is the treatment carried out?

The method of treatment is chosen individually for each patient. This takes into account the stage of the disease, the rate of progress, the presence of concomitant diseases, etc. With the timely detection of the disease, patients are advised to change their lifestyle, prescribe medications that regulate cholesterol levels and contribute to its elimination.

stop smoking, as tobacco smoke contributes to vasoconstriction and aggravates the course of the disease;
to follow a diet in which the amount of fatty animal products is severely limited, preference should be given vegetable food, dairy and meat products should be low-fat;
avoid physical inactivity, normalize sleep, regularly spend time outdoors.

On the late stages therapeutic methods may not be enough. In this case, patients are advised to perform an operation to expand the affected area of the vessel. If a significant narrowing of the coronary artery is detected, then bypass surgery is prescribed.

This operation is prescribed only as a last resort, when other methods of treatment do not work. As a rule, shunting is indicated for narrowing of the vessel by 75% or more. With atherosclerosis, self-medication is dangerous! Appoint adequate therapy Or only a doctor can recommend surgery.

Prevention

Can atherosclerosis be prevented? Of course, factors such as age and hereditary predisposition cannot be defeated, but external causes leading to disease can be completely eliminated. To reduce the risk of developing such a serious disease, you must:

Give up smoking. Smokers suffer from atherosclerosis much more often than people who avoid this habit.
Move more. Of course, you should not immediately try to become a master of sports, the loads should be feasible and dosed.
Avoid extra pounds. It is necessary to monitor body weight and try to get rid of extra pounds.
Adjust nutrition. It is not necessary to become a vegetarian, but with age it is worth significantly reducing the amount of fatty animal foods.

So, atherosclerosis of the coronary arteries is serious illness, which leads to the development of such a life-threatening condition as coronary artery disease. You should try to take care of your health of cardio-vascular system from a young age. And if the first signs of the disease are detected, it is necessary to start treatment in a timely manner, without leading to the development of complications in the form of a heart attack.

A chronic disease, the development of which leads to the deposition of lipid clots on the surface of the endothelium is called atherosclerosis of the coronary vessels. Pathology develops slowly, causing ischemic lesions myocardium, which causes narrowing of the vascular lumen or its complete blockage. With absence timely treatment atherosclerotic changes cause the development vascular insufficiency which can lead to the death of the patient. It is for this reason that it is necessary to consider in detail the reasons why it develops, what signs it has and how it is treated.

coronary atherosclerosis - chronic illness, leading to a slow compaction and narrowing of the vessels of the heart due to the formation of atherosclerotic plaques on the surface of the lining layer of the vessels - the endothelium. The development of pathology can occur over several decades.

The first signs of vascular lesions of atherosclerotic origin usually appear in adolescence, but the pathology begins to progress when people are in middle age. Usually, the first signs of atherosclerosis of the heart arteries begin to appear at the age of 45-55 years.

Atherosclerotic plaques develop due to the accumulation of LDL, which is bad cholesterol.

Fat clots slowly increase and bulge into the coronary lumen. There is a violation of blood flow, in some cases it stops completely. It leads to oxygen starvation myocardium, violations of its functions, the development of ischemic lesions.

This pathology has several stages of development:

at the initial stage, there is a slowdown in blood flow, microcracks appear on the vascular endothelium. These changes provoke a slow deposition of fat, so the development of a fatty spot occurs. Decrease in action protective functions leads to an increase in the proliferation of the walls of blood vessels, the growth of fatty spots and their fusion into fatty stripes.
at the next stage, the growth of lipid formations occurs. As a result, atherosclerotic plaques appear on the coronary arteries. This stage is characterized by the development of blood clots, which can break off and block the artery.
at the last stage, the atherosclerotic clot thickens due to the accumulation of calcium salts in them. For this reason, there is a narrowing of the lumen of the artery and its deformation.

The reasons

Atherosclerosis of the coronary arteries of the heart can develop under the influence of endogenous and exogenous causes. Experts identify almost 200 different factors contributing to the development of the disease.

But the most common are:

elevated blood cholesterol levels;
smoking;
arterial hypertension;
sedentary lifestyle;
eating foods rich in saturated fats;
hereditary predisposition;
gender - in women, pathology develops 4 times less often than in men;
age;
obesity;
addiction to alcohol;
diabetes.

Diagnostics

It is possible to identify atherosclerosis of the coronary vessels by conducting an electrocardiogram, on which signs of cardiac ischemia can be determined.

To confirm atherosclerosis of the coronary vessels, it is necessary to conduct a number of studies:

stress scintigraphy - a method that allows you to determine the localization of fat accumulations on the surface vascular walls and their condition;
Doppler ultrasound and intravascular ultrasound procedure, allowing to determine changes in the structure of blood vessels, wall thickness, chamber sizes, the presence of departments with impaired contractility, to assess the hemodynamics and morphology of the valves;
coronography - examination of the heart using x-rays when using contrast agent. The method helps to identify the location, size of the affected areas and the size of the arterial lumen;
stress echography - a method that allows you to identify transient disorders of contractility of the heart muscle in places where there was a violation of blood flow.

Therapy

The treatment of atherosclerosis of the coronary vessels of the heart must be approached comprehensively. It is necessary not only to use the funds prescribed by the doctor, but also to follow a diet. To cure this pathology, you must adhere to the following recommendations:

reduce fat intake by 10%. Exclude butter, lard, trans fats from the menu. They can be replaced with any vegetable oil;
reduce the use of food products containing saturated fatty acids: fatty meat, cream, eggs;
include in the diet foods rich in polyunsaturated fatty acids: fish of any kind, seafood;
eat more foods rich in fiber - fruits and vegetables;
eat less salt.

Used to treat atherosclerosis of the coronary vessels medicines belonging to different pharmacological groups. Sometimes they are combined.

Statins

Medicines included in this group help to suppress the production of the enzyme HMG-CoA reductase. It is essential for the production of cholesterol. In addition, it helps to increase the number of membrane receptors that allow you to bind and utilize low-density lipoproteins from the bloodstream. It helps lower cholesterol levels. Statins help to restore the elasticity of the vascular walls and have an anti-inflammatory effect.

most popular and effective means from the group of statins are:

Provastatin;
Lovastatin;
Simvastatin;
Atorvastatin;
fluvastatin.

Usually take these funds once a day - in the morning or in the evening. Therapy begins with a minimum dosage, and a month after the start of administration, a dose adjustment is made.

The most common side effects, manifested by the use of statins, are myopathy, nausea, diarrhea, vomiting.

Anion exchange resins

Means belonging to this group bind bile acids, which gives the liver the opportunity to synthesize them using cholesterol. To similar means relate:

Questran;
Colestipol;
cholestyramine.

The preparations are made in powder form. They are dissolved in water and drunk during meals 2-3 times a day. Already a month after the start of taking the remedy, the effect of their use becomes noticeable.

The use of these agents may lead to unwanted effects from the digestive system such as nausea, bloating, diarrhea, constipation. Most often, drugs in this group are prescribed together with statins.

Fibrates

They are appointed at elevated content triglycerides in the blood. They help to activate the production of an enzyme that promotes the breakdown of low-density lipoproteins. These include:

Benzafibrate;
Gemfibrozil.

These drugs are taken before meals twice a day. Their use can cause gastrointestinal side effects such as nausea, vomiting, and diarrhea. Sometimes observed muscle weakness and dizziness.

Folk recipes

Therapy of atherosclerosis of the heart vessels with prescriptions traditional medicine enough Long procces. To reduce the concentration of cholesterol, it is necessary not only to use products prepared from medicinal plants but still lead a healthy lifestyle.

To strengthen the walls of blood vessels and reduce the concentration of cholesterol, you need to use:

Garlic. To prepare the medicine, you will need to take 5 large heads. Clean and grind thoroughly. Then mix with May honey, taken in the same volume. Leave the resulting mixture for three days in a dark place. You can store the medicine in the refrigerator. For 6 months, take 2 grams daily before meals in the morning and evening.
Lemon. Pour 10 grams of needles with two glasses of water and boil over low heat for 5 minutes. When the broth has cooled - strain. Peel two lemons and chop thoroughly and pour over the cooled broth. Insist 3 days. Then add 50 grams of May honey and mix well. The drug is taken at 50 milliliters per day. The course of treatment is 3 months.
Onion. 50 milliliters onion juice must be mixed with 20 milliliters of aloe juice and honey, taken in the same amount. The medicine can be stored in the refrigerator and taken in a teaspoon once a day at night.

When atherosclerosis is detected rather late and threatens the life of the patient, urgent surgical intervention is required to restore impaired blood circulation. Today, two methods are used: shunting and stenting.

Stenting

A frame is installed in the lumen of the coronary vessel, which expands the area with reduced patency. The stent is a cellular metal tube. It is placed inside the affected vessel, then inflated with a special balloon, pressing into the walls.

The operation is performed using local anesthesia. During the intervention, the patient can freely communicate with the specialist and follow his recommendations. A special catheter is used to introduce the stent, conductor and balloon.

After correct installation balloon, guidewire and catheter are removed. Such an operation is quite effective, but repeated vasoconstriction is possible in 20% of cases. This is due to the overgrowth of muscle tissue.

Shunting

If a patient has a progressive narrowing of the main artery leading to the heart muscle, an operation is performed to coronary artery bypass grafting. This manipulation restores blood flow through the installation of shunts - special vascular prostheses. Bypass surgery differs from stenting in that it bypasses narrowed areas.

This operation is very serious and lasts 3-4 hours. During the procedure, a heart-lung machine is used. The recovery period is quite long. If the patient does not follow all the recommendations of specialists and stops taking the medication on his own, a relapse is possible.

Complications

In the case when atherosclerotic plaques affect several vessels at once, this can lead to lethal outcome. In addition, death can be provoked by a rupture of an atherosclerotic plaque. This happens most often in winter period in the morning, shortly after waking up. This is due to excessive physical activity or severe stress.

This leads to fluctuations in the tone of the coronary artery, increased blood flow, a sharp increase blood pressure and frequency of myocardial contractions. In addition, blood clotting is affected.

When there is a blockage of the lumen of the artery, death occurs. In 60% of cases, the death of the patient occurs even before arrival at the hospital. When partial lesion vessel appears unstable angina.

The disease can be complicated by myocardial infarction, which has characteristic features:

the appearance of a sharp pain in the chest, radiating to the back;
lowering blood pressure;
dyspnea;
fainting.

In this case, immediate hospitalization and resuscitation are needed.

Important! Cardiosclerosis is another complication. With its development, myocardial cells are replaced by scar tissue, which ceases to take part in contractions of the heart muscle and leads to excessive stress on the heart.

The following signs indicate the development of atherosclerosis:

General weakness;
Dyspnea;
The appearance of edema;
Pain in the heart, aggravated by physical exertion;
Arrhythmia.

Prevention

To prevent atherosclerosis of the vessels, you need to follow simple recommendations:

eradicate bad habits;
stick to proper nutrition;
fulfill physical exercises and take walks in the fresh air;
normalize body weight;
treat infectious diseases in a timely manner.

Only a specialist with a narrow profile can make a diagnosis, based on the results obtained after carrying out diagnostic measures.

The most terrible enemy of any inhabitant of the planet over 50 years old, an insidious enemy that overtakes unexpectedly and changes life once and for all. An enemy to be known by sight. Meet - atherosclerosis of the coronary arteries.

Really frightening data provides medical statistics Every second death in the world is due to coronary heart disease. The cause of which is atherosclerosis of the coronary arteries. It has always been like this, except for the times of total military battles. The saddest thing is that from year to year these indications change for the worse. This is despite the fact that medicine continues to develop, regional vascular centers are being opened to resolve the current situation, and new medicines are being produced. Let's try to figure out what kind of disease this is and how to defeat it.

With a significant narrowing of the arteries and arterioles (the smallest vessels) of the heart, their defeat by the atherosclerotic process, the heart does its job worse and worse. At rest, pain most often does not bother, but when walking, running, lifting weights or strong experiences, the heart begins to work faster. That's when the characteristic pains appear in the patient. As a rule, a person complains of a compressive sensation, similar to a feeling of heaviness, points with a hand to the center of the chest or left side. At rest, the pain goes away. This medical condition is called angina pectoris. In more severe cases, when atherosclerosis of the coronary vessels of the heart is even more common, similar pains occur even with the slightest movement.

Why does the heart hurt

At the beginning of the disease, a person usually does not feel sick - he has no complaints, discomfort. For a long time atherosclerosis of the coronary arteries of the heart proceeds painlessly, without making itself felt. As a rule, with an increase in atherosclerotic plaque and its bulging into the lumen of the vessel, the first symptoms appear. The vessel that supplies blood to the heart muscle becomes narrow. Blood flows through it worse. There is a lack of oxygen and the heart begins to cope poorly with the load. The body suffers, roughly speaking, from malnutrition. In medicine, there famous expression"The pain in his heart is his cry for help."

Development of the disease

Angina pectoris is a disease that can disturb a person for decades in a row. However, more often the disease progresses. If you do not pay due attention to treatment, atherosclerosis continues to grow and a heart attack develops.

At the molecular level, the cause of a heart attack is stenosing atherosclerosis of the coronary arteries. . That is, a huge total defeat vessels of the heart. It happens something like this - the plaque cover breaks and blood particles begin to “stick” to the liquid core, creating a clot. And without that narrow vessel closes completely. In the lumen of it, inflammation begins. And in that part of the muscle that was supplied from this vessel, a catastrophe occurs. If you stop receiving food, the muscle dies. At this moment, the patient feels a sharp, unbearable pain in the chest, fear, shortness of breath may appear. This moment is critical for life. Some survive, some don't. It depends primarily on how extensive the affected area is. Of course, the age and condition of the patient, and his other chronic diseases also play a role.

How to fight

The very first question asked by patients is whether atherosclerosis can be cured. Definitely not. There is no such drug that would cause the reverse development of the process, the reduction or disappearance of the plaque. Treatment is to stabilize the situation. Slow down the growth of atherosclerosis, and in the best case, stop it altogether. Ideally, you need to think about this even before the onset of symptoms. However, later it becomes literally a vital necessity.

As cliche as it sounds, you should start by changing your lifestyle. Namely, with proper nutrition. The fats that make up plaque come mostly from the fats we eat. It should be borne in mind that only animal fats should be considered “guilty” in the formation of atherosclerosis - they are the ones that are dangerous. Vegetable fats do not cause the growth of atherosclerosis. Butter, cream, fatty meat - these are the foods that need to be strictly limited. On the contrary, vegetables, fruits, cereals are extremely healthy products. Their content should be most diet. vegetable oils much attention is paid, they need to replace butter if possible.

In addition to nutrition, metabolism is of great importance. A person with increased body weight is much more at risk of developing coronary heart disease. In addition, the tendency to atherosclerosis increases diabetes mellitus, especially poorly treated, with high level blood sugar.

A significant contribution to the incidence is made by heredity. Atherosclerosis of the aorta and coronary arteries can develop even at a young age and proceed very aggressively if the patient has genetic predisposition. It can be revealed by analyzes that show the content total cholesterol and its fractions in the blood. The fact is that one of the varieties of blood fats is the most dangerous. Therefore, it is very important to do a detailed analysis. With a serious violation of lipid metabolism, an increase in "bad" cholesterol - LDL (more than 3) and an increase in total cholesterol (more than 5) are detected.

Medical treatment

There are drugs that can affect the metabolism of fats. They are called statins, and they suppress the increase in "bad" cholesterol, which causes the growth of atherosclerosis. Statins also decrease general content blood cholesterol. According to some scientific data, these drugs can even slightly reduce the size of atherosclerotic plaques, but you should not count on this seriously.

The appointment and selection of the dose of drugs of this kind should be carried out only by a doctor. Like any other medicines, they have a number side effects, for example, affect liver function. For this reason, they are prescribed strictly according to indications, focusing on tests and the severity of the disease. Timely administration of statins in suitable dosages is one of the most powerful means prevention of atherosclerosis.

Operation

It would seem that the size of the affected vessels in coronary heart disease is very small for surgery. But fortunately, modern medicine maybe even that. With severe angina pectoris or acute infarction a special intervention is performed - coronary angiography. A microscopic probe is passed into the heart vessel and contrast is injected. Under high magnification, doctors can see where blood flow is obstructed and correct the problem. With a special balloon, the narrowing site expands and a stent is installed - a mesh-like structure that increases the lumen. This operation is performed under local anesthesia. Moreover, opening the chest is not required, only a small puncture on the arm or thigh.

Stenting could be considered as salvation, if not for one thing. The vessels on which the intervention took place are again affected by atherosclerosis if statins and a number of other medications are not taken. After the operation, the patient is simply obliged to drink medicines for life, according to a certain scheme.

In summary, we can say that atherosclerosis is really enemy number one. But having examined it from all sides, we can successfully repulse the attacks. The main thing is to act on time and reasonably.