Methods for the treatment of atherosclerosis of the coronary arteries. Diagnosis and treatment of coronary atherosclerosis Coronary atherosclerosis symptoms

Atherosclerosis of the coronary arteries is a rather serious disease that can cause death, since the coronary arteries are the main vessels supplying the heart with blood. They are tortuous, and their diameter is small, so there is often a deposition of cholesterol plaques. In this case, the walls of the vessels lose their elasticity, and subsequently ulcerate.

Most often, the disease affects people over 45 years of age, but in some cases, atherosclerotic changes can also be detected in people under the age of thirty.

Factors contributing to the development of the disease

Atherosclerosis of the coronary arteries of the heart can be triggered by the following factors:

1. Improper nutrition, in which too much bad cholesterol is formed in the human body.
2. Bad habits such as smoking or drinking alcohol.
3. hereditary predisposition.
4. Chronic stress or depression.
5. Natural aging of the body and gender. Often the disease is observed in men whose age is more than 40 years.
6. Lack of adequate physical activity.
7. Metabolic disease.
8. Diseases of the endocrine system (often coronary atherosclerosis becomes a companion of diabetes mellitus).
9. Hypertension, in which the pressure rises above 140/90 mmHg.

Symptoms of the disease

At the initial stage, the disease does not manifest itself in any way, and it can only be detected during examination. In the future, the patient develops unstable angina.

Symptoms of atherosclerosis of the coronary arteries:

1. Pressive or burning pains in the chest extending to the left shoulder or back.
2. Painful sensations intensify after excitement or physical exertion and last no more than a quarter of an hour, while normalizing the patient's condition disappear on their own.
3. Stopping seizures is obtained with the help of Nitroglycerin.
4. If the patient is in a horizontal position, he has shortness of breath.
5. Angina may be accompanied by dizziness, cephalgia, nausea.

Depending on the class of angina pectoris, it appears both during strong physical exertion, and at rest and after minimal activity.

The general signs of atherosclerosis include the rapid aging of the patient. His skin becomes thin and dry, tissue turgor is disturbed, and the arteries on the flexor surfaces and temples look tortuous.

How the disease is diagnosed

To diagnose atherosclerosis of the coronary vessels, an anamnesis is collected and the actual and standard body mass index is determined, and blood pressure is measured. It is also necessary to donate blood for sugar and cholesterol.

Methods for diagnosing the disease include:

• Ultrasound examination of the heart.
• Electrocardiogram (graphic recording of the work of the heart and pulsation of the heart muscle)
• Bicycle ergometry (a study that reveals hidden coronary insufficiency and determines individual susceptibility to physical activity).
• Treadmill test (an electrographic study carried out after exercise on a treadmill).
• Angiography (contrast x-ray examination of blood vessels, evaluating the functional state of the vessels and pathological processes).
• Computed or magnetic resonance imaging.

Therapy

Treatment of atherosclerosis of the coronary arteries should be comprehensive. It is necessary not only to take the drugs prescribed by the doctor, but also to adhere to the diet. In order to get rid of the disease, you must follow the following recommendations:

• Reduce your fat intake by at least 10%. Eliminate butter, trans fats, lard from the diet. Replace them with vegetable oils (olive, sunflower, corn, linseed).
• Reduce the consumption of foods containing saturated fatty acids (eggs, cream, fatty meats).
• Increase the amount of foods containing polyunsaturated fatty acids in the diet (fish of any kind, seafood).
• Increase the amount of foods rich in fiber (vegetables, fruits).
• Reduce salt intake.

For the treatment of atherosclerosis of the coronary vessels of the heart, drugs from different pharmacological groups are used. In some cases they are combined.

Statins

Drugs from this group suppress the production of the enzyme HMG-CoA reductase, which is responsible for the production of cholesterol. It also increases the number of membrane recipes that allow low-density lipoproteins to bind and be removed from the bloodstream. This helps lower cholesterol levels. Statins restore the elasticity of the vascular wall and have an anti-inflammatory effect.

The most popular and effective drugs from the statin group include:

• Lovastatin.
• Simvastatin.
• fluvastatin.
• Atorvastatin.
• Provastatin.

As a rule, drugs are taken once a day after dinner, since the maximum production of cholesterol occurs at night. Treatment starts with the minimum dose of any agent, which is gradually increased.

The most common side effects that occur with the use of statins are nausea, vomiting, diarrhea, and myopathy.

Anion exchange resins

The drugs of this group bind bile acids, as a result of which the liver synthesizes them, additionally consuming cholesterol. These drugs include:

• Cholestyramine.
• Colestipol.
• Questran.

Medicines are produced in the form of powders, which are dissolved in a liquid and taken with meals 2-3 times a day. The effect of the application is observed a month after the start of administration.

When using such drugs, there may be side effects from the digestive system in the form of nausea, bloating, stool disorders. Most often, drugs of this group are prescribed in combination with statins.

Fibrates

They are prescribed for elevated plasma triglyceride levels. They contribute to the active production of an enzyme that breaks down low-density lipoproteins. Such medicines include:

• Gemfibrozil.
• Benzafibrate.

Take these medicines twice a day before meals. With their use, side effects from the gastrointestinal tract develop in the form of nausea, vomiting, diarrhea. In rare cases, muscle weakness or dizziness may occur.

Folk recipes

Treatment of atherosclerosis of the coronary arteries with the help of traditional medicine is a rather lengthy process. In order to reduce cholesterol levels, you need not only to take herbal remedies, but also to change your lifestyle.

To lower cholesterol and strengthen the walls of blood vessels use:

• Garlic. To prepare the remedy, 5 large heads of garlic are thoroughly crushed, mixed with the same amount of May honey and left in a dark place for three days. Store the medicine in the refrigerator and take 2 g daily for six months in the morning and evening before meals.
• Clover. 80 g of red clover flowers are poured with a liter of vodka and allowed to brew for at least ten days. Filter and consume 15 ml of tincture at lunchtime and in the evening before bedtime. Treatment continues for at least six months.
• Lemon. 10 g of needles are poured into 400 ml of water and boiled over low heat for 5 minutes. After cooling, filter. 2 lemons, peeled and finely chopped. The pulp is poured with the resulting broth and insisted for 3 days. Add 50 g of honey and mix thoroughly. You need to take 50 ml of the drug per day. Treatment is continued for three months.
• Fuck root. The product is rubbed on a fine grater and mixed with low-fat sour cream. Take one teaspoon daily with meals. Reception continues for at least 2 months.
• Onion. 50 ml of juice squeezed from the bulbs is mixed with 20 ml of aloe juice and the same amount of honey. The product is stored in the refrigerator and taken 5 ml once a day before bedtime. The course of treatment is 3 months.

In the event that atherosclerosis is detected late, and it poses a threat to the patient's life, surgical intervention is necessary in order to restore impaired blood circulation. There are two methods to fix the problem - stenting and shunting.

Stenting

A frame is installed in the lumen of the coronary vessels, expanding the narrowed area. The stent looks like a metal tube made up of cells. It is placed in the affected vessel, then inflated with a special balloon, pressing into the walls.

The intervention is performed under local anesthesia. During the operation, the patient can communicate with the surgeon and follow his commands. A special catheter is used to insert the stent, guidewire, and special balloon.

Once the balloon is correctly positioned, the guidewire and catheter are removed. The operation gives good results, but in 20% of cases, re-narrowing of the vessel is possible. The reason for this is the overgrowth of muscle tissue.

Shunting

If a patient has a progressive narrowing of the main artery that leads to the heart muscle, coronary artery bypass grafting is performed. This operation allows you to restore blood flow by installing special vascular prostheses (shunts). Unlike stenting, shunting makes it possible to bypass areas of narrowing.

This is a major surgical operation that lasts for 3-4 hours. When it is carried out, a heart-lung machine is used. The rehabilitation period after such a surgical intervention is quite long. If the patient does not comply with all the doctor's prescriptions and stops taking medications on his own, a relapse is possible.

Complications

If several vessels are affected by atherosclerotic plaques, this can cause the death of the patient. Also, a lethal outcome can provoke a rupture of an atherosclerotic plaque. Most often it occurs in the cold season in the morning after waking up. Severe stress or physical activity also becomes a provocateur.

As a result of this, there is a fluctuation in the tone of the coronary artery, increased blood flow, a sharp increase in blood pressure or heart rate. The coagulation ability of the blood also has an effect.

With thrombosis of the entire lumen of the coronary artery, a fatal outcome occurs. In 60% of cases, the patient's death occurs before he gets to the hospital. With partial damage to the vessel, unstable angina occurs.

A complication of the disease can be myocardial infarction, which is characterized by symptoms:

• Sharp pain in the chest area, which can radiate to the back.
• Drop in blood pressure.
• Dyspnea.
• Loss of consciousness.

In this case, immediate hospitalization and resuscitation are required.

Another complication of the disease is cardiosclerosis, in which heart muscle cells are replaced by scar tissue. It does not participate in the contraction of the heart and causes an excessive load on the myocardium.

Signs of the appearance of cardiosclerosis indicate:

• Arrhythmia.
• Pain in the region of the heart, which is aggravated by physical exertion on the body.
• Edema.
• Dyspnea.
• Weakness.

Prevention

To prevent atherosclerosis of the vessels, it is necessary:

1. Get rid of bad habits.
2. Normalize food. Eliminate fatty and fried foods from the diet. Preference should be given to vegetables and fruits cooked boiled or steamed with a small amount of vegetable oil.
3. Exercise and walk outdoors.
4. Normalize body weight.
5. Treat infectious diseases promptly.

With atherosclerosis of the coronary arteries, it is necessary to seek advice from a cardiologist, endocrinologist, rheumatologist and vascular surgeon.

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 is provided by 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 squeezing sensation, similar to a feeling of heaviness, points with a hand to the center of the chest or the 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 is a well-known expression "pain in the 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 lesion of the 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. The already 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 make up the majority of the diet. Much attention is paid to vegetable oils, they should, if possible, replace butter.

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 blood sugar levels.

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 a genetic predisposition. It can be detected by tests that show the content of total cholesterol and its fractions in the blood. The fact is that one of the 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 reduce total blood cholesterol levels. 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 of side effects, for example, they affect liver function. For this reason, they are prescribed strictly according to indications, focusing on tests and the severity of the disease. Timely intake of statins in suitable dosages is one of the most powerful means of preventing atherosclerosis.

Operation

It would seem that the size of the affected vessels in coronary heart disease is very small for surgery. But fortunately, modern medicine can even do 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.

The heart is the most important organ in the human body. Rhythmic heartbeats help carry oxygenated blood throughout the body. This is a natural process. And through what vessels does the myocardium itself (this is the name of the middle layer of the heart muscle, which makes up most of its mass) receive the necessary amount of oxygen to function normally? Through the coronary (also called coronary vessels).

Important! The coronary arteries are the only source of blood supply to the heart. Therefore, it is so important that they are in “working condition” and function normally.

Atherosclerosis of the coronary vessels of the heart is a pathology of a chronic nature, which is characterized by the formation of cholesterol plaques that significantly block the lumen of the arteries and prevent normal blood flow. Statistics say that it is this disease that occupies one of the first places among diseases of the cardiovascular system. Moreover, the pathology is difficult to diagnose at the initial stage; and when it is already revealed at a late stage, it is difficult to treat. What provokes the development of pathology? How to deal with it? What are its symptoms? What preventive measures can prevent the development of atherosclerosis of the coronary vessels? Let's figure it out. There is never enough useful information.

Reasons for the development of atherosclerosis

The main reason for the development of atherosclerosis of the coronary vessels is the presence of elevated cholesterol levels (of the order of 6 mmol / l and more) in the blood. What can lead to this state of affairs:

• Consumption of animal fats in large quantities.
• Decreased activity of the metabolic process.
• Failure of the intestines in terms of excretion of fat-containing substances.
• The presence of a hereditary predisposition to atherosclerosis of the coronary vessels.
• Psycho-emotional overstrain and stressful situations.
• Diabetes.
• Failure of the hormonal background.
• Rapid weight gain, that is, obesity.
• Disorders in the work of the central nervous system.
• Inactive lifestyle (i.e. physical inactivity).
• Do not forget about the age of patients and the gender factor. It's no secret that the older the person, the slower the metabolism. Up to 60 years, the disease is more often diagnosed in men; in women, the risk of developing the disease increases after the onset of menopause.

• High blood pressure (i.e. hypertension).

On a note! Atherosclerosis of the aorta of the coronary vessels can be triggered by the same factors that were described above. We remind you: the aorta is the largest blood vessel located above. It is from it that the two main arteries (right and left) of the coronary blood supply depart.

The mechanism of development of vascular atherosclerosis

The starting point for the development of atherosclerosis of the aorta of the coronary vessels and arteries is damage to the endothelium as a result of autoimmune pathologies, exposure to viruses and bacteria, and allergic reactions. It is in these places that fatty deposits (plaques) form. Over time, they become more and more, as there is a constant flow of new volumes of "building material". As a result, connective tissue is formed in the lesions, which is the reason for the narrowing of the lumen of the aorta and coronary vessels; their blockages; failure of the local circulatory process and, as a result, serious chronic diseases (for example, coronary heart disease or myocardial infarction) and even death. That is, in the presence of cholesterol plaques, there are two options for the development of pathology: the first - the vessel is slowly but surely clogged up to its final blockage; the second - a thrombus, having reached its maximum in volume, simply breaks and thereby blocks any movement of blood through the artery. Both are very bad.

Who is at risk

Who is predisposed to atherosclerosis of the aorta of the coronary cerebral vessels and arteries? There is a certain group of people who have every chance to develop such a pathology in their body. This category includes those who:

• He leads a sedentary lifestyle, that is, he constantly either sits or lies. As a result, blood stagnation occurs in the body and, as a result, cholesterol deposits on the walls of the arteries.
• Has high cholesterol.

Remember! The more cholesterol in the blood, the greater the risk of blood clots.

• Suffering from diabetes. Metabolic disorders are one of the main causes of pathology.
• Is overweight.

• Eats incorrectly. That is, the diet contains a large amount of salt and animal fats.
• It has high blood pressure (this contributes to damage to the walls of blood vessels).
• Smokes often and a lot.

Symptoms of the disease

All signs that blood circulation in the heart is not at the proper level are divided into two categories - ischemic and general. The former are directly related to the work of the heart muscle, and the latter to the deterioration of blood flow to various parts of the body.

Of the ischemic symptoms, it is worth highlighting the following:

• The presence of a heart muscle rhythm that is somewhat different from normal. This happens as a result of the fact that with an insufficient amount of blood, the heart begins to work “idle”.

• There is an increase in blood pressure due to congestion in the coronary arteries.
• Attacks of fear in a patient caused by problems with the heart muscle. The pulse quickens, and the influx of testosterone increases, which only aggravates the situation.

Symptoms of atherosclerosis of the coronary vessels of a general nature:

• Shortness of breath, which is observed at the initial stage of the attack.
• Dizziness resulting from insufficient blood pressure.
• Failure of the CNS.
• The presence of pain (burning and pressing nature) in the sternum, which can be given to the left shoulder or back. As a rule, they occur during physical exertion, and they are associated with a lack of oxygen in the heart.

• Increased nervousness.
• Loss of consciousness.
• Coldness felt in the limbs (legs and hands).
• Puffiness.
• Lethargy and weakness.
• Nausea, sometimes turning into vomiting.
• Redness of the skin.

Important! At the initial stage of development, atherosclerosis of the vessels of the coronary arteries does not manifest itself in any way. The first symptoms appear only at the moment when the plaques begin to grow and obscure part of the lumen of the vessels. Therefore, it is necessary to undergo regular examinations, especially for people at risk.

The main stages of atherosclerosis

The main phases of the development of the disease can take decades to develop and, in the absence of any fight against the disease, can lead to serious consequences. There are five stages of atherosclerosis:

• prelipid phase. It is characterized by some accumulation of protein compounds and lipids in the smooth muscles. During this period, there is a deformation of the intercellular membranes, the formation of blood clots (soft in their structure), the loss of elasticity by the muscles, as well as the production of collagen in the body. At this stage, it is possible to return to a normal state if you adhere to proper nutrition and a healthy lifestyle.
• lipid phase. The patient does not show any anxiety, despite the fact that there is a further growth of the connective tissue. During this period, there is a rapid increase in body weight.
• phase of liposclerosis. Quite full-fledged fibrous plaques are formed.

• phase of atheromatosis. At this stage, atherosclerotic plaques, blood vessels, muscle tissue and connective tissue are destroyed. As a result, disturbances occur in the work of the central nervous system. Brain hemorrhages are possible.
• phase of calcification. On the plaques, there is a hard coating, and the vessels become brittle and completely lose their elasticity and shape.

Atherosclerosis of coronary cerebral vessels

The disease can develop for a long time completely asymptomatically or with some mild manifestations. The clinic begins to be observed only when atherosclerotic plaques already interfere with cerebral circulation, causing ischemia and vascular damage to the brain (that is, dyscirculatory encephalopathy). The result is either temporary dysfunction or severe tissue damage.

There are three aortas of the coronary cerebral vessels:

• First. This is the initial stage, which is characterized by symptoms such as general weakness, fatigue, lethargy, headaches, inability to concentrate, tinnitus, decreased mental activity and irritability.
• Second. This is a progressive phase, which is characterized by an increase in psycho-emotional disorders. The patient develops a depressive state, there is a tremor of the fingers or head; problems with memory, hearing and vision; headaches, constant tinnitus, uncoordinated movements, slurred speech, suspiciousness and anxiety.
• Third. At this stage, the patient has a persistent violation of speech function, complete indifference to his appearance (that is, apathy), memory lapses and loss of self-service skills.

Treatment of cerebral atherosclerosis is a long process and cannot lead to complete healing. True, as a result of regular and complex therapy, it is possible to achieve some slowdown in the development of pathology.

There are several methods of surgical intervention for the treatment of the disease:

• Shunting (that is, plastic abdominal surgery), which allows you to let the blood flow around the affected area of ​​the vessel.
• Endarterectomy, during which the atherosclerotic plaque and altered tissue of the vessel wall are removed.
• Extra-intracranial anastomosis (that is, the connection of the internal system of the carotid artery with its external component).
• Removal of the affected area of ​​the artery (that is, clogged with atherosclerotic plaque) and its restoration by installing an artificial prosthesis (that is, prosthetics of the brachiocephalic trunk).
• As a result of operational measures, a resection of the inner surface of the carotid artery occurs.

Diagnosis of atherosclerosis

When a patient goes to a medical institution, first of all, a specialist listens carefully to him. Moreover, all the smallest details are important, since it is they and clinical analyzes that make it possible to make an accurate diagnosis. In addition to collecting anamnesis and visual examination, the doctor prescribes the following laboratory and instrumental studies:

• A complete blood count to determine your cholesterol level.
• Determination of the ankle-brachial index, that is, the measurement of pressure in the ankle and shoulder area.
• Electrocardiogram. Sometimes, to make a diagnosis, daily ECG monitoring is necessary, in which a recording device that records all readings is attached with straps to the human body and remains with him throughout the entire examination.
• Examination on a special analyzer called a cardiovisor.
• Radionuclide research.
• Veloergometry. This method allows to reveal the latent form of coronary insufficiency.
• Treadmill test. In the process of this diagnosis, the state of the heart muscle is examined at the time of a certain physical activity.
• Intravascular ultrasound. With it, you can get a clear picture of the lumen of the vessels.
• duplex scanning. A non-invasive ultrasound examination that can be used to evaluate blood flow characteristics.
• Ultrasound of the heart. Using this method, you can determine the extent of damage to the organ.
• Stress echocardiography. This method, using ultrasound, allows you to evaluate the anatomical structure and functioning of the heart muscle at the time of exercise, as well as the pericardial space.
• CT scan.

Only after a comprehensive diagnosis of atherosclerosis of the coronary vessels has been carried out, the specialist prescribes adequate treatment.

Important! Do not self-medicate: at best, it will not give any results, and at worst, it will simply aggravate the situation with your health.

Treatment of vascular atherosclerosis

In many ways, the treatment of atherosclerosis of the coronary vessels of the heart depends on the stage of the disease. If the disease has just begun to develop, then, sometimes, it is enough:

• Taking certain cholesterol-lowering drugs (i.e. statins). Also, the doctor may prescribe beta-blockers, diuretics, antiplatelet agents, and others that help eliminate the symptoms of atherosclerosis.

Remember! Only a specialist can prescribe drugs and determine their dosage.

• Lifestyle changes. A balanced diet, moderate physical activity under the supervision of a cardiologist, abstraction from stressful situations, as well as giving up bad habits such as smoking and drinking "strong" drinks will help you quickly cope with the disease.

On a note! You can use the advice of traditional medicine, after consulting with your doctor. For example, eating garlic gives a good effect in the fight against atherosclerosis. True, if it causes a rapid heartbeat in the patient, then it is better to purchase garlic-based products in the pharmacy network.

How to treat atherosclerosis of the coronary vessels in severe cases? Most likely, you can not do without surgical intervention:

• The most common option is the installation of a stent, with the help of which the affected vessel is expanded, thereby ensuring normal blood flow.

Important! A patient who has undergone stenting will have to take statins and other drugs for life, because if this is not done, the vessels will again be affected by atherosclerosis.

• Another option is coronary artery bypass grafting. Using this method, you can start the blood flow around the affected area of ​​the vessel.

Prevention

In order not to subsequently engage in the treatment of atherosclerosis of the coronary vessels, it is necessary to implement a number of preventive measures:

• Regularly load the body with moderate physical activity (for example, walk, swim, do morning exercises or simply dig beds in your garden). The most important thing is more movement.
• Treat any pathologies you have in a timely manner. It would be nice if you visited a cardiologist once every few years.

• Try to avoid stressful situations or at least abstract from them. Any psycho-emotional overstrain is harmful to health.
• If you are overweight, be sure to fight it.
• Try to alternate physical activity with rest.
• Proper nutrition is the key to health. What need to do? Refuse animal fats, eggs, butter, dairy products with a high percentage of fat content, sour cream, as well as fatty meats and fish. The intake of vegetables and fruits is welcome.
• Quit smoking and drinking hot drinks.
• Walk outside regularly.
• Use traditional medicine recipes.

On a note! If atherosclerosis has already developed, then try to slow down its progress. Follow your doctor's advice regarding both medication and lifestyle. If surgery is inevitable, then do not delay it.

Finally

Take good care of your health, especially your heart. Moreover, such a pathology as atherosclerosis of the coronary arteries manifests itself in all its glory only in the later stages. This disease is difficult to treat, but it can be stopped, and sometimes positive dynamics can be achieved. Remember: the main thing is to start the treatment of atherosclerosis of the coronary vessels on time. Health to you and your loved ones!

Doctors estimate that cardiovascular disease causes 17,000,000 deaths each year. About half of them are atherosclerosis of the heart vessels. In Europe alone, 1,950,000 people die from it every year.

Let's figure out what the diagnosis of atherosclerosis of the coronary arteries says, what is the danger of this disease, symptoms, treatment options, what complications can be obtained.

Physiology of the disease

The development of atherosclerosis begins early. It has been proven that the first proto-plaques can appear even in childhood. It usually takes more than 10 years for an atherosclerotic plaque to form. At first, it is too small to affect blood flow. As the deposit grows, it occupies an increasing part of the lumen of the vessel, significantly narrowing it - stenosing atherosclerosis of the cardiac arteries develops. If the formation of atherosclerotic plaque continues, it can clog the vessel. This condition is called obliterating atherosclerosis.

Coronary vessels - a system of arteries, veins that feed the heart muscle. Their vascular pattern resembles a branched tree, in which the smallest branches are capillaries. Only one capillary is suitable for each cell of the heart. If the blood does not reach it, the myocytes stop receiving oxygen. After a while they die off (myocardial infarction). The blood supply to the cells of other organs is always carried out by several vessels, so they endure the narrowing of the lumen of the arteries without such serious consequences.

According to ICD-10, atherosclerosis of the coronary arteries of the heart is classified as atherosclerotic heart disease (group I25.1).

Main causes, risk factors

For the development of atherosclerosis, 2 components are necessary:

• artery damage;
• metabolic disorders, especially fat.

Throughout life, the walls of blood vessels are exposed to a wide variety of damaging factors. It is not possible to determine which one caused serious damage.

According to modern ideas in the development of atherosclerosis, a violation of fat metabolism plays an important role. High levels of cholesterol, low-density lipoprotein LDL, neutral fats, low concentration of high-density lipoprotein HDL, abnormal size of lipid fractions contribute to the formation of deposits.

Therefore, doctors do not name the exact cause of atherosclerosis, but identify risk factors for its development. 80-90% of people who die from complications of coronary disease had at least one of the following factors:

• High blood pressure in people over 50. It is considered one of the most significant indicators of risk. Under the influence of hypertension, the wall of the artery becomes thin, inelastic. It is easily damaged, which provokes the formation of plaques.
• Age. Women after menopause, as well as men over 50, are more prone to atherosclerosis.
• hereditary predisposition. If the patient has relatives who had cardiovascular problems under the age of 55 (men) or 65 (women), he is at risk;
• High cholesterol, LDL. About 60% of people with coronary atherosclerosis have an abnormally high concentration of them.
• Smoking. People who smoke have a very high risk of developing the disease. Passive smokers are also prone to developing it. Cigarettes increase the level of fibrinogen, a protein involved in blood clotting reactions. Because of this, the risk of thrombosis increases. Nicotine also raises blood pressure and speeds up the heart rate.
• Diabetes. The presence of diabetes increases the risk of coronary atherosclerosis by 2-4 times in men, 3-5 times in women. The disease exacerbates the negative impact on the body of smoking, obesity.
• Diet. People whose diet is rich in saturated fats, cholesterol, salt, poor in vegetables, fruits have an increased risk of atherosclerotic plaque narrowing of the lumen of the vessels.
• Sedentary lifestyle. Increases the likelihood of heart disease by 50%, increases the complications of diabetes, hypertension, obesity.
• Obesity. In addition to the fact that being overweight is associated with an increased risk of developing coronary heart disease, it is also accompanied by triglycerides, LDL, low HDL.
• Other factors. Stress, alcohol abuse, blood homocysteine ​​deficiency, excess iron, inflammatory diseases, taking some oral contraceptives, hormonal drugs.

Symptoms of coronary atherosclerosis

In the initial stages of atherosclerosis, the deposit is too small to significantly affect the blood supply to the heart muscle. Because of this, there are no symptoms of atherosclerosis of the coronary arteries at this stage.

With the progression of atherosclerosis, oxygen deficiency develops in the myocardium. This condition is called coronary heart disease. The first symptoms usually do not appear constantly, but with significant physical exertion, stress. They may include:

• An attack of angina pectoris (angina pectoris). It is manifested by a feeling of pain, compression in the central or left side of the chest, as if someone is standing on it. Usually, discomfort disappears after a few minutes or after the cessation of physical activity. For some people, especially women, the pain may be fleeting or sharp, radiating to the neck, arm, or back;
• Dyspnea. Myocardial cells begin to work worse, which causes the heart to pump less blood than the body needs. The body tries to compensate for the lack of oxygen by breathing more frequently, which causes shortness of breath;
• General weakness, chronic fatigue.

If the cholesterol plaque blocks the lumen of the vessel, myocardial infarction develops. A typical symptom is chest compression, sharp wild pain that radiates to the shoulder, arm, less often the jaw, neck. Sometimes the development of a heart attack is accompanied by shortness of breath, intense sweating.

For some people, a heart attack may be asymptomatic.

Modern diagnostics

In the early stages of coronary atherosclerosis, there are no symptoms. At the appointment, the doctor first of all interrogates the patient, conducts a general examination, listens to the heart. Then the patient takes a biochemical blood test so that the doctor has an idea about the functioning of the internal organs. If, based on the results of a general examination, blood biochemistry, the doctor suspects the possibility of developing atherosclerosis, the patient is referred for further examination.

To diagnose atherosclerosis of the coronary vessels, the following methods are used:

• Electrocardiogram. Records the passage of electrical signals through the heart. With a heart attack, it will be difficult for the impulse to pass through the scar tissue, which will be displayed on the ECG. This type of study is used to detect past heart attacks. Some patients are shown daily monitoring of the ECG. To do this, a person puts on a small device that is worn for 24 hours.
• Echocardiogram. A subspecies of ultrasound, which helps to obtain an image of the heart, assess the wall thickness, size of the chambers, and the condition of the valves. These indicators change with heart disease.
• stress test. Assign to patients whose symptoms appear only during exercise. Such patients are offered to walk on a treadmill or pedal an exercise bike. The doctor monitors the patient's ECG all this time. Sometimes, instead of physical activity, a person is given drugs that make the heart work hard. Then the doctor can examine the work of the heart with an MRI.
• Angiogram. The doctor injects a small amount of dye into the coronary vessel. After a while, he takes a picture of the heart (using X-ray/MRI). The dye makes the vessels visible, so areas of constriction are clearly visible in the image.
• CT scan. Allows the doctor to identify the most dangerous atherosclerotic plaques that contain calcium. May be combined with angiography.

Features of treatment

Therapy for atherosclerosis of the coronary vessels begins with lifestyle changes (quit smoking, move more), diet, treatment of concomitant diseases. Most of the diet should be plant foods, from animals it is allowed to leave poultry meat, fish, eggs, low-fat milk. Red meat consumption should be limited. It is recommended to avoid obviously unhealthy food - fast foods, snacks, street shawarma, pasties.

If the above measures are not enough, or at the time of admission, the state of human health causes concern, for the treatment of atherosclerosis of the coronary arteries, drug therapy and surgical manipulations are connected.

Conservative therapy

Atherosclerosis of the coronary vessels in the initial or middle stages can be treated with medications. In fact, the disease itself cannot be cured. It is in the power of the doctor to slow down its progression, to remove some of the symptoms. Tasks of therapeutic treatment:

• reduce the load on the heart;
• relieve vascular spasm;
• reduce ;
• prevent thrombosis;
• reduce the risk of heart attack;
• normalize blood pressure.

To achieve these goals, the following groups of drugs are used. Most pills need to be taken for life.

Lipid-lowering drugs

Medicines of this class normalize indicators of fat metabolism: cholesterol, LDL, HDL, triglycerides. These include:

• Statins (simvastatin, atorvastatin, rosuvastatin, pitavastatin). The most powerful representatives of the group. They block the synthesis of liver cholesterol, reduce the concentration of LDL, triglycerides, slightly. They are prescribed for the treatment of atherosclerosis, prevention for people at risk.
• Fibrates (fenofibrate, gemfibrozil). Before the invention of statins, they were widely used in the treatment of patients with atherosclerosis. Most effectively reduce the concentration of triglycerides, increase HDL, to a lesser extent affect the level of cholesterol, VLDL.
• A nicotinic acid. High doses of the drug, which is better known as vitamin B3 (PP), are prescribed to reduce triglycerides, LDL. But since the drug needs to be used in doses that exceed the daily requirement by 50-300 times, taking niacin is almost always accompanied by adverse reactions. Because of this, the use of nicotinic acid is very limited.
• Bile acid sequestrants (colestyramine, colestipol). Medicines that prevent bile acids from being reabsorbed, which forces the body to use cholesterol to synthesize them;
• Cholesterol absorption inhibitors (ezetimibe). Prevents the absorption of dietary cholesterol.

Blood-thinning drugs

Necessary at any stage of development of coronary atherosclerosis. Decreased blood viscosity prevents the formation of blood clots. The most popular drug is acetylsalicylic acid (aspirin). It is indicated at the initial stage of the disease. For more severe atherosclerosis, warfarin is recommended.

Antihypertensive drugs

High pressure is considered one of the most significant factors that damage the artery wall. A decrease in indicators by 35-40% inhibits the progression of atherosclerosis. To correct the pressure prescribe drugs bisoprolol, valsartan, lisinopril, amlodipine.

Surgery

In atherosclerosis of the coronary arteries, surgical intervention is necessary if the size of the deposits is significant. The two most common techniques are shunting and stenting.

Shunting involves creating a bypass. To do this, an artificial or transplant vessel is sewn above, below the atherosclerotic plaque, through which blood can flow freely.

Stenting - restoration of blood flow is achieved by installing a metal frame - a stent - in a narrowed area. To do this, a catheter with a deflated balloon is inserted through a large vessel. The surgeon, under computer control, moves it towards the atherosclerotic plaque and then inflates it. The lumen of the vessel expands, the plaque becomes flatter. To fix the result, the catheter delivers a folded spring (stent) to the narrowing site, unfolds it. A rigid frame is formed that supports the artery in an open state.

Folk remedies

At the very initial stages of atherosclerosis, when the first symptoms have not yet appeared, you can try to be treated with herbal preparations, although this is ineffective.

• Heart grass, yarrow, chestnut bark - 100 g each, rue grass, knotweed, lemongrass leaves, cumin seeds, sunflower petals - 50 g each. Prepare a mixture from the listed plants. 1 st. l. place in a thermos, pour a glass of boiling water, let it brew for 20-30 minutes. Strained infusion drink 100 ml 3 times / day before meals.
• 20 g of cumin seeds, Japanese Sophora pods, 30 g of valerian root, lemongrass leaves, 40 g of hawthorn flowers, nettle leaves. Pour boiling water over 1 tablespoon, leave for half an hour, strain. Drink 150 ml of infusion 2 times a day before breakfast, dinner.
• Herbs in the same proportions: birch leaf, nettle leaves, sage, horsetail grass, knotweed, hawthorn inflorescences, caraway seeds, rose hips, brown algae, yarrow. 3 art. l. place in a saucepan, pour three cups of boiling water. Cover with a lid, leave for 3 hours. Take a glass before meals 3 times / day. For patients older than 70 years, the dose is reduced to half a glass.
• Mix equal amounts of hawthorn flowers, knotweed grass, goldenrod, St. John's wort, yarrow. Place a tablespoon of the mixture in a saucepan, pour a glass of boiling water, put on a small fire. Boil 3 minutes. Set aside, let stand for 10 minutes. Drink warm, a glass 3 times / day before meals. A portion of the infusion must be prepared for each reception.
• Mix the same amount of rue grass, goose cinquefoil, mistletoe, horsetail, yarrow. Pour a tablespoon of the collection with a glass of water, let stand for 3 hours. Put on fire, cook for 5 minutes. Let stand 30 minutes, strain. For 2-3 months, drink half a glass of infusion 2 times / day. The fifth collection contains potent herbs. Check with your doctor about safe use.

Many biologically active components of plants are able to interact with medicines. Therefore, treatment with folk methods must be discussed with the therapist.

Complications

Atherosclerosis of the coronary arteries can significantly disrupt the functioning of the heart. Possible complications of the disease:

• angina;
• myocardial infarction;
• heart failure;
• arrhythmia.

The death of the patient can occur after the rupture of the cholesterol plaque, fragments of which will block the arteries. Most of these cases occur in the morning hours of the cold season. Severe stress or physical exertion can provoke lethal complications.