Atherosclerotic Heart Disease
Atherosclerotic heart disease is a chronic, slow, pathological change in the coronary arteries that results from the occlusion of their lumen until complete obturation due to the formation of cholesteric layers. The result of the above changes in the coronary arteries, is the oppression of trophic heart muscle and, as a consequence, a violation of the basic functions of the heart.
Fortunately, atherosclerotic heart disease belongs to the category of slowly progressing pathologies of the cardiovascular system, so the level of diagnosis of this condition is currently quite high. Despite this, according to world statistics, there is a high level of mortality from acute coronary syndrome, which is the main manifestation of atherosclerotic lesion of the coronary arteries.
Thus, atherosclerotic heart disease is a collective term that unites all cardiac pathologies, the origin of which is the violation of blood flow in the coronary artery system.
Causes of atherosclerotic heart disease
In the development of atherosclerotic heart disease, as well as atherosclerotic vascular lesion of other localization, the combination of modifiable and persistent factors of provocation available to the patient is of great importance. Of course, a person can not eliminate the genetic predisposition to the development of atherosclerotic lesion, but the modification of the lifestyle in the form of quitting smoking, adherence to the hypocholesterolemic diet, normalization of glucose values in the blood, and weight loss significantly reduces the risk of provocation of the lethal outcome from an acute coronary attack.
Thus, with a combination of predisposing factors, there is an excessive accumulation of cholesterol layers in the projection of the coronary arteries. The global community of cardiologists holds the view that atherosclerotic heart disease without hypercholesterolemia can not develop, since cholesterol is the pathological substrate of atherosclerotic plaque.
Symptoms of atherosclerotic heart disease
Considering clinical variants of the course of atherosclerotic heart disease, it should be read that in the early stages of development this pathology proceeds absolutely asymptomatically. Pathognomonic clinical symptoms develop only in the case of a pronounced narrowing of the internal lumen of the coronary artery and are manifested in the development of a typical attack of cardialgia or angina pectoris , cardiac arrhythmias, chronic circulatory insufficiency, and even sudden death syndrome.
The main pathognomonic clinical criterion for the development of atherosclerotic heart disease is the appearance in the patient of frequent episodes of a heart attack resulting from damage to the surface of an atherosclerotic plaque and the formation of a blood clot obstructing normal blood flow. The main predisposing factor for the damage of atherosclerotic plaque is a sharp increase in the level of catecholamines in the blood, which explains the development of symptoms of a heart attack after an excessive psychoemotional load. The principal difference between a heart attack and atherosclerotic heart disease from cardialgia and angina pectoris is that the result of the attack is the development of irreversible pathomorphological changes in the structure of the heart muscle, which inevitably provokes the suppression of its basic functions.
A classic heart attack is an episode of severe pain syndrome localized in the projection of the left half of the chest with a characteristic irradiation to the upper limb and neck. The type of pain syndrome in atherosclerotic heart disease is similar to a stenocardic attack, that is, pain is predominantly burning. In addition to severe pain syndrome, patients suffering from atherosclerotic heart disease, note the increasing respiratory disorders in the form of progressive dyspnea, which increases in the horizontal position.
In some situations, the development of classical acute coronary syndrome is preceded by the appearance of nonspecific symptoms in the form of episodes of angina pectoris. The diagnosis of "atherosclerotic heart disease" is impossible without highly specific imaging techniques (X-ray contrast methods, echocardioscopy, radionuclide techniques).
Treatment of atherosclerotic heart disease
The choice of the method of treatment of a patient suffering from atherosclerotic heart disease depends primarily on the severity of occlusion of the coronary arteries and consists in the use of surgical treatment, as a radical elimination of signs of blood flow disturbance, as well as pathogenetic conservative therapy. Drug treatment for this pathology is used primarily to prevent the progression of atherosclerosis and consists in the use of drugs of the statin group (oral administration of Torvacard in a daily dose of 10 mg). Treatment of coronary artery atherosclerosis involves lifelong admission of drugs of the salicylate group (Cardiomagnesium in a daily dose of 75 mg), as well as prolonged intake of cholesterol reducing drugs under the control of laboratory indicators of liver function.
At present, the only effective method of leveling the manifestations of atherosclerotic heart disease is to perform surgical treatment in the form of aortocoronary shunting, the principle of which is to form a "bypass" for the restoration of normal blood flow. This method of correction of coronary artery atherosclerosis has a limited field of application, since the imposition of aortocoronary shunt involves an open transthoracic access operation.
Currently, vascular surgeons are increasingly preferring alternative methods of surgical treatment of atherosclerotic heart disease, which include balloon dilatation, laser angioplasty and the establishment of intravascular stent.
Despite the effectiveness of surgical treatment in terms of eliminating existing atherosclerotic plaques, this method does not prevent further progression of atherosclerotic heart disease. To this end, in the postoperative period and throughout life, a patient suffering from atherosclerotic changes in the coronary arteries should adhere to the dietician's specific recommendations, and also take oral forms of the statin drugs for life.
? Atherosclerotic heart disease - which doctor will help ? If there is or suspected the development of atherosclerotic heart disease, you should immediately seek advice from such physicians as a therapist and / or cardiologist.