Cardiosclerosis - this concept refers to the morphological and pathological process that leads to a local or diffuse proliferation of connective tissue in the heart, followed by the seal body.As a result, cardiosclerosis functional units (cardiomyocytes) are replaced by nonfunctional tissue and the heart loses its contractile capacity, as well as the ability to conduct a signal from the sinus node.Any chronic inflammation occurring in the heart muscle, may provoke cardio heart.
Cardiosclerosis no cure, and treatment is reduced only to the suppression of symptoms.In severe cardiosclerosis needed a heart transplant, which gives a chance to a very small percentage of the population.
morphologically identify the following causes of cardiosclerosis: the outcome of the inflammatory process associated with an infectious agent, allergic disorders, and that happens very rarely, a foreign body;the result of rheumatic;the outcome of the organization of the c
large number of micro-organisms cause myocardial damage, but not all cases of myocarditis will lead to cardio.Indolent chronic inflammation predisposes to the appearance of cardiosclerosis.
Cardiosclerosis is a manifestation of chronic ischemic heart disease and atherosclerosis may be, diffuse small-focal or postinfarction macrofocal, resulting in the formation chronic cardiac aneurysm.
Cardiosclerosis occurs on the background of the existing pathology and therefore the symptoms cardiosclerosis superimposed on the symptoms associated diseases.As a result, reduce the number of functioning muscle cells, myocardium loses its ability to efficiently deliver oxygen to all tissues and organs in cardiosclerosis.Of developing heart failure.For a long time the body unable to compensate for the lack of blood flow using the hypertrophy of the healthy portion of the myocardium.Thus, the first manifestation of heart failure at cardiosclerosis appear on stage, difficult to treat.
Depending on the location of cardiosclerosis isolated right ventricular and left ventricular heart failure.Symptoms are different.Left ventricular failure manifested in the "overflow" of lung blood.The result is shortness of breath, the patient takes a forced situation to improve breathing, there are attacks of breathlessness, cough.In the terminal phase cardiosclerosis there pulmonary edema, which can lead to death.The attack of pulmonary edema can occur at night, when a person is in a horizontal position.The skin is pale, wet, choking causes the patient to take a forced situation, frequent pulse, breathing, bubbling, frothy pink sputum, blood pressure is lowered.
If right heart failure appear swelling in the legs, and with the further progression of the disease edema "rise" above;increased liver;swollen veins in the neck;accumulates fluid in the peritoneal, pleural and pericardial;subcutaneous tissue swells.
There are several stages of heart failure.
I stage - dyspnea and tachycardia occur only during physical work and alone person feels well.
II A step in the left ventricular failure - shortness of breath, tachycardia appear under light load, moderate cyanosis of the extremities.
II A step in the right ventricular failure - swelling of the feet and ankles occur in the evening, moderate palpitations, mild cyanosis of the extremities (acrocyanosis).
II B stage - a clear stagnation in both the systemic circulation, a significant increase in the liver, swelling, persistent, reduced working capacity.
III stage - characterized by constant manifestations and symptoms alone terminal functional disorders of all systems and organs.
There is also a division into functional classes, depending on the physical capabilities of the patient.For the first class is characterized by the absence of functional limitations in physical activity.Functional class II - Moderate limitation of ability to work with the occurrence of dyspnea, palpitations during normal operation.In patients with functional class III in any physical work symptoms of heart failure.The fourth functional class is characterized by constant presence of symptoms of heart failure.
In connection with the violation of the impulse from the sinus node due to morphological changes in the myocardium in cardiosclerosis, there are various types of heart rhythm disturbances.Arrythmia most frequently detected only at prophylactic examinations, since a small amount of any subjective sensations arise.
cardiosclerosis With the progression of the patient complains of disruption of the heart, "fading" of the heart.Danger are PVCs, especially in patients with coronary artery disease.
paroxysmal tachycardia arrhythmia characterized by ectopic nature with sudden acceleration rate cuts and sudden decline in the same rhythm.In connection with cardiosclerosis excitation wave is delayed in some parts of the heart and "circulates" in this department.So there is an increase in excitability of the myocardium.The patient complains of palpitations, the study of the frequency of the pulse is determined by more than 150 per minute.There is shortness of breath, severe weakness.With the development of cardiogenic shock, blood pressure drops sharply, emerges a cold sweat, the patient loses consciousness.Often, there are pains in the heart.
Atrial fibrillation often accompanies the atherosclerotic, postinfarction cardiosclerosis and myocardio.Cardiosclerosis provokes a circular excitation wave in the atria or the ventricles.Such atrial wave superimposed on the basic rhythm and the frequency of the waves in this case is 350-600 1 minute.These waves are called atrial fibrillation or atrial fibrillation.Subjective feelings at the same time reduced to the unpleasant feeling of rhythm disorders, dizziness, weakness during exercise.The prognosis for patients with cardiosclerosis, atrial fibrillation depends on the frequency of occurrence and the area covered by the infarction cardiosclerosis.
AV block occur as a result of involvement in cardio myocytes, which are involved in carrying the momentum from the atrioventricular node.If I - II degree does not give any clinical manifestations, the full blockade of the weakness, rare palpitations, dizziness, headaches, loss of consciousness.These symptoms show a decrease in blood supply to the brain.
Sick Sinus Syndrome is also a manifestation of cardiosclerosis.Sclerotic changes lead to a reduced function of the sinus node, leading to bradycardia and stops rhythmic activity.
Tahi-bradiaritmichesky variant occurs when the formation of rhythm begin to take part other structures.As a result, there may come a transition to a permanent form of atrial fibrillation.In the initial stages of the disease a person does not complain.Then there are the symptoms associated with a reduction in brain blood flow: weakness, dizziness, memory loss.Cardiac complaints include shortness of breath, angina.Circulatory failure limb patient presents with pain in the calves, heavy legs.For asystole episodes characteristic "lapse of memory" swallowing the endings of words, there are cases of loss of consciousness (Adams' disease).
Besides complaints of the patient, the diagnosis of cardio is exposed on the basis of electrocardiography, echocardiography, determination of patency of coronary vessels.All diagnostic methods indicate the presence of non-functional portion of the myocardium.Reduced ejection fraction of blood coronaries impassable.Depending on the type Cardiosclerosis may prevail certain symptoms.
atherosclerotic lesions disrupt blood flow in the coronary arteries due to deposits on the walls of blood vessels and the formation of atherosclerotic plaque formation of platelet aggregates, and then a blood clot in the plaque.In this region of the blood supply may be affected by one or many branches of the coronary arteries.With long flowing ischemia occurring organic changes in the heart muscle tissue replacement at its junction.When this disease can develop as a small-focal cardiosclerosis and diffuse cardiosclerosis.It depends on involved in coronary atherosclerosis.
mechanism of atherosclerotic cardiosclerosis is ischemic in nature and has the symptoms of coronary heart disease.In the beginning stages of cardiosclerosis patient complains of pain stenokardicheskie character, which stoped nitrates, rhythm disturbances, weakness, swelling, decreased work capacity.Coronary angiography shows that the arteries supplying the heart and enlighten them deformed closed atherosclerotic overlays.In the study of the composition of blood, showed increased cholesterol, which is directly linked to the progression of atherosclerosis.
forecast for this type of cardiosclerosis determined by the scale of destruction.Melkoochagovogo cardio can lifelong not express themselves, diffuse option is very dangerous complications.
Postinfarction cardio - is one of the manifestations of coronary heart disease.As the name it is clear that this type of cardiosclerosis arose on the site of the damaged myocardial tissue as a result of a heart attack.In place of a heart attack produced inflammation, which is soon replaced by connective scar.
infarct can be different sizes.Melkoochagovogo cardio formed by small focal infarction.Diffuse cardiosclerosis characterized with massive myocardial damage.
To diagnose myocardial infarction needs with prior myocardial history, symptoms of heart failure and arrhythmias.
prognosis for this version cardiosclerosis unfavorable, as often compounded reinfarction.
term "diffuse" in this case means "evenly distributed".
Diffuse cardiosclerosis - a concept that characterizes the pathology in terms of the vastness of the affected myocardium.That is the heart muscle is affected uniformly and completely.There is a cardio often against a background of coronary heart disease when affected a large area of infarction and myocarditis.
Symptoms of diffuse cardiosclerosis current version are more severe and progress faster.Therefore it requires immediate therapy cardiosclerosis not to have any life-threatening complications.
Myocarditis - polietiologic disease.Myocardial inflammation may be a result of infections, systemic inflammatory diseases, allergic reactions, toxic effects from exposure to drugs and so on. A great number of pathogens cause inflammation of the myocardium.Bacteria, viruses, protozoa, helminths, Rickettsia, spirochetes, fungi cause myocardial damage.
Cardiosclerosis quickly develops in myocarditis caused indirectly.Medicinal substances cause myocarditis, which is based on an allergic reaction.In the treatment of cytostatics, anti-drugs, antibiotics, anticonvulsants, nonsteroidal anti-inflammatory, diuretic an immune response with the involvement of the myocardium.
For cardio also keeps uremic myocarditis that occurs as a result of toxic effects on the body, systemic lupus erythematosus, dermatomyositis cause idiopathic myocarditis.This results in damage to the endothelium of microvessels that supply blood to the myocardium.As a result of blood flow out blood cells and impregnate the heart tissue.Full-blooded vessels can not fully supply the myocardium with oxygen, and eventually are replaced by connective muscle tissue.This process leads to cardio.Inflammation in this case should be of a chronic nature.
appearance of cardiac complaints in infectious myocarditis is preceded by symptoms of intoxication.Most often affects people between the ages of 35-45 years.After 1-2 weeks, after infectious diseases there are pains in the heart in 85% of patients, feeling disruptions, shortness of breath during physical exercise, weakness, sweating.The intensity of pain symptoms increase, is not stopped by nitrates.
Dyspnea in myocarditis manifested at the stage of starting cardiosclerosis.Often patients with myocarditis complain of fever.Myocarditis allergic nature can appear rashes on the skin.When cardio is already developed, there are arrhythmias.Thromboembolic complications are possible with both in acute and chronic myocarditis, which went into cardio.Adrift myocarditis divided into acute, subacute, chronic, recurrent, latent.It contributes to chronic cardiosclerosis.The duration of the disease for more than 6 months indicates chronic form of the flow.
cardiosclerosis Treatment is aimed at addressing the underlying syndromes.Since cardio is a myocardial changes in the fabric of a different kind of regression is not out of the question.In the case of cardiosclerosis Treatment is aimed at slowing down the process of reorganization and improvement of the heart.
to slow down the process of the therapy of the underlying disease.If the infection is caused by cardio, then apply antibiotic, antiviral, antifungal, anthelmintic, antiprotozoal drugs.
therapy is the most dangerous consequences of cardiosclerosis - heart failure, reduced to reduce the load on the heart.Patients with heart failure should observe cardiosclerosis protective regime, physical activity is calculated individually in accordance with the functional class of the disease.The food in this condition should be rich in protein, easy to digest, should contain a small amount of salt.The use of liquid is reduced to 1.5 liters per day.
For patients first functional class exercise boils down to daily work, but without undue stress.Functional class II implies the elimination of physical training and hard work.For the III and IV functional classes sharply limit physical activity until polupostelnogo regime.
Drug therapy involves the following groups of drugs: cardiac glycosides, beta-blockers, angiotensin-converting enzyme inhibitors, diuretics, angiotensin II receptor antagonists and of the first type, inotropic agents neglikozidnye nature, peripheral vasodilators.
Diuretics are the main means in the unloading of the heart muscle.In the early stages of heart failure at cardiosclerosis Hypothiazid applied at a dose of 25-50 mg per g., With subsequent increase of the dose to 75-100 mg on. You can assign netiazidovye diuretics - Gigroton - 50-200 mg d. In order to maintain a normal levelPotassium can be shared with these agents or taking Spironolactone Triamterene.
If heart failure in more severe stages, use Furosemide - 20-40 mg d. May increase the dose to 400 mg d. Ethacrynic acid - 25-50 mg d., With the possibility of increasing the dose to 250 mgd. Bumetamid - 0.5-1.0 mg h., followed by a maximum dosage of 10 mg d.
By reducing the body's response to diuretics should combine two or more drugs.If the potassium content increased to 5.4 mmol / l during treatment with potassium-sparing diuretics, then the dose should be reduced.