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 obstruction due to the formation of cholesteric layers. The result of the aforementioned changes in the coronary arteries is the inhibition of the trophism of the heart muscle and, as a consequence, the 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, a combination of modifiable and persistent provocation factors available to the patient is of great importance. Of course, a person can not eliminate the genetic predisposition to the development of atherosclerotic lesion, however, a 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 provoking a lethal outcome from an acute coronary attack.

Thus, with a combination of predisposing factors, there is an excessive accumulation of cholesterol depositions in the projection of the coronary arteries. The global community of cardiologists is of the opinion that atherosclerotic heart disease without hypercholesterolemia can not develop, since it is cholesterol that is the pathological substrate of atherosclerotic plaque.

Symptoms of atherosclerotic heart disease

When 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 a 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 is that the result of an attack is the development of irreversible pathomorphological changes in the structure of the heart muscle, which inevitably provokes the inhibition of its basic functions.

A classic heart attack is an episode of severe pain, 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, the pain has a predominantly burning character. In addition to severe pain syndrome, patients with atherosclerotic heart disease, note increasing respiratory disorders in the form of progressive dyspnea, increasing in 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 a method of treatment for a patient suffering from atherosclerotic heart disease depends primarily on the severity of occlusion of the coronary arteries and consists of 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 atherosclerosis of the coronary arteries implies lifelong reception of preparations of the group of salicylates( Cardiomagnesium in a daily dose of 75 mg), as well as prolonged intake of cholesterol reducing drugs under the control of laboratory parameters of liver function.

Currently, 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" to restore 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 have increasingly opted for 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 development of atherosclerotic heart disease, you should immediately seek advice from such physicians as a therapist and / or cardiologist.