Atherosclerosis of the coronary arteries of the myocardium. Coronary atherosclerosis - its causes, symptoms, diagnosis and treatment. Hypertension - high blood pressure

Among all heart diseases, coronary atherosclerosis ranks special place. This pathology is accompanied by severe symptoms, which, unfortunately, are often ignored until a heart attack occurs in the form of a heart attack. This disease is considered incurable, but with timely detection and complex therapy, doctors can alleviate the patient's condition and maintain his ability to work until old age.

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What is pathology

In medicine, atherosclerosis coronary arteries called vascular disease, which is accompanied by the formation of dense lipid deposits on the intima of the vessels. The pathology develops gradually and in most cases is found on late stages. The problem is based on a change in lipid metabolism, in which a large amount of lipoproteins accumulate in the blood high density. Over time, these substances settle on the inner wall of the vessel - the intima, due to which its lumen narrows.

As a rule, atherosclerosis begins in the aorta coronary vessels, that is, in the largest sections of the bloodstream. Lipid deposits are located closer to the branches. The pathological process impedes blood flow, as a result of which the heart experiences a lack of oxygen and nutrients. Since the work of the organ is continuous and quite intense, this causes noticeable clinical symptoms.

Atherosclerosis of the aorta of the coronary arteries develops with young age. However, due to the fact that the growth of lipid deposits is slow, the manifestation (the first exacerbation) of the disease occurs closer to the retirement age - at 50-55 years. That is why the disease is often considered a natural companion of old age. However, in medical statistics last years there was a trend towards an increase in cardiac ischemia and mortality due to detached blood clots in young people.

Development of the disease

At careful attention to their own health, a person can detect the first symptoms of atherosclerosis of the coronary arteries long before the onset of old age. This, according to experts, is the norm, especially if you take into account the lifestyle modern people. It predisposes to more early appearance massive cholesterol plaques in the vessels that feed the heart muscle.

In its development, the disease goes through several stages, each of which can last for decades:

Initial to clinical stage accompanied by a slight deposition of cholesterol in the form of fatty spots on the walls of blood vessels. This usually occurs where the intima of the artery is damaged. Over time, the lipoprotein spot is converted into longitudinal or transverse strips, the thickness of which does not exceed a few microns. Clinical signs atherosclerosis of the coronary vessels at this stage are absent.
The second clinical stage of atherosclerosis of the heart vessels is accompanied by the growth of lipid deposits. Due to the increase in their thickness, a decrease in the blood supply to the heart is noticeable, especially if the patient is in a state of activity. At this stage, fibrin fibers, red blood cells a large thrombus may form. Experts call this process multifocal atherosclerosis of the coronary arteries, which is often complicated by the separation of a blood clot and death. Symptoms at this stage are already quite pronounced: palpitations and shortness of breath appear during physical exertion, arrhythmia is observed.
The third final stage of atherosclerosis of the coronary and coronary vessels is accompanied by plaque compaction due to the addition of calcium to it. The lumen of the arteries at the same time significantly narrows, the walls of the arteries are deformed, become less elastic and dense. Accompanied by state sharp pains under the sternum during loads of any intensity, arrhythmia, periodic heart attacks, general weakness.

Although modern medicine has extensive opportunities to eliminate atherosclerosis, treatment is more effective when the disease is detected in the initial stages.

Diagnostics

Detection of coronary atherosclerosis in most cases occurs during routine heart examinations. The physician may suspect a pathology ECG results: signs of ischemia will be clearly visible on it. Used to confirm the diagnosis complex methods diagnosis of coronary atherosclerosis. They usually include:

stress scintigraphy, which allows you to determine the location of lipid deposits, their size and the degree of protrusion into the lumen of the vessel;
in combination with intravascular ultrasound of the coronary arteries, which are necessary to identify sections of the arteries with impaired blood flow and contractile functions;
radiography of the heart vessels with contrast (coronary angiography), which is designed to determine the localization and extent of atherosclerotic foci;
stress echocardiography to detect abnormalities contractility heart and blood flow changes that occur intermittently, such as during emotional or physical exertion.

In addition, a number of laboratory tests are carried out that allow you to establish the concentration of high-density lipoproteins in the blood.

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The disease rarely affects one part of the circulatory system. When diagnosing coronary atherosclerosis, it may be necessary to study other groups of vessels (, and so on).

Video: coronary angiography of the heart - accesses, technique and stages

Treatment Methods

The approach to the treatment of the disease depends entirely on the stage of atherosclerotic changes and the symptoms present. At the initial stage of atherosclerosis of the coronary arteries, treatment involves conservative treatment. To prevent further development of the disease, it is enough to change your lifestyle:

give up smoking and alcohol;
normalize nutrition, first of all, exclude animal fats and sweets from the menu, replacing them fresh vegetables and fruits, white dietary meat and fish;
regularly engage in feasible sports - swimming, yoga, gymnastics or race walking(the optimal sport and the degree of stress will be determined by the attending physician).

In addition to strengthening blood vessels and normalizing the level of harmful lipoproteins in the blood, these measures will help normalize weight.

Shown in atherosclerosis of the coronary arteries of the heart and medicines. Patients with this diagnosis are prescribed complex therapy to reduce harmful lipids in the blood. use statins: Atorvastatin, Rosuvastatin, Pitavastatin and their analogues. The drugs of this group actively inhibit the enzymes responsible for the synthesis of harmful fatty compounds in hepatocytes. In addition, they contribute to the restoration of the inner lining of blood vessels. Due to this property, they are indispensable in the initial stages of atherosclerosis.

Statins are not prescribed to patients with severe liver dysfunction: with hepatosis, hepatitis, liver failure, cirrhosis.

In addition, patients with coronary atherosclerosis are prescribed drugs that reduce myocardial oxygen demand, reduce the severity of ischemic changes and reduce. For this purpose, drugs of several groups are used:

preparations containing beta-blockers - Bisoprolol, Nebilet, Betalok, Anaprilin;
drugs that block ACE - Enalapril, Lisinopril, Perindopril;
inhibitors calcium channels- Amlodipine, Amlotop, Diltiazem, Cardilopin;
means for thinning the blood and preventing thrombosis - Clopidogrel, Aspicor, Aspirin Cardio.

The dosage and combination of drugs is selected by the doctor individually, taking into account the current condition of the patient, test results and existing concomitant diseases.

If the patient has signs of stenosing atherosclerosis of the coronary arteries, they resort to surgical intervention. During the operation, various methods are used:

coronary artery bypass grafting to create an artificial channel bypassing the affected areas of the artery;
balloon angioplasty for forced expansion of the lumen of the artery;
stenting an artery to expand its lumen.

Such methods can radically solve the problem in advanced cases, but they do not cancel the life-long intake of the previously listed drugs.

The prognosis of coronary atherosclerosis depends entirely on timely detection disease and the patient's compliance with all the prescriptions of the cardiologist. With adequate and competent therapy, the prognosis is favorable, while running cases heart atherosclerosis often ends in severe complications and death.

Video: balloon angioplasty and coronary artery stenting

HEART DISEASE – Heart-Disease.ru – 2007

Coronary atherosclerosis is a lesion of the coronary arteries that feed the heart, in which their lumen narrows, and the blood supply to the heart decreases.

Atherosclerosis is a complex, multi-stage pathological process, affecting the inner shell (intima) of the arteries of large and medium caliber. Intima contains a thin layer connective tissue and delimited from the muscular membrane of the artery (media) by an internal elastic membrane, and from the lumen of the vessel by a monolayer of endothelial cells forming a continuous smooth non-adhesive surface. The endothelium plays the role of a semi-impermeable membrane, which, on the one hand, is a barrier between the blood and the vascular wall, and on the other hand, provides the necessary exchange of molecules between them. On the surface of the endothelium are specialized receptors for various macromolecules, in particular, for low density lipoproteins. The endothelium secretes a number of vasoactive substances (endothelin, prostacyclin, nitric oxide), as well as factors of the coagulation and anticoagulation systems, due to which it plays a key role in the regulation of vascular tone, blood flow and hemocoagulation.

Currently, atherosclerosis is considered as a reaction to damage. vascular wall(primarily the endothelium). Damage does not mean mechanical injury endothelium, and its dysfunction, which is manifested by an increase in permeability. Hypercholesterolemia is the most important damaging factor.

In general, atherosclerosis is a process that is characterized by patterns inherent in any inflammation: exposure to a damaging factor (low-density lipoproteins that have passed through the endothelium of the vessel, where they have undergone oxidation), cell infiltration, phagocytosis and the formation of connective tissue.

Infiltration occurs by monocytes circulating in the blood, which are converted into macrophages, directed to capture oxidized low-density lipoproteins with their subsequent destruction. So on the walls of the vessel lipid strips are formed - foamy cells formed from macrophages with accumulated cholesterol esters.

Subsequently, connective tissue develops around the lipid accumulation zone and a fibrous atherosclerotic plaque is formed.

Atherosclerosis of the coronary arteries does not always manifest itself immediately. Often the disease for many years asymptomatically damages the heart and blood vessels and, if not treated timely diagnostics and treatment leads to angina pectoris, myocardial infarction, disorders heart rate and heart failure.

In most cases, if symptoms are present coronary disease heart, the diagnosis of the disease is not difficult. For this, methods such as ECG, daily ECG monitoring, echocardiography, radionuclide studies, exercise tests (bicycle ergometry and treadmill test) are used.

However, with the diagnosis of the disease on early stages before the onset of symptoms, the situation is different.

Early detection of atherosclerosis of the coronary arteries became possible after the advent of techniques computed tomography with very short time obtaining sections on the devices of electron beam tomography and multislice computed tomography. A feature of these methods is the possibility of obtaining images of coronary artery calcifications. The study takes only 5-10 minutes in total, and the time of direct data collection is 30-40 s (one breath hold). Such studies are not burdensome for the patient, do not require special training and performing physical activity. The results of the study do not depend on the gender of the patient and his physical fitness.

Causes of atherosclerosis of the coronary arteries, and methods of its treatment

Many people know that with atherosclerosis, cholesterol plaques settle on the walls of blood vessels, which gradually reduce the lumen of this vessel. Atherosclerosis of the coronary arteries is the same process, but it already occurs specifically in the coronary arteries, due to which no enough blood. What are the reasons for this condition?

Causes of blockage of blood vessels

Atherosclerosis of the heart vessels can develop due to internal and external causes. If you thoroughly count all the reasons, there may be about 200 of them. The most common among them are as follows:

hypertension;
high cholesterol (cholesterol is the main component of plaques that settle on the arterial walls);
smoking (in tobacco smoke contains substances that damage the walls of blood vessels and accelerate the development of atherosclerosis);
passive lifestyle;
excess weight.

The main cause of the disease is high level cholesterol

These are just some examples. There is a family-hereditary nature of the causes, when the content of various classes of lipids decreases in the plasma. The hereditary nature also includes negative eating habits, which include eating animal fats and foods that are high in cholesterol.

If a person understands that some of these prerequisites are present in his life, he needs to be more careful and more attentive to his health. In addition, it is important to detect the onset of the disease in a timely manner.

Symptoms of the disease

Atherosclerosis of the coronary arteries is characterized by symptoms that do not always prompt a person to immediately consult a doctor. These signs may masquerade as other diseases. It is very important to identify them as early as possible and seek help. Symptoms may be as follows:

Chest pain is a reason to see a doctor

chest pain, pressing or burning, may radiate to the back or left shoulder;

shortness of breath, especially manifested at the beginning of pain, sometimes due to lack of air, a person cannot lie down, as this feeling is aggravated in this position to such an extent that a person cannot breathe at all;

dizziness;

nausea;

vomit.

As can be seen, atherosclerosis manifests itself in signs characteristic of coronary artery disease, angina pectoris, myocardial infarction and cardiosclerosis. Accordingly, you need to imagine how these diseases manifest themselves. For example, in myocardial infarction, there are strong chest pain, which resemble angina pectoris, but do not go away after nitroglycerin. Loss of consciousness and manifestations of heart failure are also possible. With cardiosclerosis, edema and shortness of breath appear.

About fifty percent of patients before they have heart attack experience some of the listed symptoms, but do not pay attention to them. We must not forget that atherosclerosis of the coronary arteries can for a long time do not manifest themselves in any way, so you need to be regularly examined, especially for those people who are at risk.

Diagnostic methods

Since very often atherosclerosis of the heart vessels is accompanied by symptoms of coronary artery disease, diagnosis is not difficult. Several methods are used to make an accurate diagnosis.

Device for 24-hour ECG monitoring

ECG, daily ECG monitoring;

echocardiography;

bicycle ergometry, treadmill test;

radionuclide research;

CT scan;

multislice CT;

electron beam tomography.

Without a doubt, a detailed account of the patient about his condition is very important. It is important to list all symptoms, even those that seem minor. This will help to identify diseases associated with atherosclerosis and put accurate diagnosis on which the whole direction of treatment will depend.

Treatment

In many ways, treatment depends on the stage of atherosclerosis. If the disease was detected on time, then at the beginning of its development it may be enough to use drugs that lower cholesterol levels. It is also very important to make lifestyle changes, which include reducing stressful situations, moderate exercise and diet.

If during the examination it becomes clear that these methods are not enough, a decision can be made to expand the area of the vessel narrowed due to pathology, otherwise it is called stent implantation. Bypass surgery may also be needed, which involves creating an additional pathway that bypasses the affected area of the heart. Coronary artery bypass grafting is performed if a significant narrowing is detected main artery that leads to the heart.

You need to understand the following: if shunting is scheduled, it means that there is no other way out. In this case, the lumen of the artery can be narrowed by 75 percent. In some medical institutions shunting may be offered if the patient has already had a heart attack. This operation is performed under general anesthesia.

In any case, you can't do self-treatment. Only a doctor can prescribe the necessary drug therapy or surgical intervention. However, these methods will bring little benefit if you do not follow a diet and do not lead in moderation. active image life.

Proper nutrition first step towards good health

Atherosclerosis of the coronary vessels loves unhealthy food, so you do not need to feed it with such. It is better to eat more fruits and vegetables, as they contain a lot of potassium, fiber, folic acid and vitamins. They also do not contain cholesterol and a large number kilocalories and fat, which contribute to the development of atherosclerosis. It is advised to consume dairy products, as they contain useful elements. However, this advice should not be extended to butter and sour cream.

If you consult a doctor, you can use the methods traditional medicine. For example, garlic can be very useful, as it delays the formation of cholesterol plaques. But you need to be careful, as some garlic can cause strong heartbeat. Such people are advised to purchase preparations based on garlic in a pharmacy.

Some of these treatments are included in the prevention of atherosclerosis. Generally speaking, it is important to lead a healthy lifestyle for prevention.

Preventive measures

Atherosclerosis of the coronary vessels especially loves those people who do not take care of themselves. How to avoid it?

An active lifestyle is your longevity

Our heart loves and appreciates being handled with care, which includes caring for the vessels that help it work. It is better to make every effort now to keep yourself in shape than to run to the doctors in search of the right treatment later.

coronary atherosclerosis

IHD - ischemic heart disease - TREATMENT ABROAD - Heart-attack.ru - 2008

Atherosclerosis is a gradual process in which cholesterol plaques (clumps) settle on the walls of the arteries. Cholesterol plaques cause hardening of the walls of the arteries and narrowing of the internal canal of the artery (lumen). Arteries narrowed by atherosclerosis cannot deliver enough blood to maintain normal functioning parts of the body they supply. For example, atherosclerosis of the arteries causes a decrease in blood flow to the legs.

Decreased blood flow in the legs can consequently cause pain in the legs when walking or exercising, trophic ulcer, longer healing of wounds on the legs. Atherosclerosis of the arteries that supply blood to the brain can lead to vascular dementia (mental degradation due to the gradual death of brain tissue over many years) or stroke ( sudden death brain tissue).

For many people, atherosclerosis can remain latent (without symptoms or health problems) for many years or even decades. Atherosclerosis can develop from adolescence, but all symptoms and health problems usually appear already in the period of maturity, when the arteries are already significantly narrowed.

Smoking cigarettes, high blood pressure, elevated level cholesterol and diabetes can accelerate the development of atherosclerosis and lead to earlier onset of symptoms and complications, especially in people with a family history of atherosclerosis at an early age.

Coronary atherosclerosis (or coronary arterial disease) denotes atherosclerosis, which causes thickening and narrowing of the coronary arteries. Diseases resulting from reduced blood flow to the heart muscle due to coronary atherosclerosis are called coronary heart disease (CHD).

coronary heart disease include:

heart attacks,
sudden death
chest pain (angina),
abnormal heart rhythms
heart failure due to weakening of the heart muscle.

The heart is the most important body in the human body. Rhythmic heartbeats help carry oxygenated blood throughout the body. it natural process. And through which vessels the myocardium itself (this is the name of the middle layer of the heart muscle, which makes up most its masses) gets required amount oxygen to function properly? Through the coronary (also called coronary vessels).

Important! The coronary arteries are the only source blood flow 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 - pathology chronic nature, which is characterized by the formation of cholesterol plaques, significantly blocking the lumen of the arteries and preventing normal blood flow. Statistics say that it is this disease that occupies one of the first places among diseases. of cardio-vascular 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. useful information never a lot.

Reasons for the development of atherosclerosis

main reason 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 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.
crash hormonal background.
speed dial body weight, i.e. 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 called the largest blood vessel located above It is from it that the two main arteries depart (right and left) coronary blood supply.

The mechanism of development of vascular atherosclerosis

Starting point 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 body fat(plaques). 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 illnesses chronic (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 coronary aortic atherosclerosis? cerebral vessels and arteries? There is a certain group of people who have every chance to similar pathology developed in their bodies. This category includes those who:

Leads sedentary image life, that is, constantly either sitting or lying. 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 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 body.

From ischemic symptoms 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 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 form 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 in smooth muscle proteins and lipids. During this period, deformation of the intercellular membranes, the formation of blood clots (soft in structure), the loss of elasticity by the muscles, and the production of collagen in the body occur. At this stage, it is possible to return to a normal state if you adhere to proper nutrition and healthy lifestyle life.
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 rapid increase body weight.
phase of liposclerosis. Quite full-fledged fibrous plaques are formed.

phase of atheromatosis. At this stage, the destruction of atherosclerotic plaques, blood vessels, muscle tissue and connecting. As a result, disruptions occur in the work of the central nervous system. Brain hemorrhages are possible.
phase of calcification. On the plaques it is observed hard plaque, 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 symptoms. pronounced manifestations. The clinic begins to be observed only when atherosclerotic plaques already prevent cerebral circulation causing ischemia and vascular lesion brain (that is, discirculatory encephalopathy). The result is either temporary dysfunction or severe tissue damage.

There are three coronary aortas cerebral vessels:

First. it initial stage which is characterized by symptoms such as general weakness, fast fatiguability, 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 depression, there is a tremor of the fingers or head; problems with memory, hearing and vision; headache, constant noise in the ears, 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(i.e., apathy), memory lapses, and loss of self-care 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 (i.e. plastic abdominal operation), which allows you to put 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 (i.e. connection internal system carotid artery with its outer component).
Removal of the affected area of the artery (that is, clogged with atherosclerotic plaque) and repair it by installing artificial prosthesis(that is, prosthetics of the brachiocephalic trunk).
As a result of surgical measures, resection occurs inner surface carotid artery.

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 who clinical tests allow for an accurate diagnosis. In addition to collecting anamnesis and visual inspection, 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 reveals the hidden form 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, makes it possible to evaluate anatomical structure and the functioning of the heart muscle at the time of physical exertion, as well as the pericardial space.
CT scan.

Only after the complex diagnostics atherosclerosis of the coronary vessels, the specialist prescribes adequate treatment.

Important! Do not self-medicate: best case 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 medications and determine their dosage.

Lifestyle changes. Balanced diet, moderate physical activity under the control of a cardiologist, abstraction from stressful situations, as well as the rejection of such bad habits how smoking and drinking "strong" drinks will help to 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 a patient, then it is better to purchase in pharmacy network garlic-based products.

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 deal with the treatment of atherosclerosis of the coronary vessels, it is necessary to carry out a number of preventive measures:

Regularly engage the body in moderate physical activity (for example, walk, swim, do morning exercises or simply dig up beds in your backyard). 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.
In the presence of excess weight be sure to fight him.
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 regularly fresh air.
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 surgical intervention inevitable, then do not delay with him.

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!

Many people know that with atherosclerosis, cholesterol plaques settle on the walls of blood vessels, gradually reducing their lumen. Atherosclerosis of the coronary arteries is the same process, but it already occurs specifically in the coronary arteries, due to which an insufficient amount of blood enters the heart muscle.

Causes of blockage of blood vessels

Atherosclerosis of the heart vessels can develop due to internal and external causes, there are more than 200 of them, and the most common are:

high cholesterol (the main component of plaques deposited on the arterial walls);
smoking (tobacco smoke contains substances that damage the walls of blood vessels and accelerate the development of atherosclerosis);
hypodynamia;
excess weight.

Cholesterol plaque on the wall of an artery

There is a family-hereditary nature of the causes, when the number of different classes of lipids decreases in plasma. This includes negative eating habits: eating animal fats and foods high in cholesterol.

If a person understands that some of these prerequisites are present in his life, he needs to be more careful and attentive to health. It is important to detect the onset of the disease early.

Symptoms of the disease

Pathology is characterized by symptoms that do not always prompt an immediate visit to the doctor. These signs may masquerade as other diseases. The symptoms are as follows:

chest pain, pressing or burning, may radiate to the back or left shoulder;
, especially manifested at the beginning of pain, sometimes due to lack of air, a person cannot lie down, the feeling is aggravated and there are difficulties with breathing;
dizziness;
nausea;
vomit.

As can be seen, atherosclerosis manifests itself in signs characteristic of coronary artery disease, angina pectoris, myocardial infarction and cardiosclerosis. Accordingly, you need to imagine what symptoms are typical for these diseases. With myocardial infarction, there are severe chest pains that resemble angina pectoris, but do not go away after nitroglycerin. Loss of consciousness and the occurrence of manifestations of heart failure are possible. With cardiosclerosis, edema and shortness of breath appear.

About fifty percent of patients experience some of these symptoms before that heart attack, but do not pay attention to them. We must not forget that atherosclerosis may not manifest itself for a long time, so you need to be regularly examined, especially for those people who are at risk.

Diagnostic methods

Since very often atherosclerosis of the heart vessels is accompanied by symptoms of coronary artery disease, diagnosis is not difficult. Several methods are used to make an accurate diagnosis.

ECG, daily ECG monitoring;
echocardiography;
bicycle ergometry, treadmill test;
radionuclide research;
CT scan;
multislice CT;
electron beam tomography.

Device for daily monitoring ECG

Without a doubt, a detailed account of the patient about his condition is very important. It is important to list all symptoms, even minor ones. This will help to identify diseases associated with atherosclerosis, and make an accurate diagnosis that determines the entire direction of treatment.

Treatment

In many ways, treatment depends on the stage of atherosclerosis. If the disease was detected on time, then at the beginning of its development it is enough to use drugs that lower cholesterol levels. It is also very important to change your lifestyle, which includes reducing stress, moderate exercise and diet.

If during the examination it becomes clear that these methods are not enough, a decision can be made to expand the section of the vessel narrowed due to pathology, otherwise it is called. Also, sometimes they resort to shunting, which involves the creation of an additional path that bypasses the affected area of the heart. carried out if a significant narrowing of the main artery is detected.

You need to understand the following: if such a procedure is scheduled, it means that there is no other way out. In this case, the lumen of the artery can be narrowed by 75 percent. In some medical institutions, bypass surgery may be offered if the patient has already had a heart attack. This operation is performed under general anesthesia.

In any case, you can not engage in self-treatment. Only a doctor can prescribe the necessary drug therapy or surgery. However, these methods will be of little benefit if you do not follow a diet and do not lead a moderately active lifestyle.

Atherosclerosis loves junk food, so don't feed it junk food. It is better to eat fruits and vegetables, as they are rich in potassium, fiber, folic acid and vitamins. They also do not contain cholesterol, a large amount of kilocalories and fat, which contribute to the development of atherosclerosis. It is recommended to consume dairy products as they are rich in useful elements. But do not extend this advice to butter and sour cream.

You can use the methods of traditional medicine, if the permission of the doctor is obtained. Garlic is very useful, it delays the formation of cholesterol plaques. But one must be careful, it causes a strong heartbeat in some patients. It is advisable for such people to purchase preparations based on garlic in a pharmacy.

Preventive measures

Atherosclerosis affects people who do not take care of themselves. Measures to prevent the occurrence of pathology include these rules:

Quit smoking. Statistics show that smokers suffer from cardiovascular diseases several times more often than other people.
Move more. Sports such as swimming, skiing, running, walking and morning exercises are useful.
Get rid of excess weight.
Proper nutrition. You need to stop eating butter, fatty dairy products, eggs and animal fats.
The use of medicinal herbs.

The heart loves and appreciates careful handling, which includes taking care of the vessels that help it work. It is better to make every effort now than to run to the doctors in search of the right treatment later.

is a gradually developing chronic illness, which is characterized by the deposition of cholesterol on the walls of blood vessels. First symptoms this disease should alert any person, because advanced stage is inevitable death.

Essence of pathology

How does blockage occur? Not immediately: throughout years cholesterol, or lipoprotein with different densities, accumulates in the blood. These substances, being in the walls of the vessel, accumulate over time and burst them, gradually blocking the artery. Through a very narrowed lumen, the blood carries too little oxygen for normal operation organ fed by this artery. As a result, ischemia develops against the background of constant oxygen starvation.

Coronary atherosclerosis develops throughout a person's life: from youth to 50-55 years. During this period, the patient begins to feel the first signs of the disease, which all developed in his body.

The disease affects not only the coronary arteries, plaques occur absolutely everywhere, throughout circulatory system. However, the most dangerous of them are localized in the renal artery, in the mesenteric vessels, in the arteries of the legs. And most importantly, in the arteries that feed.

Most often, atherosclerosis affects the coronary arteries. This is due to the very structure of these vessels, which have a complex branching, in addition, they are very thin, with small gaps. Such a structure is easily affected by cholesterol plaques.

Atherosclerosis of the coronary arteries does not always have a bright severe symptoms. For example, if a cholesterol plaque blocked renal artery, a person can live and not notice pathology in his body. This is due to the fact that the required amount of oxygen for the kidney does not change in any situation. While for the heart, the amount of oxygen consumed is directly proportional to the load exerted on it. AT calm state the heart is able to pump about 5 liters of blood, while running or active games, this volume increases 5 times. In other words, the load on the myocardium is enormous, and therefore its need for oxygen increases significantly. Such a situation when atherosclerotic vessels clog and do not supply the myocardium with oxygen, and is called.

Symptoms of the disease

Atherosclerosis affecting the coronary arteries is the same as coronary heart disease. It is subdivided into various forms gravity. Chronic form disease is characterized by angina pectoris, arrhythmia, chronic heart failure. Acute is manifested by myocardial infarction, unstable angina and sudden stop hearts.

Atherosclerosis is still most often characterized by angina pectoris. Symptoms of this disease appear when the load increases, when insufficient oxygen enters the artery blocked by the cholesterol plaque, and the person begins to feel pain in the chest.

These symptoms are short-lived, because when you return to normal state body pain goes away. Besides, pain can be neutralized with nitroglycerin, which tends to dilate the coronary artery, which increases the supply of oxygen to the myocardium.

Pain symptoms are expressed depending on the severity of the load. This allows you to distribute the degree of the disease according to the so-called functional class. That is, in the first functional class, chest pain appears after significant physical exertion, for example, jogging for several kilometers. The second functional class is an insignificant load when Everyday life person, walking up the stairs to several floors, a short run. And the third functional class includes pain, which is constant under any load.

Causes of the onset and development of pathology

Atherosclerosis of the coronary arteries occurs for the same reasons as in principle. Cholesterol plaques in all vessels are formed along common reasons for this pathology:

Diagnosis of the disease

Atherosclerosis of the coronary arteries is diagnosed using modern hardware. The more accurately it is possible to establish the location of the cholesterol plaque, its size, the higher the probability favorable treatment. For this apply:

Treatment of the disease

Treatment of the disease is aimed at eliminating the causes of the appearance of cholesterol plaques, at removing existing formations and at the coronary heart disease itself.

For this, a person undergoes a rather complicated course of treatment:

The patient is prescribed a course of drugs that reduce myocardial oxygen demand.
At the same time, the patient takes drugs that prevent the formation of cholesterol plaques, as well as lower cholesterol levels in general.
A prerequisite for recovery is compliance proper diet, completely excluding fatty fried foods from the patient's diet, food containing an abundance of salt, hot peppers and smoked meats. The patient's diet should now contain vitamins, calcium and other beneficial minerals. Diet should help a person lose weight.
Therapeutic exercise or sport recommended by a cardiologist.
The patient must categorically refrain from smoking and drinking alcohol: not only for the duration of therapy, but also in the future.
Treatment of diseases disease-causing vessels: hypertension and diabetes mellitus.

Dieting

All procedures and medical measures are prescribed by a doctor. Compliance with them and the implementation of prescriptions are mandatory exactly to the extent indicated by the specialist. Otherwise, the treatment will not give results - pills alone in such a situation will not help the body.

Mortality from coronary heart disease is quite high - it is inherently the main cause of death in people over 50 years of age. Quality of life in this case completely depends on the will of the patient: on his desire to live a normal healthy life.