ISCHEMIC HEART DISEASES. STENOCARDIA

Аннотация

Coronary artery disease is an acute or chronic damage to the heart muscle, which is caused by the reduction or cessation of blood supply to the myocardium as a result ofpathological currents in thecoronary artery system. KEYWORDS: Atherosclerosis, arterial hypertension, heart failure, angina, stenocardia, ischemia, nitroglycerin. Etiology: Atherosclerosis of coronary arteries (90%) Angiospasm of coronary arteries as a result ofnervous emotional tension, stress. Changes in theendothelium ofcoronary arteries. Violation of microcirculation. Increased activity of the blood coagulation system (hypercoagulation) Risk factors: hypercholesterolemia AG smoking low mobility fat pressure. RISKFACTORS ●It is divided into2 ●: Unchangeable factors-gender, age, generation ●. Modifiable factors are smoking, alcohol intake, obesity, inactivity, hypercholesterolemia, arterial hypertension, diabetes, etc. ●3factors are themain ones: Arterial hypertension, hypercholesterolemia, smoking. ●Among them isatherogenic dyslipoproteinemia, which leads to atherosclerosis. ●If low-density LP isreduced by1%, mortalityfrom YUIK isreduced by2%. Classification of 1984, which was developed based on the suggestions of WHO experts (1979): 1.Sudden coronary death. 2.Angina. -2.1. Exertion angina. -First onset of angina pectoris. -Stabletension angina(FS I-IV). -2.2.Spontaneous angina pectoris. 3. Myocardial infarction. - Transmural (with a large hearth) - Nontransmural (with a small focus) 4.Post-infarction cardiosclerosis. 5.Heartrhythm disorder. 6.Heartfailure. 98,7:ROTCAFTCAPMI.SECNEICS LACIDEM,5202, yraurbeF,5emuloV gro.srehsilbupcimedaca.www Yu.I.Kclassification (2000 4th Congress ofCardiologists ofUzbekistan with changes). 1. Sudden coronary death (in the UK, sudden coronary death can occur during intense physical exertion (running, skiing fast, intensively participating in other sports). This diagnosis is sometimes made at the time of exertion or 30 minutes after exertion. within 6 hours (usually 1hour) when available) 2.Angina. 2.1.stabletension angina(with FS). 2.2.unstableanginapectoris: -First onset angina pectoris. -progressive angina pectoris. -Angiospasticanginapectoris. -Angina in themorning after aheart attack. -Postoperativemorning angina pectoris. 3.Painlessmyocardial ischemia. 4.Myocardial infarction: -Q istoothless -Qtoothed. 5.Post-infarction cardiosclerosis. 6.Violationof heart rhythm and conduction. 7.Heartfailure STENOCARDIA ●Ishemicheart disease (CHD) is acommon type and ischaracterized byagenesis pains. ●Stablestress anginaFS I –anattack ofangina occurs during strong physical exertion. ● Stable tension angina FS II-an attack occurs when walking more than 500 meters with limited physical exertion, climbingabove 1floor. ●Stableangina pectoris FS III-pain attack occurs when walking 500meters. ●Stable tension angina FS IV-At rest, an attack of angina occurs when walking up to 100 meters, talking, withlimited physical activity. ●Spontaneous (Prinsmetal) angina pectoris. It is characterized by specific symptoms. Angina pains appear suddenly at the same time without tension, often in the evening. Pains ofhigh intensityandduration of10-15minutes ormore. ●First-onset angina pectoris. Entering the group of unstable angina, it passes to stable anginaafter 15-25 days inyoung people, and after 2monthsin theelderly. ●Atypical transientanginapectoris (myocardial ischemia) 1. The arrhythmic equivalent of angina pectoris (the ischemia zone is located in the conduction zone). Rhythm disorders occupy the main place intheclinic. 2.Asthmaticequivalent of angina pectoris (acute left ventricular failure). 3.Peripheral equivalent ofangina pectoris (absence ofchest pain). ●Painless myocardial ischemia. Clinical signs are not observed. It often ends with sudden coronary death or acute myocardial infarction. This form of ischemic heart disease is characterized by acute paroxysmal pain in the area of the heart lasting from a few seconds to 20 minutes. In this case, the blood flow along the coronary vessels, that is, the vessels that supply the myocardium with blood, is disturbed, which causes pain in the area of the heart 98,7:ROTCAFTCAPMI.SECNEICS LACIDEM,5202, yraurbeF,5emuloV gro.srehsilbupcimedaca.www orbehind thechest. ●Pain behind the sternum begins after stress and physical exertion, disappears when resting andtaking nitroglycerin. ●The EKG can show signs of ischemia in the myocardium or the appearance of these signs during physical exertion. ●The main method of diagnosis includes angiography, in which narrowing of the coronary arteries can beseen. Causes ofcoronary syndrome: •Atherosclerosisof coronary vessels; •Coronary vasospasm; •Coronary artery obstruction(emboli, button anomalies, arteritis, artery occlusion); •Strongly developed hypertrophy of the myocardium; As a result of myocardial metabolism disorders: hyperthyroidism, anemia, paroxysmal tachycardia. Angina inwhatcases thepainstarts: •Cold. •Food. •Excitement. •Emotionalstress.