Atherosclerosis of the heart vessels - what is it and how to deal with it. Atherosclerosis of the coronary vessels: causes, symptoms, diagnosis, methods of treatment, prevention Damage to the muscles of the heart due to atherosclerosis of the coronary vessels

Atherosclerosis confidently takes the lead among cardiovascular diseases leading to death. The main reasons for this dynamics: a passive lifestyle provokes its development, the disease is difficult to detect in the early stages and cure in the later stages. The main threat among different types of atherosclerosis is coronary atherosclerosis, which will be discussed below.

The coronary artery is the artery that delivers oxygenated blood to the "central" muscle of the heart, the myocardium. The latter is responsible for the rhythmic contractions of the heart, which form the basis of blood circulation and do not stop throughout a person's life.

Atherosclerosis is a chronic disease of the arteries, in which cholesterol plaques form in them, blocking the lumen of the artery and interfering with normal blood flow.

Atherosclerosis of the coronary arteries is a blockage inside the coronary arteries that leads to a lack of oxygen in the tissues of the heart.

Why narrows the lumen of the artery?

It's all about cholesterol. Its high concentration leads to the formation of plaques from it on the inner walls of the arteries. The walls become narrower, there is less oxygen in important organs, tissues undergo hypoxia and die.

High cholesterol levels can have several causes. The most obvious is malnutrition. The more fried potatoes enter the stomach, the more harmful (in excess) the substance enters the bloodstream. Less obvious is poor metabolism, including lipoproteins, which are responsible for removing cholesterol from the body. High density lipoproteins do their job, and similar low and very low density proteins can themselves be deposited in plaques along with cholesterol.

Plugs initially appear as deposits on the inner walls of blood vessels. Over time, the growths become larger due to the receipt of new portions of the "building material" and the appearance of connective tissue in the lesions. This is how coronary sclerosis develops. Subsequently, one of two things happens: either the vessel slowly but surely overgrows until it is completely blocked, or the clot breaks, releasing its contents and immediately blocking the artery.

In the case of a slow development of the disease in the coronary vessels, the patient begins to detect coronary heart disease (CHD) in a chronic form. This diagnosis means that the heart does not have enough oxygen, and it is accompanied by pain in the heart, shortness of breath, dizziness, fatigue. When a thrombus ruptures, IHD occurs in an acute form - myocardial infarction. In this case, the oxygen supply to the heart muscle stops abruptly, and the myocardium begins to undergo necrosis or, more simply, die. In this case, the issue of human life is resolved in the next few hours or even minutes.

Thus, the narrowing of the lumen of the artery is caused by the deposition of cholesterol on the walls of blood vessels, leads to their blockage and can be the cause of both serious chronic diseases and sudden death.

Who is predisposed to the disease?

• Elevated blood cholesterol levels. More cholesterol means more chances for a blood clot.
• Sedentary lifestyle. Stagnation of blood in the body helps cholesterol to settle on the walls of the arteries.
• Obesity. Excess weight puts a strain on the entire body, including the cardiovascular system.
• Hypertension. Increased pressure increases the chance of damage to the walls of blood vessels.
• Diabetes. Metabolic disorders can unpredictably affect the entire body.
• Wrong nutrition. Especially dangerous is a large amount of animal fats, cholesterol and salt.
• Smoking. It constricts and dilates blood vessels, increasing the load on them, and also spoils the internal structure of arteries and veins.

Those who have several of these factors in their lives should think about their future, since the chance of developing atherosclerosis for them is quite high.

Symptoms of atherosclerosis

All symptoms of insufficient blood circulation in the heart can be divided into two categories: general and ischemic. General ones are associated with a deterioration in blood flow throughout the body, ischemic ones are associated specifically with the heart.

General symptoms:

• Shortness of breath, poor exercise tolerance. The lungs have to supply more oxygen to the body to make up for the lack.
• Dizziness. With insufficient blood pressure, the brain cannot work normally.
• Coldness in hands and feet. The blood does not reach the distant areas of the body in sufficient volume, as a result of which the temperature drops.
• Nausea, vomiting, feeling unwell, clouding of consciousness. Everything that accompanies diseases of the cardiovascular system.

These symptoms are a sure sign that the disease has not yet gained full strength, but is already approaching.

Of the ischemic symptoms, it is worth highlighting the following:

• Attacks of angina pectoris. Sharp pain in the chest, usually in the back. It manifests itself during physical exertion and is due to the fact that the heart cannot get enough oxygen.
• Wrong heart rhythm. With a lack of blood, the heart can work “idle”.
• Hypertension. Blockages in the coronary arteries increase blood pressure.
• Ischemic heart disease in chronic or acute form. As noted above, lack of nutrition for the myocardium can result in a number of problems, including fatal ones.
• Cardiophobia. Simply put, it is the fear of death in the event of any heart problems. The danger is that any fear increases the flow of testosterone and pulse, and these changes can aggravate a heart attack or heart attack.

These symptoms indicate that there is a problem and needs to be addressed urgently. Therefore, if you find yourself with several of these cardiac symptoms or coronary artery disease, the main thing is not to panic and immediately consult a doctor.

Medical diagnosis of the disease

The diagnosis of almost any disease, including atherosclerosis, is based on asking the patient about his state of health (anamnesis) and various tests.

In addition to anamnesis and tests, ultrasound of the heart and echocardiography are used. An ultrasound picture of the heart allows you to assess the extent of the lesion: changes in the internal shape, wall thickness, the level of contractility of the chambers. Carrying out the procedure during physical activity allows you to see areas that receive less oxygen. Often, 24-hour ECG monitoring is used, in which the recording device is attached to the body and remains with the person for a long time.

Computed tomography (CT), multislice CT, electron beam tomography allow you to expand the picture, learn more about the patient's heart condition. The introduction of contrast agents during examinations show a detailed pattern of arteries, veins and vessels. Based on this information, the doctor can choose the type of treatment.

Intravascular ultrasound, radionuclide studies, treadmill test, scintigraphy and bicycle ergometry are prescribed if necessary to clarify the details of the diagnosis.

In general, the diagnosis of atherosclerosis of the coronary arteries is quite extensive in its methods and depends on the individual patient, his capabilities and the capabilities of the hospital in which he is located.

How to treat coronary arteries?

The first and most important rule in treatment is no self-treatment! At best, it will not have any effect, and the disease will develop further. At worst, the disease can be aggravated.

In mild to moderate cases, drug therapy and lifestyle changes may suffice. The drugs are aimed at two goals: the fight against further narrowing of the lumen of the vessel and the elimination of the consequences of coronary atherosclerosis. The first point is achieved by reducing the content of cholesterol in the blood, the second is realized by strengthening and protecting the heart muscle.

Lifestyle improvement plays an even more important role here than pills. An adequate diet, moderate exercise under the guidance of a cardiologist, the rejection of bad habits, the treatment of obesity and other diseases such as diabetes will put the patient on his feet as quickly as medical intervention. And in general, there is not a single disease that would be badly affected by a healthy lifestyle.

In severe cases, if there is no other way out, the doctor may prescribe surgery. A common option is the implantation of a stent, with which you can expand the damaged vessel and ensure normal blood flow. If this is not enough, coronary artery bypass grafting may be required. This method allows you to create a healthy blood bypass while ignoring the atherosclerotic vessel.

Regardless of which of the methods the doctor prescribes to the patient, you need to start treatment as soon as possible - take pills, run in the morning or sign up for surgery, because in atherosclerosis, lost time can cost further well-being or even life.

Prognosis for atherosclerosis

If treatment is started on time, the development of the disease can be stopped. It is almost impossible to completely restore damaged arteries, but with timely measures taken and competent medical intervention, sclerotic plaques will decrease, blood flow will increase and the patient's condition will improve.

But you need to come to terms with the fact that atherosclerosis of the coronary arteries of the heart is a disease that you have to live with. You can’t take pills for a week, run, eat vegetables and recover. Those who are faced with this disease need to change their lifestyle, adjusting it to new conditions, if they do not want to spend the remaining time in hospitals and intensive care units.

Disease prevention

If the reader feels well and does not plan to devote 10-20 years of his life to the fight against a serious chronic disease, he should now think about his health. Adding fuel to the fire is the fact that atherosclerosis of the coronary vessels of the heart does not manifest itself in any way at an early stage, and it can be detected only upon the onset of symptoms. That is, too late.

Prevention is simple: you need to give up bad habits, play sports or physical labor, eat well, treat diseases in a timely manner and visit a cardiologist every few years for an examination. Naturally, following this list is not so easy, but following it will improve the quality of life and greatly prolong it.

As a result, atherosclerosis of the coronary arteries is a dangerous chronic disease that manifests itself in the later stages and, if not handled carefully, can lead to death. It affects the central arteries of the heart and is reluctant to treat, although it is possible to stop it and even achieve positive dynamics. In order not to find yourself lying in intensive care after a heart attack, you need to see a doctor in time when symptoms appear, and even better - take care of your health and not get sick at all.

Atherosclerosis of the coronary arteries is a chronic disease characterized by the formation of plaques in the lumen of the arteries. They interfere with normal blood flow, narrowing and blocking its lumen.

If left untreated, the disease progresses and can be the cause of death of the patient. Atherosclerosis of the coronary arteries is dangerous for the development of coronary heart disease and myocardial infarction. According to the international classification of diseases of the 10th reading, atherosclerosis is assigned code 170.

Causes of the disease

Atherosclerosis of the coronary vessels develops due to a violation of lipid metabolism. It is this condition that provokes an increase in the level of cholesterol in the blood, which is why cholesterol plaques form on the walls of blood vessels. Gradually growing, they block the lumen, and this prevents the normal movement of blood.

This process is long and can develop over decades, while a person does not even suspect that irreversible pathological changes occur in the vessels. Experts identify many factors that predispose to the development of atherosclerosis, among them:

• abuse of high-fat foods;
• lack of physical activity;
• genetic predisposition;
• vascular weakness;
• high blood pressure;
• belonging to the male sex;
• age over 45;
• obesity;
• long-term smoking;
• diabetes.

In addition, hormonal changes contribute to an increase in blood cholesterol levels. Therefore, the period of menopause in women is a kind of period of risk for the development of atherosclerosis. Psychoemotional stresses also disrupt lipid metabolism. Under the influence of the above factors, the inner wall of the artery is first damaged.

Low-density lipoproteins, or, as they are otherwise called, "bad cholesterol" easily penetrate into the places where defects are formed. This is how a lipid stain is formed. As a result of various chemical reactions occurring in this area, an inflammatory process begins. All this favors the accumulation of cholesterol and connective tissue, the gradual formation of an atherosclerotic plaque.

A similar pathological process entails the following changes in the vascular wall:

• malnutrition of the artery;
• proliferation of connective tissue;
• deposition of calcium salts on the walls of blood vessels;
• decreased elasticity of blood vessels;
• deformation and compaction;
• narrowing of the lumen;
• violation of the blood supply to organs.

Atherosclerosis develops as a result of blockage of an artery by a cholesterol plaque.

The course of the disease and symptoms

At the beginning of its development, the disease has a slow course and can develop for many years, but actively progresses in the second half of life. Most often, the disease manifests itself between 40 and 55 years. This mechanism is triggered by a combination of negative factors and hereditary predisposition. Signs of the disease become noticeable with severe circulatory disorders.

This occurs when the lumen of the vessels is narrowed by more than half. In this case, we speak of stenosing atherosclerosis. Atherosclerosis of the aorta of the coronary arteries is asymptomatic for a long time. The aorta is the largest vessel of the human body, and for a long time it narrows without specific clinical manifestations. Pathology can be suspected by specific symptoms.

With the defeat of the thoracic aorta, the blood supply to the heart and cerebral vessels is disturbed. This is manifested in the development of angina pectoris. Pain in the region of the heart is given to the spine and upper chest, as well as to the arm. The pain is permanent and can last for several days in a row. In addition, blood pressure rises, general weakness and dizziness occur.

Violation of blood flow in the cerebral arteries can cause causeless fainting.

Coronary atherosclerosis is characterized by the following manifestations:

• sharp and burning retrosternal pain;
• irradiation of pain in the upper body and jaw;
• feeling of discomfort after minor physical activity;
• dyspnea;
• pain lasts no more than 15 minutes;
• painful symptoms are eliminated after taking nitroglycerin.

Depending on the depth of changes occurring in the myocardium and blood vessels, there are 3 stages of the disease: ischemia, thrombonecrotic changes, fibrosis. At the stage of ischemia, the heart experiences a shortage of arterial blood, which leads to hypoxia and dystrophic changes. The main manifestation of this stage is chest pain.

The gradual increase in plaque size increases the risk of rupture, and atherosclerosis enters the thrombonecrotic phase. It is characterized by damage to atherosclerotic deposits and subsequent thrombus formation with blockage of the lumen of the artery. This stage can be manifested by myocardial necrosis, or infarction.

This is the most dangerous form of coronary heart disease (CHD). Its main symptom is superintense sharp pain in the chest, accompanied by an increased fear of death. At the stage of fibrotic changes, chronic ischemia develops as a result of stenosing atherosclerosis.

Complications of atherosclerosis of the aorta and heart vessels are the following conditions:

• insufficiency of arterial circulation;
• sclerotic changes in the myocardium;
• cardiac ischemia;
• heart attack.

Acute pain in the region of the heart is an alarming sign indicating possible atherosclerosis

Diagnostic methods

Diagnosis of atherosclerosis of the coronary arteries is carried out in 2 stages. First, the patient is interviewed. It is important that he talks in detail about the symptoms that bother him. When listening to the heart, the doctor will detect muffled tones and systolic murmur in the upper part of the organ. Pathology will be indicated by tachycardia (rapid pulse). This is revealed by counting heartbeats in 1 minute.

At the second stage, laboratory and instrumental methods of examination are assigned. With the help of a blood test, an elevated cholesterol level is detected. For this, a lipid profile is performed. It also reflects the levels of lipoproteins and triglycerides. The change in liver and kidney tests is assessed through a biochemical blood test and is an important diagnostic indicator.

The diagnosis is confirmed by the results of the following instrumental methods of examination:

• Coronary angiography. X-ray of the heart with contrast allows you to identify the location of the affected vessel, its length and degree of narrowing.
• Doppler intravascular ultrasound. Structural changes in the vessels, such as wall thickness and impaired contractility, are identified. In addition, hemodynamics and the condition of the valves are assessed.
• Stress scintigraphy. The location of lipid plaques and the degree of their severity are determined.
• Stress-ECHO. Assesses changes in cardiac contractility in areas with impaired blood flow.

Treatment Methods

Therapeutic tactics for atherosclerosis of the coronary arteries is determined by the severity of the disease and its stage. Pathology requires a change in lifestyle, in particular, it is necessary:

• completely stop smoking and drinking alcohol;
• exclude animal fats, fried foods and sweets from the diet;
• increase the consumption of fresh vegetables and fruits, dairy products;
• follow the recommendations of the cardiologist on physical activity;
• take measures to reduce weight in the presence of extra pounds.

The disease is subject to conservative and surgical treatment. Drug therapy is used at the initial stage of atherosclerosis of the heart vessels and can slow down the course of pathological changes, as well as eliminate the symptoms of the disease. Symptomatic therapy includes taking painkillers and drugs that normalize blood pressure and blood circulation.

In the treatment, drugs from the statin group are necessarily used. Against the background of their reception, there is an effective decrease in the level of cholesterol in the blood. This action is due to the ability to suppress the production of cholesterol in the liver. These are drugs such as Mevacol, Lovastatin, Simvastatin.

With atherosclerosis of the coronary arteries, drugs are also prescribed that reduce the heart's need for oxygen. Their use allows minimizing the manifestations of ischemia. For this, the patient is prescribed beta-blockers, antiplatelet agents, calcium channel blockers, ACE inhibitors.

Fibrates are prescribed to prevent the formation of fats in the liver. But their intake must be carried out in short courses, since long-term use will negatively affect the state of the body. These drugs include Fenofibrate and Clofibrate. Thrombolytic drugs are prescribed to restore blood flow.

Treatment of atherosclerosis of the coronary arteries is aimed at restoring patency and eliminating pathological deposits on the walls of blood vessels.

Surgical methods of treatment are used in advanced cases of the disease. The following methods are practiced:

• Balloon angioplasty. A catheter with a balloon is inserted through the femoral artery into the affected vessel, which expands the narrowed area.
• Coronary artery bypass grafting. An alternative path for the passage of blood is created, bypassing the artery affected by the plaque.
• coronary stenting. A frame stent is installed on the walls of the narrowed artery, holding the walls in an expanded state.

Atherosclerosis of the coronary arteries is a slowly progressive but severe disease leading to the death of the patient. Therefore, it is important to monitor the level of cholesterol in the blood and, if a change in indicators is detected, adjust lifestyle and nutrition. These measures will help prevent complications in the presymptomatic period of the disease.

If the pathology was revealed at a later stage, then it is important to follow the doctor's recommendations regarding the use of medications. This determines the favorable prognosis for the patient's life. Atherosclerosis is dangerous for the development of coronary heart disease and myocardial infarction.

Among heart diseases there is coronary heart disease. The cause of its development is atherosclerosis of the heart vessels. The complication of the problem is that the development of the initial stages of the disease is practically not accompanied by symptoms.

If atherosclerosis can be detected in the early stages, then this will positively affect the treatment: you can get significant changes in the vessels and reduce the likelihood of complications.

Until recently, atherosclerosis was found only in people over 45 years of age. Now there is a tendency to "rejuvenate" the disease.

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What is pathology

Atherosclerosis of the coronary vessels of the heart (ICD code - 10) is a chronic disease accompanied by the formation and growth of fatty plaques. The latter arise due to the accumulation of cholesterol on the walls of blood vessels, as well as low-density lipoproteins. The more of these "helpers", the more plaques grow.

Over time, they begin to close the lumen in the arteries. This leads to the fact that the flow of blood in them decreases and, as a result, may stop altogether.

As a result, there are problems with the organs that receive oxygen and nutrients from this “blocked” flow. This leads to ischemia of the organs, their oxygen starvation and impaired performance.

Atherosclerosis does not occur overnight. This takes years. Initially, atherosclerosis begins to occur in adolescence.

At first, it develops slowly, but during the transition to the second half of life, the disease begins to progress and makes itself felt after 45 years.

Plaques of deposited cholesterol can “infect” arteries in absolutely any part of the body. Arteries of the lower extremities, renal, brain, mesenteric vessels, aorta can be affected. But the coronary vessels that supply blood to the heart suffer the most.

The seriousness of the problem is that the coronary vessels are tortuous, strongly branched and rather narrow. They are the first to be "attacked" by plaques and "overgrown".

But the development of atherosclerosis is not always accompanied by obvious symptoms. There are cases when a patient suffers from a disease for a long time, but at the same time does not feel any symptoms. This can be explained by the fact that the brain and kidneys are in dire need of oxygen.

But the heart is not, because the need for oxygen arises during the physical activity of the body. So at rest, 5 liters of blood flows through the heart, while during exercise - 30 liters / min. In proportion to the increase in the amount of blood, there is a need for oxygen.

In the case of the development of atherosclerosis, the vessels underlying the heart are “clogged” with plaques and do not allow the necessary volume of blood to pass into the heart. At the same time, plaques seal the walls of blood vessels and prevent them from expanding normally. All this leads to a failure of myocardial circulation.

The resulting myocardial ischemia due to developing atherosclerosis is called coronary heart disease (otherwise IHD).

The reasons

Atherosclerosis is a lesion of arterial vessels throughout the body. Therefore, atherosclerosis of the coronary and cerebral vessels has the same.

The disease occurs for the following reasons:

• the presence of diseases such as diabetes and obesity;
• bad habits such as smoking and excessive drinking;
• increased levels of cholesterol in the blood;
• immobility;
• arterial hypertension;
• malnutrition, accompanied by the use of a large amount of carbohydrates, animal fats, salt and ignoring or low consumption of fish, vegetables, vegetable oils and fruits.

Symptoms

Since coronary heart disease and atherosclerosis of the coronary vessels are one and the same, their symptoms are the same. There are two types of IBS:

With atherosclerosis and its clinic is closely related to angina pectoris. This disease is accompanied by pain in the chest, caused by a lack of blood flow to the myocardium due to vasoconstriction by plaques.

Such pain attacks last, as a rule, no more than 15 minutes, are observed during the period of physical activity and stop after its completion.

You can remove pain with nitroglycerin, which leads to the expansion of the coronary vessels, due to which the blood begins to flow to the heart in the right amount.

Depending on how severe atherosclerosis of the aortic coronary vessels, angina pectoris and myocardial ischemia can be equally severe.

In addition, the symptoms and their strength directly depend on what kind of physical stress the body undergoes.

Angina is divided into several functional classes:

Diagnostics

Initially, atherosclerosis of the coronary vessels can be suspected by ECG, where signs of myocardial ischemia are clearly manifested. You can also suspect the presence of plaques using the following research methods:

Myocardial stress scintigraphy	This method allows you to determine not only the location of atherosclerotic plaques, but also in which vessel the most dangerous ones are located.
Intravascular ultrasound	Doppler is also used.
Ultrasound of the heart and DEHO-KG	Using this method, it is possible to determine structural changes: wall thickness, chamber size, identify the presence of departments with no or reduced contractility, hemodynamics and valve morphology.
Coronary angiography	This is nothing more than an x-ray examination with preliminary contrast management. This allows you to identify where the affected vessels are located, what is the length of the affected area and what is the narrowing of the vessel.

Treatment of atherosclerosis of the coronary vessels

Treatment of the disease is assigned to each patient individually. As a rule, drug therapy is prescribed, and a variety of procedures that help eliminate excess cholesterol in the blood.

Drug treatment is prescribed to eliminate the metabolic syndrome, correct various disorders that accompany the disease, and normalize heat metabolism. As a rule, such medicines are prescribed:

1. Drugs that can increase energy metabolism.
2. Medicines that prevent the blood from absorbing cholesterol.
3. Medicines that prevent the production of triglycerides and cholesterol, as well as lower their levels in blood plasma.

Additionally, Anginin, Aevit, Vasoprostan, etc. can be prescribed.

Folk remedies

Alternative medicine is also used to treat atherosclerosis of the aorta. Only in this case it must be remembered that such treatment cannot be used in any way instead of the prescribed treatment by a doctor. But in parallel, it is possible, because herbs help eliminate symptoms, break down fat cells in the blood, and normalize metabolic processes.

To clean the vessels, you can use the following recipes:

Medicinal collection from pre-crushed licorice, wheatgrass and dandelion roots (10g, 20g and 10g respectively)	The dry mass is poured with half a liter of boiling water and put on a small fire for about half an hour. You can add sugar or honey if you like. The prepared and filtered broth is drunk 2-3 times a day, 1 tbsp. This recipe is good for multifocal atherosclerosis.
Power correction	It requires the use of foods with a large amount of vitamins, as well as those capable of breaking down fat cells and removing them from the body. For example, it can be raw sunflower seeds and in the amount of 1-2 tbsp. per day or 1/2 st. chokeberry.
(treatment with leeches)	This method is often prescribed in parallel with drug treatment. The fact is that the saliva of leeches contains an enzyme that prevents blood from clotting. And this, in turn, reduces the likelihood of thrombosis.

Regardless of which method of alternative treatment you have chosen, it should be carried out only with the permission and under the supervision of your doctor.

Diet

In order to prevent the development of atherosclerosis of the coronary vessels and reduce symptoms, it is necessary to follow a diet. For this, foods rich in cholesterol are excluded from the diet, namely:

• egg yolks;
• salo;
• fatty meats;
• kidneys;
• solid animal fats;
• brain.

Add to your diet foods that can cleanse the body of cholesterol, namely: oatmeal, cabbage, low-fat cottage cheese, potatoes.

Use vegetable oils instead of animal fats. Don't forget vegetables, whole grains, and fruits.

Prevention

If the patient has already been diagnosed with atherosclerosis even in the initial stage, then treatment should be immediately prescribed, followed by a long recovery of the whole organism and in order to avoid developing into a more serious stage.

Atherosclerosis is a chronic disease, so the patient is prescribed medications that must be drunk for life. To reduce atherosclerotic plaques, it is recommended:

1. Follow a special diet that reduces the intake of cholesterol in the body.
2. Engage in physical therapy.
3. Completely give up bad habits.

All this, combined with compliance with the doctor's instructions, will avoid the occurrence of unnecessary dangerous consequences.

Atherosclerosis of the coronary arteries is a systemic pathology that is chronic and occurs due to the formation of cholesterol plaques on the inside of the arterial membrane.

Atherosclerosis of the coronary vessels is a progressive pathology that leads to such diseases of the heart organ:

• IHD - ischemic heart disease;
• Unstable angina;
• Irregular heart rhythm - arrhythmia;
• coronary insufficiency;
• Acute coronary syndrome;
• Myocardial infarction.

The development of atherosclerotic plaques leads to a narrowing of the coronary lumen, which can lead to its complete blockage.

Often, atherosclerosis causes insufficiency in the vascular system, which ends in death.

What is coronary artery therosclerosis?

This chronic disease develops over decades, and the period of progression begins in middle and late age. The first symptoms of a disorder in the coronary arteries appear after the age of 45.

Women experience symptoms 10 years later than men. In women, pathology begins to progress during menopause.

Atherosclerotic plaques develop due to an increased index of cholesterol in the blood.

With increased total cholesterol, an increase in low molecular weight lipoproteins occurs, which leads to their deposition on the coronary endothelium in the form of a fatty spot, which is the beginning of the formation of an atherosclerotic plaque.

Cholesterol plaque gradually begins to grow, then calcium ions stick to it.

Together with calcium, the atherosclerotic plaque becomes hard and protrudes into the lumen of the artery, which leads to impaired blood flow in the main coronary vessel.

With impaired blood flow and narrowing of the coronary lumen, oxygen deficiency occurs in the myocardium, which leads to hypoxia and cardiac muscle, which provokes cardiac ischemia and heart attack.

With impaired blood flow and narrowing of the coronary lumen, oxygen deficiency occurs in the myocardium

Stages of progression

The pathology of atherosclerosis is divided into three main stages of disease progression:

• The first stage of disease progression is the initial stage of the formation of atherosclerotic plaques.. At the first stage, the blood flow is disturbed, slowing down the movement of blood in the highway, leading to the formation of microtraumas on the intima. In these places of microtrauma, free cholesterol molecules begin to settle in the form of a fatty spot. There is a growth of the spot along the endothelium, and fatty stripes are formed on the intima;
• At the next stage of the development of the pathology, the growth of cholesterol neoplasms occurs.. At the second stage of the progression of atherosclerosis on the coronary arteries, the formation of blood clots may occur, which can lead to blockage of the vascular lumen of a smaller diameter, with a particle of cholesterol deposits;
• The third stage of the progression of coronary atherosclerosis is characterized by the addition of calcium molecules to the cholesterol plaque, which leads the plaque to a solid state. Atherosclerotic plaque blocks the movement of blood in the highway. The diameter of the coronary artery is large enough, so the pathology is asymptomatic for a long time until the plaque closes the lumen by almost 70.0%. Then the pronounced symptoms of atherosclerotic lesions of the main arteries begin to appear.

Reasons for development

Atherosclerosis of the main coronary arteries of the cardiac organ occurs for internal and external reasons.

Cardiologists name more than two hundred factors that can cause the development of atherosclerotic accumulation on the cardiac coronary vessels.

The most common causes of atherosclerotic neoplasms on the walls of coronary vessels:

• An increased concentration of low molecular weight cholesterol in the blood plasma and a large amount of free cholesterol in the bloodstream. Low molecular density lipoproteins form the basis of an atherosclerotic plaque, so their high concentration leads to adherence of cholesterol molecules to the endothelium and provokes the development of atherosclerosis of the coronary arteries;
• Nicotine addiction is one of the causes of sclerosis. Nicotine synthesizes nitric oxide molecules in the body, which disrupt the blood flow system;
• Hypertonic disease- this is a pathology that precedes the development of sclerosis of the coronary arteries;
• Metabolism in the body is disturbed with a sedentary lifestyle. With improper metabolism and impaired lipid metabolism, plaque accumulates in the heart arteries;
• Lack of food culture. Excessive consumption of fatty foods leads to a violation of lipid metabolism, which provokes atherosclerosis of the arteries and causes obesity;
• Obesity, is also a provocateur of coronary atherosclerosis and cardiac pathologies;
• Genetic pathology hypercholesterolemia that is inherited from parents;
• Gender. Before menopause, women rarely experience cardiac pathologies and sclerosis of the coronary arteries, but with the onset of menopause, the risk of developing this disease increases by 5-8 times;
• Age category- men after 35 years, women - in menopause;
• Alcoholism causes atherosclerosis, because its action is detrimental to the endothelium of the arteries, which leads to the destruction of the intima;
• Failure in the endocrine system leads to diabetes, which, due to a metabolic disorder in the body and a change in the composition of the blood, leads to atherosclerosis of the coronary arteries.

Symptoms

At the first stage, the development of the disease, its course is asymptomatic and the first signs of a violation in the coronary arteries begin to appear after 30-35 years.

If a person suffers from hypertension, which is also accompanied by a passion for alcohol and smoking, then the first symptoms may appear at an earlier age - before the age of 30.

The first symptoms of coronary sclerosis:

• Pain in the chest, which can radiate to the neck and back. Often there is pain in the area of ​​​​the shoulder joint and arm;
• Shortness of breath appears during the onset of a painful attack. Very often, a person cannot lie down during an attack of pain, due to impaired breathing;
• Spinning in the head of varying intensity;
• Nausea, which provokes vomiting from the body.

Quite often, the first signs of the development of atherosclerosis of the arteries of the cardiac organ are similar to a heart attack, or other pathologies of the heart. Atherosclerosis of the coronary arteries is very difficult to diagnose and, due to similar symptoms, it is confused with angina pectoris.

With the progression of sclerosis of the coronary vessels, the symptoms are expressed in such cardiac pathologies:

• Unstable type of angina. With atherosclerosis and angina pectoris, there is pain behind the chest, which gains intensity during a period of emotional overstrain, or after overloading the body with physical labor;
• Disease cardiosclerosis. Acutely developed ischemia of the cardiac myocardium leads to the formation of fibrous areas on the myocardium. Fibrotic changes throughout the myocardium provoke insufficient contraction of the cardiac organ, which leads to a disruption in the functionality of the blood flow system, and even faster causes the progress of the coronary atherosclerosis;
• Cardiac arrhythmia develops due to a violation in the conduction of the heart rhythm through the myocardium, which can be caused by fibrous formations on the heart muscle;
• Heart attack is directly related to atherosclerosis in the main coronary arteries. When a rupture or destruction of an atherosclerotic plaque occurs, then a thrombus is formed at the same place, which blocks the arterial lumen of the highway and prevents the normal movement of blood flow through it. For this reason, necrosis of myocardial cells (cardiomyocytes) develops. Quite often, heart attacks occur at dawn from 4 o'clock in the morning and can last until 10 o'clock in the morning. During this period, the level of the hormone adrenaline rises in the blood. More than half of patients feel malaise and symptoms of approaching an attack.

Diagnostics

The primary diagnosis of coronary atherosclerosis can be based on an electrocardiogram. The cardiogram showed the first signs of ischemia of the cardiac organ.

For the final confirmation of the diagnosis of atherosclerosis of the cardiac coronary arteries, it is also necessary to donate blood for the lipid spectrum and undergo instrumental diagnostic measures:

• Stress testing to identify the localization of atherosclerotic neoplasms on the inner side of the coronary arterial membrane and the degree of its severity in the lumen of the artery;
• Doppler ultrasound of the coronary arteries. With the help of this diagnosis, all vascular changes are detected - the thickness of the membranes, the size of the arterial chambers, the localization of the violation in the contractility of the membranes of the arteries. Also, this diagnostic technique allows you to determine the hemodynamics in the blood flow system, coronary vessels and the ability of the valvular apparatus;
• method of coronary angiography. According to this technique, the study of the cardiac organ and coronary arteries is carried out by X-ray with contrast. A contrast agent introduced into the bloodstream system shows the degree of atherosclerosis damage to the arteries of the bloodstream, as well as the degree of constriction of the vessels and the work of the heart valve apparatus.

Treatment

Atherosclerosis is a pathology that can be prevented by timely prevention, as well as reduce its progression when diagnosed at the initial stage using complex treatment.

Treatment methods can be:

• Diet therapy;
• Non-drug therapy - elimination of risk factors for atherosclerosis (alcoholism, stress, smoking and physical inactivity), as well as an active fight against obesity;
• Treatment with medicines;
• Operative adjustment of the movement of blood in the bloodstream.

angina pectoris

Diet food

Pathology atherosclerosis develops in the bloodstream system when lipid metabolism is disturbed in the body. To correct fat metabolism in the body, the method of adjusting nutrition is best suited.

Diet therapy can reduce the concentration of bad cholesterol and increase the synthesis of high-molecular lipids by liver cells, and also fight atherosclerosis within the bloodstream.

The main mechanisms of the anti-cholesterol diet:

• Reducing the daily calorie content of the menu. The number of calories needed per day is selected by a nutritionist, based on the individual characteristics of the body;
• Meals should be up to 6 times a day in small portions;
• Complete rejection of sugar, and minimize the intake of simple carbohydrates;
• Refuse vegetable fats, in any form - in meat, in dairy products, in eggs;
• Increase intake of poly and monounsaturated fatty acids found in fish, nuts and vegetable oils;
• Introduce into the diet in large quantities fresh vegetables, garden greens and fruits that are rich in fiber, as well as cereals from cereals and beans. These products normalize the metabolism in the body, which reduces the cholesterol index.

foods with cholesterol

Medical therapy

They come to drug therapy only when treatment without medication and an anti-cholesterol diet have not brought the desired result.

It is also worth considering that all drugs aimed at lowering cholesterol have many side effects, so it is forbidden to use them on your own.

drug class	name of medicines	medicinal effect	daily dosage	contraindications for use
statin group	drug Atorvastatin;	decrease in total cholesterol index;	The drug Atorvastatin and Rosuvastatin - from 10.0 mg to 80.0 mg;	pathology of liver cells in severe form
	the drug Rosuvastatin;	There is a decrease in low-density lipoproteins.	Simvastatin tablets 20.0 mg to 80.0 mg
	Simvastatin tablets.
bile sequestrants	drug Cholesteramine	Increases bile production	Cholesteramine tablets from 2.0 grams to 4.0 grams	triglyceride concentration higher than 4.50 mmol per liter
		Reduced index of low molecular weight lipids.
nicotinic acid in a prolonged form of a medication	medication Nicotinic acid	Reduced index of low molecular weight lipids;	medication Nicotinic acid from 10.0 grams to 1.50 grams	gout pathology, diseases of liver cells in the chronic stage
		Increases the concentration of high molecular density lipoproteins;
		Reduced triglyceride index.
fibrate group	drug Fenofibrate	The concentration of lipoproteins increases.	dosage from 100.0 milligrams to 2.0 grams	failure of liver cells

Surgical intervention

An operation on the coronary arteries is performed only when an atherosclerotic plaque has closed the lumen of the artery by 70.0% and threatens the life of the patient.

There are open operations on the coronary arteries, as well as modern minimally invasive methods of surgical treatment of coronary atherosclerosis.

The most used operations on the coronary arteries:

• Transluminal angioplasty of coronary vessels. This is a method of introducing a balloon into the vascular lumen. With the help of this balloon, the lumen expands and does not interfere with normal blood flow in the coronary arteries. This method is minimally invasive;
• Aortic coronary bypass surgery. This is the construction of a bypass line in the bloodstream system at the site of atherosclerotic plaque development. The blood begins to circulate along the bypass channel, and its movement returns to normal. With the restored blood supply, the working capacity of the heart organ is improved.

Non-drug therapy and prevention

If we consider the causes of atherosclerosis, then one of the main reasons is a high index of cholesterol in the blood.

Non-drug therapy for lowering cholesterol and preventive measures play the same role in the human body, only at different times - preventive measures prevent the formation of cholesterol plaques on the vascular membranes, and the same methods, but as non-drug therapy, are aimed at reducing the progression of atherosclerosis pathology.

Preventive measures and methods of non-drug treatment:

• Proper cholesterol-free nutrition;
• The fight against excess weight;
• To give up smoking;
• "tie up" with the use of alcohol;
• Minimize stress on nerve fibers during stress;
• Increase activity and adequate load on the body;
• Set the mode of the day.

Forecast

Atherosclerosis of the coronary arteries poses the greatest danger to human life, because the coronary arteries are closest to the heart organ.

Only preventive measures and treatment of sclerosis at the initial stage can give a favorable prognosis. If atherosclerosis progresses, then it is quite difficult to achieve results from treatment and in 80.0% it leads to cardiac arrest.

Atherosclerosis of the coronary arteries is a condition during which there is an active development and growth of fatty plaques. The reason for this is the accumulation of cholesterol. After some time, these plaques lead to impaired blood flow, and if not treated in time, it can completely stop. Further, the organs begin, the development of oxygen starvation in the tissues.

The disease is very insidious, it develops for more than one month, it can take years or even decades. So, a teenager lives and is completely unaware that he has atherosclerosis of the aorta of the coronary arteries. In the second half of life, the disease begins to progress at a rapid rate. Therefore, symptoms usually begin to appear by the age of 55.

Cholesterol plaques affect the arteries that are located in all parts of the body. If more than one vascular pool is affected, multifocal atherosclerosis develops. But in most cases, problems are caused by damage to the coronary vessels, which are responsible for supplying blood to the heart. They are characterized by a small diameter, tortuosity, abundant branching. This is what predisposes to the "overgrowth" of plaques in the first place.

At rest, our heart pumps blood - about 5 liters per minute, with an intense load, this figure increases six times. As a result, it increases, so the muscle needs a lot of oxygen, which it receives through the blood. But when a person has atherosclerosis of the coronary vessels, the disease prevents the heart from delivering the required amount of oxygen.

Symptoms

Signs of coronary artery disease and coronary heart disease (hereinafter IHD) are the same. The disease is usually divided into two forms. So, there are acute and chronic. The first symptoms of an atherosclerotic condition include:

• pain in the chest area, which radiates to the back, left shoulder;
• shortness of breath appears before the pain syndrome, sometimes, when an attack begins, the patient is not able to be in a horizontal position;
• dizzy;
• nausea, vomiting, diarrhea occur.

These causes of vascular disease are not specific, which is why they can be confused with other pathological conditions of the cardiovascular system. This makes diagnosis and treatment very difficult.

1. There is angina pectoris. There is pain in the chest area, it begins to intensify after intense physical exertion, as well as emotional overstrain. Attacks are considered temporary, they last for 15 minutes.
2. Begins to suffer from cardiosclerosis. Myocardial ischemia, which has an acute form, provokes the appearance of areas of fibrosis, which disrupts the contractile function of the central circulatory organ.
3. An arrhythmia sets in. The development of the pathology of the coronary artery is preceded by damage to the heart muscle and impaired impulse conduction.
4. There is a heart attack. When a cholesterol plaque ruptures, its place is taken by a thrombus, which becomes an obstacle to natural blood flow, which leads to necrosis of cardiomyocytes. Most often, this condition occurs in the early morning, at this time the level of adrenaline rises in the blood.

You can eliminate the pain symptom of atherosclerosis of the coronary arteries with the help of the medical preparation "Nitroglycerin". It has a dilating effect on blood vessels, which guarantees improved blood circulation.

The reasons

Knowing the causes of coronary atherosclerosis will help prevent the onset of the disease. Therefore, the main task is to eliminate the causes, risk factors.

This form of atherosclerosis (ICD code 10 I25.1) leads to:

unhealthy diet, excessive love for fatty foods, carbohydrates, salt and rare consumption of vegetables, fruits, fish, vegetable oil;

• cigarettes and alcohol;
• obesity;
• passive lifestyle;
• diabetes;
• elevated blood cholesterol levels;
• arterial hypertension;
• genetic predisposition;

Diagnostics

You can find out about the presence of atherosclerosis using an ECG. To confirm the diagnosis, the attending physician will prescribe the following studies:

• With coronary angiography, the localization and length of the vessels that were affected by the disease are determined.
• The stress-ECHO technique allows you to learn about cardiac contractility in areas where the blood flow has been changed.
• Radionuclide research. Veloergometry.
• MRI. Doppler ultrasound and intravascular. This will help to determine changes in the vessels during illness, namely their thickness, chamber size, to get acquainted with hemodynamics, valve morphology.

Treatment

Before treating an ailment, experts determine its stage of development. Therapy lies in the need to effectively combat the manifestation of the symptoms of the disease in order to prevent IHD and the active development of the disease. First of all, the patient must take a step towards a lifestyle change:

• Give up smoking and alcohol.
• Normalize . Doctors advise to resort to a sharp reduction in animal fats, not to eat sweet and fried foods. Vegetables, fruits, dairy products should be present in the daily diet.
• Go in for sports recommended by a cardiologist. Physical activity helps to normalize metabolic processes in the patient's body.
• Work on weight loss.
• Treatment of other diseases leading to the development of atherosclerosis.

The symptoms are eliminated at the initial stage by conservative therapy, with its help the process of changes in the vessels is also inhibited. Usually statins are taken, they work well at lowering cholesterol levels.

In therapy, agents are used that reduce the need for oxygen in the muscles of the central organ of blood supply, which protects it, preventing coronary artery disease. This goal is available for antiplatelet agents, beta-blockers, ACE inhibitors, calcium channel blockers.

With the advanced form of the disease, you can not do without surgery. For this apply:

1. , it allows you to create a path through which the blood will bypass the affected area.
2. Balloon angioplasty. During the technique, a special catheter is inserted into the patient and the balloon is inflated, which leads to arterial expansion.
3. Coronary stenting involves the insertion of a stent.

Only timely diagnosis of the disease will prevent death.

Complications and prognosis

When the disease proceeds in a chronic form, the patient may develop, a gradual vasoconstriction occurs. This is a harbinger of hypoxic, atrophic myocardial damage, ischemia. Acute deficiency is the cause of a heart attack.

The prognosis of the disease depends on the patient, namely on his strict adherence to all the recommendations of the attending doctor. If the patient adheres to a diet, leads a healthy lifestyle, the progress of pathology can be stopped. With the formation of foci of necrosis, acute circulatory disorders, the prognosis is unfavorable.

A healthy lifestyle and proper nutrition will prevent the disease. Take care of your health!