What you need to know about the classification of IHD, its symptoms and stages of development

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2017.06.21
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Ischemia

The World Health Organization confirmed that 70% of the inhabitants of the Earth die because of heart and vascular diseases. Acute ischemic heart disease (CHD) is most often the cause of high mortality in all countries. It appears due to a lesion of the myocardium, which requires a certain amount of oxygen for normal operation. When oxygen comes in a small amount, the heart lacks blood supply. The process starts when the atherosclerotic plaques appear in the vessels. They clog the walls of the vessels, which reduces the clearance. The worse the permeability of blood vessels, the heavier the blood gets to the heart. If you do not start treatment in the early stages, then death will occur due to myocardial infarction.

Content

  • Clinical forms of ischemic heart disease
  • Stenocardia classes
  • Symptoms of ischemic heart disease
  • What complications can there be?
  • Diagnosis of ischemic heart disease
  • Treatment of coronary heart disease

Clinical forms of ischemic heart disease

To make an accurate diagnosis, doctors need to determine what form of IHD the patient has. The key role in the diagnosis is angina pectoris or myocardial infarction. Other types of ischemic heart disease are less common. Clinical forms of acute ischemic heart disease:

  • painless myocardial ischemia,
  • cardiosclerosis,
  • heart failure,
  • sudden coronary death,
  • angina pectoris,
  • myocardial infarction,
  • arrhythmia.

Painless ischemia proceeds without painful symptoms. Patients do not experience acute pain, dyspnea, or changes in heart rhythm. You can see the disease only with the help of an electrocardiogram.

Cardiosclerosis of the vessel

Cardiosclerosis is a consequence of a heart attack, you can determine the disease 2 months after the attack. The definition of this clinical form is due to the pathology of vascular conduction and changes in the rhythm of the heartbeat. The appearance of scars and chronic heart failure prove the appearance of focal cardiosclerosis.

Angina pectoris is a clinical form of IHD with its classification. IHD manifests itself for the following reasons:

  1. angina pectoris (appears due to physical stress or stress),
  2. unstable angina (pain at the time of tranquility),
  3. vasospastic angina (severe pressing pain behind the sternum, appears regardless of load or rest),
  4. Coronary syndrome (due to coronary artery disease atherosclerosis).

Coronary death occurs dramatically because of electrical instability of the myocardium. Often, a coronary death is called a primary heart failure.

Myocardial infarction manifests itself as a result of death of the heart muscle or its site. Necrosis affects the appearance of complications, which can be fatal.

Important! This stage of ischemic heart disease is considered one of the most dangerous. In rare cases, with rapid resuscitation, proper treatment and rehabilitation, patients who have had a heart attack can return to an active lifestyle.

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The forms of coronary heart disease are based on functional changes in the functioning of the heart muscle, since it is important to have a qualitative blood supply, oxygen supply, muscle stimulation and vascular conductivity. Determine the form of the clinical form helps decipher the cardiogram.

Stenocardia classes

Classification of CHD according to WHO covers all types of functional classes (FC) of angina, as each class differs in different symptoms and treatment.

Pathogenesis of angina pectoris

Angina pectoris is a disease in which it is easiest to determine ischemia. Doctors have established four main functional classes of angina pectoris.

Functional classes of IHD:

  • FK-1 - pain in the heart manifests itself only after physical exertion, but does not last long;
  • FK-2 - physical activity causes pain in the sternum; Attacks of angina may begin after walking (1 km) or climbing the stairs;
  • FK-3 - symptoms of angina pectoris make themselves felt when walking at 100-500 m, physical activity is reduced to a minimum;
  • FK-4 - there are pains in the moment of tranquility (more often in the morning and at night); may appear after minimal physical exertion.

The earlier a patient seeks help from a doctor, the faster and more efficiently he can cope with the symptoms of the disease. Functional classes of ischemic heart disease and angina pectoris are one concept, since the onset of ischemia depends on the neglect of angina pectoris.

Symptoms of ischemic heart disease

People who suffer from pain in the heart, it is necessary to understand that sometimes attacks of angina can appear for several years. In some cases, the symptomatology is sharp, so you can not delay with a visit to the cardiologist. Main symptoms and IHD syndromes:

  • pain in the chest, in the shoulder, shoulder or jaw area;
  • heart palpitations (arrhythmias),
  • dizziness,
  • headache,
  • weakness in the legs,
  • blurred vision,
  • profuse sweating,
  • nausea,
  • blue lips and limbs,
  • dyspnea,
  • cough,
  • edema.

Severe form of IHD can manifest as swelling of the lungs, abdomen, legs.

Puffiness of the extremities with ischemic heart disease

The patient during this period is difficult to be in a horizontal position, so people deliberately sit most of the time. Classification of ischemic heart disease is based on all these symptoms, but each clinical form has its own symptomatology.

What complications can there be?

When hemodynamic pathologies occur, it can talk about changes in the form of coronary heart disease. The consequences of myocardial ischemia can be:

  1. absence of metabolism in the cells of the myocardium,
  2. low contractility of the left ventricle,
  3. low excitability of the myocardium,
  4. deterioration of conductivity,
  5. reduction of blood circulation in the coronary vessels.

All these complications in the absence of treatment can lead to myocardial infarction or acute forms of IHD.

Diagnosis of ischemic heart disease

The examination of the patient is carried out by specialists on the basis of a cardiological hospital or dispensary. For the diagnosis, doctors use a variety of instrumental techniques. First of all - a doctor's consultation. He clarifies the symptomatology and frequency of pain.

One of the diagnostic methods

After this stage, the patient gives laboratory blood tests to determine the enzymes that increase during the development of angina pectoris. For visual inspection of the body, ultrasound is used. To see the pathology of the heart rhythm, heart activity, use electrocardiography.

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Important! When symptomatic ischemia is not manifested, use functional tests with different loads. The patient performs exercises for cardio-loading. At this point, the state of the heart is read on the ECG.

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Holter ECG monitoring is considered modern and truly effective. With its help determine the results of changing the work of the heart for the chosen time interval. For this, Holter's apparatus (portable equipment) is attached to the human body. It reads the dynamics of the heart, and the computer processes the received data. These methods help determine all clinical forms of IHD.

Treatment of coronary heart disease

The main task of cardiologists is the correct and timely diagnosis of the disease, since the treatment of different forms of IHD is different. Modern classification of IHD is based on the forms of the disease, symptoms and syndromes, which helps to approach the treatment of ischemia in a complex manner. Doctors define four main directions in the treatment of this disease:

  • drug-free treatment,
  • drug therapy,
  • surgical myocardial revascularization (aortocoronary bypass surgery),
  • coronary angioplasty.

Without medicines, one can not do without, therefore, under the term "drug-free medication physicians mean a change in the patient's activity and inclusion in the diet of dietary nutrition.

Several methods can be used to treat IHD

Other forms of treatment are also based on this rule. Adding physical exercise is only permissible during the rehabilitation period.

Drug therapy is based on the following drugs:

  • antiaggregants,
  • β-adrenoblockers,
  • hypocholesterolemic drugs,
  • diuretics,
  • nitrates,
  • etc.

Each drug is used in different ways and in different dosages. Not always patients have puffiness of the extremities or lungs. Everything depends on the initial symptoms, the frequency of manifestations of pain, the neglect of the disease, the individual characteristics of the person.

Aortocoronary shunting and angioplasty refer to surgical operations that help to get rid of the pathologies of blood vessels and myocardium. Coronary artery bypass grafting is performed to restore blood flow in a site with a damaged cardiac muscle.

Stenting of vessels

Coronary angioplasty is a low-traumatic method of dilating the vessel walls. It is carried out to increase the lumen of the vessel and prevent clogging of the vessel with a thrombus. A carcass-stent is inserted into the vessel of the cardiosurgeon, which mechanically increases the blood flow in this area.

Classification of IHD by WHO helps to separate the complexity of the course of the disease, and this affects the treatment technique. The patient is only in time to seek help from a doctor. If the time to prescribe drug therapy, to change the habitual way of life to a healthy one, then it is high probability to restore health and longevity. The main thing is to say "no" to alcohol, tobacco and unhealthy food.

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