Each of us knows that myocardial infarction is one of the most dangerous conditions of a person, which often leads to death.
However, even if the patient was provided with timely medical assistance, a heart attack can for a long time make itself felt unpleasant symptoms and diseases, one of which is called postinfarction cardiosclerosis.
Cardiosclerosis is a pathological process that affects the myocardium: the tissue of its muscle fibers is replaced by a connective tissue,which leads to a violation of its functioning.
According to statistics, cardiosclerosis becomes the most common cause of death and disability of people in the post-infarction state and with different forms of IHD.
Causes, types and forms of
The most common cause of cardiosclerosis is myocardial infarction .A characteristic scar is formed 2-4 weeks after tissue damage, so this diagnosis is made for all patients who have had the disease.
A little less often cardiosclerosis develops as a complication of other diseases of : cardiac myocarditis, atherosclerosis, ischemic disease and myocardial dystrophy.
Postinfarction cardiosclerosis is classified as a pathological process. On this basis, the disease is divided into a focal and diffuse form.
Focal Postinfarction cardiosclerosis is characterized by the appearance in the myocardium of individual scars, which can be both large and small( large-focal and small-focal form of the disease).
With diffuse cardiosclerosis connective tissue develops throughout the myocardium evenly.
Danger and complications of
The main danger of cardiosclerosis is that the neoplastic tissue can not perform the contractile function of and conduct electrical impulses, respectively, the body does not perform its work to the fullest.
If the pathology progresses, the myocardium begins to expand greatly, various parts of the heart are involved in the process, as a result of which vices, atrial fibrillation, internal blood flow, pulmonary edema and other complications develop.
The clinical manifestations of postinfarction cardiosclerosis depend on the prevalence of the pathological process and its location - the larger the scar and the less healthy tissue, the more likely the development of complications. Patients with this disease are concerned about the following symptoms:
- dyspnoea, which occurs after physical exertion and at rest, and increases in prone position;
- heart palpitations and pressing pains in the sternum;
- cyanosis, or blue lips and extremities, which occurs due to disruption of gas exchange processes;
- arrhythmias arising due to sclerotic changes in the conductive pathways;
- reduced performance, a constant sense of fatigue.
Concomitant manifestations of may include anorexia, swelling of the cervical veins, pathogenic enlargement of the liver, swelling of the extremities, and accumulation of fluid in the body cavities.
Since postinfarction cardiosclerosis can lead to serious consequences and even death, with any unpleasant sensations in the heart area, heart rhythm failures, dyspnea and other such manifestations, should consult the cardiologist as soon as possible( especially if they accompany the patientin the postinfarction state).
After myocardial infarction, a diagnosis of cardiosclerosis is made automatically, but sometimes it happens that the patient for a long time does not suspect the presence of the disease. To diagnose it, the following procedures are used:
- External inspection of .When listening to cardiac tones, you can identify the weakening of the first tone at the top, sometimes - systolic noise in the area of the mitral valve and the rhythm of the canter.
- Electrocardiogram .These studies show focal changes characteristic of a previous myocardial infarction, as well as diffuse changes in the myocardium, blockade of the bundle of the bundle, hypertrophy of the left and right ventricles, and defects in the heart muscle.
- ultrasound of the heart .Evaluates the contractile function of the myocardium and allows to identify scar formation, as well as changes in the shape and size of the heart.
- Radiography .With chest radiography, a moderate increase in heart volume is diagnosed, mainly due to its left divisions.
- Echocardiography of the .One of the most informative methods of diagnosing postinfarction cardiosclerosis. It allows to determine the localization and volume of the degenerated tissue, chronic cardiac aneurysm, as well as violations of the contractile function.
- Positron Emission Tomography .It is performed after the introduction of the isotope and makes it possible to distinguish the foci of altered tissue that does not participate in contraction from the healthy one.
- Angiography of the .The study is conducted to determine the degree of narrowing of the coronary arteries.
- Ventilator .Determines the violation of the movement of the valves of the mitral valve, which indicates a violation of the functionality of papillary muscles.
- Coronarography .It is performed for evaluation of coronary circulation and other important factors.
To date of a unified method for the treatment of postinfarction cardiosclerosis does not exist , since the function of the affected area can not be restored.
As conservative agents for the treatment of cardiosclerosis , the following preparations are prescribed:
- ACE inhibitors that slow the process of myocardial scarring;
- anticoagulants for the prevention of blood clots;
- metabolic drugs for improving the nutrition of myocytes;
- beta-blockers that prevent arrhythmia;
- diuretics, reducing the accumulation of fluid in the body cavity.
In the most difficult cases, surgical methods of are used: removal of aneurysm along with aortocoronary bypass, balloon angioplasty, or stenting( to improve the viable myocardial tissue).
In case of recurrence of ventricular arrhythmia, a cardioverter defibrillator is installed, and with an atrioventricular blockade, an electric pacemaker is installed.
The diet ( refusal from table salt, alcohol, coffee, products containing cholesterol) is very important, control of the drunk fluid, rejection of bad habits and therapeutic exercise. Part of the complex therapy can also be sanitation.
Survival Forecast and Prevention
The prognosis for this disease depends on the percentage of tissue damage, the degree of change in the heart muscle, and the condition of the coronary arteries. If cardiosclerosis occurs without pronounced symptoms of and cardiac rhythm disturbances, then the prognosis for the patient is good.
For complications in the form of arrhythmia and heart failure , the treatment will take significantly longer and will have less effect, and in the diagnosis of an aneurysm there is a direct danger to life.
As preventive measures it is necessary for to lead a healthy lifestyle and monitor the condition of their heart , regularly undergoing electrocardiography and examinations with a specialist. With any manifestation of ischemic disease, which can lead to the development of a heart attack, the doctor can prescribe drugs that strengthen cardiovascular activity, antiarrhythmics, vitamins( potassium, magnesium, etc.).
Postinfarction cardiosclerosis is a dangerous disease that often leads to severe consequences, up to the cause of death. But with the right attitude to one's own health, one can not only minimize its unpleasant manifestations, but also extend one's life for several decades.