Cardiosclerosis: causes, symptoms, drugs for treatment

Cardiosclerosis, or the development of connective scar tissue in the heart muscle, is an irreversible process that gradually impairs the contractility of the heart. Cardiosclerosis can occur not only after myocardial infarction, but also as a result of myocarditis. In this regard, it is necessary to know in which cases the formation of cardiosclerosis is more likely, and how to prevent these processes.

Myocarditis is a rather serious disease that can not only cause dangerous cardiac disorders, but also provoke the development of serious complications and long-term consequences.

In order to talk about the occurrence of complications after myocarditis, both in acute and long-term periods, it is necessary to understand what this nosological form is.

Myocarditis is an inflammatory pathomorphological change in the thickness of the heart muscle, causing disturbances in the activity of cardiac smooth muscle cells.

(cardiomyocytes) at the molecular level, as well as causing certain clinical manifestations.

Causes of cardiosclerosis

1. Functional disorders:

Damage to the heart muscle as a result of inflammatory diseases.
Hypoxia due to insufficient blood supply to the heart muscles due to narrowing of large cardiac vessels.
Stretching of the walls of the heart, which leads to an increase in its volume.

2. Lifestyle and bad habits of the patient:

Alcohol abuse and smoking.
No, minimal or excessive physical activity.
Repetitive stress.
The habit of overeating and, accordingly, excess body weight.

Hereditary factors play an important role in the occurrence of the disease.

Atherosclerotic cardiosclerosis

This form of pathology develops against the background of atherosclerosis (narrowing of the lumen due to the accumulation of fatty plaques on the walls) of large vessels that extend from the heart. This leads to myocardial hypoxia with subsequent atrophy of muscle fibers and their scarring.

As a result of the replacement of muscle cells with connective tissue, the contractile and conductive functions of the heart are disrupted, which leads to the development of other more dangerous diseases of the organ.

Causes

The main cause of atherosclerotic cardiosclerosis is the narrowing of the lumen of the coronary arteries due to the deposition of cholesterol particles on their walls.

The risk of developing pathology increases in the following conditions:

arterial hypertension (high blood pressure);
hereditary predisposition;
diabetes;
renal dysfunction;
lack of physical activity;
poor nutrition, consumption of fatty, fried foods;
bad habits;
violation of fat metabolism;
taking oral contraceptives.

Atherosclerotic sclerosis most often affects men over 45 years of age.

Symptoms

In the early stages, the pathology is not accompanied by any symptoms.

As the scar tissue grows, the patient develops the following symptoms:

gradually increasing shortness of breath;
fast fatiguability;
discomfort in the heart, which intensifies at night;
arrhythmia (irregular heartbeat);
headache;
noise in ears;
muscle weakness.

In advanced stages, swelling of the legs and a hacking cough occur. If the lumen of the coronary vessels decreases by 70% or more, cardiosclerosis progresses sharply and can cause pulmonary edema, aortic rupture, myocardial infarction (death of a section of muscle tissue of the heart) and other life-threatening diseases.

Diagnostics

To identify atherosclerotic sclerosis, the following diagnostic procedures are used:

general and biochemical blood tests;
electrocardiogram;
Ultrasound of the heart;
bicycle ergometry (assessment of myocardial functionality during physical activity).

In some cases, daily ECG monitoring and radiography of the coronary vessels are prescribed to assess the degree of narrowing of their lumen.

Treatment

With atherosclerotic cardiosclerosis, the patient should change their lifestyle and diet, and exclude fried and fatty foods from the diet.

Conservative treatment includes taking the following medications:

agents that improve the nutrition of cardiac muscle tissue;
drugs that reduce the flow of calcium into muscle tissue;
reducing blood pressure;
diuretics;
blood thinners;
blood thinning drugs.

In severe cases, surgical treatment is carried out - stenting (expansion of the lumen of the vessel using a metal installation), coronary artery bypass grafting (creation of a bypass for proper blood circulation), angioplasty (minimally invasive operation involving expansion of the lumen of the vessel using a catheter). For each patient, a treatment regimen is developed individually.

Classification of cardiosclerosis

According to the morphological principle, focal (most often occurs as a complication after myocardial infarction and myocarditis) and diffuse cardiosclerosis, in which the connective tissue spreads to the entire myocardium, are distinguished.

For etiological reasons, the following types are distinguished:

Post-infarction. As a result of myocardial infarction, scars form at the site of necrotic damage, which reduces the contractility of the heart muscle. The more cases of myocardial infarction a patient has suffered, the more scar tissue is formed. The threat of chronic aneurysm increases due to protrusion of the walls of the heart muscle, which is stretched and weakened by connective tissue. Aneurysm rupture is associated with high mortality.
Myocardial. Myocardial inflammation develops mainly in young patients with chronic allergic and infectious diseases. With this form, the right ventricle of the heart increases in volume and is insufficiently supplied with blood.
Atherosclerotic. As a rule, it is the result of atherosclerosis of the coronary vessels and coronary heart disease. This form of the disease develops over a long period of time, because due to damage to blood vessels, heart cells do not receive enough oxygen, hypoxia develops, the course of coronary heart disease is complicated, and cholesterol levels increase. This leads to diffuse cardiosclerosis, which is accompanied by arrhythmia.

Typology of the disease

Today, two approaches to the classification of cardiosclerosis are proposed. The first relies on the history of the disease and proposes to subdivide it into atherosclerotic and myocardial. The second approach is based on the localization of the disease, depending on which cardiosclerosis can be either diffuse or focal. Let's look at these terms in more detail:

The atherosclerotic form of the disease got its name in honor of the pathology that causes it - atherosclerosis of the arteries.
Myocardial cardiosclerosis is a direct consequence of various types of myocarditis.
The diffuse type of the disease is diagnosed when necrosis affects muscle tissue relatively evenly.
In focal cardiosclerosis (also known as scar), connective tissue replaces muscle tissue in individual areas of the heart, varying in size.

Consequences of cardiosclerosis

Aneurysms and heart defects.
Arrhythmia.
Thromboembolism.
Chronic fatigue syndrome.
Chronic heart failure.

Symptoms of cardiosclerosis

Very often the initial stages of the disease are asymptomatic. In the clinic of the onset of sclerosis, the first symptom may be arrhythmia. Typical manifestations of the diffuse form should be considered heart failure and disturbances in the rhythm of the heartbeat.

Symptoms regardless of the form (post-infarction or atherosclerotic):

heart rhythm disturbances;
dyspnea;
the appearance of fluid in the abdominal and pleural cavities;
pain in the heart area;
increased heart rate;
pulmonary edema;
increase in liver size.

As the area of affected heart tissue increases, the severity of symptoms increases.

Very often the course of cardiosclerosis is accompanied by arterial hypertension. In this case, high blood pressure alternates with long periods of normal blood pressure.

Post-infarction cardiosclerosis

Develops in patients after myocardial infarction. Dead areas of the heart are replaced by scars. If left untreated, this form of cardiosclerosis can lead to the development of arrhythmia.

Causes

Post-infarction cardiosclerosis develops for two reasons:

dystrophy of cardiomyocytes (myocardial cells) against the background of a heart attack;
heart injury (during operations, gunshot wounds).

Predisposing factors to the development of the disease:

obesity;
sedentary lifestyle;
stress;
smoking;
hard physical labor;
genetic predisposition;
hypertension (high blood pressure).

Symptoms

Post-infarction cardiosclerosis develops over a long period of time, the clinical picture is determined by the massiveness of scar growths.

The following symptoms may indicate the presence of the disease:

swelling of soft tissues;
dyspnea;
cough;
periodic heart pain;
cyanosis of lips, fingertips, nose;
feeling of heaviness behind the sternum;
fast fatiguability.

In severe forms of the pathology, the patient's condition constantly worsens. Lack of treatment can lead to cardiac tamponade (accumulation of blood in the cavities of the organ), disruption of the rhythm of myocardial contractions.

Diagnostics

To make a diagnosis, the following studies are prescribed:

Ultrasound scanning of the heart - shows the structure of the organ and the level of blood flow;
ECG – reflects the conduction of impulses through the myocardium;
general blood analysis;
24-hour monitoring – tracking the work of the heart for 24 hours using a special device;
Ventriculography is a contrast method that shows the structure and structure of the heart.

Treatment

In the early stages of post-infarction cardiosclerosis, it is possible to manage with conservative methods of therapy.

Medicines prescribed:

agents that improve the nutrition of cardiac muscle tissue;
reducing the concentration of fatty particles in the blood;
drugs that reduce the flow of calcium into muscle tissue;
reducing blood pressure;
blood thinners;
normalizing myocardial tone;
diuretics;
drugs against arrhythmia.

If the conservative approach is ineffective or severe cardiosclerosis is present, surgical methods are used:

expansion of the lumen of large vessels that extend from the heart;
bypass surgery - restoration of blood flow to the heart by bypassing the affected areas of the arteries;
Stenting is the replacement of an area of narrowing of a vessel with a prosthesis (stent).

The treatment regimen is selected individually, taking into account the degree of neglect of the pathology and the presence of concomitant health problems.

At-risk groups

The risk of cardiosclerosis is highest in patients with pathologies in the development of the heart and cardiovascular diseases, as well as in people with various types of allergies.

Pregnant women can be identified as a separate group. Pregnancy causes hormonal, autonomic, metabolic and hemodynamic changes in the body of women and can act as a proarrhythmogenic factor. Complex heart rhythm disturbances are diagnosed both in pregnant women with cardiovascular pathology and in patients without changes in metabolism and the condition of internal organs.

Cardiosclerosis in children is possible against the background of myocardial pathologies, for example, inflammatory and dystrophic processes, in particular diseases of the heart muscle caused by metabolic disorders in heart cells. These biochemical disorders significantly weaken the contractile, conductive, excitatory and automatic functions of the myocardium.

How to make a diagnosis?

ECG signs

Post-infarction cardiosclerosis is established on the basis of anamnesis (previous infarction), laboratory and instrumental diagnostic methods:

ECG - signs of a heart attack: a Q or QR wave may be observed, the T wave may be negative, or smoothed, weakly positive. The ECG may also show various rhythm disturbances, conduction disturbances, and signs of an aneurysm;
X-ray - expansion of the heart shadow mainly on the left (enlargement of the left chambers);
Echocardiography - zones of akinesia are observed - areas of non-contractile tissue, other contractility disorders, a chronic aneurysm, valve defects, an increase in the size of the heart chambers can be visualized;
Cardiac positron emission tomography. Areas of reduced blood supply are diagnosed—myocardial hypoperfusion;
Coronary angiography - conflicting information: the arteries may not be changed at all, or their blockage may be observed;
Ventriculography - provides information about the functioning of the left ventricle: it allows you to determine the ejection fraction and the percentage of scar changes. Ejection fraction is an important indicator of heart function; if this figure decreases below 25%, the prognosis for life is extremely unfavorable: the quality of life of patients significantly deteriorates; without a heart transplant, survival is no more than five years.

Cardiosclerosis medications

The European Society of Cardiology recommends the following medications for the treatment of cardiosclerosis, eliminating the symptoms of the disease, as well as its root cause:

Antihypertensive drugs. To maintain vascular tone and normalize blood pressure, ACE inhibitors (Captopril, Enalapril, Ramipril) are prescribed; calcium antagonists (Amlodipine, Semlopin, Phenigidine), beta blockers (Atenolol, Bisoprolol, Metoprolol), antiplatelet drugs (Aspirin), lipid-lowering drugs (Simvastatin, Atorvastatin, Allesta).
Cardioprotectors (antianginal agents). Their task is to maintain the functional activity of the heart and counteract the influence of negative exo- and endogenous factors on it. These include organic nitrates (Nitroglycerin, Isosorbide Mono- and Dinitrate); sydnonimines (Mosikor, Sidocard); metabolic agents (Trimetazidine).
To normalize heart rate and conduction: amiodarone (Amiodarone), dronedarone (Multak).
To normalize metabolic processes - potassium and magnesium preparations: Panangin, Asparkam, Magnerot.
Antibiotics and corticosteroids: for myocarditis and other inflammatory processes.

Diagnosis of cardiosclerosis

To diagnose the disease, the following studies are carried out:

ECG - on it you can see the affected areas, changes in the heart, failures.

Biopsy - changes in the heart can be detected.

Angiography – this procedure is performed directly to diagnose coronary cardiosclerosis. ECHO KG - this study shows the degree of growth of pathological tissue and helps to see the functioning of the heart valves.

X-ray – allows you to see the stage of the disease and detect an aneurysm.

CT or MRI - these studies help to detect foci of growth.

Treatment of cardiosclerosis

Since it is not possible to completely cure the disease, treatment is aimed at treating complications and eliminating symptoms.

Treatment is carried out in several ways, and one of them is surgery:

A heart transplant is a complete organ transplant.

Coronary bypass surgery.

Installation of a pacemaker - this type of treatment is carried out in the presence of arrhythmia, as well as in case of disruption of the rhythm. In case of an aneurysm, an operation is performed in which the aortic aneurysm is completely removed.

Treatment with drugs:

List of used literature

Stryuk R.I., Shoikiemova D.U., Borisov I.V.; State Budgetary Educational Institution of Higher Professional Education "Moscow State Medical and Dental University named after. A.I. Evdokimov" Ministry of Health of the Russian Federation, Moscow, Russia / Pregnancy as a risk factor for heart rhythm disturbances
POKROVSKAYA E.M., 2, Ph.D., N.A. VOLOV 2, Ph.D., I.S. VASILYEVA 2, GORDEEV I.G. 1, Doctor of Medical Sciences, Professor, PAVLIKOVA E.P., 2, Doctor of Medical Sciences, Professor 1 State Budgetary Educational Institution of Higher Professional Education “Russian National Research Medical University named after. N.I. Pirogov" of the Ministry of Health of Russia, Department of Hospital Therapy No. 1, Faculty of Medicine 2, State Budgetary Institution "City Clinical Hospital No. 15 named after. O.M. Filatova "DZ Moscow / NEW OPPORTUNITIES FOR TREATING PATIENTS WITH HEART FAILURE DUE TO POST-INFARCTION CARDIOSCLEROSIS
Berezin A. E., Doctor of Medical Sciences, Professor of the Department of Internal Medicine No. 2 of the 1st Medical Faculty of Zaporozhye State Medical University / Combined potassium and magnesium preparations in the treatment of patients with high cardiovascular risk.

Consequences

A patient with the diagnosis in question needs lifelong medical supervision. Knowing what post-infarction cardiosclerosis is, one cannot ignore the situation, as this leads to inevitable complications in the form of the following consequences:

Why does post-infarction cardiosclerosis (PICS) develop and how does it manifest?

pericardial tamponade;
atrial fibrillation;
thromboembolism;
blockades;
pulmonary edema;
tachycardia;
decreased automaticity of the sinoatrial node.

These processes negatively affect a person’s quality of life. The patient loses tolerance to physical activity, loses the opportunity to work and lead a normal life. Advanced cardiosclerosis provokes the appearance of an aneurysm, the rupture of which leads to death in 90% of non-operated patients.

Frequently asked questions about cardiosclerosis

Which doctor treats cardiosclerosis?

If you suspect cardiosclerosis, you should contact a cardiologist.

What signs should you see a doctor for?

High blood pressure; arrhythmia; increased fatigue and swelling of the limbs.

Can cardiosclerosis develop in children?

Cardiosclerosis in children can develop against the background of inflammatory and dystrophic processes in the myocardium - in particular, diseases of the heart muscle caused by metabolic disorders in heart cells.

Drug treatment

The drug Furosemide

In the treatment of heart failure against the background of post-infarction cardiosclerosis, the following is used:

Diuretics. When edema develops, diuretics or diuretics are prescribed: furosemide, hydrochlorothiazide, indapamide, spironolactone. Diuretic therapy is recommended to be prescribed with small doses of thiazide-like diuretics for compensated myocardial heart failure. For persistent, severe edema, loop diuretics are used. During long-term treatment with diuretics, monitoring of blood electrolyte balance is mandatory.
Nitrates. To reduce the load on the heart and dilate the coronaries, nitrates are used: molsilodomin, isosorbide dinitrate, monolong. Nitrates help relieve the pulmonary circulation.
ACE inhibitors. The drugs cause dilation of arteries and veins, reduce pre- and afterload on the heart, which helps improve its functioning. The following drugs are widely used: lisinopril, perindopril, enalapril, ramipril. Dose selection begins with a minimum; if tolerated, the dosage can be increased. The most common side effect of this group of drugs is the appearance of a dry cough.
Importance of Antioxidants
Metabolic, antioxidant drugs. In order to saturate the heart muscle with energy and oxygen, improve metabolic processes, the following drugs are used in treatment: cocarboxylase, riboxin, lipoic acid, creatine phosphate, vitamin E. These drugs are prescribed in courses of 1-2 months at least twice a year.
B-blockers. An important group of drugs that helps reduce heart rate, increase left ventricular ejection fraction, and increase exercise tolerance. Metoprolol, propranolol, oxprenolol are representatives of the group. They are prescribed in combination with diuretics and ACE inhibitors. When taking b-blockers, heart rate monitoring is required.
Antiplatelet agents. To improve the rheological properties of blood and prevent thrombosis, aspirin, aspicard, and cardiomagnyl are used in treatment.
Statins. All patients with a history of myocardial infarction are prescribed statins to prevent hypercholesterolemia.

Drug treatment of post-infarction cardiosclerosis, or rather its manifestations: heart failure, arrhythmias, is a very complex process that requires deep knowledge and experience from the attending physician, since combinations of three or more medications from different groups are used when prescribing treatment. The doctor needs to clearly know the mechanism of their action, indications and contraindications, and individual tolerance characteristics. And self-medication for such a serious illness is simply life-threatening!

How much does it cost to treat cardiosclerosis in Israel?

The price for medical services at the Ikhilov clinic is one of the most affordable in the world. Taking into account the level of the medical institution and the qualifications of doctors, as well as the quality of the treatment provided, Ikhilov can be compared with the best clinics in the world, but the cost of treatment is usually 2-3 times lower than in Western Europe or America. WITH

You can find out the exact cost of treatment in this Israeli clinic by filling out the application form on this website or asking the relevant questions in the online chat. In addition, consultation on price and treatment issues is available by telephone; to do this, you need to call the specified number or request a call back.

Benefits of treatment in Ikhilov

High treatment efficiency
High information content and diagnostic accuracy
Cardiac surgeons with many years of experience
Affordable prices for medical services, no prepayments
The most modern methods and equipment to achieve optimal treatment results

If you or your loved ones have signs of cardiosclerosis, and you would like to get a consultation with an Israeli doctor, order it today. Our medical consultant will do everything possible so that within two to three working days you can communicate directly with a cardiologist from Ikhilov.

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Causes

The following factors play an etiological role in the development of atherosclerotic cardiosclerosis. Age. Most cases of the disease occur in people over 50 years of age. As the body ages, the activity of elastase, the production and breakdown of cholesterol, and the concentration of acidic mucopolysaccharides increase.

Gender. In men, atherosclerosis develops more often and at an earlier age. In women, under the influence of sex hormones, beta lipoproteins are formed more slowly, and the concentration of alpha proteins, on the contrary, increases, which is why the risks of atherosclerosis are reduced. Smoking. The effect of nicotine on vascular permeability is extremely negative, since with this type of intoxication the production of adrenaline sharply increases, the synthesis of bradykinin is stimulated, and damage to the walls increases.

Hereditary predisposition. Type 3 lipid metabolism disorders mainly occur in families with coronary artery disease and hypertension. But according to Mendel's laws, only type 2 is inherited. Sedentary lifestyle. It has long been recognized by everyone that movement is one of the components of health. The higher a person’s activity, the better the compensation mechanisms and collaterals (bypass paths of blood flow) in his body.

Tendency to overeat. The calorie content of food consumed should not exceed the body's needs, since abundant nutrition will lead to obesity and all related problems. To avoid the development of diseases, you should not be guided by appetite - you need to eat food based on the calories expended.

Eating fatty and high-calorie foods in large quantities leads to increased cholesterol

In addition to predisposing general factors that can lead to the appearance of atherosclerosis, there are several diseases that also provoke and accelerate the pathological process. This list includes:

arterial hypertension (all types);
diabetes;
obesity;
hypothyroidism;
gout.

In this case, it is customary to pay attention to the risk factors present for pathology, which imply various changes in the biochemical and clinical parameters of the body, bad habits and the presence of concomitant diseases. They are divided into:

the main ones are arterial hypertension, hypercholesterolemia (increased cholesterol in the blood) and nicotine intoxication;
additional – sedentary lifestyle, diabetes, obesity, gout.

Clinical guidelines

There is no single method (or set of tools) for restoring damaged myocardium. For post-infarction cardiosclerosis, clinical recommendations are aimed at:

slowing the development of heart failure;
pulse stabilization;
stopping scarring;
minimizing the likelihood of recurrent heart attack.

The objectives can be solved only with an integrated approach. The patient needs:

maintain a daily routine;
limit loads;
quit smoking;
avoid stress;
stop drinking alcoholic beverages.

Diet therapy plays an important role in the treatment of post-infarction cardiosclerosis. It is recommended to eat six meals a day in small portions. Preference should be given to “light” foods high in magnesium, potassium, vitamins and microelements.

It is necessary to minimize the consumption of foods that provoke stimulation of the nervous and cardiovascular systems, as well as increase gas formation. This:

Diffuse cardiosclerosis: symptoms, treatment tactics, preventive measures

coffee;
legumes;
cocoa;
onion;
radish;
strong tea;
garlic;
cabbage.

Daily consumption of table salt should not exceed 3 g.

To avoid the formation of new cholesterol plaques that worsen the patency of blood vessels, you will have to completely avoid fried foods, smoked foods, spices, and sugar. Limit fatty foods.

Conservative treatment

Since damaged tissue cannot be restored, treatment of post-infarction cardiosclerosis is aimed at blocking symptoms and preventing complications.

In conservative therapy, drugs from the following pharmaceutical groups are used:

ACE inhibitors (Enalapril, Perindopril), slow down scarring, lower blood pressure, reduce the load on the heart;
anticoagulants reduce the risk of thrombosis; this group includes: Aspirin, Cardiomagnyl, etc.;
diuretics prevent fluid retention in the body cavities; the most common are: Furosemide, Indapamide, Hydrochlorothiazide, etc. (with prolonged use, laboratory monitoring of the electrolyte balance in the blood is required);
nitrates (Nitrosorbide, Monolong, Isosorbide mononitrate) reduce the load on the vascular system of the pulmonary circulation;
metabolic drugs (Inosine, potassium drugs);
beta-blockers (Propranolol, Atenolol, Metoprolol) prevent the formation of arrhythmias, reduce the pulse, and increase the percentage of blood ejected into the aorta;
statins are recommended for correcting cholesterol levels in the body;
antioxidants (Riboxin, Creatine phosphate) help saturate heart tissue with oxygen and improve metabolic processes.

Attention: drug names are given for informational purposes. It is unacceptable to take any pharmaceuticals without a doctor's prescription!

If drug treatment does not produce results, the patient is indicated for surgical intervention.

Revascularization operations (CABG, etc.)

When a large area of the myocardium is affected, only a heart transplant can significantly help. This drastic measure is resorted to when all other methods have not brought a positive result. In other situations, manipulations related to palliative surgery are performed.

One of the most common interventions is coronary artery bypass grafting. The surgeon dilates the blood vessels of the myocardium, which improves blood flow and stops the spread of sclerotized areas.

If necessary, CABG surgery for post-infarction cardiosclerosis is performed simultaneously with resection of the aneurysm and strengthening of weakened areas of the heart wall.

Cardiosclerosis: what it is, description, symptoms, treatment tactics

When the patient has a history of complex forms of arrhythmias, installation of a pacemaker is indicated. These devices, due to a stronger impulse, suppress the discharges of the sinus node, thereby reducing the likelihood of cardiac arrest.

Surgery is not a panacea; after it, further compliance with all medical recommendations is required.