Ischemic changes in the ventricular myocardium. Pathological changes in the myocardium: moderate and severe – causes, prognosis, treatment. Causes of myocardial changes

Minor deviations from the norm in the structure of the heart can be detected in every second person. They are a consequence of various pathological processes, especially of an inflammatory nature. In a child, a similar problem often occurs during puberty, and in older people - due to age-related changes in the cardiovascular system. They are detected mainly by chance during a routine examination. There is no point in knowingly worrying about the presence of moderate changes in the myocardium without knowing what they are. They usually do not affect the body in any way and do not appear, but the person will have to be fully examined to determine the causative factor and change their lifestyle.

Pathological abnormalities in the structure of the heart predominantly occur in its lower part (in the left ventricle). If they are not particularly pronounced, are not a consequence of cardiac pathology and do not progress, then often there is no clinical picture. Such changes do not always appear on an ECG (electrocardiogram). They can be identified mainly through a more detailed examination.

More pronounced diffuse changes are manifested by characteristic cardiac symptoms. You can find a list of them below:

pain in the chest area (angina pectoris), provoked by cardiac ischemia;
a feeling of shortness of breath and the appearance of edema is characteristic of cardiosclerosis;
dizziness and signs of asthenia (weakness) occur with anemia.

Patients often develop symptoms of chronic heart failure after experiencing a myocardial infarction. In more rare cases, the cause is hidden in thyroid dysfunction. It begins to produce significantly more than the required amount of hormones, which leads to the following symptoms:

trembling (tremor) of the limbs;
weight loss;
bulging (displacement forward) of the eyes, characteristic of exophthalmos.

The symptoms that arise gradually progress. The patient’s quality of life will decrease until shortness of breath appears after any physical activity, causing a significant decrease in working capacity. If moderate changes in the left ventricular myocardium occur against the background of heart failure, then over time the person may lose the ability to independently perform everyday activities. To prevent such complications, it is necessary to be fully examined to identify the cause of the pathological abnormalities in the structure of the heart. Treatment will be aimed at eliminating it and alleviating the general condition.

Types of pathological changes

Changes in the structure of the heart muscle are divided into several types depending on the factor that influenced their development.

The genesis (reason for development) and localization of the listed types of deviations are different. Based on size, they are divided into diffuse and focal changes in the myocardium. The first type is diagnosed most often. It is characterized by damage to all parts of the heart. Focal deviations are single areas. In both cases, the changed areas are gradually replaced by connective tissue that does not allow electrical impulses to pass through. It will be impossible to reverse the process at this stage.

Causes of deviations in the structure of the myocardium

Each case has its own reasons for the occurrence of deviations in the structure of the myocardium. They have a detrimental effect on the heart and blood vessels. Inflammatory changes appear in a patient due to myocarditis. The disease can be infectious in nature and aseptic, that is, caused without the help of microorganisms. Diffusely located lesions develop due to the influence of such factors:

Rheumatism affecting connective tissues. The cause of the development of pathology is the entry into the body of a streptococcal infection. It occurs after tonsillitis, tonsillitis, scarlet fever and other similar diseases.
Typhus caused by the bacteria Rickettsia. It is characterized by damage to the nervous and cardiovascular systems.
Viral infections, which are characterized by complications on the heart muscle. Measles, rubella and influenza are particularly common.
Autoimmune disorders caused by lupus erythematosus and rheumatoid arthritis, causing complications in the heart muscle.

Cicatricial abnormalities in the structure of the myocardium manifest themselves mainly for the following reasons:

Long-term cardiac ischemia leads to increased fibroblast activity. They provoke the proliferation of connective tissue.
A heart attack appears as a scar. If its extensive form has been experienced, then necrosis affects the volumetric area of the myocardium.
Surgeries on the heart muscle leave behind a trace in the form of a patch of connective tissue at the site of the intervention.

Dystrophy of cardiac muscle tissue manifests itself mainly due to a failure of metabolic processes in cardiomyocytes of a non-inflammatory nature. The changes gradually worsen against the background of the development of other pathologies.

Heart cells lack vital elements to function normally, causing them to become exhausted and arrhythmias to occur. In medicine, myocardial dystrophy is also called cardiodystrophy. The most current list of reasons for its occurrence is as follows:

Constant disruptions in the functioning of the liver and kidneys lead to the development of failure of these organs. Toxic substances begin to accumulate in the blood, which disrupt metabolic processes throughout the body.
Diseases of the endocrine organs (pancreas, thyroid, adrenal glands) provoke excessive production of hormones. They affect the entire body, especially the cardiovascular system.

Anemia occurs due to an acute deficiency of hemoglobin in the blood. Lack of this iron-containing protein often causes myocardial dystrophy.
Various irritating factors (stress, overwork, overeating or dieting) gradually provoke depletion of the heart muscle.
In childhood, the problem arises due to a combination of psycho-emotional overload and insufficient physical activity. In a child, these factors provoke the development of vegetative-vascular dystonia, which disrupts the normal regulation of the heart due to disruptions in the autonomic nervous system.
Diseases caused by infections (tuberculosis, influenza, malaria) can deplete the body and have a detrimental effect on all its systems.
Fever and its inherent dehydration overload the heart and blood vessels and provoke dystrophy due to a lack of nutrients.
Acute intoxications caused by alcohol, medications and chemicals, or chronic intoxications caused by poor environment or work, lead to depletion of the body.

The most common and common cause of heart dystrophy is a lack of nutrients in the body due to an incorrect diet. Sometimes it is provoked by the following diseases:

atherosclerosis;
ischemia;
hypertonic disease;
arrhythmia;
myocardial hypertrophy.

Metabolic abnormalities are caused by disruptions at the cellular level. They manifest themselves as impaired exchange of potassium and sodium in cardiomyocytes, as a result of which the heart does not receive the required energy for full contraction and relaxation. If the changes that occur are not serious and occur due to overwork, obesity, stress and hormonal surges (during pregnancy, during puberty), then we are talking about a nonspecific lesion. They are also provoked by disruptions in the metabolism of cardiomyocytes. Severe metabolic disorders in heart cells occur due to the influence of the following factors:

hypertension;
cardiomyopathy;
acute rheumatic fever;
cardiosclerosis;
angina pectoris.

It is considered a completely natural phenomenon if the left ventricle of the heart is slightly changed in children or the elderly. In the first case, the problem lies in changes in the body associated with active growth and an imperfect metabolic process. In older patients, deviations in the structure of the myocardium are acceptable due to aging and wear of all tissues.

Diagnostic and treatment methods

The cardiologist prepares treatment only on the basis of the examination results. If the patient does not have a dangerous heart pathology, then the doctor may advise taking vitamin complexes, especially in autumn and winter, monitoring blood pressure levels and adjusting lifestyle. If there is a suspicion of the secondary nature of changes in the myocardium, that is, development under the influence of other diseases, the following diagnostic methods will be prescribed:

Donating blood to determine the amount of hemoglobin, checking the level of white blood cells and the erythrocyte sedimentation rate.
Study of the composition of urine to assess the condition of the kidneys.
Carrying out a biochemical blood test to determine the level of protein, sugar and cholesterol.
Conducting 24-hour ECG monitoring with and without exercise to assess the condition of the heart.
Performing an ultrasound examination of internal organs to check for abnormalities in their structure.
Study of the heart muscle using an echocardiograph to visualize its parts and determine the cause of myocardial changes.
The use of electrocardiography (ECG) to detect any abnormalities in the heart's rhythm, as well as in its conductivity and structure.

Having received all the necessary data, the doctor will assess the patient’s condition. If the cause is not only in the heart, then he will advise you to consult with other specialists (endocrinologist, gastroenterologist, hematologist) to develop a comprehensive treatment. An important advantage of a timely course of therapy is the high chance of eliminating pathological changes. In fact, in 90% of cases, myocardial cells are able to recover completely.

If even modern diagnostic methods could not help identify the cause of the problem, then treatment is aimed at achieving the following goals:

stop the clinical picture of heart failure;
protect cardiomyocytes and restore their functions;
normalize metabolic processes in the heart.

The following groups of drugs are commonly used in the treatment of heart failure:

Cardiac glycosides (Strofanthin, Digitoxin) increase vascular tone, eliminate arrhythmias, reduce the duration of the contraction phase of the heart muscle and improve its nutrition.

Antiarrhythmic drugs (Amiodarone, Dofetilide) block beta and alpha adrenergic receptors, improve myocardial nutrition and have a coronary dilation effect.
Diuretics (Lasix, Britomar) reduce venous return to the heart and remove excess moisture from the body, lowering blood pressure.

To stimulate metabolic processes, doctors prescribe the following drugs based on beneficial substances:

"Cocarboxylase" (coenzyme);
“Doppelgerts Active”, “Asparkam” (magnesium, potassium);
“B-Complex”, “Neurobion” (B vitamins);
"Preductal", "Mexidol" (antioxidants);
"Riboxin" (metabolic agent).

The following drugs may be required as an addition to the main treatment regimen:

hypotensive;
sedatives;
hormonal (for endocrine disruptions);
antiallergic;
antibacterial.

Folk remedies are often included in the treatment regimen for myocardial changes, as they saturate the body with necessary substances and calm the nervous system. The most relevant decoctions of the following herbs:

hawthorn;
Melissa;
motherwort;
peppermint;
cranberry;
peony;
rose hip.

Maintaining a healthy lifestyle

Comprehensive treatment of any pathology consists not only of taking medications, but also of a properly selected diet. In the presence of moderate changes in the myocardium, it is recommended to adhere to the following rules:

It is not recommended to overeat or starve;
the daily amount of salt consumed should not exceed 5 g;
It is imperative to add vegetables and fruits to your diet;
the daily menu should contain only low-fat varieties of fish and meat;
You need to eat 4-5 times a day, and take your last meal 3-4 hours before bedtime;
It is advisable to completely avoid fatty foods;
It is recommended to cook by steaming or boiling.

The rules of a healthy lifestyle, which are given below, will help normalize metabolic processes in cardiomyocytes:

sleep at least 6-8 hours a day;
to refuse from bad habits;
try to avoid stressful situations;
exercise at a moderate pace without overload.

Forecast

Moderate changes in the structure of the heart muscle are not pathology. They are a consequence of the influence of other diseases, so if the cause is eliminated in a timely manner, the process can be reversed without harm to health. The prognosis will improve if you follow all the doctor’s recommendations and do not allow the condition to worsen, since cardiomyocytes will need time to fully recover. In mild cases, it can be cured without drug therapy.

A less optimistic prognosis when moderate changes are combined with signs of heart failure. It is possible to completely reverse the process if the muscle tissue of the myocardium has not yet been replaced by connective tissue that does not transmit electrical signals. Doctors usually prescribe medications that improve metabolic processes and give recommendations for correcting nutrition and rest.

Serious diffuse changes cause the development of dangerous forms of heart failure and cardiosclerosis. It is impossible to completely eliminate them. Treatment consists of attempts to stop the pathological process and improve the patient’s quality of life.

Moderate changes in the myocardium are among the most common pathological abnormalities in the structure of the heart muscle. In most cases, they lead to nothing and do not manifest themselves. The problem is usually discovered during a routine examination. As a means of treatment, the doctor prescribes drugs that improve metabolic processes in cardiomyocytes and stabilize the functioning of the heart. If the case is advanced, then it is not possible to completely reverse the changes and the patient will have to take medications for life.

The human heart muscle is a unique complex of cells that are capable of transforming energy obtained as a result of biochemical processes into mechanical energy that causes contractions of the heart. This type of activity depends on many factors contributing to intracellular metabolism in the myocardium. Therefore, any changes in the constancy of the internal environment of the body can be reflected in disruption of the vital activity of heart cells, be it heart disease, hormonal imbalance in the body, or a condition after an infectious disease.

Diffuse changes in the myocardium are not a disease, but a syndrome, upon detection of which the doctor should determine whether the cause was a serious illness or minor metabolic disorders. The occurrence of such signs is due to the fact that some cells, due to biochemical changes, begin to work and contract not quite correctly, as a result of which the electrical activity of the areas of the heart muscle recorded on the ECG will not be uniform. In other words, diffuse changes in the myocardium are accumulations of altered cells through which the conduction of electrical impulses is impaired.

Disturbances in cell activity can be not only diffuse, that is, covering areas throughout all parts of the heart, but also focal, for example, with the formation of small or large scars in the myocardium. Scars are represented by connective tissue that cannot conduct impulses and is electrically inert, which is what the doctor sees on the cardiogram.

Why do myocardial changes occur?

The reason for such deviations on the cardiogram can be either harmless or quite serious, posing a threat to human life. In order to find out more precisely what exactly causes diffuse or focal changes in the myocardium, it is necessary to carefully examine the patient. Pathological changes in the myocardium can be caused by various processes, and therefore several subgroups are distinguished among them.

The causes of inflammatory changes are– infectious or aseptic (without the participation of microorganisms) inflammation of the heart muscle. As a rule, areas of inflammation are located diffusely, but can also occur in the form of foci.

Myocarditis. The photo on the right shows a heart in cross section. Arrows indicate diffuse inflammatory processes in cardiac tissue during myocarditis

Myocarditis of varying severity occurs in diseases such as:

Acute, caused by hemolytic streptococci due to previous tonsillitis, scarlet fever or chronic tonsillitis,
Diphtheria, typhus,
Influenza viruses, measles, rubella, Coxsackie, etc.
Autoimmune diseases, for example, rheumatoid arthritis with heart damage, etc.

Dystrophic changes in the myocardium are characterized by metabolic and functional disorders in cardiac cells caused by non-inflammatory and non-coronarogenic (not caused by damage to the coronary arteries) diseases. Literally, this means that myocardial cells lack nutrients to carry out their vital functions, which leads to their heterogeneous contraction. This condition is called differently. This condition may occur in the following cases:

Severe dysfunction of the liver and kidneys with the development of failure of these organs, as a result of which toxic metabolic products accumulate in the blood,
Diseases of the endocrine organs - tumor of the adrenal glands, hyperfunction of the thyroid gland, as a result of which excess hormones or insufficient absorption of glucose by the heart cells lead to disruption of intracellular metabolism,
Constant stress, exhausting physical activity, malnutrition and starvation, chronic fatigue,
In children, in addition to the previous reason, changes in the myocardium can be caused by increased emotional and mental stress in the absence of sufficient mobility, as a result of which disturbances in the regulation of the heart from the nervous system develop,
– decrease in hemoglobin in the blood and, as a result, oxygen starvation of myocardial cells,
Acute and chronic infectious diseases (influenza, malaria, tuberculosis),
Fever and dehydration,
Lack of vitamins in food,
Acute and chronic intoxications - alcoholism, occupational poisoning with chemicals, etc.

Metabolic changes in the myocardium are caused by disruption of repolarization processes in muscle cells. Depolarization and repolarization are subtle mechanisms for the exchange of potassium and sodium ions within each cell, the energy generated during which is converted into the energy necessary for contraction and relaxation of the cell. When the electrolyte composition in the blood and heart muscle is disturbed, a change in the metabolism of muscle cells occurs. Sometimes such violations in the ECG conclusion are formulated as nonspecific changes in the myocardium.

In addition to conditions that can provoke myocardial dystrophy, this can be caused by coronary arteries and,. That is, those conditions in which the heart does not receive enough nutrients and microelements. We can say that disruption of repolarization processes and moderate changes in the myocardium mean that this is not so much coronary heart disease as the first bell for the patient that the blood supply to the heart muscle is impaired, and in the near future he is likely to develop myocardial ischemia.

Minor and moderate changes in the myocardium of the left ventricle in childhood due to imperfect metabolism and in elderly people due to the aging processes of all internal organs are considered absolutely normal.

Cicatricial changes in the myocardium indicate that an inflammatory process previously occurred in the heart muscle or a myocardial infarction with necrosis (death) of heart cells was suffered. Scar changes after myocarditis, also called, as a rule, diffuse, and after - focal. The differences between these terms are that cardiosclerosis is a diagnosis that reflects the disease, and cicatricial changes in the myocardium are the pathomorphological basis of the disease, reflected on the cardiogram. Post-infarction cardiosclerosis is often represented by a focal scar, and can be large or small focal, and located along one or several walls of the left ventricle - the lower (posterior) wall, its anterior or lateral sections.

Can there be symptoms with diffuse changes in the myocardium?

As a rule, in the absence of cardiac pathology, changes on the ECG do not manifest themselves clinically and are only an accidental finding during examination. However, the patient must undergo further examination as prescribed by the doctor to make sure that he does not have initial signs of any disease and, if necessary, begin timely treatment.

By themselves, diffuse changes in the myocardium do not have any clinical signs, especially if we are talking about minor or moderate changes. Nevertheless, pronounced changes heart muscle in most cases indicate some kind of cardiac or other disease, therefore, symptoms of the underlying disease may appear. These include heart pain caused by myocardial ischemia; and edema in cardiosclerosis; signs of chronic heart failure after a previous myocardial infarction; trembling of the limbs, weight loss and anterior displacement of the eyeballs (exophthalmos) with hyperfunction of the thyroid gland; pallor, dizziness and weakness with anemia, etc.

In this regard, a patient with diffuse changes in the myocardium must remember that if he experiences unpleasant symptoms, he should consult a doctor as soon as possible to determine the cause of this condition.

What examination may be needed?

In each specific case, only a doctor, when examining the patient in person, can decide whether there is a need for further examination. For example, with minor diffuse changes in the myocardium in adult patients without signs of a serious illness, the doctor may limit himself to recommendations for correcting blood pressure levels, maintaining a healthy lifestyle and taking vitamins.

If there is a suspicion of a disease that has caused changes in the myocardium, additional diagnostic methods may be prescribed:

Treatment

Therapy for absolutely any disease begins with lifestyle correction and the basics of a balanced diet. When it comes to dystrophic or metabolic changes in the myocardium of minor and moderate severity, sleep patterns, proper rest and diet become of fundamental importance.

To sufficiently supply the heart muscle with energy substrates, it is necessary to receive balanced and healthy food 4-6 times a day.

The diet includes lean varieties of meat and poultry, which is most important for anemia, sea and red fish, red caviar, fruits and vegetables, especially peaches, apricots, bananas, carrots, potatoes, spinach, and nuts. Daily consumption of dairy products, grains and cereal products is also beneficial. Confectionery and chocolate, fatty meat and poultry are limited. Salty, fatty, fried, spicy and spicy foods, alcohol, coffee, carbonated drinks are excluded.

To improve metabolism (metabolism) in cardiac tissues, drugs such as:

Panangin, asparkam, magnerot, magne B6 - contain potassium and magnesium necessary for proper myocardial contractions,
Actovegin, Mexidol are antioxidants that eliminate the negative effects of lipid peroxidation (LPO) products in myocardial cells,
Vitamins A, C, E, group B are essential participants in intracellular metabolism.

If pronounced diffuse changes in the myocardium are caused by a disease, its treatment is required. For example, replenishment of hemoglobin deficiency with iron-containing drugs, correction of thyroid function, antihypertensive drugs for arterial hypertension, antibiotic therapy and prednisolone for myocarditis, diuretics and cardiac glycosides for heart failure caused by cardiosclerosis, etc.

The myocardium is the heart muscle; some of its structural changes are often provoked by external and internal factors. Transformations do not always indicate pathology or any negative disorder, but in any case, they need to be focused on. After all, the heart is an important organ of the human body; it is akin to a car engine: it converts biochemical reactions into mechanical energy. The movements of the heart muscle must maintain rhythm; any disturbances in this process and changes in the myocardium are shown by an electrocardiogram (ECG).

Signs of a problem

Cardiac activity depends on many criteria that affect intracellular metabolism in the tissues of the heart muscle. The constancy of the internal environment can be periodically disrupted, which can lead to disruptions in the functioning of the heart cells. Diffuse changes in the myocardium are not considered a disease; it is a syndrome that means an accumulation of changed cells with impaired conduction of electrical impulses in a given area, clearly displayed on the ECG. It is important to determine the cause of such failures; it may be hormonal in nature, infectious in origin, or a consequence of heart disease of varying severity.

Changes are not always only diffuse, covering sectors in each department of the organ. They can be focal as a result of the formation of scars in the myocardium of any size. The scar is a connective tissue that does not conduct impulses; the electrical inertia of this area is visible on the cardiogram.

The variety of myocardial diseases is very large, but the general signs of problems with the cardiovascular system and symptoms of myocardial changes are as follows:

burning and pressing pain behind the sternum;
shortness of breath at the slightest physical exertion or even at rest;
disturbances of heart rhythm and contraction frequency;
increased fatigue, general weakness, chronic fatigue.

The primary change in the heart muscle provokes the development of certain processes:

myocardial hypoxia;
circulatory disorders;
disruptions in the transport of oxygen to cells and tissues;
irreversible necrotic consequences.

A critical case of the development of myocarditis is an acute infarction; its course also varies.

Causes of myocardial changes

The detected deviations have different origins. The reasons can be minor or significant. The latter provoke a fatal outcome. A thorough examination will reveal the problem to an experienced cardiologist.

Changes in the myocardium can form several groups of factors:

Inflammatory. They cause myocarditis. Its nature can be infectious or aseptic, that is, pathogenic microorganisms do not take part in this process. Typically, such areas have a diffuse location, but sometimes there are foci of inflammation.

Manifestations of myocarditis, expressed with varying degrees of intensity, accompany the following pathologies:

typhus, diphtheria;
acute rheumatic fever or rheumatism of streptococcal origin, which is a consequence of tonsillitis, tonsillitis, scarlet fever;
weakened immune system (systemic lupus erythematosus, rheumatoid arthritis affecting the heart, etc.);
damage by viruses of rubella, measles, influenza, etc.

diseases of the endocrine system: hyperfunction of the thyroid gland, diabetes mellitus, tumor of the adrenal glands, as a result, an excessive amount of hormones or a lack of glucose in the heart cells provoke disruptions in metabolic processes within these cells;
liver and kidney failure lead to the accumulation of toxins in the blood resulting from metabolic processes;
anemia - a decrease in hemoglobin levels - brings with it a lack of air for the heart muscle cells;
dehydration, fever;
severe physical conditions: frequent stress, hard work, constant overwork, malnutrition and starvation;
mental stress combined with increased emotional stress leads to changes in the myocardium in children, especially if the child is not active enough; here among the consequences are vegetative-vascular dystonia and disruptions in the control of the nervous system of the heart;
infections: tuberculosis, influenza, malaria;
intoxication - acute or chronic, including alcoholism, work in hazardous industries, constant contact with chemicals;
food unsaturated with vitamins.

Diagnosing and fixing the problem

Minor changes in the myocardium will not require drastic measures. The patient will be advised to adjust blood pressure, take a course of vitamins and adhere to a healthy lifestyle.

More serious changes in the myocardium already imply the presence of a disease; for diagnosis, the following measures are usually performed:

Clinical blood test. Examines hemoglobin levels and inflammation criteria.
Biochemistry of blood. Determines the condition of the liver, kidneys, the amount of glucose, protein, cholesterol.
General urine analysis. Evaluates renal activity.
Ultrasound. Visual examination of internal organs.
ECG. Diffuse changes are indicated by a decrease in T waves, responsible for ventricular repolarization. Focal changes are indicated by negative T waves in 1–2 sectors.
Echocardiogram. The most informative method that identifies the causes of changes in the heart muscle thanks to clear visualization of its parts.

Therapy must be combined with correction of diet and lifestyle. Changes in the myocardium of a dystrophic or metabolic nature by default require proper rest, adherence to sleep patterns and diet.

The heart responds well to those present in the diet:

nuts;
spinach;
carrots and potatoes;
apricots, peaches, bananas;
lean poultry and meat;
red fish and caviar;
cereals, grains;
dairy products.

Chocolate and confectionery products should be consumed to a minimum. Fatty meat and poultry are extremely rare. Soda, coffee and alcohol are excluded. You should also remove spicy, fatty, salty, spicy and fried foods.

The following drugs help improve metabolic processes in heart muscle cells:

“Asparkam”, “Panangin”, “Magne B6”, “Magnerot” - potassium and magnesium stabilize the frequency of contractions.
“Mexidol”, “Actovegin” are antioxidants that eliminate lipid oxidation products in myocardial cells.
Vitamins A, B, C, E - without them, intracellular metabolism is impossible.

If the cause of myocardial changes is a disease, then appropriate therapy will correct the situation. The lack of hemoglobin is compensated for with iron-containing drugs; for myocardial inflammation, antibiotics and Prednisolone are prescribed; for cardiosclerosis, urinary agents and cardiac glycosides are indicated.

All people know that the most important organ in the human body is the heart. Any disturbances in its work immediately have a negative impact on well-being. A person cannot live without this organ. Therefore, it is very important to monitor the condition and activity of the cardiovascular system.

And if after the ECG some changes were detected, and the doctor said that you have moderate changes in the myocardium. Should I be concerned in this case, and what measures should be taken?

What are moderate changes in the myocardium

The human heart works throughout life without rest or interruption. Therefore, over the years, even in a healthy person, this organ gets tired, and various disturbances in the functioning of the cardiovascular system arise. Changes in the myocardium are not always life-threatening; some simply require correction of the daily routine and nutrition.

If a person does not complain, and changes are detected only during a routine medical examination, then there is no need to worry.

But if various deviations in well-being occur, you need to sound the alarm. And the first thing you need to do is make an appointment with a cardiologist.

The main complaints of the patient with changes in the myocardium

interruptions in the heart;
heart pain;
fluctuations in blood pressure;
lack of air at the slightest physical exertion;
drowsiness;
fatigue, weakness.

Is treatment required in this case? It all depends on the appearance of the transformations, because they are all classified into varieties.

Types of pathological changes

There are several types of myocardial transformations

nonspecific;
dystrophic;
metabolic;
diffuse.

Depending on the type, therapy is prescribed. Let's look at each variety.

Nonspecific changes

Moderate nonspecific changes in the ventricular myocardium are the safest type

Usually these conditions do not pose a particular danger to life and health, they can be completely reversible. Often they do not manifest themselves in any way, but are only noticed on a cardiogram. A patient with nonspecific changes in the myocardium most often does not present any complaints.

They arise for a reason

food or chemical poisoning ;
frequent stress;
infectious diseases;
poor nutrition;
overwork;
violations of the daily routine;
lack of sleep;
drinking alcoholic beverages.

Otherwise, nonspecific changes in the myocardium are called repolarization. In this case, usually no special therapy is required, but the doctor may advise adjusting the work and rest schedule, diet, and feasible sports activities.

Dystrophic changes

Dystrophic changes in the myocardium occur due to a lack of nutrients that the heart muscle should receive. Otherwise, this condition is also called “cardiac dystrophy.”

Cardiac dystrophy occurs for many reasons

physical overload;
frequent stress;
low hemoglobin;
diseases of the endocrine system, in particular diabetes mellitus;
poisoning;
dehydration of the body;
infectious diseases;
chronic diseases;
disorders of the kidneys and liver, causing intoxication;
diets leading to a lack of vitamins;
alcohol intoxication.

Sometimes dystrophic changes occur in childhood. In this case, they do not require treatment, since the child's heart is prone to change. The same can be said for older people, whose cardiovascular system is already susceptible to fatigue and, as a result, imperfect.

Often, dystrophic changes in the myocardium can be seen in schoolchildren taking exams.

Diffuse changes

These are changes that uniformly affect the heart muscle. They arise as a result of inflammation of the myocardium due to a large number of medications or a violation of the water-salt balance. This leads to metabolic disorders and disease, hypoxia.

Among the causes of hypoxia are the following:

frequent stress;
chronic diseases;
physical overload;
excess weight;
hypothermia of the body;
alcohol intoxication.

This condition is easily corrected with the help of a proper diet and daily routine. Have a good night's sleep.

The symptoms of the disease are as follows

dark circles under the eyes;
dyspnea;
increased fatigue;
spots before the eyes;
decreased performance;
lack of air;
drowsiness.

If these signs appear, you must urgently contact a specialist and conduct an examination.

Metabolic changes

Dysmetabolic changes in the myocardium are considered the most harmless and do not have any symptoms and, as a rule, are detected after the next examination. They arise due to overwork, stress, and as a result of taking certain medications.

Usually the doctor recommends in these cases to simply change your daily routine or rest. However, you should not take this disease lightly and neglect the doctor’s advice, because this can lead to serious consequences.

Left ventricular hypertrophy

This is already a dangerous change in the myocardium, requiring careful conservative and sometimes surgical treatment.

Normally, the thickness of the left ventricular myocardial wall is 7-11 mm, but with some complications (high blood pressure, for example), the heart has to pump more blood. As a result, the myocardial wall stretches, unable to withstand the overload, and an increase in the size of the ventricle develops.

This condition is called left ventricular hypertrophy. It can be either congenital or acquired. The latter occurs in athletes and people experiencing constant physical overload. Therefore, people who have connected their lives with sports are recommended to undergo regular medical examinations.

Otherwise, LVMH is called an “overworked heart.” It is especially dangerous when LVMH occurs during pregnancy. Then there is a threat to both the life of the mother and the fetus. Therefore, it is urgent to take action.

There are diseases that provoke left ventricular myocardial hypertrophy:

arterial hypertension;
atherosclerosis of the aorta;
narrowing of the aortic valve.

But if the myocardial expansion is no more than 18 mm, then no treatment is prescribed.

What are the symptoms of this disease?

Usually a person feels with left ventricular hypertrophy:

dizziness;
weakness;
shortness of breath;
swelling;
chest pain;
interruptions in the heart.

Symptoms usually increase after exercise and stress. They also intensify during pregnancy.

Diagnostic and treatment methods

If these symptoms appear, a person should immediately contact a medical facility for examination.

It usually consists of procedures such as

external examination of the patient, measuring blood pressure, pulse;
echocardiograms;
electrocardiograms;
duplex scanning of the aorta.

Doppler echocardiography is sometimes ordered to determine blood flow velocity and turbulence.

If identified moderate changes in the left ventricular myocardium, then supportive treatment can be prescribed. These are usually drugs containing potassium and magnesium (for example, Panangin or Asparkam).

The doctor will also recommend a special diet, which involves avoiding salty, smoked, and fatty foods. On the contrary, it will be useful to include foods rich in potassium and magnesium in your diet.

Healthy foods

fish roe;
dried apricots;
raisin;
buckwheat;
bananas;
prunes;
walnuts;
fish of the salmon family.

But if there is left ventricular hypertrophy, special treatment is required. When this disease is combined with hypertension, antihypertensive drugs are usually prescribed.

This is usually

angioconverting enzyme inhibitors;
beta blockers;
drugs that block calcium channels.

If LVMH is accompanied by aortic atherosclerosis, then the following medications are prescribed

statins;
endotheliotropic drugs;
blood thinners.

For concomitant arrhythmia, nitrates and antiarrhythmic substances are prescribed

If left ventricular myocardial hypertrophy is caused by a heart defect, then surgery cannot be avoided.

There are usually two types of surgeries for LVH: aortic valve replacement and aortic stenting.

There is treatment for this condition with folk remedies. This recipe works well.

You need to take a lemon, pass it through a meat grinder, add dried apricots, prunes, raisins, and pour honey. Take a teaspoon of the mixture in the morning.

Forecast

With a mild course of the disease, the prognosis is favorable if you follow all the doctor’s recommendations: normalize your daily routine, establish a balanced diet, and get proper rest.

If there is hypotrophy of the left ventricle, complicated by a heart defect, then surgery is necessary. In its absence, life expectancy is no more than five years in 95% of patients.

According to statistics, more than half of older men and about a third of women suffer from various heart diseases. Myocardial ischemia is one of the most common pathologies; it is widespread both in highly developed countries and in those where the level of medicine leaves much to be desired.

The particular danger of this disease is that it can proceed in a latent form for years, only occasionally manifesting itself as unpleasant sensations in the heart area, and subsequently causes a massive heart attack and sudden death.

So, let's figure out what it is - myocardial ischemia, and what types of pathology there are.

Typically, the disease is classified as follows:

– is the most common form of ischemia. It is usually asymptomatic and is diagnosed mainly in older people. People who have prerequisites for atherosclerosis are especially susceptible to this pathology.
– one of the most severe and irreversible manifestations of ischemia. This condition is necrosis of areas of the myocardium due to acute lack of oxygen, and is often the cause of death. But even with successful healing of the necrotic lesion, a scar will still remain in its place (post-infarction cardiosclerosis).
– disruptions in the normal functioning of the heart, in which it stops contracting with the proper frequency.
Sudden coronary death.
Post-infarction cardiosclerosis.

In any case, myocardial ischemia causes the gradual development of pathological changes in the heart. Such patients are particularly at risk in the limbs, kidneys, or brain.

A special form of pathology is transient ischemia of the heart muscle. This disease occurs in approximately 1/2 of the patients suffering from coronary heart disease, but it does not manifest itself externally at all - abnormalities can only be detected with the help of instrumental examination. Most often, this pathology develops in smokers, hypertensive patients and patients with congestive heart failure.

The main sign by which one can suspect is pain, which occurs in both chronic and acute forms of the pathology.

The heart is an organ that works without interruption, pumping a huge amount of blood throughout the body, and expending large amounts of nutrients and oxygen. And sudden vascular spasms, blood clots and atherosclerotic plaques interfere with normal blood circulation, resulting in pain and pathological changes.

Myocardial ischemia of the left ventricle is usually the basis of all ischemic heart diseases, since the left part of the organ bears a much greater load than the right, and in order to properly supply it with oxygen it requires consistently good blood circulation.

The causes of myocardial ischemia can be very diverse, but among the main provocateurs it is customary to highlight the advanced age of patients, being male, genetic predisposition, obesity, smoking, hypertension, physical inactivity and metabolic disorders.

Of course, people of respectable age are the main patients of cardiology departments, since over the years the metabolic processes in the body deteriorate, various diseases develop, and degenerative changes in the blood vessels begin. Although recently there has been a clear trend towards rejuvenation of cardiac pathologies, especially among residents of megacities.

In the female body, estrogens play a certain protective role, so myocardial ischemia occurs much less frequently in the fair sex than in men. However, at the age of approximately 70 years, when the period of persistent menopause sets in, the chances of getting the disease are equal for both sexes.

Obesity entails a huge number of pathologies, since it causes the deposition of lipid formations on the arterial walls, as a result of which blood circulation becomes difficult and hypoxia () of the heart tissue begins. The situation is further aggravated by the presence of diabetes mellitus in the patient.

All of these factors provoke the occurrence of the main causes of lack of oxygen - blood clots, atherosclerosis.

Symptoms of myocardial ischemia largely depend on the type of disease and the degree of arterial damage. The most common type of disease is the so-called angina pectoris, when pain in the heart area appears after any physical effort.

Signs of angina pectoris include:

Pain in the chest region, which radiates to the left arm and the area between the shoulder blades, and appears or intensifies during physical activity.
Shortness of breath during emotional stress or fast walking.

If the listed signs and symptoms occur only during periods of exertion, last no more than half an hour and are relieved with nitroglycerin, they speak of exertional angina. In cases where pain occurs for no apparent reason, we can talk about so-called angina at rest. If the pain tends to intensify from time to time, the effect of taking medications is gradually lost and resistance to physical activity decreases, they speak of a progressive form of pathology.

Myocardial infarction is an extremely severe ischemic manifestation, which makes itself felt by very severe pain in the retrosternal region. The person becomes restless, shortness of breath appears, the skin becomes bluish, fear of death and psychomotor agitation arise. In rare cases, the patient begins to have a stomach ache, but no direct manifestations of a heart attack are observed.

A very dangerous version of ischemia is sudden cardiac death, which occurs against the background of an attack of angina or necrosis. This condition requires urgent resuscitation measures.

Diagnosis of myocardial ischemia is carried out by examining and interviewing the patient, listening to the heart and lungs, on the basis of which the doctor may suspect the diagnosis. To confirm or refute it, the patient is prescribed a number of additional studies: an electrocardiogram at rest and with stress, a biochemical blood test, Holter monitoring.

To clarify the diagnosis, examinations such as coronary angiography, MSCT, contrast-enhanced CT and scintigraphy are also performed. Unfortunately, due to the lack of necessary equipment, some of the studies are not available in all medical institutions, so patients are forced to go to private clinics to conduct them.

Treatment

Treatment of myocardial ischemia is prescribed individually for each patient, and depends on the severity of the pathology, the patient’s condition, and the presence or absence of concomitant diseases. However, the basic principles of therapy remain unchanged in all cases.

First of all, the treatment of ischemic diseases involves:

Moderate physical activity (exercise, walking) and avoiding excessive overload.
Compliance with a special diet (the same as that prescribed for atherosclerosis) aimed at improving metabolism. If body weight is significantly higher than normal, it must be reduced by reducing the amount of food and reducing its calorie content.
Drug therapy, medications for which are prescribed by a doctor individually.

All patients, without exception, are prescribed antiplatelet agents - acetylsalicylic acid, on the basis of which they are created, shows excellent results in the fight against pathology. If necessary, the doctor additionally prescribes the use of anticoagulants. In case of a heart attack, heparin is required.

Beta-blockers are considered very important drugs, which help regulate the heart rate and reduce the need for oxygen, thereby increasing the life expectancy of patients.

Fibrates and statins help reduce the content of atherogenic cholesterol fractions, while increasing the amount of antiatherogenic ones.

Nitroglycerin is very effective in relieving pain. It is used both in the form of tablets and injections. However, this drug should be used with extreme caution by hypotensive patients, since its side effects can include a sharp decrease in blood pressure, fainting and dizziness.

To remove excess fluid that creates a load on the myocardium, diuretics are used - thiazide, diuretics and loop drugs.

Almost all treatment regimens for ischemic diseases include ACE inhibitors, since they relieve vascular spasms and normalize blood pressure, stabilizing its values.

If a patient has cardiac arrhythmia, he is prescribed antiarrhythmic drugs. For tachycardia, beta blockers will be required, for other forms - cordarone or amiodarone.

In cases where the arteries are very severely affected and drug therapy does not have the desired effect, surgical correction is performed. Both more gentle techniques (stenting or balloon angioplasty) and radical ones (coronary artery bypass grafting) are used.

Ischemic heart diseases always have an extremely serious prognosis. The vast majority of people become disabled as a result of this pathology, and the risk of complications and even death is extremely high. Due to the widespread prevalence of the disease, specialists are making every possible effort to find the best way to treat the pathology and its successful prevention.