Ischemic changes in the ventricular myocardium. Pathological changes in the myocardium: moderate and pronounced - 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 the result 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 revealed mainly by accident during a routine examination. Knowingly worry about the presence of moderate changes in the myocardium, not knowing what it is, is not worth it. They usually do not affect the body in any way and do not manifest themselves, but a person will have to be fully examined to determine the causative factor and change their lifestyle.

Pathological abnormalities in the structure of the heart mainly occur in its lower part (in the left ventricle). If they are not particularly pronounced, are not a consequence of cardiological pathology and do not progress, then often the clinical picture is absent. On an ECG (electrocardiogram), such changes do not always appear. It is possible to identify them mainly with a more detailed examination.

More pronounced diffuse changes are manifested by characteristic cardiac symptoms. You can see their list below:

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

Often, patients show symptoms of chronic heart failure after experiencing myocardial infarction. In more rare cases, the cause lies in the dysfunction of the thyroid gland. She begins to produce significantly more than the required amount of hormones, which leads to the following symptoms:

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

The resulting symptomatology gradually progresses. The patient's quality of life will decrease until the appearance of shortness of breath after any physical activity, due to which the ability to work significantly decreases. If moderate changes in the left ventricular myocardium manifested themselves against the background of heart failure, then over time a person may lose the ability to independently perform daily activities. To prevent such complications, it is necessary to be fully examined in order 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.

Varieties of pathological changes

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

Genesis (cause of development) and localization in the listed types of deviations are different. By size, they are divided into diffuse and focal changes in the myocardium. The first type is diagnosed most often. It is characterized by the defeat of all parts of the heart. Focal deviations are isolated areas. In both cases, the altered places are gradually replaced by connective tissue that does not transmit electrical impulses. It will no longer be possible to reverse the process at this stage.

Causes of abnormalities in the structure of the myocardium

In each case, there are reasons for the occurrence of abnormalities in the structure of the myocardium. They have a detrimental effect on the heart and blood vessels. Inflammatory changes appear in the patient due to myocarditis. The disease is of an infectious 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 ingestion of streptococcal infection. It occurs after tonsillitis, tonsillitis, scarlet fever and other similar diseases.
Typhus fever caused by the bacteria rickettsia. It is characterized by damage to the nervous and cardiovascular systems.
Viral infections, which are characterized by complications of the heart muscle. Measles, rubella and influenza are especially common.
Autoimmune disruptions caused by lupus erythematosus and rheumatoid arthritis, provoking complications in the heart muscle.

Cicatricial abnormalities in the structure of the myocardium are manifested mainly for the following reasons:

The prolonged course of cardiac ischemia leads to an increase in the activity of fibroblastates. 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.
Postponed operations on the heart muscle leave a trace in the form of a piece of connective tissue at the site of intervention.

Dystrophy of the tissues of the heart muscle is manifested mainly due to the failure of metabolic processes in cardiomyocytes of a non-inflammatory nature. The changes are aggravated gradually against the background of the development of other pathologies.

Heart cells lack vital elements for normal functioning, due to which they are depleted and arrhythmias occur. In medicine, myocardial dystrophy is also called cardiac dystrophy. The most current list of reasons for its occurrence is as follows:

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

Anemia is manifested 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 failures in the autonomic part of the nervous system.
Diseases caused by infections (tuberculosis, flu, malaria) can deplete the body and adversely affect all its systems.
Fever and its characteristic dehydration overload the heart and blood vessels and provoke degeneration due to a lack of nutrients.
Acute intoxication caused by alcohol, medicines and chemicals, or chronic, caused by poor ecology or at work, lead to depletion of the body.

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

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

Metabolic abnormalities are triggered by malfunctions at the cellular level. They are manifested by impaired metabolism 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 have arisen are not serious and arise 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 malfunctions in the metabolism of cardiomyocytes. Severe metabolic disorders in heart cells are manifested 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 elderly people. In the first case, the problem lies in the restructuring of the body associated with active growth and an imperfect metabolic process. In aged patients, deviations in the structure of the myocardium are permissible due to aging and wear and tear of all tissues.

Diagnostic and treatment methods

Treatment by a cardiologist is compiled only on the basis of the results of the examination. If the patient does not have a dangerous cardiac pathology, then the doctor may advise taking vitamin complexes, especially in autumn and winter, to control the pressure level and correct the lifestyle. If there is suspicion of the secondary nature of myocardial changes, that is, development under the influence of other diseases, the following diagnostic methods will be prescribed:

Blood donation to determine the amount of hemoglobin, check the level of leukocytes and erythrocyte sedimentation rate.
Study of the composition of urine to assess the condition of the kidneys.
Performing a biochemical blood test to determine the level of protein, sugar and cholesterol.
Daily ECG monitoring with and without exercise to assess the condition of the heart.
Performing ultrasound examination (ultrasound) of internal organs for the presence of deviations in their structure.
Examination of the heart muscle using an echocardiograph to visualize its sections and determine the cause of myocardial changes.
The use of electrocardiography (ECG) to detect any abnormalities in the rhythm of the heart, as well as in its conduction and structure.

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

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

stop the clinical picture of heart failure;
to secure 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 ("Strofantin", "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 dilating 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 nutrients:

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

As an addition to the main treatment regimen, the following drugs may be required:

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

Folk remedies are often introduced into the treatment regimen for myocardial changes, since they saturate the body with the necessary substances and soothe the nervous system. The most relevant decoctions on the following herbs:

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

Compliance with a healthy lifestyle

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

overeating or starving is not recommended;
the daily amount of salt consumed should not exceed 5 g;
it is imperative to add vegetables and fruits to your diet;
on the daily menu there should be only low-fat varieties of fish and meat;
you need to eat 4-5 times a day, and take the last meal 3-4 hours before bedtime;
it is advisable to completely abandon fatty foods;
it is recommended to cook steamed or by 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 a pathology. They are a consequence of the influence of other diseases, therefore, with the timely elimination of the cause, the process can be reversed without harm to health. The prognosis will improve if you follow all the doctor's recommendations and prevent the condition from worsening, since cardiomyocytes will take time to fully recover. In mild cases, it is possible to recover without drug therapy.

Less optimistic prognosis with a combination of moderate changes with signs of heart failure. The process can be completely reversed if the muscle tissue of the myocardium has not yet been replaced by connective tissues that do not transmit electrical signals. Doctors usually prescribe medications that improve metabolic processes and give recommendations for correcting nutrition and rest.

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

Moderate changes in the myocardium are among the common pathological abnormalities in the structure of the heart muscle. In most cases, they do not lead to anything and do not appear. The problem is found mainly during a routine inspection. As a means of treatment, the doctor prescribes drugs that improve metabolic processes in cardiomyocytes and stabilize the work of the heart. If the case is neglected, 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 able to transform the energy received as a result of biochemical processes into mechanical energy that causes the heart to contract. This type of activity depends on many factors that promote intracellular metabolism in the myocardium. Therefore, any shifts in the constancy of the internal environment of the body can be reflected in the disruption of the vital activity of the heart cells, whether it be heart disease, hormonal disorders 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 what caused it - a serious illness or minor metabolic disorders. The appearance of such signs is due to the fact that part of the cells during biochemical shifts begin to work and contract not quite correctly, as a result of which the electrical activity of the heart muscle areas 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.

Disorders of cell activity can be not only diffuse, that is, covering areas in all parts of the heart, but also focal, for example, during 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 both harmless and quite serious, posing a threat to human life. In order to more accurately find out 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 diffusely located, but they can also occur in the form of foci.

Myocarditis. The photo on the right is a cross-section of the heart. Arrows indicate diffuse inflammatory processes in the heart tissue in 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, measles, rubella, Coxsackie viruses, etc.
Autoimmune diseases, for example, rheumatoid arthritis with heart damage, etc.

Dystrophic changes in the myocardium are characterized by metabolic and function disorders in the heart cells, caused by non-inflammatory and non-coronary (not caused by coronary artery disease) diseases. Literally, this means that myocardial cells lack nutrients for their vital activity, which leads to their inhomogeneous contraction. This state is called in another way. This condition can occur in the following cases:

Severe violations 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 - adrenal tumor, thyroid hyperfunction, as a result of which an excess of hormones or insufficient absorption of glucose by heart cells leads to a violation of intracellular metabolism,
Constant stress, exhausting physical activity, malnutrition and starvation, chronic overwork,
In children, in addition to the previous reason, increased emotional and mental stress in the absence of sufficient mobility can lead to changes in the myocardium, as a result of which dysregulation of the heart by the nervous system develops,
- a 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 intoxication - alcoholism, occupational poisoning with chemicals, etc.

Metabolic changes in the myocardium are caused by impaired repolarization processes in muscle cells. Depolarization and repolarization are subtle mechanisms of exchange of potassium and sodium ions inside each cell, the generated energy in which is converted into energy necessary for the contraction and relaxation of the cell. When the electrolyte composition in the blood and in the heart muscle is disturbed, a change in the metabolism of muscle cells occurs. Sometimes such violations in the conclusion of the ECG 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 receives insufficient nutrients and trace elements. We can say that impaired 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.

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

Cicatricial changes in the myocardium indicate that an inflammatory process previously occurred in the heart muscle or myocardial infarction with necrosis (death) of heart cells was transferred. Cicatricial changes after myocarditis, also called, as a rule, diffuse, and after - focal. The differences between these terms are that cardiosclerosis is a diagnosis reflecting the disease, and cicatricial changes in the myocardium are the pathomorphological basis of the disease reflected on the cardiogram. Postinfarction cardiosclerosis is more often represented by a focal scar, and can be large or small focal, and located along one or more 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 cardiological pathology, changes in the ECG do not manifest themselves clinically and are only an accidental finding during examination. However, the patient should undergo further follow-up examination as directed by the doctor to make sure that he does not have the 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 when it comes to minor or moderate changes... Nevertheless, pronounced changes the heart muscle in most cases indicates some kind of cardiac or other disease, therefore, symptoms may appear on the part of the underlying disease. These include pain in the heart caused by myocardial ischemia; and edema with cardiosclerosis; signs of chronic heart failure after a previous myocardial infarction; trembling of the limbs, weight loss and displacement of the eyeballs anteriorly (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 should remember that if he has unpleasant symptoms, he should consult a doctor as soon as possible to find out the cause of this condition.

What kind of examination may be needed?

In each specific case, only a doctor, during a face-to-face examination of a patient, can decide whether there is a need for further examination. So, 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 caused changes in the myocardium, additional diagnostic methods may be prescribed:

Treatment

Therapy of absolutely any disease begins with a lifestyle correction and the foundations of a balanced diet. When it comes to dystrophic or metabolic changes in the myocardium of minor and moderate severity, Sleep, proper rest and diet are essential.

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

Low-fat varieties of meat and poultry are welcomed in the diet, which is most important in case of anemia, sea and red fish, red caviar, fruits and vegetables, especially peaches, apricots, bananas, carrots, potatoes, spinach, nuts. Also useful is the daily consumption of dairy products, grains and cereals. Confectionery and chocolate, fatty meats 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, which are necessary for the correct contractions of the myocardium,
Actovegin, Mexidol - antioxidants, eliminate the negative effect of lipid peroxidation products (LPO) in myocardial cells,
Vitamins A, C, E, group B are irreplaceable participants in intracellular metabolism.

If pronounced diffuse changes in the myocardium are caused by a disease, 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 a heart muscle, some of its structural changes are often provoked by external and internal factors. Transformations do not always speak of pathology or any negative violation, 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 follow the rhythm, all sorts of violations of 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 disturbed, which is fraught with malfunctions in the work of heart cells. Diffuse changes in the myocardium are not considered a disease, it is a syndrome that means the accumulation of changed cells with impaired conduction of electrical impulses in this area, clearly displayed on the ECG. It is important to determine the cause of such failures, it can be of a hormonal nature, an infectious origin, or be a consequence of heart diseases of varying severity.

Changes are not always only diffuse, covering sectors in each section 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 inertness 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 pains behind the sternum;
shortness of breath at the slightest physical exertion or even at rest;
violations of the heart rhythm and frequency of contractions;
increased fatigue, general weakness, chronic fatigue.

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

myocardial hypoxia;
circulatory disorders;
failures in transporting oxygen to cells and tissues;
irreversible necrotic consequences.

A critical case of the development of myocarditis is an acute infarction, its course is also different.

Causes of myocardial changes

The detected deviations have different origins. The reasons can be minor and 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. Are the cause of myocarditis. Its nature can be infectious or aseptic, that is, pathogens do not participate in this process. Usually, such areas have a diffuse location, but sometimes there are foci of inflammation.

The manifestations of myocarditis, expressed with varying degrees of intensity, are accompanied by the following pathologies:

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

diseases of the endocrine system: hyperfunction of the thyroid gland, diabetes mellitus, adrenal gland tumor, as a result, an excessive amount of hormones or a lack of glucose in heart cells provoke disruptions in metabolic processes inside these cells;
hepatic and renal failure lead to the accumulation of toxins in the blood, formed as a result of metabolic processes;
anemia - a decrease in the level of hemoglobin - brings with it a lack of air for the cells of the heart muscle;
dehydration, fever;
difficult physical conditions: frequent stress, hard work, constant overwork, malnutrition and starvation;
mental stress in combination with increased emotional stress lead to changes in the myocardium in children, especially if the child is not active enough; here, among the consequences of vegetative-vascular dystonia and failures in the control of the nervous system of the heart;
infections: tuberculosis, flu, malaria;
intoxication - acute or chronic, including alcoholism, work in hazardous work, 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 correct 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 indices and criteria for inflammation.
Blood biochemistry. Determines the state of the liver, kidneys, the amount of glucose, proteins, cholesterol.
General urine analysis. Evaluates renal performance.
Ultrasound. Visual examination of internal organs.
ECG. Diffuse changes are indicated by a decrease in the T waves, which are responsible for ventricular repolarization. Focal changes are evidenced by negative T waves in 1–2 sectors.
Echocardiogram. The most informative method that identifies the causes of changes in the heart muscle due to clear visualization of its departments.

Therapy must be combined with diet and lifestyle correction. By default, changes in the myocardium of a dystrophic or metabolic nature require adequate rest, adherence to sleep 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, cereals;
dairy products.

Eat chocolate and pastries to a minimum. Fatty meat and poultry are extremely rare. Soda, coffee and alcohol are excluded. You also need to remove spicy, fatty, salty, spicy and fried foods.

The following drugs contribute to the improvement of metabolic processes in the cells of the heart muscle:

Asparkam, Panangin, Magne B6, Magnerot - potassium and magnesium stabilize the frequency of contractions.
"Mexidol", "Actovegin" - 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 replenished with iron-containing drugs, antibiotics and "Prednisolone" are prescribed for myocardial inflammation, urinary drugs and cardiac glycosides are indicated for cardiosclerosis.

All people know that the most important organ in the human body is the heart. Any disturbances in his work immediately affect his well-being negatively. 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. Is it worth worrying 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 disorders occur in the work of the cardiovascular system. Changes in the myocardium are not always life-threatening, some simply require correction of the daily regimen and nutrition.

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

But if there are various deviations in health, you need to sound the alarm. And the first thing 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.

Varieties of pathological changes

There are several types of myocardial transformations

non-specific;
dystrophic;
metabolic;
diffuse.

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

Nonspecific changes

Moderate nonspecific changes in the ventricular myocardium are the safest type

Usually these conditions do not pose any particular danger to life and health, they can be completely reversible. Often they do not manifest themselves in any way, but are seen only on the 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;
improper nutrition;
overwork;
violation of the daily routine;
lack of sleep;
taking alcoholic beverages.

Otherwise, nonspecific changes in the myocardium are called repolarization. In this case, special therapy is usually not required, but the doctor may advise you to adjust the work and rest regimen, diet, and feasible sports.

Dystrophic changes

Dystrophic changes in the myocardium occur due to the lack of nutrients that the heart muscle should receive. Otherwise, this condition is also called "cardiodystrophy".

Cardiac dystrophy occurs for many reasons

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

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

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

Diffuse changes

These are changes that evenly 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 to disease, hypoxia.

Among the causes of hypoxia, the following can be distinguished

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

This condition is easily corrected with the correct diet and daily regimen. Adequate sleep.

The symptoms of the disease are as follows

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

When these signs appear, it is necessary to urgently consult 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, due to the intake of certain drugs.

Usually, the doctor recommends in these cases, simply change the regime of the day or take a break. However, you should not be frivolous about this disease 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 wall thickness of the left ventricular myocardium is 7-11 mm, but with some complications (increased pressure, for example) the heart has to distill more blood. As a result, the wall of the myocardium is stretched, not withstanding the overload, and an increase in the size of the ventricle develops.

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

Otherwise, LVH is called "overworked heart." It is especially dangerous when LVH occurs during pregnancy. Then there is a threat to both the life of the mother and the fetus. Therefore, urgent action is needed.

There are diseases that provoke left ventricular myocardial hypertrophy:

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

But if the expansion of the myocardium is not 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. During pregnancy, they also increase.

Diagnostic and treatment methods

When the listed symptoms appear, a person should urgently go to a medical institution for examination.

It usually consists of procedures such as

external examination of the patient, measurement of blood pressure, pulse;
echo cardiograms;
electrocardiogram;
duplex scanning of the aorta.

Doppler echocardiography is sometimes done to measure blood flow velocity and turbulence.

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

Also, the doctor will advise a special diet, which involves avoiding salty, smoked, fatty foods. On the contrary, it will be beneficial to include in the diet foods rich in potassium and magnesium.

Healthy foods

fish caviar;
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

angio-converting enzyme inhibitors;
beta blockers;
drugs that block calcium channels.

If LVH is accompanied by atherosclerosis of the aorta, then the following drugs are prescribed

statins;
endotheliotropic drugs;
blood thinners.

With concomitant arrhythmias, nitrates and antiarrhythmic substances are prescribed

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

Typically, there are two types of surgery for LVH: aortic valve replacement and aortic stenting.

In this condition, there is treatment with folk remedies. This recipe helps a lot.

You need to take a lemon, mince it, add dried apricots, prunes, raisins, pour honey. Take the mixture a teaspoon in the morning.

Forecast

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

If there is left ventricular hypotrophy, complicated by heart disease, 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 elderly 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 lies in the fact that it can proceed in a latent form for years, only occasionally manifesting itself as unpleasant sensations in the region of the heart, and subsequently causes a massive heart attack and sudden death.

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

Typically, the disease is classified as follows:

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

In any case, myocardial ischemia causes the gradual development of pathological changes in the heart. Such patients are especially at risk of limb, kidney, or brain risk.

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

The main symptom by which one can suspect is pain that occurs in both chronic and acute forms of pathology.

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

Ischemia of the left ventricular myocardium is usually the basis of all ischemic heart diseases, since the left side of the organ has a much greater load than the right, and invariably good blood circulation is necessary for its normal supply with oxygen.

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

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

In the female body, estrogens play a certain protective role, therefore, in the fair sex, myocardial ischemia occurs much less often than in men. However, at the age of about 70, when the period of persistent menopause begins, the chances of getting sick 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 is impeded and hypoxia () of the heart tissues begins. The situation is further aggravated by the presence of diabetes mellitus in a patient.

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

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

Signs of angina pectoris are:

Pain in the chest region, which radiates to the left arm and the area between the shoulder blades, and appears or intensifies during physical exertion.
Shortness of breath with emotional strain or brisk walking.

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

Myocardial infarction is an extremely severe ischemic manifestation that makes itself felt with very severe pain in the retrosternal region. A person becomes restless, he has shortness of breath, the skin becomes cyanotic, there is a fear of death and psychomotor agitation. In rare cases, the patient begins to have a stomach ache, and there are no direct manifestations of a heart attack.

A very dangerous variant of ischemia is sudden cardiac death, which occurs against the background of an attack of angina pectoris 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 assigned a number of additional studies: an electrocardiogram in a calm state and with stress, a biochemical blood test, and 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 the necessary equipment, some of the examinations are not available in all medical institutions, so patients have 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, the presence or absence of concomitant diseases. At the same time, the basic principles of therapy in all cases remain unchanged.

First of all, the treatment of ischemic diseases involves:

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

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

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

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

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

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

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

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

In the case when 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 (coronary artery bypass grafting) are used.

Ischemic heart disease always has an extremely serious prognosis. The overwhelming majority of people as a result of this pathology acquire disability, 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.