Ischemic heart disease (CHD)

Ischemic heart disease – lack of blood supply to the heart muscle, stimulated by atherosclerosis of the coronary arteries of the heart, thrombosis of atherosclerotic or normal arteries is called coronary heart disease (CHD). In developed countries, this disease is the main cause of death for people of working age.

Ischemia translated from Latin means lack of blood supply. The human heart works continuously throughout life. Therefore, it constantly needs oxygen and other substances necessary for work. During physical activity, the body’s need for oxygen and nutrients increases and the heart is forced to work harder, in turn, it also needs increased blood supply. Only the human brain is more sensitive to oxygen starvation.

To deliver oxygen to muscle cells, the heart has its own branched vascular system. They are called coronary arteries. With the narrowing of these vessels, the delivery of oxygen and nutrients to the heart is reduced and the heart muscle begins to suffer from oxygen deficiency.

The most common cause of narrowing of the coronary vessels are the so-called atherosclerotic plaques that form on the walls of blood vessels. They lead to a decrease in the amount of blood pumped through this vessel, to a slowdown in blood flow. Sometimes they can block the lumen of the vessel. Atherosclerosis is the cause of 97-98% of cases of coronary heart disease.

Other causes (inflammation of the walls of the arteries, trauma, etc.) are much less common. When the lumen of the vessel is reduced, blood delivery is reduced, ischemia occurs.

This is especially dangerous during physical and psycho-emotional stress, when the heart must work hard, when, in turn, the heart muscle needs increased nutrition and more oxygen, and its delivery is limited. Under such conditions, an attack of angina pectoris or myocardial infarction occurs.

Today, the main causes of changes in the vessels leading to IHD are called nutritional factors:

  • high-calorie diet, leading to the development of obesity;
  • excessive consumption of fats, especially animals, which increase the concentration of cholesterol in the blood;
  • lack of vegetable oils (polyunsaturated fatty acids) in the diet, as well as an excess of flour and sweets;
  • insufficient intake of fiber, pectins and fetates contained in fruits and vegetables and having a hypocholesterolemic effect;
  • deficiency of antioxidants (vitamins A, E, C, supplied with food).

The course of the disease can be different, therefore, the following clinical forms of coronary heart disease are distinguished, which can manifest themselves in isolation or in combination with each other:

  • angina pectoris (angina pectoris, stable angina, spontaneous or variant angina);
  • acute form of coronary heart disease: myocardial infarction (large-focal, small-focal);
  • postinfarction cardiosclerosis;
  • heart rhythm or conduction disturbances;
  • heart failure;
  • silent form of coronary heart disease;
  • sudden death. According to the international classification, this includes cases of sudden cessation of cardiac activity, probably due to ventricular fibrillation or asystole (disappearance of heart contractions) in the absence of data to make another diagnosis.

The most common cause of sudden death is coronary heart disease and at autopsy, damage to the arteries of the heart is found.

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