People with ischemic heart disease. How is acute coronary heart disease manifested and why is it dangerous? Reasons for the development of the disease. Description of risk factors

Ischemia, the symptoms of which are manifested not only by pain in the chest area, is a disorder of the coronary circulation, which leads to insufficient blood supply to the myocardium, metabolic disorders and inadequate supply of oxygen to the heart muscle. Recently, a fairly common disease of cardio-vascular system, which leads to severe irreparable deterioration in health and even lethal outcome. The risk group includes mainly men, women during the period, as well as after menopause, which, with a change in hormonal levels, brings with it a weakening of the body and provokes many diseases.

There are several forms of cardiac ischemia:

• The initial one is painless. There is a decrease blood pressure, discomfort in the chest, shortness of breath.
• Primary arrest - characterized by cardiac arrest. In this case, without immediate professional help, it leads to death.
• Angina. There is a blockage of the coronary arteries with plaques that cause pain in the chest, arm, neck, and facial part.
• Heart attack. Termination of the full flow of blood to the heart.
• Heart failure or cardiosclerosis. Scarring of areas of the heart, violation of the shape of the valves.

If you do not seek medical help in a timely manner, serious complications are possible. At the first sign, you should immediately consult a doctor. The cardiovascular system is involved in the process of blood circulation of the whole organism, and the heart, as its independent organ, also needs blood supply. Coronary vessels or arteries feed the myocardium and heart muscle.

But there are reasons that lead to disruption of this process and the development of coronary disease:

• Atherosclerosis. The formation of cholesterol on the walls of blood vessels.
• Arterial hypertension. Due to the constant increase in blood pressure, there is an increase in the left ventricle and a violation of the full blood supply.
• Diabetes. It leads to the formation of cholesterol plaques, which impede blood circulation.
• Thrombosis. The mechanism of rapid blood clotting makes it impossible for it to enter the organs through the vessels.

These diseases often not only provoke ischemia, but are subsequently concomitant diseases. Much complicate the treatment and recovery of patients.

Provoke violations and improper functioning of the organs of the cardiovascular system can not only diseases, but also the characteristics of the body and the life of the person himself:

• Stress, nervous strain. They lead to constant arrhythmia, disruption of the supply of nutrients and oxygen to the organs.
• genetic predisposition. It is inherited along with the genetic code.
• Gender identity. In men, ischemia is more common.
• Excess weight. Exceeding normal body weight leads to an increase in the volume of blood that the heart must push out in one contraction. The tone of the walls gradually worsens, the load on the vessels increases.
• Availability bad habits. Smoking provokes an excessive amount of carbon monoxide and a lack of oxygen in the blood.

Gradually and with age, the vessels lose their elasticity, so after 45-50 years there is a high probability that ischemia will appear. Symptoms in the stronger sex are more pronounced, as they are more vulnerable to ischemia. This is due not only to physiological characteristics. The reasons are difficult conditions work, bad habits and stressful situations.

Untimely visit to the doctor, when there are complaints of coronary artery disease, leads to coronary heart disease, which manifests itself in men with characteristic symptoms:

• severe pain in the chest;
• lack of air, shortness of breath;
• fainting, darkening in the eyes;
• dizziness and migraine;
• bouts of nausea;
• increased sweating;
• arrhythmias.

The prerequisites for the appearance of cardiac ischemia in this case are atherosclerosis, the formation of blood clots in the vessels, elevated level cholesterol and coronary artery spasms. All this contributes to a lack of nutrients in the body and disruption of the full process of blood circulation.

Signs of ischemia of the heart in women and children

Signs of cardiac ischemia in women are not as bright as in men, since for a long time only men were susceptible to cardiac ischemia. In women, this disease was observed quite rarely. Now it is considered age-related and manifests itself during menopause. Changes occurring in the body, lack of estrogen affects the work of the cardiovascular system in 20% of women.

Women still have individual signs of cardiac ischemia:

• bouts of acute sharp pain in the back;
• short angina - lasts no more than 15 minutes;
• dyspnea;
• indigestion;
• swelling of the extremities may appear in the evening;
• loss of consciousness or frequent dizziness.

In women, the cause for ischemia of the heart can be stress, hard mental work, age from 55 years. Then, as in men, the disease begins by the age of 40.

Diseases of the cardiovascular system affect even young children. There are several reasons for their occurrence. These include heredity, overwork during the educational process, congenital pathologies.

In a child, ischemia shows its characteristic symptoms:

• Pain, feeling of constriction of the chest. The duration reaches 30 minutes.
• Numbness and sharp pain in the left side of the face, arm and forearm.
• Lack of oxygen, shortness of breath, signs of suffocation.

In most cases, even the drug "Nitroglycerin" is not able to alleviate the condition. AT childhood mortality from ischemic disease is much higher. Therefore, at the first even the slightest suspicion of a violation of the heart, it is urgently required to call an ambulance.

An ischemic attack usually begins after heavy physical exertion or a strong emotional shock. A person feels squeezing pain in the chest, there is profuse sweating.

In such cases, it is necessary to know exactly the rules of how to provide first aid for angina pectoris:

• call an ambulance immediately emergency care;
• it is convenient to put the patient on the bed, raising his head and loosening the belt and collar of the clothes;
• try to calm and distract;
• open windows, turn on a fan or air conditioner in the summer;
• pour warm water into a heating pad and place it at the feet of the patient.

You can also give the drug "Nitroglycerin", depending on the severity, you can give from 1 to 4 tablets. A person should put them under the tongue and dissolve.

It is impossible for angina pectoris to cause excitement, give unfamiliar drugs and force a person to move. Until the ambulance arrives, it is better to keep quiet and, in case of severe anxiety, apply valerian tincture.

Most The best way to avoid ischemia is to constantly monitor your health and undergo a medical examination. In the case when symptoms suddenly appear in the chest or left side of the body, contact a specialist.

The main measures for the prevention of coronary disease are simple daily rules that must be observed:

• Stick to a healthy nutritious diet. Control weight, avoid obesity.
• Move more and accustom the body to walks in the fresh air.
• Don't forget about physical activity.
• Get rid of bad habits.
• With a hereditary predisposition, spend more time visiting doctors.
• Take, on the advice of a specialist, drugs that strengthen the heart and blood vessels, for example, Entresto (you can read about the drug) or Kordanum medicine.

Many diseases are the result of the wrong way of life of the person himself. It is necessary to take into account environmental problems, which also play a large role in the deterioration of health. Avoid at all costs stressful situations and excessive loads.

When the vessels that feed the heart begin to narrow, the blood flow to the myocardium is disrupted, which leads to the emergence of various cardiovascular pathologies, united under the concept of "ischemic heart disease".

Causes of ischemia

The most common cause of coronary heart disease (CHD) is the development of atherosclerosis. When the disease occurs, damage to the arteries occurs: the walls of the vessels become denser, the gaps in the arteries are greatly narrowed, and the general blood flow is disturbed. Oxygen starvation occurs in the heart muscle, which leads to the appearance of diseases of the cardiovascular system.

There are more than 30 causes that trigger the processes of atherosclerotic lesions of the arteries. Main reasons:

• Smoking. In the vessels, nicotine provokes a spasm. Contained in tobacco carbon monoxide causes damage to the walls of blood vessels, and this increases the risk of atherosclerosis.
• Age. With age, the arterial walls become thinner, the body begins to irreversible processes, the risk of development and occurrence of various ailments increases significantly. Dangerous for coronary heart disease is considered to be over 55 years old (for women) and over 45 years old (for men).
• Hypertension. The constant increase in pressure, if left untreated, leads to rapid wear of the walls of the arteries and accelerates the aging process.
• Heredity. A certain contingent of people whose relatives suffered from diseases of the cardiovascular system have a high risk of developing coronary heart disease.
• Constant and chronic stressful situations. In the process of stress, arteries are destroyed. Often people try to "relieve stress" through alcohol, smoking, or overeating. All these factors together lead to the destruction of the walls of blood vessels.
• Sedentary lifestyle and obesity. Physical inactivity and overeating put a strain on the heart and blood vessels.
• The presence of cholesterol in the blood. The formation of cholesterol plaques is one of the main factors in the development of atherosclerosis.

Taking hormonal contraceptives, chronic infections, and increased blood clotting can also trigger coronary disease.

In men, the risk of atherosclerosis and ischemia is several times higher than in women (usually the risk occurs during menopause). This is due to hormonal factors, differences in lifestyle and some genetic characteristics.

There are cases that coronary heart disease occurs in people without bad habits, thin build, with normal pressure and fairly high physical activity. Here, the causes of the disease lie in a change in the composition of the blood: blood test indicators can indicate the risk of developing coronary disease, and the doctor will prescribe preventive measures by his warning.

Symptoms of coronary artery disease

The disease goes through several stages, depending on this, the symptoms of coronary heart disease are classified as follows:

1. Asymptomatic stage. The disease does not make itself felt, although cholesterol plaques are already beginning to appear in the vessels, which are still too small to clog the passage.

2. First manifestations. The size of the plaques is increasing, the artery is almost half closed. Heart failure begins to develop, symptoms appear:

• Pain in the sternum (radiating to the back, left arm, etc.);
• Dyspnea;
• severe dizziness;
• Frequent unstable heartbeats;
• excessive sweating;
• Clouding of consciousness (pre-fainting state) or fainting.

3. Progression of the disease. The gaps in the artery are getting smaller, the work of the heart is deteriorating. Against the background of pain behind the sternum, swelling occurs, shortness of breath bothers even at rest, tachycardia attacks appear more often, unreasonable anxiety and fear of death begin to appear.

4. The final stage. At this stage, the likelihood of critical conditions (myocardial infarction or sudden cardiac arrest) increases. Manifestations:

• Sudden uncontrolled pressure surges;
• Severe pain in the sternum (manifested in any condition);
• Atrial fibrillation.

All of the above symptoms of coronary heart disease do not manifest themselves simultaneously - in certain form IHD may be dominated by one or the other signs.

Classification of coronary heart disease

Ischemic disease includes several clinical forms that manifest themselves in different ways:

In women, the manifestations of ischemia are more vague and not permanent. There is weakness and frequent fatigue, which can cause the disease to be confused with the usual flu or indisposition from overwork. Therefore, in women, coronary artery disease is diagnosed more often already in the later stages, when immediate treatment is required.

Often, forms of coronary disease can pass one into another (acute coronary syndrome): angina attacks, for example, can be replaced by a heart attack or even sudden death.

Diagnosis

Before treating IHD, a cardiologist prescribes a number of diagnostic measures aimed at identifying the form and stage of the disease.

How is ischemia diagnosed?

• Drawing up an anamnesis: clarification of complaints and determination of the causes leading to the onset of the disease, the presence of cardiovascular diseases in relatives.
• Initial examination: heart murmurs are heard, the presence of wheezing in the lungs is determined, the presence of edema is checked, pressure is measured.
• Ordering blood and urine tests. Studies of indicators make it possible to establish signs of coronary heart disease, to detect probable complications and prerequisites for the onset of the disease.
• Electrocardiogram: determines the electrical activity of the heart, reveals disturbances in the functioning of the myocardium. If ischemia manifests itself exclusively during stress, an ECG with stress is prescribed: the patient performs certain physical efforts, and the device simultaneously records the performance of the heart.
• Echocardiogram. Ultrasonic waves help to study the work of the heart muscle in real time: to study blood flows inside the heart, assess the state of blood vessels, and identify a possible heart attack. An echocardiogram, just like an ECG, can be done with exercise.
• Coronary angiography: evaluates the state of the myocardium and vascular patency by introducing a special dye into the vessels. The procedure can cause complications, so it is usually performed when there are indications for surgery.
• MRI and computed tomography: allows you to more accurately assess the condition in which the coronary arteries are located.
• Holter monitoring: detects violations of the heart muscle in dynamics. The patient during the day wears a special device that records changes in the work of the heart in vivo, which allows you to quickly identify the prerequisites for the onset of pathology.

After the examination, the diagnosis of "ischemic heart disease" is not made - there must be a decoding of the disease: IHD: exertional angina, IHD: myocardial infarction, etc.

Treatment of the disease

Treatment of coronary heart disease is a set of specific measures, the purpose of which is to regulate the necessary blood flow to the myocardium in order to prevent the development of additional pathologies.

There are the following directions of treatment of ischemic disease:

1. Non-drug therapy.
2. Therapy with medications.
3. Operative (surgical) intervention.

All these measures are aimed at alleviating the symptoms of the disease, eliminating the factors that cause the disease, and reducing mortality from ischemia.

Non-drug therapy

These include activities aimed at adjusting lifestyle:

• Regular physical activity (cardio training, gymnastics, swimming).
• Change in nutrition. The transition from junk food (fatty, salty, smoked) to the introduction of more fruits, vegetables, fish, grains into the diet. In heart failure, water intake should be limited to reduce the load on the heart muscles.
• Rejection of bad habits.
• Stress management. You should reduce as much as possible the number of stressful situations (at work and in the family). Meditation, yoga, and taking sedatives will help.

At different forms coronary heart disease, the activity regimen should be limited, tk. with strong physical exertion, there is an increase in the need of the heart muscle for blood supply, which can increase the manifestations of coronary disease. Physical exercises should be carried out under the supervision of a physician, and the load should be increased gradually in the process of rehabilitation measures.

Therapy with drugs

Drugs that carry out therapy for coronary artery disease are divided into 3 main groups:

1. Antiplatelet agents (drugs that reduce clotting and prevent the development of blood clots): aspirin, ticlopedin, dipyridamole, pentoxifylline, iloprost.
2. Anti-ischemic medicines(reduce oxygen demand in the heart muscle): β-blockers (relieve pain, dilate blood vessels, restore heart rhythm) or calcium antagonists (used if there are contraindications to taking beta-blockers or if they are not effective enough). The drugs in this group include: nebivolol, bisoprolol, carvedilol.
3. Hypocholesterolemic drugs (cholesterol-lowering drugs): statins, bile acid sequestrants, fibrates, etc.

Additionally, diuretics, nitrates, antiarrhythmics can be prescribed - in the absence of contraindications to admission.

Popular drugs for ischemia:

• Thrombo ASS;
• Cardiomagnyl;
• bisoprolol;
• Aspirin Cardio;
• Nebivolol;
• Carvedilol;
• Aspigrel;
• Agrenox.

It is advisable for a patient with ischemia to have nitroglycerin tablets in the medicine cabinet - they have the ability to relax blood vessels, relieve angina attacks and pain syndrome.

Surgical intervention

If a drug therapy does not give results and there is a threat of developing a heart attack, surgical intervention is prescribed:

• Coronary angioplasty (or PTCA). The procedure is both diagnostic and therapeutic. A special frame-stent is installed in the blocked artery, which keeps the walls of the vessel from re-narrowing.
• Aorto-coronary bypass. With the help of a surgical operation, the blood supply to the heart muscle is restored by creating a bypass channel through which blood will be delivered to the myocardium.

Depending on the indications, stage and form of coronary artery disease, other surgical measures can be used: minimally invasive coronary artery bypass grafting, brachytherapy, transmyocardinal laser revascularization, etc.

Measures to prevent ischemia

Prevention of ischemia is a set of measures that eliminate risk factors for the onset of the disease and prevent complications. First of all, this is a change in lifestyle and compliance with simple rules:

• You can not drink alcohol in large quantities, and cigarettes should be abandoned altogether.
• You can’t worry and get annoyed over trifles - stress and excessive emotional stress should be avoided.
• Physical activity cannot be avoided - they must be strictly dosed and include regular cardio training, swimming, gymnastics, etc.
• You can not eat junk food (fried, spicy, salty) - you should include more cereals, fish, fruits and vegetables in the diet.
• You can not overeat - it is necessary to maintain optimal body weight and prevent obesity.

Ischemia is very dangerous and can lead to serious complications. However, if the patient complies with all the doctor's instructions regarding treatment and preventive measures, this will definitely protect him from myocardial infarction and other serious consequences. Not a single remedy can protect against ischemia if the patient does not change his habits and does not choose a healthy lifestyle.

Signs of coronary disease in men are often hidden: a person may not suspect that he is developing a pathology. You need to be attentive to your own health, pay attention to the signals of the body. Cardiovascular disease is life threatening. Coronary heart disease is common among men: they suffer 2 times more often than women. IHD manifests itself in different ways: some people have anxiety symptoms, in others they are weakly expressed or absent altogether. If coronary disease is asymptomatic, it means that it progresses and will give complications in the future. With untimely treatment, a fatal outcome is possible.

Pathology is divided into several types depending on the symptoms. There are many factors that provoke coronary disease. IHD is divided into stable and unstable angina, primary and recurrent myocardial infarction, and it can also manifest itself in the form of postinfarction cardiosclerosis and heart failure. Symptoms of coronary heart disease occur due to the fact that the heart muscle (myocardium) is poorly saturated with oxygen. Oxygen starvation of the myocardium occurs with atherosclerosis of the coronary arteries: in this case, the lumen of the veins narrows. It is associated with spasm of arteries not affected by atherosclerosis.

Also, the disease occurs due to impaired blood circulation in the myocardium. Another reason for oxygen starvation of the myocardium is a violation of blood clotting. Atherosclerosis has an undulating course, in connection with this, the symptoms of coronary disease are unstable: they can increase and subside. As we have already said, coronary heart disease may be asymptomatic, but alarming signals may appear during physical and psycho-emotional stress.

Risk factors and causes of pathology

Symptoms of coronary artery disease are more common in men, so gender is a predisposing factor. In the female body there are special hormones: they block atherosclerosis. IHD and atherosclerosis often develop in people over 45 years of age. In the development of ischemia, heredity plays a role. It is worth noting that if a man smokes a lot, the functioning of the organs is disrupted. Due to bad habits, the heart muscle can suffer.

Ischemia develops in men who smoke 15 cigarettes a day.

The next predisposing factor is high cholesterol. To avoid this problem, you need to regularly take tests, and, if necessary, start treatment. If the body has high cholesterol, serious diseases can develop. In some men, ischemia occurs due to overweight. A sedentary lifestyle also predisposes to the disease. Factors of development of ischemia can be isolated or superimposed on each other.

Manifestations of ischemia

Consider the signs of the disease. The prognosis of coronary artery disease depends on its stage and severity of symptoms. If ischemia occurs in an asymptomatic form, the person seeks help late. In this regard, the forecast is not as favorable as it could be. The latent form of ischemia entails the appearance of plaques on the vascular walls, but the lumen of the vessels will narrow gradually.

A form of ischemia is angina pectoris: with such a pathology, pressure is felt in the chest, pain can radiate to the arm, radiate to the back, shoulders.

1. With this pathology, shortness of breath appears, in particular, when walking fast.
2. Some men have high blood pressure.
3. If ischemia is latent, there is a high probability of plaque growth in the veins. In the future, the venous lumen will be half closed. If coronary disease is manifested by symptoms, a person feels pain in the heart, the functioning of the organ itself is disrupted. Gradually, the heart muscle becomes thinner. If we consider the narrowing of the arteries, it occurs abruptly, the lumen of the vessels closes completely.
4. With myocardial infarction, pain in the sternum is felt. The pressure rises, atrial fibrillation appears. At any stage of ischemia, a heart attack can occur. Even if symptoms do not appear, the disease still progresses, and the symptoms intensify.
5. With ischemia of the heart, seizures appear. If we consider seizures separately, it is worth noting that they are more common in men, since they have an increased pain threshold. Ischemia develops in those who work hard, overstrain physically. In order to avoid cardiovascular pathologies, including ischemia, you need to fully relax, allocate enough time for sleep.
6. The development of ischemia contributes to smoking, alcohol abuse.

Clinical picture of the disease

An important sign of ischemia: chest discomfort. With such a pathology, a man quickly gets tired, as a rule, he cannot do hard work. Ischemia is characterized by increased pressure, palpitations, pain in the chest and heart. With such a disease, shortness of breath appears, jumps in blood pressure are observed (it is worth noting that pressure can drop sharply). If a man has severe ischemia, he often feels dizzy. Some patients experience visual disturbances, heartburn, and it hurts to swallow. He is nauseous and has regular urge to vomit. If the pathology is asymptomatic, the person quickly gets tired. It is important to pay attention to shortness of breath. In most cases, a man cannot explain what caused it.

The peculiarity of ischemia is that it gives symptoms characteristic of indigestion. Discomfort during exercise is possible. After it stops, the symptoms disappear. As the disease progresses, the symptoms become more pronounced. There is cardiac obstruction. It is important to identify ischemia at the asymptomatic stage, then it will be possible to start treatment in a timely manner and improve the prognosis. Latent ischemia is detected during a medical examination. If the pathology is diagnosed in a timely manner, it will be possible to avoid progression. Treatment in advanced stages is difficult. In this case, the doctor prescribes a lot of medicines and, if necessary, prescribes an operation.

Symptoms of progressive ischemia

The most common form of ischemia in men is angina pectoris. Previously, this disease was called "angina pectoris". Symptoms of angina pectoris appear depending on what caused it. If a person has stable angina pectoris, he is disturbed by pressing pains in the heart. Unpleasant sensations can be given to the arm, left forearm.

Hypothermia may be the cause of angina pectoris. The disease develops as a result of intense physical exertion. Unpleasant sensations with angina are given to the back, shoulder blade. A man may experience shortness of breath, in which there will be a lack of air. Pain is localized in the left side of the sternum. With progressive angina, mental health is disturbed: a person is often nervous, breaks down. This disease occurs in people who abuse alcohol and spend a lot of time in conditions of severe physical activity. The predisposing factor is hypertension. If we talk about shortness of breath, it may be accompanied by suffocation.

Against the background of angina pectoris, tachycardia often occurs. Unstable angina is dangerous because it can be asymptomatic. In this case, the patient will feel tired, unwell. It is worth noting that the progression of unstable angina is dangerous. Learn to recognize the symptoms of ischemia and cardiac obstruction. It is important not to confuse cardiovascular diseases with pathologies associated with the gastrointestinal tract. Despite the forms and stages of ischemia, a person must feel the state of his body.

stable angina

The stable form of the disease has the same type of symptoms. If the symptoms are rapidly increasing, the development of unstable angina pectoris, a pathology that is life-threatening, occurs. You need to start treatment as soon as possible. Attacks of pathology are difficult to stop with medicines. If the signs of the disease grow in waves and last 1-2 hours, blood pressure begins to jump, the heart rate changes. In this case, we can judge the progression of unstable angina. A dangerous condition can turn into a myocardial infarction. In the acute form of the ischemic process, blood circulation in the vessels is disturbed. Tissue hypoxia develops gradually.

Symptoms of ischemia can pass within 10 minutes, in other cases they last more than an hour. With this disease, blood clots of the heart vessels can appear. Hypoxic starvation causes vital cells to die. If a person feels severe pain in the sternum, you need to see a doctor. Common symptoms of ischemia are heart pain, dizziness, and nausea. Spasmodic abdominal pain may also be present. In some patients, respiratory functions are disturbed, suffocation appears.

Symptoms of ischemia develop in different ways: they may appear once and not remind of themselves in the future. The disease leads to excessive sweating. On the ECG, a specialist can diagnose post-infarction changes: they are a sign that there is an accreting scar in the heart. Angina requires immediate treatment. If shortness of breath and spasm are detected, resembling gastrointestinal disorders, you should consult a doctor. It is worth noting that against the background of such symptoms, pain in the extremities may be present.

About prevention

Ischemia may occur due to oxygen starvation of the myocardium. The cause of the disease is coronary insufficiency: the disease develops due to the fact that the coronary vessels undergo deformation. To prevent ischemia, you should stop smoking and drinking alcohol. It is important to control blood pressure, treat diseases associated with high cholesterol. Ischemic disease can occur against the background of diabetes mellitus, in connection with this, competent treatment of this disease is necessary. It is recommended to lead a mobile lifestyle.

For decades, cardiovascular diseases have dominated and claimed lives in almost half of deaths - 48%. Among them, coronary heart disease occurs equally in men and women in old age in 21% of cases. It should be said that ischemia of the heart muscle up to 45 years is more common in the strong half of humanity.

With the onset of menopause (menopause) and the attenuation of active estrogen production, the female body becomes susceptible to pathologies such as ischemia, and from about 55 years of age, coronary heart disease with the same frequency as in men occurs among women. The development of coronary heart disease often occurs against the background of already existing diseases of the cardiovascular system - hypertension (hypertension) and atherosclerosis.

What is coronary heart disease and why is it dangerous?

Cardiac ischemia- this is a violation of the blood supply to the heart muscle or, in essence, "oxygen starvation". Ischemia occurs due to a mismatch between myocardial oxygen and nutrient requirements and the ability of the heart arteries to perform their function.

The heart is an organ that fills all the organs and systems of the body with arterial, oxygenated blood. In this case, the heart muscle does not receive nutrients and oxygen during the filling of the atria and ventricles, since the cardiac blood supply is isolated and represented by two coronary (coronary) arteries, which are branches of the aorta and the only source of nutrition for the heart muscle.

The coronary arteries branch into a rich capillary network in all three layers of the heart. Up to 20% of the ejected arterial blood passes through the coronary arteries, which saturates the specialized heart cells - cardiomyocytes and contributes to the normal functioning of the myocardium.

The danger of this disease is a violation of the normal, cardiac blood supply due to narrowing of the lumen of the vessels and, accordingly, an insufficient amount of oxygen and nutrients, which leads to electrolyte imbalance- lack of potassium, magnesium (not complete relaxation of the heart), an excess of sodium and water (arrhythmia, edema and violations of heart contractions - ischemic manifestations in the form of spasms of the heart muscle).

As a result, there is a disruption in the work of cardiomyocytes, both working and atypical (constituting the conduction system of the heart, which provides a coordinated rhythmic contraction of various parts of the heart), which in turn is the cause of the development of acute or chronic coronary heart disease.

The acute form is accompanied by:

• primary cardiac arrest- sudden coronary death with successful resuscitation and cardiac arrest, which ended in death;
• unstable angina- pain in the form of squeezing in the center of the chest, left shoulder, arms, neck, sometimes in the lower jaw, which does not disappear after taking nitroglycerin and eventually ends with myocardial infarction;
• rest angina, when even at rest, lying down, attacks of pain in the region of the heart appear.

The chronic form is expressed by stable angina pectoris (occurs during physical or psycho-emotional stress), hypertension, cardiosclerosis, arrhythmia, heart failure.

The chronic form can be asymptomatic and painless in people with a high pain threshold, as well as in patients with diabetes mellitus, with the presence of tachycardia, hypotension.

According to the NYHA (New York Heart Association) chronic The form of coronary heart disease is usually divided into four groups:

1. Pathology is present, but complaints of poor health are mild and occur during physical exertion.
2. Symptoms of shortness of breath, increased fatigue and palpitations during any physical activity are manifested. At rest there are no complaints.
3. There are symptoms of chronic fatigue, increased fatigue, shortness of breath, strong heartbeat when performing an elementary load - walking, climbing stairs. At rest there are no complaints.
4. There are complaints even at rest. With any physical activity, pain and discomfort tend to get worse.

Causes

Ischemic heart disease has the following causes:

• Genetic predisposition - metabolic syndrome (increased formation of visceral fat due to impaired carbohydrate, lipid and protein (purine) metabolism), diabetes mellitus, hyperlipedemia (significant increase in low and very low density lipoproteins in the blood - LDL and VLDL).
• Arterial hypertension as a factor in reducing the elasticity of blood vessels, the loss of their ability to stretch, the formation of cracks and ruptures.
• The development of atherosclerosis against the background of a change in the functional purpose of the vessels and the introduction of LDL and VLDL into the intima of the vessels, from which cholesterol plaques form at the site of ruptures and cracks, interfere with normal blood flow.
• Physical inactivity is a sedentary lifestyle that leads to obesity and, as a result, an increased load on the heart muscle and the development of coronary heart disease.
• Floor. Up to 45 years, this disease affects mainly men.
• Old age - with age, depletion of organs and systems manifests itself, which immediately leads to a whole "bouquet" of diseases of the cardiovascular system and the body as a whole.
• Bad habits - alcohol, smoking, proper nutrition, against this background, beriberi is formed (in particular A, E and C) and a deficiency of minerals (potassium, magnesium, etc.).
• Stress, nervous shocks.

In some cases, excessive physical activity can also be attributed to the causes of occurrence, especially for athletes and people actively involved in sports.

Ischemic heart disease - symptoms

Manifestations of symptoms of coronary heart disease are irreversible and it is impossible to cure it forever.

Ischemic heart disease has symptoms similar to other diseases of the cardiovascular system. Its first signs are expressed in pain behind the sternum, radiating to the back, left arm, there is shortness of breath, symptoms of angina pectoris, arrhythmias, palpitations during physical exertion, psycho-emotional stress.

• Weakness, nausea, dizziness, sweating, swelling of the extremities may be present. There may be fainting and signs of hypertension, inexplicable fear and feelings of anxiety.
• Symptoms do not appear all at once, which at the initial stage of development is confusing and makes it difficult to diagnose, delays treatment.

Symptoms of myocardial infarction and coronary disease in women

Female sex hormones - estrogens (estradiol, estriol, estrone) before the onset of menopause "protect" the female body from the development of atherosclerosis and, as a result, manifestations of coronary heart disease. At the same time, every eighth woman from 45 to 55 years old Clinical signs ischemic heart disease. Signs of the disease occur already in 30% of cases by the age of 65.

• The course of the disease in women has a worse prognosis - the likelihood of disability and mortality from the first myocardial infarction (or within the first year after it) is an order of magnitude higher. This is primarily due to the asymptomatic course of the disease (chronic form).
• Secondly, the influence of risk factors is more aggressive in women due to the physiological characteristics of the female body in the postmenstrual period, emotionality, and hormonal levels.
• Thirdly, not timely diagnosis due to the absence of a typical pain syndrome of angina pectoris, the frequent course of the disease with the presence of night attacks and normal health during the day.

Symptoms in men

Symptoms of myocardial infarction and coronary heart disease in men have a classic picture and are expressed in pain during exercise, lasting an average of 30 seconds to half an hour. Pain is concentrated outside the sternum, in the stomach, which can be mistaken for heartburn.

At rest, the pain goes away. Effectively helps Nitroglycerin. Symptoms of suffocation, severe weakness, sweating are possible.

Men are characterized by the manifestation of coronary heart disease with coronary death, myocardial infarction and postinfarction cardiosclerosis.

Diagnostics

Diagnosis of coronary heart disease includes a number of activities and methods. Activities include:

• daily monitoring of blood pressure;
• the need for a general blood and urine test;
• biochemical analysis blood for CPK (creatinine phosphokinase);
• ALT (aspartate aminotransferase);
• AST (alanine aminotransferase);
• troponin-I and T;
• aminotransferases;
• LDH (lactate dehydrogenase);
• myoglobin, electrolytes;
• in particular, N+ and K+.

It is mandatory to analyze the total level of total cholesterol - a lipidogram, including all fractions of lipoproteins.

Diagnostic methods include - ECG, functional tests (ECG registration during exercise by running, walking, riding a bicycle ergometer), Holter monitoring (ECG registration for 24 hours), angiography (pictures of a contrast agent injected into a patient's vein), ultrasound of the heart (information about anatomical features patient's heart).

Ischemic heart disease - treatment

Treatment of coronary heart disease is a complex application different groups medications, changes in physical activity, diet and the rejection of bad habits that provoke an acute course of the disease.

In this case, the form of coronary heart disease should be taken into account in each individual case and the treatment should be agreed with the attending doctor.

Treatment of the heart with folk remedies - recipes

Ischemic heart disease can also be treated folk remedies, which are a stimulating and strengthening method.

Below are a few recipes for folk remedies effective for coronary heart disease. All decoctions are prepared at the rate of a tablespoon of herbs per 200-250 ml.

1. Recipe for hawthorn treatment. The grass is poured with boiling water and insisted with a closed lid for two hours. Then filter and take a folk remedy, two tablespoons, three times a day.
2. Recipe from, valerian and cumin seeds. Herbs and seeds are mixed, poured with boiling water, filtered. Drink in the morning and in the evening.
3. Recipe for horseradish inhalation. To do this, take 5 g of the root and pour boiling water, leave for about two hours, then inhale.
4. An effective recipe is the collection of motherwort herbs, rose hips and hawthorn. All ingredients are taken in 6 tablespoons and poured with 1.5 liters of boiling water, the infusion is wrapped and infused for a day. Strain and drink three glasses a day.
5. Recipe for the treatment of ischemia with garlic. Grind 50 g of garlic and insist in a glass of vodka for three days. Drink an infusion of 8 drops per day, dilute with boiled water. If the taste is completely unpleasant, you can dilute a single dose in ¼ cup of milk. The treatment lasts seven days.

Preparations

Medications in the treatment of coronary heart disease, they are divided according to the mechanism of action and the location of the therapeutic effect:

• antiplatelet agents have a thinning effect on blood cells, prevent their aggregation and sticking to each other and vessels (Aspirin, Acecardol, Clopidogrel);
• β-blockers reduce heart rate and myocardial oxygen demand (Betaloc, Concor, Acridilol);
• Cholesterol-lowering drugs - statins (Lovastatin, Atorvastatin, Rosuvastatin) and fibrates (Gemfibrozil, Liponor, Traykor), reduce the risk of new cholesterol plaques and help reduce the development of old ones by reducing the level of LDL and VLDL;
• nitrates affect the contraction of vascular smooth muscles, reducing the load on the myocardium (Nitroglycerin, Isosorbide mononitrate).

Together with these drugs, anticoagulants (Heparin), diuretics (Lasix, Indapamide), ACE inhibitors (lowering high blood pressure by acting on the reninangiotensin system of the kidneys - Enalapril, Captopril) and others are used in the treatment.

Nutrition and diet in coronary heart disease

During the treatment of the disease, you can help the body and eat the “right” foods.

These include:

• lean, dietary meat - chicken, beef, rabbit, turkey;
• olive or corn oil;
• all dairy products are not high in fat;
• fresh vegetables and fruits - on average, the daily diet should contain at least 400 - 500 g of fresh fiber;
• chicken and quail eggs, but not more than 3-4 eggs per week;
• sea ​​kale;
• whole wheat bread;
• nuts, legumes;
• cereals - buckwheat, oatmeal, wheat and barley porridge;
• lean soups and broths;
• juices and compotes from natural fruits;
• sea ​​and river, non-oily fish - salmon, salmon, trout, cod, perch, hake, etc.

Foods that should be reduced or eliminated altogether:

• rice and semolina;
• spicy and salty foods;
• fatty meat and fish dishes;
• rich confectionery, chocolate, carbonated drinks, honey, marmalade, marshmallow, white bread, condensed milk;
• coffee Tea;
• alcoholic drinks;
• fried foods;
• soy sauce;
• sausages, pates;
• fast food products, mayonnaise, fatty dairy products.

The diet for ischemia should include:

1. Required, hearty breakfast- oatmeal, a slice of whole grain bread, an omelette, an apple, freshly squeezed fruit juice.
2. Lunch from a glass of kefir, yogurt, cottage cheese with fruit.
3. Dinner should include salads, recommended cereals, steamed fish or meat, baked potatoes, milk or decoctions of tinctures, juices.
4. Between lunch and dinner can have a snack if desired.
5. Dinner should consist of vegetable, milk soups, vegetable stew with boiled or steamed meat, you can drink low-fat kefir, milk, decoctions, juices.

The interval between meals should not exceed 4-5 hours. But eating when you feel full is also not worth it.

With coronary heart disease, you should not abuse the doctor's recommendations and help yourself in order to prevent complications of the disease.

1. Prevention is strict adherence to the diet prescribed by the doctor and taking drugs in the indicated doses.
2. It is desirable to exclude bad habits and the influence of stress factors that cause attacks of exacerbation of ischemia.
3. Prevention will also include maintaining a normal body weight and sufficient physical activity, constant monitoring of blood pressure and a healthy, full, fractional nutrition 4-6 times a day.
4. The main load on nutrition should be in the first half of the day, the second half of the day should be less voluminous and high-calorie. It is better to cook food for a couple, use less salt and salted foods.

The disease is associated with the formation of cholesterol accumulations (plaques) in the coronary arteries and their subsequent rupture. The basis of this condition is atherosclerosis of the vessels, accompanied by their thickening, local inflammation and thrombosis. Violation of the patency of the arteries is expressed to varying degrees, and the manifestations of the disease depend on this.

There are such forms of coronary heart disease:

• sudden death (coronary);
• angina, occurring in one of the options (tension or unstable);
• myocardial infarction and resulting cardiosclerosis.

The main symptom of the disease is bouts of retrosternal pain or discomfort during exercise, quickly disappearing after stopping or taking nitroglycerin.

Treatment includes medication and surgical procedures. They use drugs that suppress blood clotting, dilate the coronary vessels, slow down the heartbeat, and others. Chronic illness of the heart often requires surgery to restore blood flow through an artery affected by atherosclerosis.

Causes of the disease

Causes of coronary artery disease are associated with thickening of the walls of the arteries and the formation of plaques in them. This condition is called atherosclerosis. It is caused by violation fat metabolism in the body. The development of the disease occurs if the plaque reduces the patency of the artery so much that the working myocardium no longer has enough oxygen brought by the blood.

Additional causes of coronary heart disease:

• tobacco addiction;
• high cholesterol, triglycerides, or blood sugar;
• arterial hypertension.

With stress or exertion, the rhythm of the heart speeds up, and its cells need more oxygen. In violation of the patency of the coronary artery, there is a lack of blood supply. At an early stage, this is accompanied by an attack of pain, angina pectoris appears. In severe cases, blockage of the artery occurs and a heart attack develops - necrosis and scarring of the area of ​​​​the cardiac muscle.

Signs of pathology in men are more pronounced, their disease has a typical clinical picture. Symptoms of the disease in women occur at a later age, and often the clinical picture of the disease is atypical, which makes diagnosis difficult. In these cases, additional cardiac studies are needed.

Signs of coronary heart disease

Signs of coronary artery disease depend on its form, as well as on the number of affected arteries and the degree of their narrowing.

The development of the disease occurs gradually. Violation of the patency of the arteries is accompanied by oxygen starvation of certain areas of the myocardium. A violation of metabolic processes in the cells of the heart and the release of metabolic products develop. There are limited violations of myocardial contractility, there are changes in the ECG, and then the pain syndrome. The stable form of the disease is accompanied by the following typical symptoms:

• the occurrence of pain behind the sternum during physical or emotional stress;
• the pain is pressing, burning, squeezing;
• pain disappears after stopping or taking nitroglycerin after 1 to 5 minutes;
• pain radiates to lower jaw, left shoulder, elbow;
• shortness of breath and weakness on exertion often occur.

Risk factors:

• diabetes (diabetes, both types);
• arterial hypertension;
• old age (over 65 years);
• male, but after 70 years the probability of pathology in men and women becomes equal;
• smoking;
• cases of heart disease in the family;
• obesity;
• lack of physical activity;
• prolonged stress;
• alcohol abuse.

Treatment of the chronic form of the disease is usually carried out with the help of drugs.

Signs of coronary heart disease in the development of myocardial infarction:

• sharp sudden chest pain that does not go away at rest;
• lack of improvement from taking nitroglycerin;
• weakness, cold sweat, feeling of fear of death;
• sometimes abdominal pain, nausea and vomiting.

Prompt medical attention needed, often indicated surgery. With continued oxygen starvation of myocardial cells, they undergo irreversible changes. In the future, a scar forms in this area, which causes chronic heart failure and other complications.

The most severe form of the disease is sudden death, which is caused by cardiac arrest. It can develop without any precursors. However, it is often preceded by a decrease in stamina, a feeling of heartburn or discomfort in the chest during exercise, and unexplained weakness.

Disease classification

The classification of CAD is based on its clinical manifestations.

There are such forms of pathology:

• sudden death due to acute heart failure or severe arrhythmias;
• angina - with a stable course (angina pectoris, which has 4 functional classes, indicating the severity of the disease) and unstable;
• myocardial infarction;
• cardiosclerosis (cicatricial changes after a heart attack);
• abnormal heart rhythm, such as atrial fibrillation.

Classification of coronary heart disease in unstable course:

• first appeared;
• variant (pain syndrome occurs with arterial spasm, regardless of physical activity);
• progressive (exacerbation of the atherosclerotic process, accompanied by the risk of developing a heart attack).

A particularly severe circulatory disorder develops when the main trunk of the artery that feeds the left ventricle of the heart is damaged. Heart attack and unstable angina are serious conditions that require hospital treatment.

Symptoms of coronary artery disease

With atherosclerosis of the coronary arteries, cholesterol deposits appear on their walls - plaques. Inflammation can develop around the plaques, and blood clots accumulate on their surface. When such a formation is damaged, acute insufficiency blood circulation in the coronary vessels. All these conditions are accompanied by clinical manifestations of pathology.

Symptoms of coronary heart disease can come on suddenly and be fatal. In more favorable cases, a chronic form of the disease develops. It is accompanied by bouts of pain behind the sternum during exercise (angina pectoris). Such attacks occur at the same level of load (for example, when climbing to the 3rd floor), quickly disappear after stopping or taking nitroglycerin. The pain can "give" to the shoulder, left arm, jaw. It is often accompanied by shortness of breath.

Symptoms of the disease in men develop mainly after the age of 40 years. For younger men, a severe course of pathology is characteristic, an extensive heart attack or sudden death is possible. The disease occurs more often in diabetes, high pressure, smoking, sedentary lifestyle, malnutrition and stress.

Symptoms of the disease in women appear closer to 60-70 years of age, because before the onset of menopause, estrogens protect blood vessels from atherosclerosis. In this case, atypical signs of the disease are possible:

• pain is not behind the sternum, but in another part of the chest;
• weakness, dizziness during exercise;
• numbness of the fingers on the left hand;
• heartburn;
• paroxysmal shortness of breath and others.

Symptoms and treatment of coronary artery disease require observation by a general practitioner with periodic consultation with a cardiologist. In mild cases of pathology, the doctor prescribes a diet, physical exercises, antianginal drugs. With frequent attacks of pain, the development of progressive angina or heart attack, coronary angiography and surgical intervention on the heart vessels are indicated.

Diagnosis of the disease

The doctor assumes the diagnosis of coronary artery disease if the patient has complaints of attacks of retrosternal pain that occur during physical or emotional stress and pass at rest, limiting the patient's activity, that is, forcing him to stop the load. Risk factors for the disease and external examination data are taken into account.

Diagnosis includes a blood test with the determination of lipid fractions, in particular cholesterol. An ECG is prescribed, but at rest this study may not reveal any changes in the myocardium.

Diagnosis of coronary heart disease also includes 24-hour ECG monitoring, ultrasound of the heart, and a stress ECG study. Bicycle ergometry or treadmill test in many cases reveal myocardial ischemia. The results of the examination are taken into account when referring the patient to coronary angiography.

The diagnosis is confirmed with the help of CAG - the study of blood vessels by introducing a radiopaque substance into them. At the same time, doctors detect an obstruction in blood flow that causes symptoms of the disease. At the same time, stenting of the vessel can be performed - the introduction of a thin tube into its lumen, restoring the normal blood supply to the myocardium.

Another modern diagnostic method is multislice computed angiography. It often serves as an alternative to conventional CAG.

Treatment of coronary heart disease

Treatment for coronary artery disease includes non-pharmacological methods, medications and surgical interventions.

The patient is recommended to eat with a decrease in the amount of animal fats, cholesterol and an increase in the consumption of fruits, vegetables, sea fish. He should stop smoking and drinking alcohol. If you are obese, you need to lose weight. Physical exercises that do not cause deterioration of the condition are shown.

Treatment of coronary heart disease is carried out simultaneously with the correction of blood pressure, the treatment of diabetes and heart failure.

The next stage is the treatment of the disease with drugs. Drug therapy is aimed at preventing complications of the disease and eliminating angina attacks.

The main drugs that are prescribed to most patients:

• antiplatelet agents (aspirin, ticlopidine, clopidogrel), which prevent the formation of blood clots in the arteries;
• drugs that reduce the concentration of cholesterol, especially statins;
• beta-blockers, which reduce the need for oxygen in the heart muscle cells;
• ACE inhibitors, necessary after a heart attack or heart failure.

The following medicines are used to prevent pain attacks:

• beta blockers;
• nitrates (nitroglycerin and extended-release preparations);
• ivabradine;
• calcium antagonists.

All of them contribute to the expansion of the coronary arteries and increase resistance to stress.

Medicines, their dosage and mode of administration are prescribed only by a cardiologist or therapist. Self-medication with these drugs can lead to serious consequences.

How to treat coronary heart disease with the ineffectiveness of medications: surgical interventions are used for this.

• coronary bypass surgery - the creation of a new vascular path around the narrowed section of the artery;
• balloon coronary anatomy is a minimally invasive intervention during which a thin catheter with an inflatable balloon is inserted into the vessel and the narrowed section of the artery is “pushed apart”;
• stenting is the installation of a thin tube into the lumen of an artery - a stent, which is usually combined with balloon angioplasty.

The choice of surgical method depends on the severity of vascular lesions, the risk of complications, and the experience of the hospital. Surgical interventions are better than medicines in eliminating the symptoms of the disease. However, in terms of prognosis, the effectiveness of both treatment tactics is the same.

For other types of disease (heart attack, unstable angina, sudden death), intensive therapy is performed to restore the blood supply to the affected area of ​​the heart muscle.

Treatment with folk remedies

Ischemic heart disease and myocardial infarction are not treatable with only folk recipes. The patient must take prescribed medications to avoid complications. Folk methods treatment of coronary heart disease can only be used in addition to the main therapy.

Drugs for the disease improve the prognosis of the disease and relieve attacks of pain. Surgical operations restore the lumen of the coronary arteries and blood flow in the heart muscle. Treatment with folk remedies helps to improve the patient's well-being, increase resistance to stress, and normalize the balance of vitamins and trace elements. However, prescriptions should not be used. traditional medicine instead of one of the prescribed medications.

Herbal remedies for heart health:

• a mixture of crushed garlic and honey in equal proportions, which must be infused for 7 days and consumed at the table. spoon before eating;
• infusion of herb motherwort, hawthorn, lemon balm, taken in equal proportions, the mixture is poured with boiling water in the amount of 1 glass of water per 2 table. spoons of raw materials and allow to cool;
• decoction of valerian root at the rate of 1 table. spoon for a glass of water;
• an infusion of hawthorn berries and leaves, which can be drunk constantly as a tea;
• fruits of viburnum (you can grind them with sugar).

It is better to prepare all these products before use, because during storage they lose some of their vitamins and lose beneficial features.

With an increase in attacks, an increase in the number of nitroglycerin tablets taken per day, a decrease in its effectiveness, and the appearance of pain at night, the patient increases the risk of such a complication as an acute form of the disease (heart attack). In this case, you should not rely on the beneficial properties of plants, but urgently seek medical help. You need to understand that prescribed medications have proven effectiveness in treatment, while herbal medicine is designed only to reduce excitability. nervous system and restore the balance of vitamins.

Disease prevention

Primary prevention of coronary heart disease - measures to prevent its development. Secondary - aimed at reducing the risk of complications of an already developed disease. In general, all preventive measures should act on modifiable risk factors for pathology.

A person cannot change his gender, age or hereditary predisposition. However, the correct lifestyle and therapy of some concomitant diseases can solve the problem of the risk of the disease.

Prevention of coronary artery disease includes the following tips:

• stopping bad habits, especially smoking and drinking alcohol, in particular beer;
• following a diet with a reduction in the proportion of saturated fats and salt in the diet;
• the fight against obesity with a decrease in the calorie content of food;
• increase in time of active movements.

• swimming, brisk walking, Nordic walking, jogging, dancing, tennis, cycling, skiing contribute to reducing the likelihood of cardiovascular pathology;
• during classes, it is necessary to control the pulse: it should not be higher than the value calculated by the formula (200 - age in years) x 0.6;
• the duration of the workout is 30 minutes, of which 5 minutes are warm-up, 20 minutes are active movements, 5 minutes are recovery.

If the patient has hypertension and coronary artery disease, he should take medication for high blood pressure. Hypertension significantly increases the likelihood of heart attack, stroke, and death from them. The same applies to concomitant diabetes mellitus.

To find out how high the risk of complications is, you need to consult a doctor. A cardiologist determines the likelihood of a disease using a special table (SCORE scale). It takes into account the age and gender of the patient, smoking and the level of blood pressure. Based on the data obtained, each patient is given individual recommendations to achieve the target level of blood pressure and cholesterol. These may include diet, lipid-lowering drugs, and regular cholesterol monitoring.

With an existing disease, treatment is prescribed with drugs that reduce the likelihood of complications:

• aspirin;
• beta-blockers;
• ACE inhibitors;
• statins.

Vitamins do not affect the prognosis of the disease. However, their deficiency worsens general state organism. It is recommended to take vitamins with antioxidant properties: A, E, C. The positive effect on the course of the disease of ϖ-3 and ϖ-6 (omega) fatty acids, which are present in fish or sea krill oil, is recommended.

Nutrition for IHD

Diet for coronary heart disease is one of the main measures to prevent a heart attack. Doctors recommend that people who have risk factors for this pathology also observe it. Proper nutrition helps slow down atherosclerotic processes in the vessels. The disease in women is often associated with overweight and diabetes, which should be taken into account when compiling the menu.

The diet for IHD should comply with the following recommendations:

• matching caloric content to individual needs; with obesity, reducing it to 1700 kcal per day;
• restriction of foods containing a lot of cholesterol - egg yolks, liver, caviar, fatty meat, sour cream, butter;
• an increase in the share of vegetable oils and seafood containing useful polyunsaturated fatty acids;
• an increase in the proportion of vegetable fiber (vegetable dishes, fruits) while reducing the consumption of refined carbohydrates (sugar), and with concomitant diabetes, the exclusion of sweet foods;
• the protein content should not exceed 1 - 1.1 g/kg of weight, with an equal amount of animal (eg dairy) and vegetable proteins.

A person should consume a sufficient amount of fiber, vitamins and trace elements. It is recommended to limit foods that contain a lot of salt, especially with concomitant hypertension.

Meals should be fractional, up to 6 times a day. You need to have dinner 3 hours before bedtime.

Such a diet is useful for any degree of disease. With unstable angina and heart attack, it helps restore myocardial function, improves its ability to regenerate, and normalizes blood coagulation. With stable angina pectoris, proper nutrition increases the body's resistance to stress and corrects metabolic disorders.

Video about coronary heart disease