Ischemia(ISCHAEMIA, Greek ISCHō delay + Haima Blood) - a decrease in the blood supply to the body, organ or tissue due to the weakening or cessation of the flow of arterial blood to it.
Coronary heart disease(IBS; LatinMorbus ischaemicus cordisFrom the ancient Greekἴσχω - “I delay, restrain” and αἷμα - “blood”) - a pathological condition characterized by an absolute or relative impaired blood supply to the myocardium due to damage to the coronary arteries.
Coronal heart disease is due to a disorder of coronary circulation of myocardial blood, which occurs as a result of a violation of the equilibrium between coronary blood flow and metabolic needs of the heart muscle. In other words, the myocardium needs more oxygen than it comes with blood. Coronal heart disease can be acutely (in the form of myocardial infarction), as well as chronically (periodic attacks of angina pectoris).
Coronal heart disease is a very common disease, one of the main causes of mortality, as well as temporary and persistent loss of working capacity of the population in developed countries of the world. In this regard, the problem of coronary heart disease is occupied by one of the leading places among the most important medical problems of the 21st century.
The term “coronary heart disease” was proposed by the Committee of Experts of the World Health Organization (WHO) in 1962. Coronial heart disease is a disease due to a disorder of coronary circulation, leading to an imbalance between the need for myocardial oxygen and the possibilities of its actual intake through the coronary direction. Regardless of the causes and mechanisms causing such an imbalance, limited possibilities of coronary circulation are in the forefront, which leads to myocardial ischemia. Most often, this process is a consequence of atherosclerotic damage (narrowing) of the coronary arteries or a violation of their functional state (spasm). That is why the term “myocardial ischemia” is associated with the coronary -agent pathological process. Meanwhile, myocardial ischemia, even with coronary heart disease, is about 10 % of cases with atherosclerotic changes in the coronary vessels, which is confirmed by angiographic and other high -reliable research methods. In addition, myocardial ischemia is often found with hypertrophic cardiomyopathy, with aortic malformations, with anomalia of the development of coronary vessels. Thus, coronary heart disease is a disease due to organic lesions of coronary arteries (stenosis of the analrosis, thrombus) or impaired their functional state (spasm, violation of the tone regulation of tonus regulation Also, as a rule, against the background of an atherosclerotic process) with a clearly defined symptom complex, including acute and chronic pathological conditions: myocardial infarction, sudden death, angina pectoris, post -naparct cardiosclerosis, heart rhythm disorders, heart failure. With this interpretation, coronary heart disease is an independent nosological form and is the synonym for the term “Coronary heart disease"(WHO, 1959).
Classification
Currently, the most common worldclassificationcoronary heart disease proposed by the Committee of Experts of the World Health Organization. She was recommended in 1979.
The classification of coronary heart disease according to clinical forms is used, each of which has an independent meaning due to the features of clinical manifestations, prognosis and treatment tactics.
1. Infant coronary death (primary cardiac arrest).
- Sudden coronary death with successful resuscitation.
- Sudden coronary death (death).
2. Angina pectoris.
- Stable voltage angina pectoris (indicating the functional class).
- Coronary syndrome H.
- Vasospastic angina pectoris.
- Unstable angina pectoris.
- Progressive angina pectoris.
- For the first time arising angina pectoris.
- Early postinfarct angina pectoris.
3. Myocardial infarction.
4. Cardiosclerosis.
5. The painless form of coronary heart disease.
It is unacceptable to formulate the diagnosis of coronary heart disease without deciphering the form, since in such a general form it does not give real information about the nature of the disease. In a correctly formulated diagnosis, a specific clinical form of the disease follows the diagnosis of coronary heart disease through a colon, for example:"IBS: The first emerging angina pectoris"; In this case, the clinical form is indicated in the designation provided for by the classification of this form.
Also today there is a more modern classification. This is a classification of IBS WHO with additions to the BCNC, 1984.
1. Sudden coronary death (primary cardiac arrest).
- Sudden coronary death with successful resuscitation.
- Sudden coronary death (death).
2. Angina pectoris.
- Explorescence angina pectoris.
- For the first time arising angina pectoris.
- Stable angina pectoris with a functional class indicating.
- Unstable angina pectoris (currently classified according to Brownwald).
- Vasospastic angina pectoris.
3. Myocardial infarction.
4. Postinfarct cardiosclerosis.
5. Cardiac disorders.
6. Heart failure.
Risk factors of coronary heart disease
The risk factors of coronary heart disease are circumstances, the presence of which predisposes to the development of coronary heart disease. These factors are largely similar to the risk factors of atherosclerosis, since the main link in the pathogenesis of coronary heart disease is atherosclerosis of the coronary arteries.
To classify many risk factors associated with cardiovascular diseases, various models are offered in epidemiological studies. Risk indicators can be classified as follows.
Biological determinants or factors:
- elderly age;
- male gender;
- Genetic factors contributing to the occurrence of dyslipidemia, hypertension, glucose tolerance, diabetes and obesity.
Anatomical, physiological and metabolic (biochemical) features:
- dyslipidemia;
- arterial hypertension;
- obesity and nature of the distribution of fat in the body;
- diabetes.
Behavioral (behavioral) factors that can lead to exacerbation of coronary heart disease:
- food habits;
- obesity as a factor in the development of coronary heart disease;
- smoking;
- insufficient motor activity, or physical activity exceeding the adaptive capabilities of the body;
- alcohol consumption;
- behavior that contributes to the occurrence of coronary arteries.
The probability of developing coronary heart disease and other cardiovascular diseases increases with an increase in the number and “power” of these risk factors.
Methodist instructor for physical rehabilitation Shablovskaya M.G.
