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Ischemia is a condition of an anemia which most often arises owing to a vascular factor. Ischemia is shown as a result of narrowing or full obturation of a gleam of an artery. Such phenomenon leads to damage or temporary dysfunction of fabric or body. Depending on that, how strongly and quickly blood-groove parameters decrease, ischemia effects are shown. The strongest sensitivity to ischemia is shown by a myocardium and TsNS.
Ischemia significantly differs from a condition of a hypoxia. At a hypoxia air hunger because of breath disturbances is observed. The condition of insufficiency of blood supply, relative or absolute is characteristic of ischemia. Thereof there is a hypoxia of fabrics of local character and other disturbances of a metabolism. Ischemia is in most cases reversible process.
Coronary heart disease
Coronary heart disease is a chronic illness which arises as a result of insufficient supply of blood in a cardiac muscle. Ischemia of heart is shown if the need of a cardiac muscle for oxygen does not correspond to the number of its delivery on coronary arteries.
Developing of coronary heart disease is directly connected with atherosclerosis of coronary arteries, a spasm of arteries which is provoked sometimes by some drugs and biologically active agents. Also ischemia of heart can be shown owing to increase of viscosity of blood and formation of blood clots in coronary arteries.
But nevertheless atherosclerosis of coronary arteries becomes a basic reason of ischemia of heart. Vasoconstriction occurs in view of formation of plaques on their internal walls.
Generally coronary heart disease is shown at males at efficient age. Clinically ischemia of heart can be shown differently. Most often emergence at the patient of stenocardia is characteristic of this illness. In that case the patient can feel pain in a thorax. Pain generally arises during a severe stress, or as a result of an exercise stress and has the squeezing character. In development of ischemia of heart similar attacks become frequent over time. At loading heart demands that to it the bigger amount of oxygen arrived. If it is not enough oxygen, there can be a myocardium ischemia attack which is shown the squeezing pain behind a breast. Also heart arrhythmia can be shown. Similar attacks recedes after the Nitroglycerine use. If the attack proceeds about half an hour, then it is considered critical, dies off part of cells in a myocardium after a while, and, as a result, at the person serious complication — a myocardial infarction can develop. One more form of ischemia of heart — a postinfarction cardiosclerosis. It is a consequence of the heart attack postponed earlier.
Heart failure can become complication of coronary heart disease. In such state heart cannot normally function.
The diagnosis "coronary heart disease" can be made, using data of an ECG, and also research with use of radionuclide methods of research of heart, an echocardiography, daily ECG monitoring, etc. The coronary angiography method is applied to detection of atherosclerotic plaques.
Treatment of ischemia of heart always first of all is directed to reduction to norm of a blood-groove on coronary arteries. It is important to warn all obstacles which prevent intake of oxygen and nutrients to a cardiac muscle.
Therefore, it is important to treat correctly atherosclerosis, to anticipate formation of blood clots, to recover adequate blood supply of a cardiac muscle, to correct exchange processes in an organism.
For this purpose it is necessary to consider a number of factors which influence aggravations of symptoms. First of all, it is necessary to struggle with obesity, to lead active lifestyle, to keep to a diet, having refused harmful products.
As a rule, the doctor appoints complex treatments, considering specific features of the patient and disease. At therapy of ischemia of heart medicines which reduce oxygen requirement of a myocardium, means which interfere with aggregation of thrombocytes, heparin, trombolitik and other drugs are used.
In the current time surgical methods of treatment of ischemia of heart are used even more often. Surgeries are especially strongly recommended patients with heavy attacks of stenocardia. The most notable effect is brought by the operative measures directed to recovery of a normal blood-groove in a coronary artery. Among such operations — creation of a mammarno-coronary anastomosis and aortocoronary shunting. Also the angioplasty technique is used: the catheter with the inflated cylinder, the vessel allowing to expand later is entered into a coronary artery.
Doctors appoint carrying out surgical intervention also at the aneurism of heart which developed as a result of a myocardial infarction. Such operation allows to prevent heart failure in the future. Sometimes during operation trombotichesky masses in an aneurism cavity is removed. All surgical interventions at ischemia of heart are carried out only in special clinics, artificial circulation is used at the same time.
Optimum the forecast at treatment of this illness is on condition of existence of rare attacks of stenocardia. If at the patient the repeated heart attack and heart failure, then the forecast less favorable takes place.
As methods of prevention it is important to eliminate all factors which promote development of coronary heart disease. It is necessary to adhere to a special diet in which the use of products with the high content of animal fats, too sweet and salty food is limited. Very important step is also full refusal of smoking. Regular jobs are recommended by sport and if at the patient arterial hypertension or a diabetes mellitus takes place, then these diseases it is necessary to treat correctly and in time. Patients with ischemia of heart have to be observed regularly at the attending physician.
Cerebral ischemia at newborns
At newborn children cerebral ischemia is shown owing to a brain hypoxia, that is insufficient intake of oxygen in a brain of the kid in the course of incubation or at the time of delivery.
Being guided by symptoms and results of ultrasonic research of a brain, it is accepted to allocate three degrees of cerebral ischemia. At easy degree of cerebral ischemia manifestation of too strong excitement or oppression in the first week of life is possible. At medium-weight degree of an illness similar disturbances last longer, at the same time there can periodically be spasms. Children with heavy degree of cerebral ischemia need to be placed in the intensive care care unit urgently. At easy degree of ischemia the forecast favorable: as a rule, the child, several weeks later already completely recovers. At more severe forms of an illness the doctor has to define medical actions.
Chronic ischemia of a brain call the progressing brain dysfunction which is shown as a result of brain tissue damage in the conditions of long insufficiency of cerebral blood supply.
As a rule, this state arises against atherosclerosis and arterial hypertension. Often at the patient these a state are combined with brain ischemia. However and other illnesses of cardiovascular system can provoke brain ischemia as a result. Also defining value has existence at the person of anomalies of vessels, venous pathology, a compression of arterial and venous vessels, a cerebral amyloidosis. However as the main origins of chronic ischemia of a brain define nevertheless existence of atherosclerosis and arterial hypertension.
As clinical displays of ischemia of a brain there are poliformny motive frustration, also at the patient memory and ability to study qualitatively considerably worsens, the emotional background of the person suffers disturbances. Progressing, staging is characteristic of this disease.
Allocate three stages of an ischemic disease of a brain. At the first stage the symptoms described above are combined with an anizorefleksiya, not rough reflexes of oral automatism. At the patient gait can change a little, decrease coordination and stability. The person can often be irritated, fall into a depression. Manifestation of easy cognitive frustration is also possible: slowness of reactions, inertness of intelligence.
At the second stage of an illness of a disease the neurologic symptomatology becomes more expressed. However at the same time at the patient the number of complaints in view of decrease in criticism to own state decreases. Emotional frustration become more significant, the person cannot fully plan actions and keep them under control. At this stage some signs of reduction of social and professional adaptation can already be shown.
At the third stage of a disease separate neurologic syndromes are shown especially brightly: balance is broken and walking worsens, the urine incontience can be shown. Psychotic frustration, disturbances of thinking, memory, the speech are possible. As a result of sometimes frustration develop into dementia. Often such patients lose working capacity, and later — and an opportunity independently to service itself.
Diagnosis of ischemia of a brain
First of all, the doctor studies the anamnesis of the patient, paying attention to existence of characteristic components: myocardial infarction, ischemia of heart, stenocardia, arterial hypertension, etc. Physical examination at which pathologies in work of cardiovascular system come to light is without fail conducted. In the course of laboratory researches the reasons of development of a disease are defined. Also carrying out a number of tool researches is recommended. So, the patient surely passes an ECG, an echocardiography, an oftalmoskopiya and some other specific researches which are appointed by the doctor. The angiography of vessels of a brain is carried out only in rare instances.
It is important to differentiate brain ischemia with a number of somatic diseases, oncological illnesses, mental disorders. It is especially difficult to carry out sometimes differential diagnosis of ischemia with neurodegenerative diseases of which cognitive frustration are characteristic.
Treatment of ischemia of a brain
At therapy of chronic ischemia of a brain it is important to stabilize the destructive processes arising owing to a brain ishemization, to warn an ischemic stroke. At this disease hospitalization is not always shown, if at the patient cognitive frustration take place, then it is more reasonable to it to receive medical treatment in a situation, usual for it.
Medicamentous cure for ischemia of a brain applies for the purpose of optimization of a blood-groove in a brain. For stabilization of ischemia it is important to direct efforts to maintenance of normal level of arterial pressure. Therefore, in the course of therapy drugs with anti-hypertensive action are used.
That at whom atherosclerotic defeat of vessels of a brain takes place appoints also reception of hypolipidemic means. They, except other, improve functions of an endothelium, reduce viscosity of blood. Besides, at treatment of ischemia of a brain reception of antiagregantny means is appointed.
In view of a big variety of the mechanisms which are in a brain ischemia basis in a complex administration of drugs which normalize microcirculation, venous outflow is possible. Courses of treatment are appointed on two times a year and last till some months.
In especially hard cases surgical intervention is shown. However operations are reasonable in case of development of the occlusive stenosing defeat in the main arteries of the head.
At the correct and timely approach to therapy of this disease its progressing can be slowed down effectively.
As prevention measures for the prevention of ischemia of a brain it is already important to avoid from the earliest age a hypodynamia, obesity, to avoid stresses, not to abuse alcohol and not to smoke. Not less important qualitatively and judgment to exercise in a question of treatment of the accompanying diseases: diabetes mellitus, hypertension, atherosclerosis.