Cardiosclerosis of the heart - what is it?: Causes, symptoms and treatment

Why does the disease appear?

The causes of cardiosclerosis are different.
The development of the disease occurs independently quite rarely. Basically, everything develops as a complication from the consequences of other diseases. For the appearance of connecting layers in the myocardial area, only a small inflammatory process in the heart is required. This is also facilitated by the death of organ cell tissue. The accumulation of connective tissue fibers occurs due to the activation of the body’s protective functions against the manifested pathological process of inflammation.

Other causes of cardiosclerosis are divided into certain groups, which consist of atherosclerotic, myocardial forms, post-infarction cardiosclerosis and others.

Cardiosclerosis can develop in another way. There are many reasons, and many doctors and specialists work on their occurrence and consequences.

Rare reasons why cardiosclerosis develops:

presence of scleroderma;
manifestation of idiopathic cardiosclerosis;
the occurrence of hemochromatosis;
the appearance of cardiac sarcoidosis;
presence of rational exposure.

Scleroderma

To establish the exact cause of cardiosclerosis, many studies and diagnostic measures will be required. This information will help in future treatment of the disease.

Many experts argue that it is impossible to cure cardiosclerosis itself, since the tissue that has arisen in the form of a layer is no longer capable of being replaced by normal cardiomyocytes. If the root cause is eliminated, the progression of the disease can be slowed down several times. And in the near future the patient will feel well without heart problems.

Manifestations of the disease and their severity depend on the main pathological processes that caused the disease. The disease can occur against the background of:

transferred venereal diseases;
rupture of aneurysm of the left ventricle of the heart;
ventricular fibrillation;
pulmonary edema.

Symptoms of cardiosclerosis are determined depending on the damage to the myocardium. It can be focal or diffuse. The manifestation of the disease also depends on the presence of connective tissue scars and the size of their location. If the connective tissue has formed close to the conduction system, then disturbances in the form of arrhythmia occur.

Diffuse cardiosclerosis can behave secretly and under normal conditions it is impossible to detect it. Such a check can only be done using special equipment.

There are certain signals that indicate:

the occurrence of swelling of the feet, especially in the evening;
the appearance of a feeling of lack of air when taking a horizontal position;
the appearance of rapid fatigue;
the appearance of dizziness;
the occurrence of shortness of breath during significant exertion, which was previously tolerated without problems;
The heartbeat is constantly heard both during exercise and at rest.

Dyspnea

If alarm signals appear, you should definitely contact specialists for help. If there is progress in the proliferation of connective tissues, which lasts for more than one year, the formation of pronounced diffuse cardiosclerosis appears.

Cardiosclerosis is manifested by the following symptoms:

the appearance of severe attacks of shortness of breath, even with slight exertion or simply at rest;
occurrence of asthma-related episodes;
the occurrence of attacks of night suffocation;
noticeable appearance of rhythm disturbance (in the form of atrial fibrillation or ventricular extrasystole, blockade);
in the form of swelling of the extremities in the foot area;
swelling in the lumbar region, as well as in the abdominal area;
pain in the liver area (under the right lower rib).

If a transmural (extensive) infarction occurs, patients may develop a larger disease. Based on the clinical picture, this type manifests itself in the form of rhythm disturbances, angina attacks and other heart failure.

Treatment

Treatment of cardiosclerosis includes, firstly, curing the primary disease that caused scarring of the heart tissue. Of course, this point is applicable only in cases where the disease has not caused irreversible changes.

Secondly, the processes of connective tissue growth and scar formation are slowed down. For this purpose, ACE inhibitors (substances that lower blood pressure - Enap, Capoten), nitrates (nitrosorbide, cardite, isomonate, monomac), disaggregants (acetylsalicylic acid), diuretics, drugs that stimulate metabolism (riboxin, panangin), b -adrenergic blockers (propranolol, metoprolol).

Treatment is carried out in a hospital setting and is usually conservative (without surgery). An exception is the formation of an aneurysm - a curvature of the cardiac septum. In this case, urgent surgical treatment is indicated to avoid internal hemorrhage.

Methods for the prevention of cardiosclerosis and restorative procedures during treatment are generally similar to the prevention of other cardiovascular diseases and include diet, physical therapy, a strict regime of physical activity, sanatorium therapy, etc.

Cardiosclerosis is a dangerous and serious disease, but with timely and competent treatment, the prognosis is usually positive. The main thing is not to start!

About heart disease

In cardiosclerosis, normal cardiac muscle cells (cardiomyocytes) are destroyed and connective tissue is formed in their place. The fibers of this tissue do not have the ability to perform the same functions as cardiomyocytes. They do not contract, as a result of which the heart muscle partially loses its performance.

The main factor in the origin of this pathology is chronic pathologies of the cardiovascular system, as a result of which cardiomyocytes lose their protection and begin to collapse.

Cardiosclerosis is considered an extremely serious illness that can lead to damage to the main organ, and in complex cases, even death from acute failure or other complications.

The diagnosis of pathology and treatment is carried out by a cardiologist, who, if necessary, involves other specialists, including cardiac surgeons.

During diagnostic measures, diseases that were previously present are taken into account, regardless of whether they are cured or not. Such diseases include:

atrial fibrillation;
acrocyanosis;
rheumatism;
myocardial infarction;
suffered in the past, myocarditis;
IHD;
dyspnea;
atherosclerosis.

If you need to obtain more accurate results, you should use an ECG. MRI of heart tissue is also often used in studies.

Sometimes during diagnostic work it becomes difficult to differentiate forms of cardiosclerosis. This occurs when it is necessary to determine the difference between atherosclerotic and myocardial disease.

If this is an atherosclerotic form of the disease, then this can be proven using coronary artery disease. You can also determine the difference between atherosclerotic and myocardial disease using pharmacological and bicycle ergometer tests. At a younger age, changes in ECG results help differentiate.

Cardiosclerosis symptoms

Cardiosclerosis is a manifestation of chronic ischemic heart disease and can be atherosclerotic, diffuse, small-focal, or post-infarction large-focal, which results in the formation of a chronic cardiac aneurysm.

Cardiosclerosis occurs against the background of an existing pathology, and therefore the symptoms of cardiosclerosis are superimposed on the symptoms of a concomitant disease. As a result of a decrease in the number of functioning myocytes, the myocardium loses the ability to effectively deliver oxygen to all tissues and organs in cardiosclerosis. Heart failure develops. For a long time, the body manages to compensate for circulatory failure by hypertrophy of a healthy area of the myocardium. Thus, the first manifestations of heart failure in cardiosclerosis appear at a stage that is difficult to treat.

Depending on the location of cardiosclerosis, right ventricular and left ventricular heart failure are distinguished. Their symptoms are different. Left ventricular failure occurs when the lungs “overflow” with blood. As a result, shortness of breath occurs, the patient takes a forced position to improve breathing, and attacks of suffocation and cough occur. In the terminal phase of cardiosclerosis, pulmonary edema occurs, which can lead to death. An attack of pulmonary edema can occur at night when a person is in a horizontal position. The skin is pale, wet, an attack of suffocation forces the patient to take a forced position, the pulse is rapid, the breathing is bubbling, the sputum is foamy pink, blood pressure is low.

With right ventricular heart failure, swelling occurs in the legs, and with further progression of the disease, the swelling “rises” higher; the liver enlarges; veins in the neck swell; fluid accumulates in the abdominal, pleural cavities and in the pericardial cavity; subcutaneous tissue swells.

There are several stages of heart failure.

Stage I – shortness of breath and tachycardia appear only during physical work, and at rest the person feels satisfactory.

Stage II A with left ventricular failure - shortness of breath, tachycardia appear with light exertion, moderate cyanosis of the extremities.

Stage II A with right ventricular failure - swelling in the feet and ankles appears in the evening, moderate increase in heart rate, moderate cyanosis of the extremities (acrocyanosis).

Stage II B – obvious stagnation in both circles of blood circulation, significant enlargement of the liver, constant swelling, reduced performance.

Stage III – characterized by constant manifestations of symptoms at rest and terminal dysfunction of all systems and organs.

There is also a division into functional classes depending on the patient's physical capabilities. The first functional class is characterized by the absence of restrictions in physical activity. Functional class II – moderate disability with shortness of breath and palpitations during normal work. In patients with functional class III, symptoms of circulatory failure appear during any physical work. The fourth functional class is characterized by the constant presence of symptoms of heart failure.

Due to disruption of the conduction of impulses from the sinus node due to morphological changes in the myocardium during cardiosclerosis, various types of heart rhythm disturbances occur. Extrasystoles are most often detected only during preventive examinations, since with a small number of them no subjective sensations arise.

As cardiosclerosis progresses, the patient complains of interruptions in the work of the heart, “fading” of the heart. Ventricular extrasystoles are dangerous, especially in patients with coronary artery disease.

Paroxysmal tachycardia is characterized by an ectopic rhythm disturbance with a sudden acceleration of the contraction frequency and the same sudden decrease in the rhythm. Due to cardiosclerosis, the wave of excitation is delayed in a certain part of the heart and “circulates” through this part. This results in an increase in myocardial excitability. The patient complains of palpitations; when examining the pulse, a frequency of more than 150 per minute is determined. Shortness of breath and severe weakness occur. With the development of cardiogenic shock, blood pressure drops sharply, cold sweat appears, and the patient loses consciousness. Pain in the heart area often occurs.

Atrial fibrillation very often accompanies atherosclerotic, post-infarction and myocardial cardiosclerosis. Cardiosclerosis provokes the appearance of a circular wave of excitation in the atria or ventricles. Such waves in the atria are layered on the main rhythm, and the frequency of the waves is 350-600 per minute. These waves are called atrial fibrillation or atrial fibrillation. Subjective sensations in this case boil down to an unpleasant feeling of rhythm disturbance, dizziness, and weakness when performing physical activity. The prognosis for patients with cardiosclerosis with atrial fibrillation depends on the frequency of occurrence and the area of the myocardium covered by cardiosclerosis.

Atrioventricular blockade occurs as a result of the involvement of myocytes in cardiosclerosis, which are involved in conducting impulses from the atrioventricular node. If degrees I - II do not give any clinical manifestations, then with complete blockade, weakness, rare heartbeat, dizziness, headaches, and loss of consciousness are observed. These symptoms indicate a decrease in blood supply to the brain.

Sick sinus syndrome is also a manifestation of cardiosclerosis. Sclerotic changes lead to a decrease in the function of the sinus node, which leads to bradycardia and stoppage of rhythmic activity.

The tachybradyarrhythmic variant occurs when other structures begin to take part in the formation of the rhythm. As a result, a transition to a permanent form of atrial fibrillation may occur. At the initial stages of the disease, a person does not complain. Then symptoms associated with decreased blood circulation to the brain arise: weakness, dizziness, memory loss. Cardiac complaints include shortness of breath and angina. Insufficiency of blood circulation in the extremities of the patient is manifested by pain in the calves and heaviness in the legs. Episodes of asystole are characterized by: “memory failure”, swallowing of word endings, and possible cases of loss of consciousness (Morgagni-Adams-Stokes syndrome).

In addition to patient complaints, the diagnosis of cardiosclerosis is made on the basis of electrocardiography, echocardiography, and determination of the patency of the coronary vessels. All diagnostic methods show the presence of a non-functioning area of the myocardium. The ejection fraction of blood decreases, the coronary arteries are obstructed. Depending on the type of cardiosclerosis, certain symptoms may predominate.

Atherosclerotic form

The atherosclerotic form includes diseases that lead to the occurrence of a disease such as cardiosclerosis, through the manifestation of prolonged ischemia, in the form of a lack of oxygen.

If for certain reasons the muscles of the organ (heart) do not receive enough oxygen, then a certain area of the muscular system dies. This is how connective tissue appears in the affected area (at the site of two cardiomyocytes). This is a kind of beginning of the appearance of sclerosis.

The main reason for the appearance of ischemic disease is a pathological process in the middle of the coronary vessels, when a decrease in their lumen (effective diameter) appears. This is due to the accumulation of cholesterol deposits in the layers of blood vessels and their further breakthrough.

Narrowing of the coronary vessels and the causes of the process:

during prolonged stressful situations, as the functioning of the adrenal glands changes;
the width of the vessels depends on genes that are passed on through kinship;
during chronic hypertension, which is manifested by high blood pressure (arterial);
in case of obesity, when the heart is loaded much more than under normal conditions;
with impaired fat metabolism and elevated cholesterol levels;
with intensive or long-term smoking, since nicotine can cause temporary spasms of blood vessels in the heart.

Cardiosclerosis and its atherosclerotic manifestations can develop more gradually, rather than abruptly. If the process is considered in more detail, then a growth of connective tissue appears between the muscles of the heart, which are responsible for the functioning of the left ventricle. It is the left muscle that suffers first during oxygen starvation during the development of cardiosclerosis.

The pathology in question develops unnoticed and can remain silent for a long time, especially if you eat incorrectly and lead an incorrect lifestyle. Its symptoms appear when the heart muscle is practically covered with connective formations.

It takes a lot of time for atherosclerosis to develop. It is worth noting that signs of cardiosclerosis more often appear in people over 40.

Causes and risk factors

Cardiosclerosis is a fairly common disease that affects people of all ages. But the reasons why pathological processes begin to occur in the tissues of the heart muscle may vary depending on age.

Children often suffer from this disease as a result of dystrophic or inflammatory processes occurring in the myocardium. In adults, pathology is more often formed under the influence of impaired metabolism. The reasons for the development of the disease vary depending on its type.

The main factors contributing to the development of cardiosclerosis are:

High blood pressure. In hypertensive patients, blood moves much faster through the vessels. As a result, turbulence sometimes occurs in the blood flow, which contributes to the accumulation of cholesterol, narrowing of the coronary vessels and reduced access of nutrients to the tissues of the heart muscle.

Violation of fat metabolism. Cholesterol levels in the body can also increase as a result of metabolic disorders.
Smoking. Under the influence of nicotine, spasms occur in the heart muscle, which short-term impair blood supply. Frequent smoking also contributes to the accumulation of cholesterol and narrowing of coronary vessels.
Heredity. Cardiosclerosis can be a congenital disease in which a child is born with pathologically narrowed heart vessels.
Overweight. If a person is obese, his heart muscle is subject to increased stress. To ensure normal blood circulation, the heart muscle has to work much harder, which increases its wear and tear and can cause disruption of the cellular functions of the myocardium.
Nervous overload. Constant stressful situations cause increased activity of the adrenal glands. They begin to intensively produce hormones that reduce vascular tone and disrupt metabolism.
Radiation exposure. During irradiation, the molecular structure of myocardial cells can be disrupted, as a result of which they begin to collapse, being replaced by connective tissue.

Cardiosclerosis can also form as a complication of other diseases:

Sarcoidosis. This disease causes pathological processes in the myocardium, which lead to the appearance of inflammatory neoplasms. During the treatment process, the neoplasms are successfully eliminated, but in their place connective tissue appears, which causes pathology.
Hemochromatosis. The disease is characterized by the accumulation of iron in the walls of the heart. When iron levels exceed acceptable limits, inflammation occurs, accompanied by the growth of connective tissue.
Scleroderma. A disease in which connective tissue begins to rapidly grow in the body. These processes can also affect the heart muscle, leading to the formation of cardiosclerosis.

Other provoking factors are infections of various origins, allergic reactions, intoxication of the body, as well as chronic inflammatory diseases.

Diagnosis and treatment of the disease

Before therapy, the doctor is obliged to refer the patient to a series of diagnostic procedures in order to identify the stage of development of the pathology and its neglect.

Establishing diagnosis

Diagnosis of this disease begins with an external examination of the patient, measuring blood pressure and pulse. The doctor evaluates skin color, the presence of swelling of the extremities, and notices whether there is shortness of breath. Then he orders an examination.

It consists of:

Electrocardiogram, which will show the work of the heart, the number of pulses per minute.
A general and biochemical blood test, which will show concomitant pathologies, as well as the level of cholesterol in the blood.
Echocardiography, which shows the presence of scars and enlargement of the heart.
Ultrasound of the heart showing the presence of left ventricular hypertrophy, causing heart failure.
MRI indicates the condition of the blood vessels and heart.
Scintigraphy, which will show whether the disease is progressing.
Daily monitoring, which will record the work of the heart during the day.

Based on the results of the examination, the doctor makes a diagnosis and chooses treatment.

Therapy of the disease

Modern medicine has not yet invented a remedy that could restore the heart muscle. But medications are usually prescribed to support heart function and normal rhythm.

The purpose of drug treatment of myocardial cardiosclerosis is also:

avoiding the development of complications,
identification and removal of the cause of the disease,
relief of the main symptoms.

The drugs usually prescribed are:

ACE inhibitors,
adrenaline beta blockers,
statins,
nitrates,
glycosides,
diuretics.

In addition, the doctor recommends completely reconsidering your lifestyle. It is necessary to avoid heavy physical labor and not to overwork. It is also important to avoid stressful situations.

It is important to seek help from a doctor in time!

Light physical activity and walks in the fresh air are recommended. It is worth strictly observing the daily routine, going to bed and getting up at the same time, sleeping at least 8 hours at night, but no more than 10 hours.

Myocardial form

This form is capable of developing according to a completely different mechanism. The process begins to affect the muscle tissue of the heart, as well as many cardiomyocytes - this provokes an acute inflammatory process (in medicine it is called myocarditis).

When myocarditis has been cured, the body’s defense systems act in such a way that the thickness of the tissue in the myocardium, which is called connective tissue, increases.

The cause of myocarditis is most often caused by the following diseases:

after suffering from typhus;
other infections, such as trichinosis, toxoplasmosis;
when suffering from viral pathologies such as Coxsackie virus, cytomegalovirus, common rubella, influenza, Epstein-Barr virus or similar diseases;
bacterial infection (infection with streptococcus, meningococcus);
fungal infections (advanced form of candidiasis or aspergillosis);

Skin candidiasis

after suffering from diphtheria and similar diseases (heart disease in this situation can develop faster);
inflammatory diseases and their systemic manifestations;
toxic heart damage (due to alcohol or drug abuse);
with severe allergies to the medications used.

All these diseases and conditions of the body can cause serious damage to the body and its heart. In this case, everything happens secretly, from the very beginning, and then the symptoms increase sharply. It is worth noting that the development of the disease at an earlier age cannot be ruled out, but this does not happen so often.

Causes of development of myocardial cardiosclerosis

The main cause of myocarditis and its consequences (cardiosclerosis) are infectious diseases:

diphtheria,
scarlet fever,
rheumatism,
flu,
hepatitis,
adenovirus infection,
herpes.

Severe myocarditis can also occur with autoimmune or allergic diseases, intoxications, and also for an unknown reason. Any of these factors leads to the destruction of myocardial cells, the development of an inflammatory process with subsequent proliferation of connective tissue fibers.

Classification

Types depending on the location and intensity of connective tissue proliferation:

Focal cardiosclerosis. This form of the disease is characterized by the appearance of individual scar formations in the tissues of the heart. Most often, the focal form appears after myocarditis or myocardial infarction.
Diffuse cardiosclerosis. In this form of the disease, connective tissue is formed evenly over the entire area of the myocardium. Usually occurs as a complication of chronic ischemia or after toxic or infectious lesions of the heart.

Depending on the cause of its occurrence, cardiosclerosis is divided into the following forms:

Atherosclerotic. It is formed as a result of diseases that cause hypoxia of cardiac muscle cells - most often due to chronic cardiac ischemia.
Post-infarction. As a result of a heart attack, extensive death of cardiomyocytes occurs, in the place of which connective tissue appears.
Myocardial. Formed due to inflammatory processes in the tissues of the main organ.

In rare cases, cardiosclerosis may be congenital. This type of disease can occur as a consequence of other congenital heart pathologies - for example, subendocardial fibroelastosis or collagenosis.

Causes of cardiosclerosis

Diseases that can lead to the development of cardiosclerosis include the following:

1. Coronary heart disease and myocardial infarction . Within two months or more after an acute heart attack, post-infarction small- or large-focal cardiosclerosis develops. The danger of large-focal sclerosis is that a scar in the thickness of the myocardium can lead to the formation of a left ventricular aneurysm, that is, part of the ventricular wall is a protrusion that cannot contract, due to which cardiac output decreases, chronic heart failure develops and acute failure may develop with pulmonary edema. Also, a parietal thrombus may form in the ventricular cavity, which is fraught with the development of thromboembolic complications.

The figure shows a myocardial infarction: the area of necrosis, which is subsequently replaced by scar tissue, is highlighted in purple.

2. Myocarditis – inflammatory processes in the thickness of the myocardium of a viral or bacterial nature. Most often, myocarditis is caused by measles, influenza, infectious mononucleosis viruses, adenoviruses, streptococcal, and meningococcal infections. A special place is occupied by myocarditis of rheumatic nature - inflammation of the heart muscle due to acute rheumatic fever (rheumatism). As a result of myocarditis, diffuse cardiosclerosis usually develops

3. Cardiomyopathy - pathological changes in the anatomical structure of the myocardium. There are restrictive (impaired relaxation of the chambers of the heart), hypertrophic (the walls of the ventricles are thickened) and dilated (the chambers of the heart are dilated and filled with blood). Cardiomyopathies can be caused by endocrine diseases - diabetes mellitus, obesity, diseases of the thyroid gland, adrenal glands; toxic effects of alcohol, drugs, eating disorders - decreased intake of protein and vitamins from food. As a result of cardiomyopathy, diffuse fibrosis develops due to the replacement of hypertrophied or stretched muscle cells with connective tissue elements.

The figures depict myocardial hypertrophy and expansion of the heart chambers in cardiomyopathies.

4. Myocardial dystrophy - a disorder of myocardial nutrition. This is a group of metabolic disorders in the heart muscle, close in significance to cardiomyopathies, but with a significant difference - disturbances in myocardial nutrition can be reversible if the provoking factor is eliminated, since changes in the architectonics of the heart are not observed until the formation of diffuse cardiosclerosis. The diseases listed in the previous paragraph, as well as other extracardiac (non-cardiac) factors - infections, anemia, stress, autoimmune diseases, renal and liver failure, physical activity, professional sports - can lead to the development of myocardial dystrophy.

5. Atherosclerosis – deposition of cholesterol plaques in the walls of blood vessels. Leads to disruption of myocardial nutrition due to obstruction of the coronary arteries, which is the cause of coronary artery disease and myocardial infarction.

6. Hypertension can lead to the development of angiogenic cardiosclerosis (vascular origin), since long-term vascular spasm that accompanies hypertension creates additional stress on the heart with the development of left ventricular hypertrophy.

Post-infarction form of cardiosclerosis

During post-infarction cardiosclerosis, connective tissue is formed at the site where cardiomyocytes die during a heart attack. When the blood supply is tightly blocked, their partial or complete death begins.

The focus of pathology comes in different sizes, and its location depends on the location of the blockage of blood vessels. In order to compensate for the lost muscle tissue of the heart, the production of a large number of fibers for connection begins.

This is how pathological processes associated with post-infarction cardiosclerosis begin to arise, while the natural outcome is a heart attack. Death cannot be ruled out.

Atherosclerotic cardiosclerosis

Atherosclerotic changes disrupt blood flow through the coronary arteries due to the deposition of atherosclerotic plaques on the walls of blood vessels and the formation of platelet aggregates and then a blood clot in the area of the plaque. In this case, the area of \u200b\u200bthe blood supply to one or many branches of the coronary arteries may be affected. With long-term ischemia, organic changes occur in the muscle tissue of the heart with its replacement by connective tissue. With this pathology, both small-focal cardiosclerosis and diffuse cardiosclerosis can develop. This depends on the coronary arteries involved in atherosclerosis.

What complications may develop?

In almost half of patients, cardiosclerosis is not accompanied by any specific manifestations and does not threaten human life. The situation is getting worse:

When the diffuse process spreads over large areas of the organ, the walls of the heart muscle become thinner. Because of this, the myocardium cannot contract normally, insufficiency of heart function develops, the walls and cavities are stretched and the organ increases in size.
If focal cardiosclerosis is characterized by the appearance of a weak scar. This area may bulge and rupture. This problem is called an aneurysm.
If the scar appears where the electrical signal passes through, ensuring the contraction of the atria and ventricles. This causes various rhythm disturbances.

Cardiosclerosis is a rather dangerous disease that can cause complications such as acute or chronic heart failure. Acute failure can occur as a result of blockage of the heart vessels by an embolus or thrombus. Such phenomena often lead to rupture of the artery and death of the patient.

Chronic insufficiency is formed against the background of gradual narrowing of the arteries due to atherosclerotic processes. Such cardiosclerosis can lead to cardiac hypoxia, ischemic heart disease, atrophy or dystrophy of cardiac tissue.

Other complications of this disease are cardiac arrhythmias, cardiac aneurysms, chronic fatigue syndrome, thromboembolism, and acquired defects.

A consequence of the progression of pathology may be the development of a parallel disease, such as pneumosclerosis.

Pneumosclerosis. A disease in which functional lung tissue is replaced by connective tissue. In cardiosclerosis, it develops due to poor circulation and congestion in the lungs.
Left ventricular diastolic dysfunction. Damage to the myocardial muscle leads to disruption of its function. Healthy tissues try to compensate for this deficiency, while the left atrium experiences maximum load, which is the cause of its dysfunction.

Other negative consequences:

chronic heart failure;
aneurysm;
thromboembolism;
acquired vices;
atrial fibrillation;
circulatory disorders;
extrasystole;
atrioventricular block.

Complications and prognosis

Cardiosclerosis due to myocarditis is a rather serious disease, the prognosis of which is determined not only by the presence of complications, but also by the rate of progression of chronic heart failure.

Complications include cardiac arrhythmias, which can sometimes cause sudden cardiac death. These include ventricular tachycardia and ventricular fibrillation.

Among the less dangerous ones, atrial fibrillation, supraventricular variants of tachycardia and extrasystole, as well as ventricular extrasystole are more common.

The mechanism for the occurrence of arrhythmias is due to the fact that normal cardiac tissue, through which impulses are carried out in a physiological rhythm, is replaced by scar tissue, which cannot conduct impulses. As a result, impulses can circulate in one place, as they are not able to “bypass” the scar, leading to improper contraction of the heart muscle. In any case, myocardial cardiosclerosis with rhythm disturbance requires close attention of the attending physician, since the arrhythmia most often recurs.

If we talk about the prognosis, it should be noted that the earlier treatment for myocarditis and the initial stages of heart failure is started, the more favorable the prognosis for the patient’s life and work. Conversely, in severe chronic heart failure due to diffuse or large-focal cardiosclerosis, the prognosis is unfavorable, since heart failure quickly progresses to the terminal stage.

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Main symptoms of the disease

In the first stages, cardiosclerosis almost does not make itself felt. Symptoms of the disease begin to appear when pathological processes actively progress. The following symptoms may occur:

shortness of breath – in the initial stage it appears after physical activity, later shortness of breath can occur even during sleep or rest;
cardiopalmus;
heart murmurs, arrhythmia;
increased blood pressure;
constant weakness, decreased performance;
cough, attacks of which mainly occur at night;
pain in the chest area;
swelling of the limbs and abdominal cavity;
pale skin, cold extremities;
nausea, dizziness, fainting;
increased sweating.

If heart rhythm disturbances and heart failure are observed, it means that the disease is rapidly progressing. The symptoms will intensify as the pathology develops.

Cardiosclerosis refers to very severe lesions of the cardiovascular system. Lack of timely treatment will certainly lead to complications, and in extreme cases, death. Therefore, if signs such as causeless shortness of breath, rapid pulse and weakness in the body appear, you should urgently consult a cardiologist.

Symptoms of cardiosclerosis depend on the nature of myocardial damage. This can be either small or large-focal, as well as complete damage to the heart muscle. Cardiosclerosis negatively affects the functioning of the cardiovascular system, which manifests itself against the background of the main symptoms. So, diffuse and small-focal types of the disease occur with virtually no symptoms.

Shortness of breath, which occurs during normal stress on the body.
Very rapid fatigue of the body.
Dizziness and pain appear.
Palpitations are felt during rest.
When lying down, a person may feel short of breath.
Symptoms are especially active in the evening. Swelling of the legs occurs, which also indicates a malfunction of the kidneys.

If this set of symptoms is detected, you must immediately visit a doctor for an examination. In the early stages it is easier to fight the disease than to do so as the disease develops.

All of the above symptoms are characteristic exclusively of the initial stages of the development of the disease, but as the disease develops, the symptoms will only worsen.

With prolonged progression of signs of cardiosclerosis, a gradual expansion of the lesion occurs, that is, the most dangerous form develops - diffuse. It is characterized by the following symptoms:

Shortness of breath appears more and more often, even during rest.
Frequent signs of suffocation occur during night periods.
Loud heartbeat accompanied by chest pain. Frequent failures of the cardiac system and difficulty in inhaling occur.
Swelling of the lower extremities worsens.
At the same time, the liver experiences heavy loads and makes itself felt in the form of pain in the right hypochondrium.

Further aggravation of the situation leads to angina or heart failure. The large focal type leads to the development of an aneurysm. An aneurysm manifests itself in almost all cases without the presence of corresponding symptoms, but causes serious cardiac abnormalities.

Signs of cardiosclerosis

The symptoms of each type have some differences that are important to know about, so we will consider them separately.

Atherosclerotic cardiosclerosis in the early stages, unfortunately, does not have pronounced symptoms, so it is very, very difficult to identify. The cause of the disease is ischemic disease, so it is worth considering the symptoms of this disease in order to try to prevent the development of cardiosclerosis.

With the development of coronary artery disease, complaints arise of deterioration of health, shortness of breath and rapid loss of strength. At the first stage, atherosclerotic cardiosclerosis is observed rather vaguely, so it can only be identified in a hospital. An ECG machine is used to determine if the patient is short of breath.

As the disease develops, the patient experiences aching pain in the chest and heart area. Gradually the pain spreads and radiates to the arm and forearm. Often, with such pain, a person feels blurred vision, dizziness, tinnitus and fatigue.

If it detects increased heart rate, this indicates the development of the third stage of the disease. Atherosclerotic cardiosclerosis also manifests itself in the form of swelling of the lower extremities. When feeling the patient’s pulse, there is an excessive excess of the norm, often the value reaches at least 160 beats per minute.

If such symptoms are present, we can safely say that the person has atherosclerotic cardiosclerosis and requires immediate hospitalization.

Post-infarction cardiosclerosis has more distinct symptoms compared to the previous type. Often, the symptoms of all types have similar signs, but depending on the severity of pain, the corresponding types differ. So, the following symptoms are characteristic of the post-infarction form:

Shortness of breath, which does not appear immediately, but gradually. Initially when performing physical activity, and then during rest or sleep.
Periodic severe cutting pain in the heart area.
Weakness, fever up to 38 degrees, loss of strength.
Against the background of pain, appetite decreases and anorexia occurs.

Anorexia

Worsening symptoms lead to an enlarged liver and swelling of the legs. The development of pulmonary edema cannot be ruled out.

In case of acute pain, it is necessary to call an ambulance. Post-infarction or myocardial cardiosclerosis in some ways resembles the symptoms of myocardial infarction, but differs in the duration of occurrence.

Postmyocardial cardiosclerosis can develop in both adults and children. The symptoms of this type are also quite complex and require immediate treatment and therapy.

It should be noted that the main symptoms of cardiosclerosis are:

Shortness of breath and night cough. Shortness of breath has a feature of gradual increase. The cough predominantly occurs at night and is characterized by the production of sputum.
Signs of tachycardia appear.
Swelling of the legs, abdomen, enlarged liver.
Dizziness, chest pain, weakness, fainting.
When you feel the patient's limbs, you can track their coldness. Sometimes attacks of acute chest pain are characterized by increased sweating of the patient.

Postmyocardial cardiosclerosis, just like the above types, requires immediate hospitalization and initiation of treatment. Let's look at how this is done below.

As the disease develops, various clinical signs appear, one of which is arrhythmia.

At the very beginning of the development of cardiosclerosis, a person does not have any pathological signs. Complaints appear much later, when the connecting structures grow and affect new areas of the organ. Pain appears in the heart area, which becomes especially pronounced after physical exertion. As the pain syndrome progresses, the following symptoms accompany it:

dyspnea;
dry cough;
arrhythmia;
increase in the number of heart contractions;
swelling;
dizziness, headaches;
irritability, increased fatigue.

How does cardiosclerosis of the heart manifest?

general weakness, fatigue, lethargy;
prolonged shortness of breath, feeling of “lack of air”;
discomfort, periodic tingling in the heart area, manifested by minor pain and squeezing;
memory loss;
frequent coughing attacks;
pulmonary edema;
swelling of the lower extremities as a result of poor circulation and prolonged blood stagnation;
development of coma or fainting in more severe cases;
nausea, vomiting, headaches (associated with arterial hypertension);
frequent cardiac arrhythmia;
nervousness, sleep disturbances.

Attention: if the above listed signs of cardiosclerosis occur, it is recommended to consult a cardiologist or therapist!

Types of pathology

Heart disease can occur at any age, but more often it occurs after 40 years. Less commonly, it appears in childhood. Pathology can be classified depending on its distribution:

focal form of cardiosclerosis;
diffuse form of heart disease.

Focal cardiosclerosis
The focal form of cardiosclerosis occurs in the form of scars in the myocardium. The lesion can occupy different spaces on the surface of the organ. Provocation occurs after heart attacks that were successfully transferred. Thus, there are small-focal and large-focal types of cardiosclerosis and its forms:

The large-focal appearance is caused by the formation of a massive scar field of connective tissue after a heart attack (one or several). If the wall is completely overgrown, then a scar appears and further manifestation of the cardiac aneurysm.
The small-focal appearance is determined by a slight lesion of the white connective layer. They are located in the thickness of myocardial tissue. The species in question appears when the heart muscles are starved of oxygen. It is worth noting that the damage may be minor. It all depends on the intensity of oxygen supply.

Cardiac hypoxia

The diffuse form of cardiosclerosis appears due to the uniform growth of the layer throughout the tissue of the entire heart muscle along the entire myocardium. The occurrence of a diffuse form occurs due to the course of a chronic type of disease.

Heart walls and myocarditis

The wall of the heart muscle consists of 3 layers: endocardium, myocardium and pericardium, or epicardium. The myocardium is conductive, i.e. its tissue is functional and can conduct electrical impulses, it is elastic and can contract.

Myocarditis is an inflammation accompanied by pathomorphological changes in the thickness of the myocardium at the molecular level. It can be infectious, allergic or rheumatic. The outcome of any of them, with improper treatment or its absence, is the replacement of functioning cells with fibrous tissue. This condition is called myocardial cardiosclerosis and can lead to a number of complications: arrhythmia, heart failure, cardiac aneurysm.

It should be noted that this diagnosis is not entirely correct. Why? The cells are replaced by fibrous tissue, while there are no sclerotic changes yet. It would be more correct to call the process myocardial fibrosis.

In sclerosis, changes are already associated with the development of the above factors. Medical sources use a more complete name - postmyocardial cardiosclerosis.

Myocardial cardiosclerosis can develop according to different scenarios. This depends on the area of replaced tissue, i.e. fibrosis. Today, the exact reasons why some people may develop pathology and others not have been established.

Treatment tactics

Currently, a sufficiently effective treatment method for cardiosclerosis has not been developed. It is impossible to convert connective tissue back into cardiomyocytes using any medications. Therefore, therapy for this disease is usually aimed at eliminating symptoms and preventing complications.

Surgical and conservative methods are used in treatment. The first include:

Heart transplantation. It is considered the only effective treatment option. Indications for this operation are: a decrease in cardiac output to 20% or less of normal, the absence of severe diseases of internal organs, and low effectiveness of drug treatment.
Coronary artery bypass surgery. Used for progressive vasoconstriction.
Implantation of pacemakers. This operation is performed for cardiosclerosis accompanied by severe forms of arrhythmia.

If the disease has led to the formation of a cardiac aneurysm, surgery may be prescribed to eliminate it. During surgery, the affected area is removed or strengthened. These actions help prevent rupture of weak heart muscles.

For treatment, drugs are used whose action is aimed at eliminating the symptoms of heart failure:

Beta blockers: Metoprolol, Bisoprolol, Carvedilol;
Angiotensin-converting enzyme inhibitors: Enalapril, Captopril, Lisinopril;
Diuretics: Butemanide, Furosemide;
Cardiac glycosides - for example, Digoxin;
Aldosterone antagonists – Spironolactone.

These drugs modify the work of the heart, providing load regulation. Blood thinners can be used to prevent blood clots.

Treatment of myocardial cardiosclerosis

If there are signs of an inflammatory reaction, specific antiviral (Cycloferon, Acyclovir, Viferon) or antibacterial therapy (Ceftriaxone, Augmentin) is carried out; in immunoallergic processes, antihistamines (Erius, Zyrtec), hormonal agents (Prednisolone, Dexamethasone) can be used.

To improve metabolism in the heart muscle, antioxidants (Cralal, Mexiprim, Cytochrome, Kudesan), potassium and magnesium salts (Panangin, Magnicum, Kalipoz), Riboxin, Preductal, Thiotriazolin, Elcar are used.

Symptomatic treatment of heart failure includes the use of:

cardiac glycosides (Strophanthin, Digoxin);
diuretics (Lasix, Indapamide);
beta blockers (Metoprolol, Concor, Carvedilol);
ACE inhibitors (Enap, Lisinopril);
calcium antagonists (Diltiazem, Corinfar retard).

Antiarrhythmic drugs are prescribed in accordance with the identified form of arrhythmia (Lidocaine, Etatsizin, Cordarone). For conduction blockades, Izadrin and Atropine are recommended. If drug treatment is insufficiently effective, radiofrequency ablation or the installation of a pacemaker may be performed. If an aneurysm is present, surgical strengthening of the wall or resection of the protrusion is used.

Prevention

The prognosis depends on the presence of concomitant pathologies and complications resulting from the disease. In the absence of arrhythmia, the disease is much easier. Problems such as circulatory failure, atrial fibrillation, cardiac aneurysm, and ventricular extrasystole can worsen the prognosis.

To reduce the risk of developing the disease, it is necessary to follow preventive measures:

eat more protein foods, while avoiding foods containing animal fats;
do not smoke or drink alcohol;
fight obesity;
control blood pressure.

In addition, if you have any heart disease, you must regularly (every 6-12 months) be seen by a cardiologist and undergo examinations. Timely detection of cardiosclerosis will help prevent the development of the disease and minimize the risk of life-threatening complications.

Prevention of cardiosclerosis
To reduce the risk of heart failure in the form of cardiosclerosis, you must:

completely eliminate animal fats from the diet;
increase the consumption of protein products;
eliminate smoking and alcohol until the end of life;
if you are overweight, you need to get your body in order and exercise;
daily blood pressure monitoring;
Once every six months/year, be examined by a cardiologist or therapist with a mandatory ECG examination of the heart.

The most important thing in the prevention and treatment of the disease is not to give rise to symptoms and to prevent the progression of cardiosclerosis.

How does the disease occur?

Connective tissue, unlike muscle tissue, cannot contract and produce useful work. If the epicardium of a healthy heart is a thin film and does not interfere with its work, then the overgrown, pathologically thickened sclerotic connective tissue becomes sensitive ballast for the heart. And a hard, elastic scar interferes with heart contractions even more. The result is an increased load on the heart and its rapid wear and tear.

As the disease progresses and untreated, scar tissue begins to increasingly “implant” into the muscular thickness of the heart wall, replacing the striated heart tissue, gradually destroying the myocardium and deforming the heart valves.

How to treat cardiosclerosis?

Today there is no effective way to combat cardiosclerosis, since the disease itself has many directions, depending on the preferences of the body. No medications can transform the connective tissue of the heart into muscle tissue. As a preventive action, the diet for cardiosclerosis has proven itself to be the best.

For this reason, the therapy process after diagnostic actions lasts almost throughout life. Only specially trained doctors should treat a disease such as cardiosclerosis. Other specialists are involved if necessary.

If during treatment it is necessary to carry out additional diagnostic steps, then those suffering from cardiosclerosis are recommended to stay in the hospital until the results are announced. After a high-quality selection of doctors and medications has been made, treatment begins.

Hospital treatment

All results should be monitored by a doctor. There are cases when, after diagnosis, treatment at home with the use of medications is prescribed, but this happens only at the initial stage of the pathological process.

What happens during the treatment of cardiosclerosis:

symptoms of heart failure are reduced;
all work is carried out in order to improve the quality of a person’s life and his ability to work;
preventive measures are taken to reduce the likelihood of complications;
aggravating factors are eliminated;
the causes of the disease are eliminated.

In order to achieve the goals under consideration, the following techniques are used:

surgical treatment of cardiosclerosis;
palliative surgical treatment;
therapy using medications (this method is called conservative);
Diet plays an important role in managing symptoms.

There are other modern methods, but it all depends on the individual characteristics of the body.

Palliative surgical treatment

During radical surgical treatment of the disease, organ transplantation occurs. Only the use of a total organ replacement can eliminate symptoms by restoring an effective supply of oxygen to the body.

There is practically no other more effective method for treating cardiosclerosis today. If we consider this expression in more detail, we are talking about sclerosis of the damaged muscular part of the organ after a heart attack or severe myocardium has occurred.

If the form is milder, then the risk during a heart transplant is unjustified. They try to reduce symptoms with the help of medications. Today, both surgical and medicinal methods of treatment are used in different countries; which method to use depends on the state of health and the stage of the pathology.

When is a heart transplant performed:

Surgery is the last resort for treating cardiosclerosis. It is used only exclusively in situations where no drug treatment can help.
Surgery is performed if there are no pathological symptoms in the kidneys, liver or lung tissues. Concomitant diseases worsen the likelihood of a successful outcome.
It is better to do a transplant at a younger age than at an older age. An organism under 60 years of age tolerates surgery much easier.
When cardiac output decreases by 20% compared to normal. If the decrease continues, then death is inevitable.

Heart transplant

With the help of palliative surgical treatment, complications can be eliminated without eliminating the symptoms of the source of the disease itself. This method is used exclusively to improve the quality of human life.

During palliative surgical treatment, the following occurs:

Coronary vessels are bypassed. This method is used if the pathology is caused by narrowing of the coronary vessels. The essence of the operation is to expand the lumen of a narrowed vessel, restoring the normal supply of oxygen to the heart muscles. In this way, it is ensured that the death of cardiomyocytes and the further formation of a layer do not occur.
Fighting the manifestation of cardiac aneurysm (the most dangerous complication). The essence of the operation is that the protrusions of weak areas are removed with further strengthening.
Installation of pacemakers. These devices are used to adjust the heart rhythm. They are implanted under the skin in severe cases of the disease. A strong impulse is generated with suppression of natural bioelectric discharges in the sinus node.

The methods under consideration can reduce the risk of arrhythmia or complete cardiac arrest. Depending on the symptoms, the most practical method is used.

Diagnostic measures

Diagnostic methods:

ECG - changes in the electrocardiogram are nonspecific. They will show scar changes and arrhythmia, but the etiology of the processes cannot be identified.
Holter ECG of the heart is a 24-hour monitoring. It allows you to record episodic rhythm disturbances. This is a more informative technique.
ECHO-CG - allows you to assess the degree of expansion of the chambers of the heart, determine the localization of areas of sclerosis, weakening of contractility and the presence of an aneurysm. The study allows you to determine myocardial hypertrophy and valve dysfunction.
Chest X-ray - can determine the expansion of the borders of the heart and congestion in the lungs.
Myocardial scintigraphy is a radionuclide research method that allows you to completely examine the muscle and identify the size of the lesions. The essence of the method is that healthy tissues can capture certain radionuclides with varying degrees of intensity and accumulate them, which is reflected in the device. In areas of fibrosis, uptake does not occur.
Complete blood count - may indicate some diseases that caused this condition.
MRI - allows you to assess the extent of the process.