Significance of the rukhovo regime for ailments with IBS. Proper eating with ischemic heart disease

Ischemic disease of the heart - an illness that develops on aphids, damaged in the robot, bleeding through the plaques on the coronary arteries and the sound of their enlightenment. Usy іsnuyuchi likarski sobí spramovavanі on pіdtremannya ta control zahvoryuvannyam. Not less important is the correct eating in case of ischemic heart disease.

Іstotny injection on the development of ischemia of the heart to rob the way of life and the evil of various types of products. The main risk factor is the introduction of high-calorie foods. The increase in that decrease in physical fitness leads to obesity, which will kill the blame for that development of heart disease.

• broth with ribi, meat and mushrooms;
• smeared with stray;
• tsukor, honey, varennya, tsukerki, chocolate, confectionery and boroshnyanі vorobi, scho to avenge a large number of simple carbohydrates;
• bring to the minimum gostra, salted meat, smoked zhu on the menu;
• surround the living of creature fats.

Need speech and elements

Eating a sick person who suffers on IXC, can be balanced and revenge in oneself rich in vitamins. Vitamins are rich in vegetables and fruits. It is possible to live with squashing, carcassing, and even better - look at the orphan. Vitamin PP is washed away at the vines and bread with a coarse broom. Particularly important is the intake of vitamin C, which can be found in thorns, black currants. To that very ailment we often proponuyut vіdvar іz shipshini.

Beneficial injections on the passage of ailments may be deacid micro-macro-elements, a sufficient amount of such in the body of a person to treat galvanic ischemia. These elements include magnesium, potassium, iodine and phosphorus. Potatoes in uniforms, dried fruits, eggplants are rich in potassium, and iodine is found in sea products - ribs, shrimps, cabbage. In addition, the veins of the ribs are reduced in place of cholesterol, and the walls of the vessels become mimic. Ale next, choose low-fat varieties - hake, pollock.

Lecithin, vitamin F, phospholipid reduce cholesterol and prevent atherosclerosis. Eggs, tops, sour cream are laid in the body with lecithin in the most significant proportions, and stinks are used to accumulate accumulated cholesterol (they are more mature, in children the speech is vicorous for the active formation of new cells in the period of growth). Tozh zlovzhivat them not varto. The optimal quantity is 2 eggs per day. And low-fat sour cream can be seasoned with vegetable salad. Phospholipids are found in large quantities in growing olives (sonyashnikov, kukurudzyan, olive). The stench is rich in antioxidants, which is how they pereskodzhayut fat oxidation. But lovers of olive oil need to drink and bathe only in quiet places, ready to give a certificate of vigor. In the rest of the hour, the Daedals more often show a drink of an expensive product.

The treatment of a sick person for ischemia of the heart and angina pectoris is not only affected by the implantation of coryne products, but also by the pretrial rules of dietary therapy.

Likuvannya ailments of the heart

The method of dietary therapy of foundations on vikoristannі eating for the treatment of illness. Diet No. 10 is characterized by the consumption of saline, zavoi rіdini and products that avenge cholesterol. The principle of diet is based on the fact that the physiological need of the body in the necessary speeches is indicated, that energy and the level of disruption of metabolic processes.

The dietary intake is directly related to the normalization of lipid metabolism, which leads to a decrease in the intake of animal fats and cholesterol. Dietotherapy improves blood circulation and the function of the heart. Stіl No. 10 is prescribed for ailments and for other pathologies, zocrema of the intestinal tract. Later, having completed the course of such brilliance, a person will not only improve the function of the myocardium, but of other organs and systems. Tse to launch a cilian lancelet of mutually reinforcing reactions, zavdyaki like a person feels a surge of strength, forget about sleeplessness, nervousness and other unacceptable symptoms.

The diet is based on the fact that you can be cooked, and not greased, well frayed. “Come out” of dietary therapy is necessary in a step-by-step manner, regardless of the holy day, that gastronomic peace of mind. People after 40 years of doctors vzagali recommend not to be inspired by it.

In case of an aggravated overtravel, illness is prescribed especially diets:

1. Diet of Karel. Implantation of milk at a warm looking at the recommended doses.
2. Kalieva. Vzhivannya in їzhu produktіv, scho vengeance at the great kіlkostі kіlіy (potato liver, dried apricots, rodzinki, shipshina, apple). We can take note of the following recipe: grind rodzinki, dried apricots, pea hairs (in equal proportions) through a meat grinder and pour honey until a thick consistency is reached. As we grow older, we need to take 1 tablespoon of savory liqueurs a day, and for children - a teaspoon. Tse become not only an additional element of therapy, but also a miraculous prevention of the lack of necessary brown speeches.
3. Fruit and vegetable. Vegetables and fruits take revenge on the great number of cellular organisms, as a drug for cholesterol, to that we are sick with ischemic ailment of the heart, we prescribe them to live in the great number of people (75% of the total diet).
4. Hyponatremia. The basis of її is a reduction in the intake of salt, refined carbohydrates. It is indicated for atherosclerosis of vessels, elevated arterial pressure. Ration to achieve the optimal number of calories and balance for protein, carbohydrates and fat.

Healthy menu for the sick

For the whole day you can live no more than 20 g of zucru and 250 g of bread.

Snidanok. Omelet (with two eggs without zhovtkiv), vegetable salad, oil dressings. Tea with milk - 1 kuhol.

2nd contract(Approximately 3 years later). 0.1 kg of sirup and 0.15 kg of apples.

Obid (after 3:00). Fresh vegetable soup, low-fat boiled meat (no more than 0.06 kg), 0.15 kg of boiled vegetables. Compote.

Noon. Spices, fresh fruits 0.15 kg.

Supper. Puree with potato bulb and olive oil, riba 85 g, fruit 0.15 kg, tea with additional milk.

Before bedtime- 250 ml of sour milk.

Eating regimen with Karel's diet

Їyes by age	Ration
	1st diet	2nd diet	3rd diet	4th diet
8	0.1 l milk *	Milk, a piece of bread**, an egg - 1 pc.	Milk, bread - 4 pieces, eggs - 1 pc.	Milk, 6 pieces of bread, 1 egg, 1 apple
10		Milk	Milk	Milk
12				Milk, puree from two potato bulbs, 5 g olive plums.
14		Milk, 0.2 kg of rice porridge, 5 g of olive oil.	Milk, puree from two potato bulbs, 10 g of olive oil.	Milk, 100 g meat puree, 5 g butter
16		Milk	Milk
18			Milk, eggs - 1 pc.
20			Milk
22	0.1 l fruit juice
Before bedtime	0.1 l glucose (in 20% of cases)
Calorie content of the diet	445 kcal	940 kcal	1490 kcal	1690 kcal
Number of days on a diet	2 days	3 – 4 days	2 - 4 days	3 – 6 days
	*Milk in the skin taken їzhi mає but warm at the kіlkostі 100 ml ** Bread is not guilty of revenge salt

Diet for angina pectoris, as well as for other ailments of the heart, transmission of vegetables and other herbage, dairy products and eggs. It is taken in small portions, with which it can be warm, but at the same time it is not hot or cold. If the heart is ill, the physical friability is less fouled, then with an increase in the weight of the body, the calorie content of your diet will need to be reduced.

You can also buti tsikavo:

Signs of ischemic heart disease in people: diagnostic methods
Zadishka with heart failure and її exaltation by folk zasobami

Heart- A unique human organ, it takes on itself a nameless vanity: only for one year pumping 630 liters of blood, for production - 15,120 liters!). The assistants of anatomy call yoga “a mucky empty organ, a pump for pumping blood.” But the poets do not bother to fold about the new verse and song, but in the Bible it is said about the heart as if it were about life, and you need to take care of it the most. Adzhe heart takes on all the joys and blessings of the life of a person. And that is why it hurts the most - it is the main cause of death of the population in the whole world. Ale ... If you want to control the main factors of risk (chicken, improper eating, and a low-quality way of life), up to 80% of deaths can be saved.

And why work, because your heart already fell ill, because your doctors diagnosed ischemic heart disease (IXC), have you suffered a myocardial infarction? How can you help your heart in the situation that has developed?

The current medical bulk of the house is large in number of factors that can help to develop IHS. To the most "aggressive" one can include chicken, alcohol abuse, depression, chronic stress, overeating, improper eating, physical inactivity. І Yakschko Zmіniti Spadkovіst unfortunately, the vanity of stressing, often, interspersed, then the Corcortsia method of Life, is hidden at Usuenny Shkіdlivih Zvicchka (Nasampeed Vіdmova Vіd Klinnya), Optim_zatiya Charchuvnya character, the fesichna actor Tsіlki "Pіd strength" people, Orієnd good health.

Infinite greed in the form of taking physical rights does not deprive of the desired sumnivu. Mabut, Jodna Pubelikatsіya about Fіzichnaya Culture Do not do without Salovnya hopefully, Shaho, Scho attributes to іnodі rіzimnaya authors, Ala actually rushing Moso: "Fізичний привить провить волінити Беліч Ліків, аль сліні и ізичні.

What is the severity of physical activity?

With regular physical activity, a person is in good physical shape.

Physical activity promotes the promotion of "good" lipids in the blood, which also helps fight atherosclerosis.

Physical activity reduces blood flow to thrombosis.

Physical activity contributes to the normalization of arterial pressure and reduces the risk of cerebral stroke.

Physical activity contributes to the normalization of the vagi and to the development of circulatory diabetes.

Physical activity protects against stress, improves mood and sleep.

Physical activity reduces the risk of osteoporosis, and also, fractures in people of a frail age.

Ideally, the skin of a person, saving regular physical activity on a flat surface, can spare a whole range of ailments. In real life, it is often less common to blame health problems for people to reconsider their way of life, to correct the “ruh stereotype”.

But for patients with ischemic heart disease, not all kinds of vanity are suitable.

If an atherosclerotic plaque sounds like an artery that cares for the heart, the rush of blood changes, richly sour, to the heart m'yaza. Starvation begins to sour, ischemia develops. Intensive work of the heart becomes unbearable, and the heart gives a dashing signal, a pain attack develops - angina pectoris.

An attack of angina pectoris signifies the physical activity of a person. You need medication and, often, surgical treatment to get rid of painful attacks. How about the worst heart attack - myocardial infarction? A lot of patients show fear of adventurousness, stench tries to “save” the heart, sometimes inspired to walk.

In this way, physical stress in patients with angina pectoris, including those who suffered a heart attack, may have two meanings:

Superworldly activity and the urge for high intensity of unsafe things that can provoke painful attacks; їх trace uniqueness;

Pomіrnі іzichnі nіvantazhennya, yakі nebhіdno vykonuvati regularly (stretch 30-40 quills 3-5 times per day), є korisnimi. The stench can not only increase the level of "good" cholesterol (important for the prevention of further development of atherosclerosis), but also significantly improve the state of the heart-vascular system and prevent the rapid progress of heart failure. Regular aerobic training positively affects the functioning of the collateral blood flow (reserve between the arteries, which allows you to redistribute the blood stream if necessary), improving the eating of the heart. For the sake of medical records, patients, who are physically active after a heart attack, are more likely to endure repeated heart attacks in 7 times, and die in 6 times more likely, similarly to patients, as they significantly speeded up the advancement after a heart attack.

Patients, who have suffered a heart attack, are obligated to pay their due attention (to serve themselves, to work at home). Even better, as soon as the discharge from the hospital of the patient will be directed to rehabilitation in a sanatorium of a cardiological profile, it will be possible to undergo physical rehabilitation under the supervision of doctors.

However, even if you didn’t go to the sanatorium, physical rehabilitation can and should be carried out on an outpatient basis under the supervision of a cardiologist.

Possibly vikoristano kіlka rіznykh types vprav. When tsimu optimal vvazhayutsya, pіd h vykonannya yakіh robot include large groups of m'yazіv (m'yazi nіg). To reconcile the adventures, 30-minute walking, free cycling, work in the garden, as well as free dancing are important. Easiest day to go pishki. It is necessary to choose a rhythm that is comfortable for you, more or less calm, and go for walks at least 5 times a day for 30-60 minutes. If you saw that, or weakness - sit down, or turn around home. Already for a few days you can go more. The cob and change in the intensity of physical training should be discussed with a cardiologist or an exercise therapy doctor who will guard you.

Zagalna trivality of physical rights - from 25 to 60 min. Of these, 5-10 mins fall on a warm-up, 20-40 mins - without interruption for tension, and 5-10 mins for relaxation (“cooling”). Chim older patient or less training, Tim trivalіshoy may be the stage of warm-up. Sufficient for maintaining health, the situation is important, if the patient is victorious in physical fitness with a frequency of not less than 3-4 times per day. In order to escape the appearance of a strong automy, pain in the m'yazah or the cause of injuries, it is not recommended to spend a few days sleeping.

It is not guilty to cause anxiety to develop an attack of angina pectoris, or a strong ass and a heart attack, a slightly light ass is acceptable. Follow the pulse, under the hour of adventitiousness, the frequency of the heart may soon increase. The optimal increase in heart rate in case of physical urge is determined by the doctor individually, depending on the severity of the disease, the nature of the accompanying pathology. At the first stage, achieve a small increase - by 20-30% (for example, by 15-20 hits on the whip). Nadal, with good tolerability of navantage, continue to follow the pulse and do not allow overestimation 200 - Your age (for example, you are 56 years old: an unrecovered heart rate is 200 - 56 = 144).

What type of physical activity is suitable for patients after a heart attack

most?

Particularly important is the occupation that develops vibrancy. Ale, for the full effect, it is necessary to victorious and deyakі see physical activity, scho develop strength and flexibility.

Activity that develops vibrancy: walking, swimming, cycling, dancing, tennis, housework.

Activity that develops strength: walking with a puffed-up mind, transferring shopping, walking uphill gatherings, digging the earth, housework.

Activity that develops flexibility: swimming, dancing, gymnastics, garden work.

Remember that the beginning of physical ambition can be acted upon. Self-superior expansion of the circulation regime after acute coronary heart disease (myocardial infarction, unstable angina pectoris, heart surgery, progression of coronary or cardiac insufficiency) can worsen the illness, lead to complications. Povnotsіnna rehabіlіtаtsіya іn such situations mаіn іn uvazi іn іnfluence (drug therapy, surgical correction іn demand, іndivіdualі іndivіdіvіdіnі аnіdіvіdіаnі іnіdіvіdіаnі іїchіchnі tіdnovlennya aktіvіnostі) under the supervision of a qualified specialist.

So that your physical activity has brought real mischief, do your best the rules of the three "P" and the brown ones:

ü Progressiveness: increase the vanity properly. Such great adventures without preparation can cause damage to the robotic heart-vascular system.

ü Postiynost: try to keep up the regularity in activities, better than during the day. The effect is better not for three times a day, but for a couple of 30-45 pieces.

ü Correct cherguvannya navantazhennya and vіdpochinku - obov'yazkova umova to achieve high efficiency to take.

Dekіlka of brown joys:

ü Choose those types of physical activity that will bring you satisfaction. Let your friends and relatives keep you company - it's more fun at once!

ü Try to lift the bunks at the same time, if you want to go on top, step by step increase the number of surfaces, on the way you go up without an elevator.

ü Explore opportunities for increased physical activity. Get out one step earlier and go pishki.

ü How walking on your own is not a good idea for you - to get a dog. Virniy and Viddany friend will always be able to accompany you on walks and bring additional positive emotions!

Petrichko Tetyana Oleksiivna - Head of the Department of General Medical Practice and Preventive Medicine of KDBOU DPO "Institute for the Advancement of Qualifications of Specialists in Health Care" of the Ministry of Health Care of the Khabarovsk Territory, Doctor of Medical Sciences

Literature:

1. Arutyunov, G.P. Therapy of factors in the risk of cardiovascular diseases. - M.: Vidavnicha group "GEOTAR-Media", 2010. - P. 91.
2. Bubnova, M.G. Provision of physical activity among the population, yakі mаyut obezhennja at the camp of health: a method. river. / M.G. Bubnova, D.M. Aronov, S.A. Fighters. - M., 2015. - P. 5.
3. DeBakey, M. New life of the heart / M. DeBakey, A. Gotto. - M: GEOTAR Medicine, 1998.
4. Helper for the rehabilitation of ailments for ischemic heart disease after aorto-coronary bypass surgery / V.Є. Malikov and in. - M.: Type of NTSSG im. A. N. Bakulova, RAMS, 1999.
5. Oganov, R.G. Prevention of heart disease”, M.: Vidavnicha group “GEOTAR-Media”, 2009. – P. 95.

Insufficient supply of the heart sour after the sound of the arteries and their clogging with plaques lead to the development of ischemic heart disease (IXC).

There can be a lot of reasons: poisoning with alcohol drinks, the wrong diet, a low-grade way of life, which promotes the development of hypodynamia, constant stress and change, chicken shit is rotten.

Sports and ischemic illness of the heart are a garne for the day, even if thought out employment, to protect the recommendations of fahivtsiv, to help the ailment, invigorate life, and to fight against the disease.

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No need to give up, people born with the worst diagnoses often live to a ripe old age.

Why has melancholy

Navantazhennya korisn_ for the body zagalom. People who suffer from various ailments, including ischemic heart disease, sing a majestic pardon, are fully restored to physical rights.

Even if you regularly engage in sports, achieve the simplest rights, and lead an active way of life, you can improve your health and reach a visible effect:

• throw off the veil of the zavdyaki spalyuvannya fat, which will reduce the development of the development of diabetes;
• vmіti zalishatisya in good shape that form to induce stressful life situations that require a maximum of vitreousness and patience;
• normalization of triglycerides and cholesterol in the blood, in order to reduce the development of atherosclerosis;
• to avoid damage to the metabolism of the bone tissue, in the last years people suffer from partial fractures through a low gap of the bones and their increased fracture;
• to reduce the morbidity of the judge, which is the cause of a blood clot and the development of pathological processes;
• improve self-esteem, improve mood, normalize sleep;
• reduce the possibility of bloodshed in the brain by a way of stabilizing the vice.

Schoden physical development of the building to prevent the development of rich illnesses. Golovna umova - do not check for the appearance of the first symptoms, but immediately tell about your health. It’s not enough to talk about physical activity, at the same time, it’s necessary to take care of smoking and to minimize the intake of alcoholic drinks.

Skin ailments will require an individual approach for an hour, depending on the type of need and frequency. An atherosclerotic plaque, which is the main cause of acid starvation, sounds in the arteries, as if it were blood supply to the heart.

As a result, developing ischemic disease of the heart, in case of yakіy it is possible to go only to the most severe physical problems.

To show transcendental activity, cardiac m'yaz, which suffers from insufficiency of sourness, may not show the ambition, which will prevent the development of angina pectoris.

Fallow in the degree of severity and progression of the disease, you may need medical treatment or surgical intervention

The biggest variant of the development of the underdog is a heart attack, which is a different may be a lethal result. After surviving yoga, some people begin to be afraid of growing cold, so that a heart attack does not happen again, not knowing how to harm their health even more.

It is a burden for a healthy person who suffers on IXC to bring a good 40-minute light warm-up. Once every three days, it is necessary to interrupt the work, the approximate total amount to take for a day is 5. If you overdo it, strong physical ambitions can be less than foolish. The result is an attack of angina pectoris or a heart attack.

The morbidity of mortal physical urges with the development of ІХС pogogaє in the offensive:

• Zmіtsnennya sertsevyh vessels, zakoryuvannya that zvuzhennya yakah was the result of the development of atherosclerosis. The level of core cholesterol in the blood rises, and the development of heart failure fades.
• In people who have suffered a heart attack, the rate of re-infarction is reduced by 7 times. Mortality rate changes 6 times. The data were taken away by a path carried out by certified physicians, as if they were showing signs of people, as if they were active and quiet, who showed the advantage of a low-rise way of life.

You can still bring a lot of arguments to show that sports and ischemic heart disease are the right way, if not alleviating the problem, then it’s definitely causing an active progression of the disease.

More walks - not a part of any course of rehabilitation. If I don’t fear I’ll become worse, I’ll gradually increase my trivality. So do it yourself and with physical pretensions. Golovne - do not overdo it, that skin activities can be carried out under the supervision of fahivtsya.

Under the hour of the passage of the rehabilitation procedure, the patient is afraid of an early heart attack. This is a normal phenomenon, even if there are no physical advances, this show will increase no more than 20% lower.

An increase of up to 30% is allowed only in case of a positive effect of rehabilitation after an increase in profitability. Zalezhno in the age of ailing you are punished by individual employment.

Before the appointment of the doctor, you can add a course of medical treatment, indicate the frequency of examination of the doctor. The first head of the mind, who is delusional, is the maiden of a light worker at home.

I don’t show symptoms of serious illnesses, I need to regularly take care of my health and lead an active way of life, turning off the new sickness to the maximum

Significance of sports and forms of ischemic heart disease

A lot of cardiologists and professors conduct medical examinations in the halls of healing, prevention and rehabilitation of ailments, as they suffer from ischemic heart disease.

Russian professor Aronov D.M. having developed a good technique, for example, for any ailment, they were divided into chotiri classes, which should be added to the list of recognized physical advantages.

Form the manifestation of angina pectoris in the presence of a functional class of ailment:

According to the theory of a leading specialist of Russia, we are sick of the first functional class, it is recommended to show physical activity today, to work on a watch and on a garden plot.

When this varto is unique, it starts to feel weak, but the pulse sharply increases - it’s more likely to be busy on the next day.

Tі, scho vydnosyasya to another and third functional class, ailments are guilty of trohi sounding of their duties, having watched the housework in an unhanded position, trembling pіshih walks with swedish croque. With every interval between physical adventures, there may be more gains, and their trivality is short-lived.

Illness, which lies up to the fourth functional class, is to blame for the violation of physical pressures. Be it heavy, or a little walk can cause a heart attack of angina pectoris.

It is only allowed to see the lightest work on the booth, such as wiping the saw or washing the dishes. And then the people are always to blame for it, so, if you need it, give help to the perch.

Optimum advancing

It’s right that they are treated by patients, if they suffered a heart attack, they are guilty of being rіznomanіtnymi, to ensure an one-hour development of the offensive physical abilities of a person:

Before falling ill, tied with a heart, it is necessary to approach with special care. It is especially important to talk about rehabilitation after complications: a myocardial infarction, progression of an unstable form of angina pectoris.

In order to achieve a positive effect, in parallel with the physical advances, it is necessary to take care of the doctor's attributions to the doctor's doctor, perebuvayuchi with this vision.

Sometimes you may need and surgical intervention.

In order to keep busy, they brought less satisfaction and boulevards for health, it is recommended to trim the upcoming joys:

• Get physical right to bring positive emotions. It would be more fun, you can get to take your friends and relatives.
• When you go to a store, cinema, or another point of recognition, you can get off the minibus one notch earlier and podolat the route of the bag.
• When living in a richly-covered booth, it is more independent, without a vicarious lift, climb on a sprat on top, while making the route more tribal.
• In order to add variety to your walks, you can take a dog with you, which will become a guarantor of a cheerful mood that draws only positive emotions. A dog in a booth is a guarantee that the master, through his night, will not be forced to go out on a fresh day.

The skin of a person is guilty of giving a maximum hour to his health, especially when it comes to heart disease. Razumny pіdkhіd up to physical vanity and in the world of active life has not yet been fooled by anyone.

Ischemic heart disease- This group of diseases, which are based on the deterioration of the coronary hemorrhage of the myocardium, which leads to the destruction of the spondylosis between the demand of the myocardium in the sour and yogo overflow of the coronary bed. This inability can be caused through changes in the walls of the arteries, which change the clearance of the vessel (atherosclerotic plaque, thrombus, spasm of the artery) or increase the consumption of the myocardium in the intestines (increase in heart rate, AT, increase in the myocardium mast). Atherosclerosis- This is the reason for the development of IHS. In 95% of patients, who suffer from IXC, atherosclerotic lesions of the vessels are shown, in 5% - the vessels are unchanged. In clinical practice, such a classification of IXC is widely used.

Clinical classification of ischemic heart disease (VKNTs AMS SRSR, 1984)

2.1. Angina pectoris.

2.1.1. First, angina pectoris, scho vinyl.

2.1.2. Stable angina pectoris (from functional class I-IV).

2.1.3. Progressive angina.

2.2. Spontaneous angina.

3. Myocardial infarction.

3.1. Great infarction of the myocardium (transmural).

3.2. Dribnoeredkovy myocardial infarction.

4. Postinfarction cardiosclerosis.

5. Damage to the heart rhythm (from the designated form).

6. Heart failure (from the designated form and stage).

Chinniki riziku ІХС є. become a person, older than 40 years; , hypodynamia, blood diabetes, hyperuricemia and other. The main factors of the IXC, the so-called "Great Three", are arterial hypertension, hypercholesterolemia, chicken.

Let's take a look at the stages of rehabilitation of patients with IXC on the basis of two forms of IXC: stable angina pectoris and myocardial infarction.

Angina pectoris

Angina pectoris is an illness, the main clinical manifestation of which is an attack of retrosternal pain, sharply advancing, but still passing damage to the coronary blood circulation.

Pain with angina pectoris pressing, squeezing character, which radiates from the back, left shoulder, arm, neck, trivality 2-3 min. (maximum up to 20-30 min. , when the attack is over, ST segment depression is greater than 1 mm or less than that, and also the T wave is changed, which becomes smoother, biphasic, negative. myocardial shock (ALT, ACT, LDH, CPK, MV-CPK and other). terdmil test), stress echocardiography, perfusion scintigraphy of the myocardium on the ECG (changes in the ST segment, T wave), VIDLUNNIA-KG (impaired local velocities) or scintigrams (impaired perfusion of the myocardium), which confirms the presence of ailing IXC. In addition, navantage tests allow you to designate a functional class of illness and develop an individual program of yoga treatment and rehabilitation.

Angina pectoris characterized by timchasovymi attacks of chest pains, which are caused by physical or emotional pressure or other factors that lead to an increase in the metabolic needs of the myocardium (increased arterial pressure, increased heart rate). As a rule, it is known in calm or when taking nitroglycerin under the tongue. Vinicla angina pectoris- Contagious trivality up to 1 month from the moment I show it. Vaughn is polymorphic for the forecast and flow. You can regress, go into stable angina or take a progressive leak. Stable angina- illness for more than 1 month from the moment of vindication and is characterized by stereotyped attacks on the same anxiety; with it, the functional class of the ailing fallow is indicated in terms of the ability to overcome the physical challenge.

I FC. It is good for the ailments to endure the zvichaynі physical navantazhennya. Attacks of angina pectoris are less likely to be blamed for high intensity pressures. Instrumental signs of 1 FC are indicated in the table. one.

Table 1. Characteristics of the functional classes of ailments for ischemic heart disease according to the results of a test with physical aims [Mikolaeva L.F., Aronov D.M. 1988]

1 Come on angina pectoris calm (spontaneous angina pectoris) can be prevented in patients with high tolerance to physical preoccupation.

II FC. Small amount of physical activity. Attack angina pectoris when walking on a flat road for a distance of 500 m, more lower by 1 overhead. Imovirnist attack will increase in cold weather, with emotional awakening or the first year after awakening.

III FC. Virazhene exchange of normal physical activity. Proceed to blame when walking at a normal pace on a flat day for a distance of 100-500 m, with a walk on 1 overhead.

IV FC. Stenicardia Vikniku for non-religious french navatablenesses, walking on Rivan Miszu on Vіdan Messa 100 m. Characterized by Vikonnnya Sgonkard Stencardine in Splock, Zuzyenih, so the Snokarti Snokarti Sandage, Pivynnye Misokarti Mіokard's Issue (pivotchennaya Czech horizontal position).

Progressive angina- tse zbіlshennya frequency, heaviness and thriveness of attacks in vidpovіd on zvichayne for this ailing physical urge. Spontaneous (especially) angina pectoris- Tse illness, in case of any attack, blamed without a visible connection with factors that lead to an increase in the metabolic needs of the myocardium. Angina syndrome, more severe and intense, lower stress in angina pectoris, more likely to use nitroglycerin. The most common cause of this form of angina pectoris is spasm of the great arteries. Spontaneous angina pectoris can be self-induced, or it can cause stress. In the attack of spontaneous angina pectoris on the ECG, it is often manifested by ST segment sub-segment, proteolytic changes in the QRS complex are typical for IM, or enzyme activity in the serotype, which is indicative of myocardial necrosis.

Indications before hospitalization - unstable angina pectoris(up to 1 month of age, progressive angina pectoris, severe depression of spontaneous angina pectoris). The morphological substrate of this type of angina pectoris is an unstable plaque. Patients are hospitalized in intensive care cardiological hospitals due to the high risk of developing myocardial infarction or rapt death. The regime is assigned to the bed, style No. 10. Medical therapy includes administration of anticoagulants (heparin) and antiplatelet agents (aspirin), relief of pain syndrome (narcotics), hemodynamic expansion of the myocardium (nitroglycerin intravenously drip), beta-blockers and other indications - ACE inhibitors and statins (simvastatin, atorvastatin, rosuvastatin).

Three physiotherapy methods are recommended. electrosleep, medical electrophoresis (Eufilin, obzidan, gangleron) of offensive types: a flashy injection after Vermel, for a reflex-segmental technique and for a transcardial technique. For the most part, it is recommended to change the low-frequency magnetic field on the heart plate, as well as UHF therapy on the vegetative nodes of the cervicothoracic joint, or directly on the heart plate; zastosovuetsya laser intravascular prominence and injection of laser prominence on the area of ​​the sternum, the top of the heart, the left subscapular region.

Physical rehabilitation of sick people on IHS will be based on the expansion of rukhovoї activity in order to change the regimes: severe bed, non-harmful bed, warm bed, transitional and warm. The trivality of these varieties is due to their portability. An indicator of the adequacy of the anxiety is the number of attacks of angina pectoris on the heights of the anxiety and the prolongation of the year after it, the number of days of the pronounced buttocks, stomy, heartbeat, the increase in respiratory rate is not more than lower by 6-8 minutes, the increase in SBP at the range of 20-40 mm Hg. DAT - 10-12 mm Hg. increased heart rate at 8-10 minutes, daily changes in the ECG after the adventurous. About nespriyatlivu reaktsіyu svіdchat nastupnі zmіni: viniknennya stenokardії will attack, appeared virazhenoї zadishki, misrepresented sertsebittya, rozvitok aritmії, stіyka tahіkardіya of upovіlnennyam Povernennya to vihіdnoї HR, virazhene znizhennya abo pіdvischennya arterіalnogo vise blіdіst, tsіanoz, pіtlivіst, slabkіst, zmіna EC. At the end of hospital treatment, bicycle ergometry is carried out to determine the functional class. A sick person from IXC from a hospital should be sent to a polyclinic stage of rehabilitation, for which stench they can be sent to a sanatorium, depending on the indication.

At the polyclinic stage of rehabilitation ailments on ІХС poserіgayutsya for group D III dispensary form. Look around to be carried out 2-4 days at the river fallow in the functional class by a therapist, a cardiologist, a doctor in the field of rejuvenation, a neurologist; a look at the psychotherapist - 1 time per doctor, other specialists for indications. Clinical blood analysis, lipid spectrum (ChS, HDL-HDL cholesterol, HDL-HD, triglycerides) - 2 times per patient, ECG and initial tests 2-3 times per patient, 2-3 times per day, in the presence of a functional class. Hvor give rekomendatsії of navichok healthy ways Zhittya, held korektsіya faktorіv riziku (kurіnnya, nadmіrnoї masi tіla, gіperlіpіdemії, arterіalnoї gіpertenzії that іn.) Rekomenduєtsya obmezhennya vuglevodіv that nasichenih zhirіv in harchuvannі conducting ratsіonalne pratsevlashtuvannya, psihoprofіlaktika, viznachayutsya Indications SANATORIUM vіdbіr , exercise therapy and physiotherapy are prescribed, as well as indications for surgical methods of treatment (CABG, balloon coronary angioplasty, etc.). In addition, correction of drug therapy (nitrates, (beta-blockers, calcium antagonists, ACE inhibitors, drugs of acetylsalicylic acid) is carried out (in case of intolerance, clopidogrel or cyclopidine is prescribed), statins, drugs that can be tolerated).

Physiotherapy procedures include: electrosleep, UHF-therapy, low-frequency magnetic field change, paravertebral amnipulsterapia on the C5-D6 area (daily, 10 procedures per course), electrophoresis of medicines, ultrasound therapy on the heart chamber. Balneotherapy: in FC I and II angina pectoris - carbonic acid, whirlpool, radon, sour baths, in FC III "dry" carbonic acid baths.

Exercise therapy includes early hygienic gymnastics, recreational physical education, dosed walking, which should be carried out according to the functional class of the patient. When walking, the tension is dosed as follows: with I FC - walk 1 km, speed 90 krokiv per quill, 3 days a day; at the II FC - a distance of 500-600 m, a speed of 60 hours per hour, 3 ten days; with III FC, the distance is 100-150 m, the speed is 50 hours per hour, 3-4 procedures per day. After 6-7 days, with good tolerability of the challenge, the pace of walking will increase by 10 minutes per whilin for the next day. In addition, with І-ІІ FC we are ill showing employment in health groups, light sports games, swimming by the pool.

The selection of patients at the sanatorium is exuberant after the stabilization of the illness.

Indications before the sanatorium-resort treatment with ІХС є :

a) atherosclerosis of coronary arterіy s rіdkіnsnimi nacing attacks of angina-ї earthenware, with lack of inherence in the bloodistant , Kaliningradskaya group of resorts (St. Petersburg resort area and in.);

b) atherosclerotic cardiosclerosis with rare mild attacks of angina pectoris or without them, without disruption of the heart rhythm, with insufficient blood circulation, not more than stage II;

c) kardіoskleroz pіslya Transferred іnfarktu mіokarda davnіstyu bіlshe rock without napadіv abo s rіdkіsnimi attacking stenokardії for vіdsutnostі suputnoї arterіalnoї gіpertenzії, torn down rhythm that provіdnostі at nedostatnostі krovoobіgu not vische 1 ¯ stadії, of vіdnovlenoyu pratsezdatnіstyu - pokazanі mіstsevі Cardy. ; ailments with morbidity ІМ prescription not less than 3 months in case of severe stupefaction, in the presence of partial attacks of angina pectoris;

d) cardiosclerosis, including post-infarction with angina pectoris, for the presence of angina pectoris, calm, severe disruption of the rhythm and conduction, with a lack of blood circulation, not more than II-ї A stages - indications are less than medical cardiological sanatoriums;

d) mill pіslya hіrurgіchnogo lіkuvannya of drive ІHS and takozh pіslya shuntuvannya magіstralnih arterіy, pіslya vipiski Zi statsіonaru at nedostatnostі krovoobіgu not vische 1 ¯ stadії - pokazanі tіlki mіstsevі kardіologіchnі sanatorії, and bіlsh vіddalenі termіni (bіlshe rock pіslya operatsії) takozh klіmatichnі resorts.

Contraindications for referral to health resorts and medical sanatoriums in case of IHS. ischemic disease of the heart, which is accompanied by partial attacks of angina pectoris and calmness with manifestations of left ventricular insufficiency (cardiac asthma), angina pectoris IV FC and unstable angina pectoris, as well as stages - for medical sanatoriums.

In sanatorium etapі vіdnovnogo lіkuvannya Khvorov on ІHS vikoristovuyut usі dostupnі factorization reabіlіtatsії: dієtichny stіl № 10 klіmatoterapіyu, aeroіonoterapіyu, povіtryanі Vanni preformovanі factor (electrophoresis, elektroson, ekstrakorporalne UVR krovі, SCM-terapіyu, sinusoїd) vuglekislі that radonovі Vanni) . Trivaet podibran drug therapy to the patient. Ale, the main significance of physical therapy is: ranking hygienic gymnastics, recreational physical education with the benefits of fallow FC, dosed walking (div. polyclinic stage), swimming in the pool; in exercise therapy at this stage, include the methods of autogenous training, m'yazovoї relaxation, psychophysical separation and others.

Ailments ІХС serve the preschool dynamic dispensary care and do not look out of shape .

Rehabilitation of ailments from ill hearts and vessels

In the structure of disease and mortality of the population of the heart-sudinal disease, there is a lot of space. At the Russian Federation and initiatives Є.І. Chazova created that successfully implemented and develops a sovereign system of rehabilitation of ailments, as if they suffered a myocardial infarction. The model of cardiological rehabilitation, which is mainly applied to the rehabilitation of ailments with IXC and myocardial infarction, is victorious in health care as an example for introducing into practice and rehabilitation of therapeutic diseases of a professional profile.

When working with cardiological patients, it is necessary for the nurse to treat the scars: the nature of the pain in the heart, intensity, twitchiness, irradiation, as well as back, weakness, swelling. When looking around, it is necessary to turn your respect to the scorching camp, laying in a lie, viraz disguise, the color of the crooked shkir. the presence of an objective sign of the back, the severity of the bulges. In addition, the medical sisters need to evaluate the pulse, arterial pressure, body temperature, and familiarize themselves with the results of laboratory and instrumental methods of follow-up. On the basis of these data, the nurse evaluates the patient's status. The medical sister of goiter is to know the main scars and symptoms in case of cardiovascular diseases, the principles of treatment and prevention of diseases of the cardiovascular system, the main principles of the restoration of impaired functions and prevention of complications, and also the consideration of the disease of the cardiovascular system. The nurse needs to remember the symptoms of congestive phenomena in a small case of blood loss: zadishka, cyanosis, cough, poisoning, hemoptysis: in a large case of blood loss: tachycardia. swelling, heaviness in the right subcostal area, ascites. The nurse is to blame for the mother's responsibility for that newcomer from the rejoicing, the duty of indispensable assistance, rehabilitation and watchfulness for the sick. In the treatment of heart-sudine ailments, the intravenous introduction of medicinal speeches is often victorious. Therefore, the medical sister of the goiter is aware of it, and she correctly selects the system for not treating krovozamniki, to put the patient in, and to seriously watch over the work. In case of intravenous infusion of preparations, it is necessary to constantly assess the patient's status and for the need to correct the severity of the introduction. The nurse prepares patients for instrumental and laboratory methods of follow-up; The nurse is responsible for monitoring the patient's eating habits, physiological adjustments, and special hygiene, body weight, and bruises. About all the changes I will become a patient and it is necessary to inform the doctor at the same time. An important role is played by the medical sister in the process of rehabilitation. Won to carry out likuvalny gymnastics with patients. on simulators, at the pool, as well as allowing physiotherapy procedures, controlling at any stage of the patient. The nurse teaches the patient by the methods of autogenous training, m'yazovoї relaxation, roz'yasnyuє ways to prevent diseases of the cardiovascular system. If so, the nurse deals with the patient's problems and takes part in their vicissitudes. The goals of rehabilitation are. restoration of the building to self-service, turning the patient to active life and professional activity, prevention of disability.

Ischemic heart disease. Angina. Likuvannya (focus on trimetazidine)

Oslopov V.M. Oslopova Yu.V.

ischemic(coronary) sickness heart(IXC) - that unsafe disease is wider. ICHS is most often manifested angina pectoris. i.e., a pain syndrome, in typical cases it is easily recognized by a doctor.

W. Heberden in 1768 giving a classic description of the attack of angina pectoris, even though I did not know about the link sickness with the camp of judges heart. “Illness of the chest, as it is characterized by its own symptoms, is similar to the most severe pains. In the aftermath of the attacks caused by some unsafe illness, it may be of particular importance. Localization, almost the strongest pain and fear for life, suffocate me, for which ailment the most suitable name is "angina pectoris". In people who are weak to the named sickness, when walking, especially when walking after hedgehogs, they blame the flooring for severe pain in their chests, why do they give up, that they waste their lives, so they could try or try for another hour. Some ailments are buzzing, a pain attack is pinning. The pose described by the attacks of ailment is healthy.”

Apparently, basically angina pectoris pain to lie down past myocardial ischemia. However, in a number of disorders, the attack of myocardial ischemia (as a result of impaired coronary perfusion) does not manifest itself in pain - this is the so-called painless myocardial ischemia (BIM). BIM can intermittently (intermittently) with pain ischemia of the myocardium, so (in some ailments) it can be done independently (isolated). BIM is observed in 2-5% of the healthy population, in 30% of patients with post-infarction cardiosclerosis and in 40-100% of patients who suffer from stable and unstable. angina pectoris. Moreover, it is important to note that only 1/4-1/5 episodes of myocardial ischemia manifest angina pectoris. then 75-80% to become BIM (!), moreover, the rest is not a smaller world, lower angina pectoris. determines the prognosis for ailments on ІХС. The reason for BIM in 5-6 times is a risk of rapt death, in 2 times - a risk of developing arrhythmias and in 1.5 times - a risk of myocardial infarction and heart failure. The fatal result of episodes of BIM inflicting itself with it, which, on the basis of angina pectoris, patients do not recognize and do not develop [Vertkin A.L. that in. 1995]. Such a painless myocardial ischemia is recognized for the help of Holter monitoring of the ECG.

Coronary angiography is the "gold standard" for verification and visualization of coronary blood flow impairment. However vazhlivo zaznachiti, scho at a wide vprovadzhennі tsogo method doslіdzhennya in practice administered by ailing to stenokardіyu Bulo viyavleno scho at deyakih patsієntіv, SSMSC toil yak її klasichnі klіnіchnі manifest, so i vіdpovіdnі zmіni іnstrumentalnih that laboratory pokaznikіv, zvuzhennya coronary arterіy not viyavlyaєtsya at koronarografії ( "pure coronaries"). Tsei camp is described under the name "coronary syndrome X" (or microvascular sickness- Small vessel desitjase). In other words, IXC in a patient is є, and coronary arteries, which are evaluated by the "gold standard" of coronary verification sickness. - Unchanged. It is important to note that coronary syndrome X affects close to 20% of the population of the provinces. The first description of a sick person with angina pectoris, which had a chronic course, in which autopsy showed absolutely normal coronary arteries, belongs to W. Osler (1910).

In the same house and sometimes another situation - angiography in 48% of cases does not reveal atherosclerotic plaques, but it is still really true. Such plaques are seen with a special follow-up - intravascular ultrasound. This situation is explained by the fact that the plaque is formed in the subintimal space and grows in the veins of the vessel wall, as if behind the rahunok of the outer elastic membrane by stretching the normal lumen of the judge.

Like the prognosis, so is the tactics for classic angina pectoris (angina pectoris with plaques in the coronary arteries) and angina pectoris for coronary syndrome X.

Although stable angina pectoris, as it is called, rightly carries direct threats of catastrophe, a short description of angina pectoris is justified, given by the founder of venerable cardiology D.D. Pletnyovim: “Angina pectoris is the cause of that death.”

Apparently, the basis of IXC, angina pectoris becomes atherosclerotic (chronic progressive fuse) damage to the coronary arteries of great and medium caliber. Factors, yakі rob that chi іnshiy contribution to the development of atherosclerosis, even richer.

In our hour, in a flash jubilation angina pectoris becomes more radical (for example, more stenting surgery) and more prophylactic. Celebration IXC in the period of її manifesting in angina pectoris to set as its main (long-term) goals of improving life expectancy, shortening the prognosis, preventing the development of myocardial infarction and rapt death. An important goal is to improve the quality of life and reduce the symptoms of illness (change in the incidence of the attacks of angina pectoris themselves).

basis jubilation those who are ill with angina pectoris, do a healthy way of life: smoking, physical activity, normalization of body mass, dotrimannya diet, attachment of medical culture, etc. The most important is the fight against risk factors: jubilation hypercholesterolemia, hypertensive sickness. circulatory diabetes.

Then, from the above, we will understand that in order to achieve a long-term goal, the key components jubilation IXC, angina pectoris є: 1) hypolipidemic disease 2) antiaggregants.

Statini. The target concentration of lipoproteins in low blood pressure (LPNG) - 100 mg / dl (2.6 mmol / l) or even lower - 70 mg / dl (1.8 mmol / l) and less, which can be reached by pretreatment diets and high doses of statins ( for example, 40 mg for doba "superstatin" - rosuvastatin in ailments with high risk of development of cardiovascular complications).

Statins act as specific inhibitors of the activity of the key enzyme in the synthesis of alcohol cholesterol (Cholesterol) - the reductase of 3-hydroxy-3-methylglutaryl-CoA. In microsomes of the endoplasmic reticulum of hepatocytes and cytosols of all cells, statins inhibit the synthesis of mevalonic acid, an obligate precursor to the synthesis of cholesterol. Nobel laureates 1985 Michael Brown and Joseph Goldstein revealed specific receptors on the plasma membrane of fibroblasts, vicarious cells actively suppress lipoproteins, LPNG secretion, and cause apoB-100 endocytosis. LPNG transfer to cletin XC, which is synthesized by hepatocytes. Damage to the interaction of the apolipoprotein B-100 ligand receptor becomes the cause of the formation of hypercholesterolemia. Statins, inhibiting the synthesis of cholesterol, irritate the cells, compensatory poglanannya їх at the LDL warehouse. This also reduces the overall pool of cholesterol in blood plasma lipids, and cholesterol in the LPNG warehouse. Over the course of an hour, statins, inhibiting the synthesis of cholesterol, reduce the level of triglycerides in blood plasma.

Antiaggregant properties. Acetylsalicylic acid (ASA) should be given to everyone with angina pectoris, in which there is no contraindication, and the dose of 75 mg per doba may be optimal. A meta-analysis of 287 randomized trials confirmed a change in the number of cardiovascular complications (a decrease in the risk of complications by 33-50%) in patients with stable angina who received ASA. ASA is responsible for the functional state of platelets in the way of non-reversible galvanization of the enzyme cyclooxygenase (with the help of yoga acetylation). With this non-nuclear platelet, it is necessary to spend time until the resynthesis of the thromboxane A2 protein for the entire period of life (8-10 days).

For patients with angina pectoris who cannot tolerate ASA, clopidogrel may be recommended as an alternative, although this drug is not specifically viable for chronic stable angina pectoris. Pohіdne thienopiridinіv - clopidogrel galmuє aggregation of platelets іnthim, nіzh ASA, shlyakhom, - galmuє adenosine triphosphate (ATP) aggregation zadjaki blockade of P2Y12 receptors to adenosine diphosphate, rotting on the membrane of thrombocytes.

Now, about a friend, I’ll tell you about angina pectoris - the so-called pathogenetic-symptomatic therapy, when it changes, in the course of time, the number of attacks in angina pectoris and by itself improves the quality of life of patients.

don't spend. Bernard Gersh and Lionel Opi (2010) indicate that among the various drugs that are used to treat angina pectoris, they are most effective, although they do not reduce mortality in these patients.

Avoid the antianginal effect by way of vasodilation (arteriolar vein). Nitrates interact with the half moons, yak change instead of SH-group on the membrane of the smooth lingual cells of the vessels: NO, which is metabolized after the metabolic conversion of nitrates, being a pharmacologically active half, activates the enzyme guanylate cyclase. Guanylate cyclase catalyzes the release and accumulation of cyclic guanosine monophosphate (cGMP) in smooth-tonguing cells, cGMP, in its own part, initiating phosphorylation of protein kinases, which replaces ionized Ca2+ in the cytosol. Tse to bring to relaxation smooth m'yazіv arteries and venules. As a result of the expansion of the veins, the venous rotation decreases, the predilection becomes less, the demand of the myocardium in the acid changes indirectly, the postnamentation decreases, and the spasm of the coronary arteries decreases due to the arteriolar vasodilatation. It is worthy of note that low patients cry out loudly with their heads.

An alternative to nitrates is molsidomin and nicorandil.

β-blockers. β-adrenergic blockers may have a pleasant effect on patients on IXC, which is realized by various mechanisms. Under the influx of β-blockers, the frequency of heart rates (HR) decreases - this is appropriate for ailments on ІХС, to which the robot changes heart. in consequence of this, the demand of the myocardium in acidity is reduced. It is important to note that β-adrenergic blockers in angina pectoris are due to the presence of doses that give a clear clinical effect of β-adrenergic blockade, so that the heart rate changes in the daytime to reach 60-55 / min. With a change in heart rate, the hour of diastolic filling of the coronary arteries is delayed, which, by its own accord, brings more trival coronary perfusion. However, the development of supra-world bradycardia in case of treatment with β-adrenoblockers in progressively reduced myocardial velocities can cause an appearance in patients with IXC heart failure.

To prevent the anti-chemic effect, the mechanism of re-entry is disturbed (so that the circulation of the awakening along closed paths is not broken), so that the conduction of the impulse, which is stimulated by the ischemia, is not disturbed, and does not cause a blockade of the entrance. Significantly, that β-adrenergic blockers change (!) coronary blood flow (i, it was given b, їx cannot be blocked with IXC). However, as a result of a one-hour change in the consumption of the myocardium in acidity, the balance of consumption and consumption of the myocardium in the acidity is improved. In case of any increase or increase, coronary blood flow in the ischemic division of the myocardium, subendocardial zocrema. β-adrenergic blockers reduce the risk of recurrent myocardial infarction and early heart death, which is attributed to more frequent episodes of myocardial ischemia (including painlessness) in early years in patients on IXC.

The negative side of the stagnation of β-adrenergic blockers is the deterioration of the quality of life in the appearance of poor tolerance of physical stress, impotence and obesity, impaired tolerance to glucose.

To the world, an alternative to β-blockers is the selective inhibitor of If-channels of the sinus node ivabradine.

Angiotensin converting enzyme (ACE) inhibitors. The risk of congestion with ACE inhibitors, zocrem, perindopril at a dose of 8 mg per day, in patients with stable angina pectoris was demonstrated in the EUROPA multicenter study, as well as in the HOPE study.

The medical therapy of IXC patients with stable angina pectoris was changed as an alternative to radical - operative methods of coronary artery stenting.

In the classical COURAGE study for its results, it was shown that with stable angina pectoris, stress on aphids of multiple coronary artery disease, and with a sharp decrease in systolic function heart and if symptoms are not severe, active multi-component drug therapy is not available to catheter inserters for mortality and morbidity, development of myocardial infarction and other important cardiovascular complications. This fact was confirmed by MASS II (2007), a meta-analysis of 17 randomized studies and then a meta-analysis of 61 studies.

In this rite, Suchasna lіkarska terapіya in stabіlnih ailments on ІHS dozvolyaє dobivatsya rezultatіv good, at the same hour for Relief mіnі-іnvazivnih vtruchan coronary arterіyah mozhna rozrahovuvati on polіpshennya rezultatіv Lachey have retelno vіdіbranih patsієntіv at vrahuvannі bezlіchі obstavin that obov'yazkovostі nastupnoї іntensivnoї lіkarskoї therapy.

It is important that the non-operational treatment of IXC, angina pectoris was systematic, easy-going, complex, directing pathogenesis in all directions.

We have great respect for those who have their own place in whom laser therapy borrows. With the inclusion of a laser in the complex therapy of IXC, angina pectoris, we showed an improvement in the clinical picture of disease and these instrumental methods were followed up with the treatment of ailments without laser therapy (with the improvement of cell membranes). The best result when the laser is turned on (remote and contact methods infusion on the top area heart. the middle third of the sternum and the subscapular area are angry; 1-5 mW, 60 s on the floor) in the treatment of withdrawal symptoms in patients with IXC, angina pectoris, which is considered to be the so-called III quartile of Na+-Li+ protitransport in the erythrocyte membrane (Na+-Li+ protransport in between 276 -347 micromoles Li per 1 liter of clitin per year) (genetically determined sign).

Apparently, in case of coronary disease of the heart, expansion of stenosis of the coronary arteries is impossible, and an increase in the consumption of the myocardium in acidity leads to an imbalance between the supply of the myocardium by acidity and iogo consumption in the disease, acute coronary insufficiency, which manifests itself The sequence of strokes at the hour on the cob of inconsistency in the delivery of sour to the myocardium until the attack of angina pectoris and distant lesions is called the "ischemic cascade" (Fig. 1). With which kidney, impaired perfusion and metabolism are detected (they are detected by additional radionuclide methods and ultrasound myocardial contrast studies). Then the damage to the local diastolic function of the myocardium is blamed (they are diagnosed for additional Doppler visualization of tissues, mimicking the severity of myocardial deformity - the so-called "strain rate" of myocardial segments for the ischemic deformation is always local). Further, systolic dysfunction of the myocardium develops (which is manifested in stress echocardiography). After that, there are changes to the ECG, myocardial ischemia. Clinical manifestations of myocardial ischemia as an angina pain - angina pectoris only complete the whole cascade of subdivisions. The continuation of ischemia after the appearance of angina causes the heart to reverse (stagnation, or stun, myocardium), and then irreversible (apoptosis and necrosis) damage to the myocardium.

From the baby of the 1st stage, we understand that damage to the metabolism of the myocardium is blamed for ischemia of the myocardium too early (early fast) and accompanying ischemia in all other periods (go) "cascade" and every hour the development of angina pectoris. In connection with cym, it is clear those who are one of the most important causes of myocardial ischemia and metabolic diseases.

Apparently, in case of ailment of the cardiovascular system, a clear pathology due to the recognition of various hemodynamic diseases cannot guarantee an optimal result. That is why it is of interest to establish preparations that are pleasantly injected into the metabolism of the myocardium.

Cardiomyocytes, on the view of skeletal m'yazyv, vicarious as an energy substrate of free fatty acids (FFA), if necessary, decompose lactic acid (lactate) for the removal of supplementary energy. Glucose is also an energy source for cardiomyocytes. When FFA is the main source of energy in a healthy human heart (about 60%), stinks inhibit the oxidation of glucose in the myocardium. Macroergic phosphates provide energy metabolism, which is necessary for cardiomyocytes both for mechanical work, and for ion transport and for other processes that require energy vitrate.

Apparently, the presence of sour is not necessary for the metabolism of glucose - glycolosis, but 2 ATP molecules become pure energy in the process of glycolosis. With increased glucose intake, the secretion of insulin increases and the penetration of glucose into cardiomyocytes increases further, and the oxidation of pyruvate increases. Insulin reduces the intake of FFA in the blood, lowering its concentration in the blood and, obviously, its intake in the cardiomyocyte. Tim itself changes β-oxidation and increases the absorption of acetyl coenzyme A from pyruvate. There is competition for kisen between acetylcoenzyme A, which is soluble in pyruvic acid, and acetylcoenzyme A, which is soluble in the oxidation of FFA. Zreshtoyu begins to over-oxidize glucose, which ensures up to 2/3 ATP [Mari R.S. that spivavt. 2009]. With supra-world fatty liver, on the other hand, there is an increase in the concentration of FFA in the blood, increased availability for cardiomyocytes, in consequence of which the intensity of β-oxidation and glucose oxidation increase.

In the minds of myocardial ischemia, naturally, activation of anaerobic glycolysis, increased accumulation of glucose from the blood by cardiomyocytes, and absorption during the breakdown of glycogen occur. As a result, pyruvate synthesizes lactic acid (lactate) and 2 ATP molecules. Synthesis with any excess lactate is seen in cells, and vin, apparently, serve as a reliable sign of myocardial ischemia. Lactate, accumulating in the cytosol, leads to acidification of the internal medium, overwhelming the cells with Na +, Ca2 + and disrupting the health of cardiomyocytes to a weakening and shortening. Excess intracellular Ca2+ activates phospholipase, which leads to damage to the membranes of cardiomyocytes. In case of ischemia, regardless of the increased ingestion of glucose by cardiomyocytes, a change in glucose oxidation is still possible. In the minds of ischemia, FFA is changed and occupied by cardiomyocytes, however, in mitochondria, it is still necessary to increase the intensity of β-oxidation of FFA. In this way, in case of moderate manifestations of ischemia in cardiomyocytes, I continue to dominate more sour way of the current energy supply. Nadal, with severe myocardial ischemia, blocking and β-oxidation of FFA, and anaerobic glycolysis.

With vicarious FFA as an energy substrate, the efficiency of energy security of the myocardium is 30% greater, lower with vicarious glucose, the proteolysis of FFA will require more high acidity, which in the minds of ischemia is not visible to cardiomyocytes. When vikoristannі in the capacity of the energy substrate of glucose, the amount of ATP, which is dissolved, is 15% more per 1 mole of clay acid, lower when FFA is utilized. In this way, the "sourness" of the ATP molecule, taken away during the utilization of glucose, is less, lower in the case of β-oxidized FFA, so that the increased utilization of FFA for the safety of myocardial function leads to an increased "implantation" of sourness. Also, the most effective way of energy recovery with normal blood flow in the myocardium is the utilization of FFA, and in the minds of yogo ischemia, it reduces the oxidation of glucose, to which the way allows you to stain the acid more economically.

In view of the above, it is possible to develop visnovoks about those who use metabolic therapy - "reversing" the metabolism of cardiomyocytes from the oxidation of fatty acids to the oxidation of glucose. Drugs, which do not really affect hemodynamics, but instead "change" myocardial metabolism from FFA oxidation to glucose oxidation, are called cytoprotectors, or antianginal drugs with a metabolic mechanism of action.

In the 1970s and 1980s. great hopes in this plan called for such preparations as inosine, ATP, cytochrome C and in. Prote їh klіnіchne zastosuvannya not svіdchilo pro skіlki — nebіd pomnіnі effektіvnіst, vplіvіv on polіshennya i'll become ill on ІХС. In order to change the situation, it was necessary to create preparations with direct cytoprotective action.

Growing interest in cytoprotectors for demonstrations at the European Congress of Cardiology near Paris (France) in 2011 At that time, it became clear that atherosclerotic damage to the heart is not the only factor that leads to ischemia, and more than 50% of myocardial infarctions occur in patients with critical stenosis of the coronary arteries. For this reason, the alternative, “revolutionary” (“Copernican Revolution”) was promoted to the exaltation of ailments on ІХС – it was emphasized that the emphasis was on the cardiomyocyte itself as the main target of ischemia, and not on the coronary artery.

Myocardial cytoprotection includes stimulation of intracellular glucose metabolism, as well as suppression of FFA metabolism. Modification of the metabolism of cardiomyocytes victorious for the prevention of myocardial ischemia and induces a lesser amount of acid per unit of ATP, which is absorbed.

The classic cytoprotector is the drug trimetazidine. Vіn prinіchuє the metabolism of fatty acids, z yakim pov'yazane znachne spozhivannja sourness, and for rahun tsgo zbіshuє іntensivnіst metabolizm glucose with zmenshenni consumption in sourness and blood flow. Trimetazidine may have such power: support the energy metabolism of the heart and neurosensory organs in periods of episodes of ischemia; change in the magnitude of intracellular acidosis and changes in transmembrane ionic current, which is due to ischemia; reduce the rate of migration and infiltration of polynuclear neutrophils in ischemic that reperfusion tissue of the heart, changing the size of myocardial fluctuations. Dani effect trimetazidine beware of the presence of any direct hemodynamic effect.

In patients who suffer from angina pectoris, trimetazidine increase coronary reserve, improve the development of ischemia, alleviate physical stress, starting from the 15th day of therapy; interspersed sharply AT without any significant changes in cardiac rhythm; significantly reducing the frequency of attacks of angina pectoris, significantly changing the need for nitroglycerin, improving the transient function of the left duct in patients with ischemic dysfunction.

Detailed, detailed look trimetazidine Bulo zrobleno L.G. Oganezova (2013). The efficacy of trimetazidine has been proven in various randomized placebo-controlled and recent trials, and the results of any trials of this drug have been praised by both Russian and foreign cardiological associations for the treatment of angina pectoris. A good evidence base for trimetazidine bula otriman is in the studies TRIMPOL I (1999), TRIMPOL II (2001), TRIMER (2002), PARALLEL (2007), PRIMA (2009).

A PARALLEL (Program for the detection of patients with ineffective therapy with β-adrenergic blockers and a consistent assessment of the effectiveness of adding trimetazidine to therapy with stable angina pectoris) R.G. Oganiv and spivavt. (2007) showed that the addition of trimetazidine to β-adrenergic blockers in patients treated for ICS, stable angina pectoris is little more important than the addition to β-adrenergic blockers of isosorbide dinitrate (followed on 903 patients for 3 months). The authors report on visnovoks, that in case of 3-fold nitrification of nitrates, the tolerance to them increases, while in case of 3-fold exposure to the cytoprotector trimetazidine, the frequency of attacks of angina pectoris is significantly reduced. Dosledzhenny PRIMA Yu.A. Vasyuk and spivavt. (2009) showed in 876 patients with stable angina pectoris

II-III functional class, which zastosuvanya trimetazidine significantly changes the number of ailments with chronic heart failure (such key symptoms have changed, like a bum, swelling of the lower limbs and increased stomly).

Also, trimetazidine is an important warehouse complex therapy for stable angina pectoris, it can have a direct cytoprotective effect on myocardial ischemia, which leads to rational sourness. Trimetazidine can be compared for antianginal effect with β-blockers, nitrates and calcium antagonists.

A new drug trimetazidine, Predizin, has appeared on the Russian pharmaceutical market. Predizin is available for prolongation of the form, in the form of puffs, 35 mg. Vin zastosovuetsya 2 p. for the harvest in the evening and in the evening at noon hour їzhi. Predizin is not likely to zastosovuvat for usunennya attacks in angina pectoris.

At the end, say so. Great Hippocrates in V Art. to the sound e. saying: "Sublata causatolitur morbus" - "Usuvayu the reason, you suvaesh the ailment." We suffer from angina pectoris for stenting of the coronary arteries, unfortunately, we do not suffer from illness, and early attacks of angina pectoris begin. Vikoristovuyuchi complex, pathogenetically true, but, unfortunately, rich in what polypragmatic drug therapy for angina pectoris and atherosclerosis, which lie in the basis, we also do not use ailments. Prote easing the suffering of the patient and the zbіlshennya trevalosі yogo zhittya reach. In the complex of current medical therapy of angina pectoris, the “Copernican Revolution” was conceived on the cardiomyocyte itself as the main target of ischemia, and not on the coronary artery.

Literature

1.Gupte S.A. Targeting the pentose phosphate pathway in syndrome X-related cardiovascular complications // Drug Dev. Res. 2010 Vol. 71. P. 161-167.

2. Kheradmand F. Rasmi Y. Nemati M. Mohammadzad M.H. ABO-Rh blood groups distribution in cardiac syndrome X patients // J. Cardiovasc. Dis. Res. 2012. Vol. 3(3). P. 197-199.

3. Oslopov V.M. Oslopova Yu.V. Borisov D.V. Cardiac syndrome X. Pathophysiological mechanisms of development and possibility of screening verification of Na + -Li + -protitransport activity in the erythrocyte membrane // Kazan Medical Journal. 2013. V. 94. No. 3. pp. 355-360.

4. Kukharchuk V.V. Summaries of the XIV International Congress on Atherosclerosis // Cardiological Bulletin. 2006. Vol. I (XIII). No. 2. pp. 58-61.

5. Kukharchuk V.V. іz spіvavt. Subclinical atherosclerosis as a risk factor for cardiovascular complications // Journal of International Medicine. Cardiology. 2013. No. 3 (4). Z. 18-22.

6. Opi L.Kh. Faces in the practice of a cardiologist / L.Kh. Opi, B.J. Gersh/Prov. from English; for zag. ed. and s dod. prof. V.M. Khirmanova. M. Rid Elsiver, 2010. 784 p.

7. Titov V.M. іz spіvavt. The study of individual fatty acids and lipids in blood plasma lipoproteins in patients with hyperlipidemia while taking statins // Cardiological Bulletin. 2006. Vol. I (XIII). No. 2. pp. 32-38.

8. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis randomized trials antiplatelet therapy for prevention death, myocardial infarction and stroke in high-risk patients // Br Med J. 2002. Vol. 324. R. 71-86.

9. Metelitsia V.I. Dovіdnik іz klinіnії pharmacolії ї sercevo-sudinnyh likarskih zabіv. 2nd view. rework that dod. M. BINOM - St. Petersburg. Nevsky dialect, 2002. 926 p.

10. Oslopov V.M. Fedoseeva T.S. Agregal (Clopidogrel) - the most important storage part of the treatment of ailments for stable angina pectoris, angioplasty and stenting of the coronary arteries // Praktichna meditsiny. 2011. No. 4 (52). Z. 208-212.

11. Oganov R.G. Mamedov M.M. National clinical recommendations of VNOK. M. Siliceya-Polygraph, 2008. 512 p.

12. Fox K.N. European Trial On Reduction of Cardiac Events with Perindopil in Stable Coronary Artery Disease Investigators: efficacy of perindopril in reduction of cardiovascular events of patients with stable coronary artery disease: randomized, double-blind, placebo-controlled, multi / Lancet. 2003 Vol. 362. R. 782-788.

13. HOPE Investigators. Effects of angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients // N Engl J Med. 2000 Vol. 342. R. 145-153.

14. HOPE Study Investigators. Effect of ramipril on cardiovascular and microvascu-lar outcomes in people with diabetes mellitus. Results of HOPE study and MICRO-HOPE substudy // Lancet. 2000 Vol. 355. R. 253-259.

15. Boden W.E. that in. COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease // N Engl J Med. 2007 Vol. 356. R. 1503-1516.

16. Coronary revascularization (surgical or percutaneous) is associated with early mortality in diabetic subjects but nondiabetic subjects with multivessel disease: analysis from the Medicine, Angioplasty, or Surgery Study (MASS II). 2007 Vol. 115. R. 1082-1089.

17. Schomig A. ta in. Meta-analysis 17 randomized trials of percutaneous coronary intervention-based strategy in patients with stable coronary artery disease // J Am Coll Cardiol. 2008 Vol. 52. R. 894-904.

18. Trikalinos T.A. that in. Prospective coronation approaches for inaccurate coronation artery disease: a quantitative 20-year synopsis and network meta-analysis // Lancet. 2009 Vol. 373. R. 911-918.

19. Amirov N.B. Oslopov V.M. Na+-Li+-protitransport: efficiency of laser therapy in clinics of internal diseases. Kazan: Maddoc, 2013. 240 p.

20. Oslopov V.M. Significance of membrane disorders in the development of hypertensive disease: Dis. … doc. honey. Sciences. Kazan, 1995. 485 p.

21. Oslopov V.M. Arterial hypertension and clitin membrane (theory and practice of the membrane concept of primary arterial hypertension Yu.V. Postnova) Kazan: Maddok, 2012. 460 p.

22. Armstrong W.F. Stress echocardiography: introduction, history, and methods // Prog Cardiovasc Dis. 1997 Vol. 39. R. 499-522.

23. Oslopov V.M. іz spіvavt. Instrumental methods for the follow-up of the cardiovascular system: a guide book. M. Geotar-Media, 2012. 624 p.

24. Lupanov V.P. Functional navantage tests in the diagnosis of IHS. Methodical help. M. 2004. 48 p.

25. Olesova V.M. Markatyuk O.Yu. Yurova Yu.Yu. Circumscribed by A.G. Metabolism of the myocardium and preparations and metabolic activity // Kardiologiya. 2013. V. 53. No. 1. pp. 66-71.

26. Cardiology: National Kerіvnitstvo / ed. Yu.M. Belenkova, R.G. Oganov. M. Geotar-Media, 2010. S. 1232.

27. Statsenko M.Є. Metabolic cardioprotection with meldonium ischemic ailments of the heart: bags and prospects / M.Є. Statsenko, S.V. Turkina // A jubilant doctor. 2012. No. 7. S. 62-65.

28. Oslopov V.M. Oslopova Yu.V. Urazmanova A.A. Renaissance of cytoprotective metabolic therapy of IXC due to drug administration Cardionat (Meldonium) // Praktichna meditsina. 2011. No. 4 (52). Z. 198-200.

29. Grabczewska Z. Bialoszynski T. Szymanski P. Sukiennik A. Swiatkiewicz I. Kozinski M. Kochman W. Grzesk G. Kubica J. Use of trimetazidine in maximal anti-chemotherapy in patients with advanced coronary disease Journal. 2008. Vol 15. No. 4. P. 344-350.

30. Napoli P. Taccardi A. Trimetazidine: future of cardiac function? // Future Cardiol. 2009 Vol. 5 (5). R. 421-424.

31. Gunes Y. Guntekin U. Tuncer M. Sahin M. Effect of Trimetazidine on Heart Rate Variability in Patients with Heart Failure. Arg Bras Cardiol. 2009 Vol. 93(2). R. 145-148.

32. Iskesen I. Saribulbul O. Mustafa Cerrahoglu, MB; Var A. Nazli Y. Sirin H. Trimetazidin Reduces Oxidative Stress in Cardiac Surgery // Circ J. 2006. Vol. 70. R. 1169-1173.

33. Vitale C. Wajngaten M. Sposato B. Gebara O. Rossini P. Fini M. Volterrani M. Rosano G. MX. Trimetazidine improves the great ventricular function and quality of life in typical patients with a white artillery case // European Heart Journal. 2004 Vol. 25. R. 1814-1821.

34. Rosano G. Vitale C. Sposato B. Mercuro G. Fini M. Trimetazidin improves left ventricular function in diabetic patients with CVD: a bilateral placebo-controlled study // Cardiovascular Diabetology. 2003 Vol. 2.

35. Beiardinelli R. Solenghi M. Volpe L. Purcaro A. Trimetazidin improves endothelial dysfunction in chronic nerve disease: an antioxidant effect // European Heart Journal. 2007 Vol. 28. R. 1102-1108.

36. Tuunanen H. Engblom E. Naum A. Nagren K. Scheinin M. Hesse B. Airaksinen J. Nuutila P. Iozzo P. Ukkonen H. Opie L. Knuuti J. Trimetazidine a Metabolic Modulator Dilated Cardiomyopathy // Circulation. 2008 Vol. 118. R. 1250-1258.

37. Oganezova L.G. Possibility of cytoprotective therapy in the treatment of ischemic ailments of the heart // RMZ. 2013. No. 19. P. 953-955.

38. Oganov R.G. Glezer M.G. Deev A.D. (Vid the name of the participants in the study). Results of the Russian research PARALLEL // Cardiology. 2007. No. 3. S. 4-13.

39. Vasyuk Yu.A. Shkolyar O.L. Kulikov K.G. that in. In addition to the therapy with Preductal MB with CHF in patients with stable angina pectoris, they suffered a hostile myocardial infarction. The results of the study PRIMA // Heart failure. 2009. Vol. 10. No. 1. pp. 34-36.

40. Oslopov V.M. Oslopova Yu.V. Urazmanova A.A. Renaissance of cytoprotective metabolic therapy of IXC due to drug administration Cardionat (Meldonium) // Praktichna meditsina. 2011. No. 4 (52) S. 198-200.

41. Oslopov V.M. Oslopova Yu.V. Nikiforov A.M. Current statements about the nature of primary arterial hypertension, the principles of success and the success of a new highly selective β-adrenoblocker bisoprolol - Bisogam // Praktichna meditsiny. 2011. No. 4 (52). pp. 227-232.

Angina pectoris

At the heart of ischemic heart disease lie deposits on the walls, or rather, atherosclerotic plaques in the walls of the coronary arteries, as if “scaling on the teapot” sounds the enlightenment of the judge. The plaques step by step change the clearance of the arteries, which leads to insufficient eating of the heart meat. The process of atherosclerotic plaque formation is called atherosclerosis. Shvidkіst yogo development of rіzna і to fall in іd rich factors. You know about qi factor risk.

The coronary arteries play a vital role in the life of the heart meat. The blood that flows through them brings sour and life speech to all the souls of the heart. If the arteries of the heart are afflicted with atherosclerosis, then in the mind, if the need for heart oil in sourness is increased (physical or emotional pressure), it can lead to myocardial ischemia - insufficient blood supply to the heart oil. Tsei camp is a signal of the heart about sour insufficiency and angina pectoris. Thus, angina pectoris is not an independent illness, but a symptom of ischemic heart disease. Among the people, the camp took away the name "angina pectoralis".

Different types of angina pectoris

Establish a few options for angina pectoris, or rather three:

Stable angina. which includes 4 functional classes in the fallage of the type of interest that can be transferred.

Unstable angina. stability or instability of angina pectoris is indicated by the manifestation of angina pectoris.

Variant angina pectoris. or Prinzmetal's angina. This type of angina pectoris is called vasospastic.

It is necessary to indicate that angina pectoris is fixed in 0.2 - 0.6% of the population with overweight in people 55 - 64 years old, it is blamed on 30,000 - 40,000 grown-ups per 1 million population in rіk, due to the increase in breadth vіku. Before myocardial infarction, stable angina occurs in 20% of patients, after myocardial infarction - in 50%.

Stable angina:

It is important that 50-75% of the heart sounds due to atherosclerosis for the vindication of angina pectoris of the artery. As a result, no jubilation is carried out, atherosclerosis progresses, plaques on the walls of the arteries swell. Thrombi settles on them, the lumen of the judge sounds more loudly, blood circulation improves, and attacks of angina pectoris are more frequent and blamed for light physical anxiety and feel calm. Stable angina pectoris (tension) is stale due to severity, it was taken to be divided into functional classes:

• I functional class - attacks of retrosternal pain are rarely blamed. Pain is blamed for the over-the-top great, swiftly victorious ambition.
• Functional class II - attacks develop during quick walks, quick walks, especially in frosty weather, in cold winds, sometimes on a cold day.
• III functional class - the degree of exchange of physical activity, attacks appear when walking up to 100 meters, sometimes in cold weather, when walking out onto the street, on the first top, they can be provoked by praise.
• VI functional class - there is a sharp decrease in physical activity, the patient becomes untimely victorious whether a physical work without showing attacks of angina pectoris; It is characteristic that attacks of angina pectoris can develop calmly - without any physical or emotional preoccupation.

Seeing the functional classes allows the doctor to correctly choose faces and general physical preferences for a particular skin type.

Unstable angina:

As zvichna angina pectoris changes its behavior, it is called an unstable or pre-infarction camp. What is it? For unstable angina pectoris, consider the following:

First, angina pectoris, which vinikla in life, not more than one month ago;

Progressive angina pectoris, if there is a rapid increase in the frequency, severity and severity of attacks, the appearance of no attacks;

Quiet angina pectoris - the appearance of attacks of angina pectoris in calm;

Post-infarction angina pectoris - the appearance of calm angina pectoris in the early post-infarction period (10-14 days after myocardial infarction).

In any case, unstable angina pectoris is an absolute indication for hospitalization in resuscitation and intensive care. TERMINATELY CLICK SHVIDKA FOR ADDITIONAL HELP.

How to treat stable and unstable angina?

20.09.2017

With unbalanced eating in the blood-bearing arteries, atherosclerotic plaques are established and atherosclerosis is established. Illness gives relief from attacks of angina pectoris and ischemic heart disease. The volume of blood flow changes, it is bad for the body to get acid.

Operations on the heart and ischemic disease can cause complications: heart failure or myocardial infarction.

Causes of IXC

We can see the factors that call for ischemic disease of the heart:

• tyutyunopalinnya;
• diabetes;
• seated robot;
• zaiva vaga;
• damage to lipid metabolism;
• atherosclerosis;
• filthy is the quality of drinking water and other reasons.

Іsnuє impersonal factors that call for ischemic heart disease

For the treatment of ischemia of the heart, people prescribe therapy with medicinal preparations, recommend a special diet - style number 10.

Should I prescribe a diet?

A diet was prescribed for IXC, angina pectoris, this effect on the body:

• Galmuє the process of ailments that are developing, atherosclerosis.
• Stabilization of exchange processes and lipid profile of blood.
• Reduces the risk of movement and spasm of blood vessels.
• Rozrіdzhuє krov, pіdtrimuє sertsevy m'yaz in tone.

Which products change the lipid profile?

At the menu, it is necessary to add products to help remove cholesterol from the body. At the same time, change the number of ailments from high cholesterol. In the case of eating a child, the amount of cholesterol can be increased by 300 milligrams.

Vivesti cholesterol to help:

• Pisna fish. At її fat there are speeches that mark the walls of the vessels. In some cases, the likar allows fatty varieties of ribi. You can extinguish, cook, zapkati.
• Fruits, vegetables and berries. The stench is rich in cellular tissue and carbohydrates, to improve the work of the intestines. Cream of cholesterol stink is removed from the body and the products of metabolism. A handful of potatoes is necessary to surround, її starch is added to the body fat.
• Buckwheat, wheat and wheat groats.
• Korisno add whiskers to the soup or porridge, but no more than three tablespoons for doba. The stench will help to relieve the body of carcinogens and cholesterol.

E products that have high cholesterol levels:

• Creatures fat and Vershkov oil. As soon as the hour of obstezhennya, a high amount of triglycerides was revealed, the patient should be taken in the fat.
• Meat. Rich offal cholesterol.
• Eggs, ribeye and shrimp caviar.
• Milk, sour cream, cheese and cheese.
• Alcohol. Take out calories and eat more.
• Licorice, boroshnyane. Through those that produce eggs, zukor and fat, stench are high-calorie.

Licorice and Boroshnyan are contraindicated

Diet in case of ischemic heart disease, after attacks of angina pectoris, it is due to include the disease:

• Steep broth cooked on rib, meat or mushrooms.
• Stravi from legumes, instead of radish, radish or smoked products.
• Malt and health.
• Gravi from mixed mushrooms, spinach and fresh sorrel.
• I'll smear riba and m'yaso.

Stravi not guilty but smeared

How to reduce the risk of spasm?

Ischemic disease of the heart is characterized by spasms of the blood vessels, the person feels a strong pain in the heart. The stench can be pungent, to press or squeeze. Spasm can be relieved with nitroglycerin. Include cowbass, drink and canned food in the diet.

Buy a drink and add a lot of salt, if people want to drink after living. The number of natives in the body increases, which creates an interest in the work of the heart-vascular system. After the appearance of hypertension, angina pectoris, the walls of blood vessels may rupture.

Change the arterial pressure and prevent spasms of the vessels, you can use the salt, enough to drink a teaspoon. Cooked herbs do not take fresh, as if adding spices to them.

What work in the viscosity of the blood?

Krim medicamental benefits to supplement the drinking regimen. On a day, a person can drink close to two liters of water, as if it’s smoky on the street, about three liters. You can win pure water, milk, compote, various juices. You can't drink beer and soda water.

Preservation of heart tone

Ischemic disease of the heart, and also angina pectoris does not appear, as in eating, eat diet number 10c and live such products:

• Khlib.
• Olive oil (10 g per doba), unrefined roslinna (one tablespoon).
• Sea fish (one hundred grams per doba).
• Soupi cooked on vegetables, beetroot, milk.
• M'yasnі that ribnі stravi have be-yakom vglyadі, kіm obsmazhuvannya.
• Dairy products.
• Omelet on one egg without a chew, or once on this day one boiled an egg.
• Salad with vegetables.
• Making pasta, various cereals, casseroles.
• Fresh fruits in season, berries.
• Compote without grapes and jelly.
• Different peas.
• Weakly brewed tea, nasty from herbs, sik from fruits (dilute with water).

Bread and sea fish are included in the diet of the sick

Dodatkovo take vitamins, folic acid, sodium, magnesium, chlorine phosphorus. Microelements, for example, manganese, zinc, salt, iodine and others, are included in the warehouse.

If polyvitamins are not suitable, then natural products will come to the rescue: beetroot, carrot, selery root, seaweed, peas, sonyashnikova or harbuzi.

Rehabilitation period after myocardial infarction, after attacks of angina pectoris and IXC, may be on the verge of a sudden death, recognized by the doctor. Diet therapy will help patients to become more or less healthy.

Eating regimen with IXC

On the day of maє buti no less, nіzh іst priyomіv їzhі. Portion size is small. You can't eat hotter or colder.

Reception їzhi not less than two years before bedtime. You can eat fruits, salads, fermented milk products, juices.

Їst is necessary for offal, but more often

Sour fruits can be watered with honey, as if for a new allergy, as well as vicarious tsukor in a small quantity. You give weight to your body, through your heart it is even more important to cope with your work. One zayviy kilogram adds twenty grams of cholesterol to the body.

Diet No. 10s

Livelihood in diagnosing IXC can be suvorim, for a quick recovery of health. The patient is assigned a style number 10c, this diet is considered healthy. It helps to normalize the pressure, lose weight, stabilize blood viscosity, reduce cholesterol and normalize fat metabolism.

Such a pathology can be blamed on various illnesses, and the drug is prescribed to that diet on an individual basis.

Dotrimuyuchis diet, you can normalize the vice

The healthy diet menu number 10 looks like this:

First snidanok:

• Vіdvarene lean meat - 50 grams.
• Vegetable salad with additional olives - 60 grams. Vegetables can be cooked.
• Weakly brewed tea, diluted with milk - 200 milligrams.

Other reference:

• Salad - 150 grams. You can have it in other meals: apples, cabbage (marine or white cabbage), cucumbers, carrots, boiled eggs.

• Sleepy vegetable soup - 200 milligrams.
• Riba abo m'yaso - 70 grams.
• Zapikanka or mashed potatoes - 150 grams.
• Jelly - 130 grams.

• Fresh apple - 1 piece.
• Compote - 200 milligrams.

• Steamed fresh fish, baked in oven or aspic ‒120 grams.
• Vegetable boiled, with additional olive oil (180 grams), or licorice casserole with jam - 250 grams.
• Compote, diluted with water, tea - 200 milligrams.

Afternoon supper:

• Sour-milk drink (kefir) - 200 ml.
• Rusks - 100 grams.

For the whole day you can win 150 grams of visivkiv, or you can replace them with 100 grams of white fresh bread. Zukor is allowed at a quantity of troch more than fifty grams.

At ІХС є i rozvantazhuvalny days, illness is accompanied by zayvimi kilograms. Conduct their follow-up only for the doctor's recommendation.

It is not possible to rule the rozvantazhuvalny days on your own, because it is necessary to protect the functioning of the herbal, blood-bearing and nervous system, and it is possible to build only a medical fahivets.

Also, ischemic heart disease and atherosclerosis are diagnosed more often. In the main pathology, they blame it on the rotten eating and unsatisfactory life. Adzhe smeared, smoked, boroshnyanі herbage will spoil our lives. Ale, yakscho dotremuvatisya diet, your health can be trohi podtrimati.