Ischemia
The content of the article:
- Causes and risk factors
- Forms
- Stages
- Signs of ischemia
- Diagnosis of ischemia
- Ischemia treatment
- Possible complications and consequences of ischemia
- Forecast
- Prevention
Ischemia (from the Greek ischō to retain + haima blood) is a pathological condition that occurs when the blood supply to any part of the body is disturbed. A circulatory deficiency causes metabolic disorders, and also leads to disruption of the functioning of certain organs.
All tissues and organs in the human body have different sensitivity to lack of blood supply. The cartilage and bone structures are less susceptible, the brain and heart are more vulnerable. Ischemia of the heart muscle leads to the development of angina pectoris.
Ischemia of the calf muscles during exercise (causing intermittent claudication) or at rest (causing pain that occurs at rest) is common in older adults with peripheral vascular atherosclerosis in the extremities far from where the aorta branches into the iliac arteries.
Causes and risk factors
The development of ischemia can be caused by:
- atherosclerotic changes in the coronary arteries that prevent collateral blood flow;
- blood diseases;
- acute blood loss;
- heart failure;
- severe stress;
- injuries of varying severity;
- embolism;
- thrombosis;
- shock (cardiogenic, painful, burns);
- tendency to spasms of arteries in the ischemic area;
- mechanical compression of the vessel by the tumor;
- intestinal obstruction;
- increased blood viscosity;
- poisoning with biological and chemical poisons;
- thickening of the walls of blood vessels;
- obliterating endarteritis;
- torsion of the tumor, polyp or fibroid on the pedicle;
- anemia;
- osteochondrosis.
Risk factors for ischemia:
- heart rhythm and conduction disorders;
- tendency to thrombus formation;
- high blood cholesterol levels;
- genetic and hereditary factors (a tendency to thrombosis, blood diseases, vascular diseases in a family history, abnormal vascular tortuosity);
- blood viscosity, which increases the resistance to blood flow.
- unhealthy lifestyle (alcohol abuse, nicotine addiction, sedentary lifestyle, overweight);
- the age factor (women over 55, men over 45-50);
- long-term use of hormonal drugs by women.
The risk of ischemic heart disease increases in the presence of diabetes mellitus, hypertension, atherosclerosis, thromboangiitis obliterans, chronic severe anemia, chronic sciatic nerve neuritis, coxarthrosis.
Forms
By the nature of the flow, they are distinguished:
- acute ischemia - occur as a result of a sharp slowdown or cessation of blood flow in a certain area;
- chronic ischemia - develop with a gradual impairment of blood circulation.
According to the etiological factor, the following forms of ischemia are distinguished:
- angiospastic - caused by prolonged reflex spasm of the blood vessel, leads to tissue hypoxia, creates conditions for starting the process of active thrombus formation;
- redistribution (a type of angiospastic) - due to the redistribution of blood flow between organs due to a decrease in the volume of circulating blood;
- obstructive - associated with thrombus formation, occurs when there is an obstruction to the blood flow in the artery, complete or partial closure of the lumen of the artery by a thrombus, atherosclerotic plaque or embolus;
- compression - occurs with external mechanical compression of the artery wall or tissue site with a connective tissue scar, adhesions, an enlarging tumor, trauma, tourniquet, foreign body.
In a separate group, ischemia of newborns is distinguished, which may be the result of intrauterine and extrauterine hypoxia, asphyxia, disturbances in placental blood supply, severe anemia, maternal gestosis, infections, previa or placental abruption, arterial hypotension or hypertension. Ischemia in newborns can cause the development of serious neurological disorders.
Source: fb.ru
Stages
Depending on the intensity of the symptoms, there are three stages of the course of ischemic disease:
- Compensated (spastic) - disorders of vascular regulation are characteristic; tissue hypoxia is compensated by collaterals, which take on a part of the load, cover the tissue oxygen demand and maintain a reserve of blood flow. Amenable to drug therapy;
- Subcompensated - characterized by the appearance of structural signs of atherosclerotic vascular lesions, ischemic foci, trophic disorders, irreversible changes. The blood flow velocity is critical, pain occurs at rest, vascular drug therapy is ineffective;
- Absolute - leads to the appearance of severe trophic disorders, irreversible changes and complete dysfunction of the affected organ (ischemic ulcers, necrosis of organs and body parts, sclerosis, heart attack).
Signs of ischemia
The manifestations of ischemia depend on the degree of decrease in the intensity of tissue blood supply and other microcirculation disorders. The main symptoms of coronary artery disease depend on which organ is affected.
Symptoms of chronic cerebral ischemia:
- frequent dizziness;
- memory disorders, impaired ability to concentrate;
- violation of coordination of movements;
- deterioration of vision;
- feeling short of breath;
- hearing impairment;
- noise, ringing in the ears.
Acute cerebral ischemia (ischemic stroke) is a serious life-threatening condition. The first signs of ischemia:
- sharp, intense headache, dizziness;
- fainting, other disturbances of consciousness;
- violation of visual function;
- stupor, stunnedness, severe lethargy;
- numbness, weakness of the upper and lower extremities;
- pain in the heart, arrhythmias;
- excessive sweating;
- tachycardia;
- violation of coordination of movements;
- paralysis.
Bowel ischemia symptoms:
- nausea, vomiting;
- increased peristalsis, frequent urge to defecate;
- diarrhea;
- streaks of blood in the stool;
- severe abdominal pain.
Symptoms of lower limb ischemia are usually pronounced:
- pain in the calf muscles, which are worse at night and when walking;
- gait disturbances, intermittent claudication;
- coldness of the limbs, marbled skin tone;
- the formation of trophic ulcers on the feet and toes.
Ischemic heart disease has the following manifestations:
- angina pectoris;
- tachycardia;
- chest pain (usually with severe psycho-emotional shock or physical exertion);
- dyspnea;
- pallor, cyanosis of the skin;
- weakness;
- pain in the left hand;
- lowering blood pressure.
Myocardial ischemia can occur without severe pain, it is revealed in this case during examination of the heart.
Diagnosis of ischemia
Laboratory methods for diagnosing ischemic disease include a general and biochemical blood test, blood sugar test, blood pressure measurement, lipid profile, coagulogram.
The most informative instrumental methods for diagnosing heart ischemia are ECG, coronary angiography, computed and magnetic resonance imaging, ultrasound cardiography, daily stress monitoring, duplex angioscanning of the carotid arteries.
Ischemia treatment
Ischemia treatment is carried out with medication, physiotherapy, surgical methods. Therapy is selected individually, depending on the form of the disease, its severity, concomitant diseases, general condition and age of the patient. Pharmacological treatment is aimed at correcting hemodynamic disorders and disorders, eliminating the cause that provoked the development of ischemic disease. Directions of therapy:
- removal of vasospasm;
- restoration of blood circulation in the tissue;
- normalization of vessel patency, expansion of arteries damaged by atherosclerosis, strengthening of their walls;
- disclosure of all possible bypass routes for blood supply;
- stopping the development of cholesterol plaques;
- elimination of the cause of the vessel overlap, removal of a blood clot;
- decrease in blood viscosity;
- an increase in the oxygen content in the blood;
- creating conditions for the formation of a collateral mesh;
- protection of ischemic tissue of the damaged organ;
- treatment of concomitant heart diseases and cerebrovascular insufficiency.
For this, thrombolytics, prostaglandins, drugs that improve blood circulation are prescribed. In the acute form of pathology, they are used in the form of intravenous infusions, after the acute symptoms subside and in chronic ischemia - in tablet form.
Non-drug methods in the treatment of ischemia play as important a role as drug therapy. This is, first of all, a lifestyle correction, diet, normalization of body weight, water regime, which allows to normalize increased blood clotting.
Source: syl.ru
With severe obstruction of blood vessels (stenosis of the carotid arteries more than 60%) and severe ischemia, they resort to normalizing blood circulation using balloon angioplasty and stenting. Microsurgical artery bypass grafting is an effective means of arresting critical ischemia. To restore the lumen of the carotid arteries, endarterectomy is performed.
Possible complications and consequences of ischemia
Ischemic disease can lead to disability and death. The consequences of ischemia include myocardial infarction, stroke, heart failure, cardiogenic shock, electrical instability of the heart, paresis and paralysis when the motor areas of the brain are affected.
Forecast
With timely diagnosis and adequate therapy, it is possible to stop the progression of pathology and stabilize the condition of patients. Risk factors, if they have not been eliminated, and complications worsen the prognosis. The presence of a heart attack and other serious diseases in the patient's history, age, and the patient's willingness to carefully adhere to medical recommendations are important.
Prevention
Preventive measures to prevent the development of ischemia or reduce the existing one:
- nutritional correction;
- increased physical activity;
- normalization of body weight;
- drinking enough fluids;
- rejection of bad habits;
- normalization of blood pressure and lipoprotein levels;
- maintaining the nervous system in a stable state;
- control of blood viscosity in people at risk.
YouTube video related to the article:
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
