Cardiovascular diseases: classification, symptoms, diagnosis

Home — For the public

Map of medical organizations
Vaccination
Clinical examination
Fluorography
Addresses and opening hours of clinics
Emergency rooms
Oncology
Where to take an HIV test
Healthy child's office
Services
Prevention of CVD
Disease Prevention
World Patient Safety Day
Newspaper "Medical News"
specialist
School of Health

— Disease prevention

HIV infection
All about vaccination
All about proper nutrition
Hepatitis
Flu
Dementia
Schoolchildren's health
STD
Tick-borne encephalitis
Whooping cough
Measles
Legionellosis
Meningococcal infection
Oncology
Acute intestinal infection
Pediculosis
First aid
Pneumococcal infection
Pneumonia
Prevention of rabies
Dependency Prevention
Rotavirus infection
Diabetes
Cardiovascular diseases
Injuries
Tuberculosis
Tularemia
Physical activity
Obstructive pulmonary disease
Exotic infections
Ecology
Why is swimming in ponds dangerous?

— Cardiovascular diseases — What are cardiovascular diseases?
Cardiovascular diseases (CVD) are a group of organic and functional pathologies of the circulatory system (heart, arteries, veins). Cardiac disorders can be suspected by pain and a feeling of heaviness in the chest, shortness of breath, uneven heart rhythm, and rapid heartbeat. When the vessels of the head and neck are damaged, headaches, tinnitus, and fainting may occur. Peripheral vascular diseases are accompanied by pain in the legs, swelling, and lameness. Most CVDs are extremely life-threatening; if their symptoms appear, you should immediately contact a cardiologist or therapist - he will refer you to the right specialist.

Epidemiology

Cardiovascular (CV) diseases are a serious health problem worldwide due to their high prevalence and high mortality rate. In the world, about a third of all deaths occur from diseases of the circulatory system (85% of them due to heart attack or stroke), more than 75% occur in countries with low and medium levels of economic development. In Russia, the incidence of CVD is more than 19% in the structure of all diseases, mortality is 50%. Experts from the World Health Organization (WHO) predict a further increase in morbidity and mortality from CVD.

People of retirement age are more susceptible to vascular and heart diseases, but over the past decades these diseases have become significantly younger. Thus, coronary heart disease is often first diagnosed at the age of thirty, and from the age of forty it becomes the cause of premature death. Morbidity statistics show that in men the incidence and mortality from cardiovascular pathologies is 1.5 times higher than in women.

Who is at risk?

Those who lead an unhealthy lifestyle, as well as those who are predisposed to them from birth, are most at risk of developing vascular diseases.

There are general risk factors for vascular damage, which include:

smoking – it is one of the main risk factors; male gender;
frequent and severe stress;
rare physical activity;
work that involves lifting heavy objects, standing for long periods of time, or staying in one position;
hypothermia;
excess weight;
a lot of salt and fat in food;
diabetes;
high cholesterol;
high blood pressure.

Classification of CVD

The most common, socially significant CVDs include:

Hypertension is a persistent increase in blood pressure.
Atherosclerosis is the blocking of the arterial lumen by cholesterol plaques. Damage to the coronary vessels leads to coronary heart disease, the arteries of the head and neck to ischemia (lack of blood supply) to the brain, and large arteries of the legs to ischemia of the limb.
Coronary heart disease is a disorder of the blood supply to the myocardium caused by obstruction (narrowing of the lumen) of the coronary arteries. The acute form of the disease is myocardial infarction.
Cardiac arrhythmias are disturbances in heart rhythm and conduction.
Inflammatory heart diseases are lesions of an autoimmune or infectious nature that affect the pericardial sac, muscle layer or internal connective tissue lining of the heart - pericarditis, myocarditis, endocarditis, respectively. Rheumatic carditis is most often recorded.
Cerebrovascular pathologies are diseases of the blood vessels of the brain. An acute form of circulatory disturbance in the great vessels of the head and neck is ischemic stroke (cerebral infarction). If the integrity of the vascular wall is damaged or incompetent, a hemorrhagic stroke (bleeding in the brain) develops.
Thromboangiitis obliterans is a progressive closure of the small arteries of the legs (first due to spasm, then associated thrombosis), accompanied by ischemia of the limb.
Venous thrombosis and pulmonary embolism (PE) are complete or partial closure of the lumen of the veins or the main artery responsible for the blood supply to the lungs with a blood clot.

Significantly less common:

congenital and acquired heart defects;
heart tumors;
systemic vasculitis;
thromboembolism of the arteries of the systemic circulation (peripheral, mesenteric and others).

Blood supply to the brain

Four large arteries are responsible for the transport of oxygen and nutrients to the brain tissues: two internal carotid and two vertebral. The vertebral arteries are responsible for supplying blood to the brain stem. At the base of the brain they merge into the basilar artery.

Each internal carotid artery is divided into anterior and posterior. These vessels supply the frontal, temporal, parietal, and occipital lobes.

At the base of the brain, the internal carotid branches, the basilar artery and the branches connecting them form a closed circle of Willis. It is named after the English doctor Thomas Willis. This anatomical formation ensures the redistribution of blood and the preservation of nutrition of parts of the brain during blockage of blood vessels. The outflow of blood from the cranial cavity occurs through the jugular veins.

Brain diseases occur when large and small vessels are damaged. Depending on the cause, symptoms occur acutely and require immediate medical attention or develop gradually, slowly leading to a deterioration in a person's quality of life.

The main causes of arterial damage include atherosclerosis and hypertension. In the first case, plaques form on the inner surface of the vascular wall, narrowing the lumen of the arteries. They have a thin cover and contain lipids inside. When such plaques rupture, blood platelets adhere to the damaged surface, leading to blockage of the lumen (thrombosis). The provoking factor is often vasospasm.

Arterial hypertension also damages the walls of blood vessels: they become denser, and areas of expansion (aneurysms) appear. These vulnerabilities can cause arteries to rupture or become blocked.

A condition in which small cerebral arteries are affected and the blood supply to the brain is affected is called discirculatory encephalopathy. Nerve cells do not receive enough oxygen and nutrients and die. A developed network of arteries cannot solve this problem. The process is not limited to any one area of the brain; lesions are found in various parts.

Causes of CVD development

Damages of the heart and blood vessels are multifactorial pathologies - they arise against the background of several predisposing conditions. The main cause of the vast majority of cardiac and cerebrovascular pathologies is an increase in the level of low-density lipoproteins (LDL) in the blood. An increase in their concentration leads to excess cholesterol, which forms plaques on the walls of blood vessels, narrowing their lumen.

An important role in the development of CVD is played by hereditary predisposition - those at risk are those whose immediate relatives (brothers, sisters, parents) have the corresponding disease. The likelihood of developing cardiovascular pathologies is increased by diabetes mellitus, kidney and thyroid diseases, infections (most often streptococcal - sore throat, scarlet fever, erysipelas, impetigo). In women, the triggering factor is conditions accompanied by hormonal changes: more often - menopause, less often - pregnancy.

The leading risk factors include lifestyle features and their adverse consequences:

Physical inactivity. A sedentary lifestyle negatively affects the condition of the vascular walls and myocardium, increases the risk of thrombosis, and contributes to the occurrence of excess weight and diabetes.
Diet errors. Increased salt consumption increases the risk of hypertension, excess sweets in the diet leads to diabetes, obesity, and increases LDL levels. Abuse of animal fats contributes to the development of atherosclerosis. Lack of proteins, microelements (potassium, magnesium, iron, copper, zinc, selenium), most vitamins negatively affects the condition of blood vessels and the heart, and myocardial function.
Psycho-emotional stress. Acute stress is accompanied by the release of adrenaline, which increases the load on the heart, which can lead to myocardial infarction. Chronic stress is accompanied by increased levels of cortisol, which slows down the production of growth hormone. Deficiency of this hormone in adults indirectly provokes the development of CVD.
Excess body weight is usually a consequence of the influence of the factors listed above. Obesity is a favorable condition for the occurrence of thromboembolism, increases LDL levels, and creates additional stress on the heart and blood vessels.
Bad habits. Each episode of alcohol abuse leads to a decrease in the contractile function of the myocardium and impairs blood circulation. Tobacco smoking leads to increased blood pressure, provokes blood clots, the formation of atherosclerotic plaques, and increases the risk of arrhythmia.

Often one primary CVD leads to the development of another. Thus, atherosclerosis and arterial hypertension are the main causes of coronary heart disease, rheumatic carditis often leads to acquired defects, cardiac arrhythmias, and heart rhythm disturbances lead to thromboembolism of the arteries supplying blood to the limbs and internal organs.

Prevention of vascular diseases

Prevention of vascular diseases is the reduction or complete elimination of risk factors, as well as the normalization of blood flow.

This is mainly facilitated by a healthy lifestyle:

weight control;
avoiding hypothermia;
proper nutrition, which limits the total caloric content of food, as well as the content of salt and fat in it. With this diet, preference is given to fish, vegetables and vegetable oils;
to give up smoking;
limiting emotional overload and stress;
limiting prolonged standing;
timely treatment of hypertension and diabetes.

Symptoms of Cardiovascular Diseases

Diseases of the heart and blood vessels in the initial stages are often asymptomatic and can manifest acutely - manifestations of a heart attack or stroke. The debut (or exacerbation of chronic pathology) is often preceded by nervous shock, overwork, physical exertion, and overeating. Most heart pathologies are accompanied by heart failure.

Symptoms of heart disease:

Acute heart failure - cold sweat, sudden loss of strength, severe suffocation, cough with foam (a sign of pulmonary edema), cyanosis of the skin (cyanosis)
Chronic heart failure - fatigue, poor exercise tolerance, shortness of breath, suffocation, dry cough (sometimes hemoptysis), scanty urination, edema, ascites.
Myocardial infarction - acute chest pain radiating to the left shoulder, upper back, neck, chin (sometimes intense abdominal pain); shortness of breath, severe weakness, cold sweat; feeling of anxiety, fear of death.
Rheumatic carditis – increased sweating, fever, signs of heart failure.
Cardiac arrhythmia - palpitations, a feeling of “fading” of the heart, dizziness, fainting, manifestations of heart failure.

Signs of vascular pathologies:

Arterial hypertension - heaviness, pain, pulsation in the back of the head; lethargy, dizziness, tinnitus, nausea; sensation of “floaters” before the eyes.
Stroke - can begin gradually, with a weakening of muscle tone, numbness of certain areas of the face and limbs. Then lethargy and loss of sensitivity intensify to paresis, and the affected areas expand. Impairments in hearing, vision, speech, and coordination of movements may develop. General cerebral symptoms – nausea, vomiting, confusion, coma.
Chronic cerebrovascular accident - attacks (transient ischemic attacks) are accompanied by more pronounced signs of arterial hypertension, transient disturbances in speech, hearing, vision, memory, unsteadiness of gait, and fainting. Symptoms disappear within 24 hours.
Pathologies of peripheral arteries accompanied by ischemia (thromboembolism, thromboangiitis obliterans and atherosclerosis) - acute, unbearable pain, transient lameness, dry skin, change in its shade (at first pale, as it progresses - purple), the appearance of poorly healing ulcers.
Deep vein thrombosis - a feeling of bursting pain in the affected limb, swelling, cyanosis of the skin, visible vascular network.
PE – may combine signs of heart failure and stroke. Other symptoms are fever, pain in the right hypochondrium, skin rashes.

Acute CVD requires emergency medical care and intensive care. If you suspect these pathologies, you should immediately call an ambulance.

Palpitations

Palpitations can occur during intense physical activity, as a result of a person's emotional arousal, or due to overeating. But a strong heartbeat is very often an early warning sign of cardiovascular disease.

A strong heartbeat manifests itself as a feeling of disruption in the functioning of the heart; it seems that the heart is almost “jumping out” of the chest or freezing. Attacks may be accompanied by weakness, discomfort in the heart, and fainting.

Such symptoms may indicate tachycardia, angina pectoris, heart failure, or impaired blood supply to organs.

If you have at least one of the listed symptoms, it is important to immediately consult a doctor and undergo tests that will reveal the true cause of the ailment. One of the most effective methods of treating any disease is its early diagnosis and timely prevention.

Complications of CVD

According to WHO, cardiovascular pathologies are the main cause of death and often lead to disability. Death is not uncommon with large heart attacks and strokes, massive pulmonary embolism, heart failure complicated by pulmonary edema, and cardiogenic shock. A stroke can lead to a wide range of neurological disorders, and chronic cerebrovascular accident can lead to progressive cognitive impairment. Peripheral arterial pathologies are dangerous due to the development of gangrene with subsequent amputation of the limb (often at a young age). CVDs have a detrimental effect on the state of the reproductive sphere: impotence is often registered in men, and infertility and childlessness in women.

Diagnostics

The diagnosis of pathology of the heart or blood vessels is established based on the results of a clinical examination, a patient interview, and a number of instrumental and laboratory tests. The main instrumental methods used in the diagnosis of CVD:

Electrocardiography (ECG) is an electrophysiological method used in the diagnosis of arrhythmias and myocardial infarction. A variation is Holter monitoring, which allows you to take readings throughout the day using a portable device.
Echocardiography (EchoCG) is an ultrasound method of examining the heart that reveals both functional disorders and structural disorders (tumors, vegetations, defects, inflammation). It is also prescribed for suspected pulmonary embolism.
MRI, CT (magnetic resonance, computed tomography) of the brain - used in the diagnosis of strokes.
Ultrasound scanning and dopplerography of blood vessels - used in the diagnosis of chronic cerebrovascular accidents and peripheral vascular diseases.

Laboratory tests include:

In the diagnosis of inflammatory heart diseases - biochemical study of the protein spectrum, general blood test, bacterial blood culture.
In the diagnosis of atherosclerosis - a biochemical test for the level of cholesterol, LDL, triglycerides.
If any CVD is suspected, a coagulogram is performed.

Modern equipment allows diagnosis without invasive procedures.

Treatment

Depending on the type of pathology, treatment is carried out under the guidance of a cardiologist, neurologist, vascular surgeon, neurosurgeon, cardiac surgeon, phlebologist, rheumatologist. Emergency conditions require the help of a resuscitator. There are conservative and surgical methods for treating CVD.

Conservative methods include:

drug therapy – medications are prescribed depending on the diagnosis;
plasmapheresis, autohemotransfusion - in the treatment of rheumatic carditis;
thrombolysis – dissolution of a blood clot during arterial embolism;
physiotherapy – in the treatment of chronic cerebrovascular accidents, thromboangiitis obliterans.

Surgical methods for treating CVD:

thromboembolectomy – surgical removal of a blood clot in case of ineffectiveness or contraindications to thrombolysis;
thrombectomy – for deep vein thrombosis;
stenting of peripheral vessels and coronary arteries – for atherosclerosis,
heart valve replacement – for endocarditis;
stereotactic aspiration of hematoma – for hemorrhagic stroke.

Today, open surgical interventions are rarely performed; preference is given to vascular surgery - this contributes to the speedy recovery of the patient and minimization of postoperative complications. However, after treatment of severe CVD, patients most often require long-term rehabilitation.