Heart of heart: what you need to know

Heart of heart: what you need to know

I. Anatomy and Physiology of the heart: the basis of understanding

The heart is a complex muscle organ located in the chest, between the lungs and a little shifted to the left. Its main function is to pump blood throughout the body, providing organs and tissues with oxygen and nutrients. To understand how to maintain heart health, you must have a basic idea of its anatomy and physiology.

A. The structure of the heart:

• Heart chambers: The heart consists of four cameras: two atria (right and left) and two ventricles (right and left). Atrium receive blood from veins, and ventricles pump blood into arteries.

• Heart valves: Four valves regulate the flow of blood through the heart and prevent its reverse current:

  • Trickpidal valve: Located between the right atrium and the right ventricle.
  • Mitral valve (double): Located between the left atrium and the left ventricle.
  • Light valve: Located between the right ventricle and the pulmonary artery.
  • Aortic valve: Located between the left ventricle and aorta.

• Wall of the heart: The wall of the heart consists of three layers:

  • Andocards: The inner layer lining the heart chambers.
  • Myocardium: The middle, thickest layer consisting of the heart muscle and responsible for the contractions of the heart.
  • Epicard: The outer layer covering the heart.

• Pericardium: A bag surrounding the heart and containing a small amount of liquid to reduce friction during contractions.

• Coronary arteries: Blood vessels that supply the heart muscle with blood. They depart from the aorta and braid the heart.

B. Physiology of the heart: how the heart works:

• Cardiac cycle: The heart cycle consists of two phases: systole (contractions) and diastole (relaxation).

  • Systole: The ventricles contract, pushing blood into the aorta and the pulmonary artery. The atrium relaxes and filled with blood.
  • Diastola: The ventricles relax and are filled with blood from the atrial. The atrium is reduced to complete the filling of ventricles.

• Heart conductivity: The heart muscle is reduced in a certain sequence provided by the electrical system of the heart.

  • Sinus node: Located in the right at the atrium and is a “rhythm” of the heart, generating electrical impulses that launch the heart cycle.
  • Atrioventricular (AV) knot: Slow down electrical impulses, allowing atriums to be completely reduced before the reduction of ventricles.
  • A bundle of GISA and Purkinya fibers: Distribute electrical impulses through the ventricles, providing their synchronous contraction.

• Cardon output: The volume of blood thrown out by the heart in one minute. It depends on the frequency of heart contractions and the stroke volume (blood volume thrown out by the heart for one contraction).

• Regulation of the heart: The work of the heart is regulated by the nervous and endocrine systems.

  • Nervous system: The sympathetic nervous system increases the heart rate and the strength of contractions, and the parasympathetic nervous system (through the vagus nerve) reduces them.
  • Endocrine system: Hormones, such as adrenaline and norepinephrine, increase the heart rate and the strength of contractions.

II. Risk factors for cardiovascular diseases:

Cardiovascular diseases (SVD) are a group of diseases that affect the heart and blood vessels. Understanding the risk factors of the SVD is crucial for the prevention and early detection. These factors can be divided into modified (those that can be influenced) and non -modeled (those that cannot be influenced).

A. Modified risk factors:

• High blood pressure (hypertension): Increased blood pressure exerts an additional load on the heart and blood vessels, leading to their damage.

  • Optimal blood pressure: Less than 120/80 mm Hg. Art.
  • High blood pressure: 130/80 mm RT. Art. And above.
  • Hypertension factors: Unhealthy nutrition (high sodium content, low potassium content), overweight, insufficient physical activity, alcohol abuse, smoking, stress, some drugs.

• High blood cholesterol (hypercholesterolemia): The high level of “bad” cholesterol (LDL) can lead to the formation of plaques in the arteries, narrowing them and making it difficult to blood flow.

  • LDL (low density lipoproteins): “Bad” cholesterol that promotes the formation of plaques.
  • HDL (high density lipoproteins): “Good” cholesterol that helps remove the LDL from the arteries.
  • Triglycerides: Another type of fat in the blood, the high level of which also increases the risk of the CVD.
  • Factors contributing to hypercholesterolemia: Unhealthy nutrition (high content of saturated and trans fats), overweight, insufficient physical activity, smoking, genetic predisposition.

• Smoking: Smoking damages blood vessels, increases blood pressure, reduces the level of HDL and increases the risk of blood clots.

  • Nicotine: Causes narrowing of blood vessels and increases blood pressure.
  • Carbon monoxide: Reduces the amount of oxygen entering the heart.
  • Oxidizing stress: Damages cells of blood vessels.

• Diabetes: Diabetes damage the blood vessels and increases the risk of other risk factors of the SVD, such as hypertension and hypercholesterolemia.

  • Insulin resistance: The cells of the body do not respond properly to insulin, which leads to an increase in blood sugar.
  • Hyperglycemia: Increased blood sugar.
  • Damage to blood vessels: A high blood sugar level damages the walls of blood vessels.

• Obesity: Obesity is associated with an increased risk of hypertension, hypercholesterolemia, diabetes and other risk factors of the SSZ.

  • Body mass index (BMI): A measure used to assess weight in relation to growth.
    • Normal BMI: 18,5-24,9
    • Overweight: 25-29,9
    • Obesity: 30 and above
  • Viral fat: Fat accumulating in the abdominal cavity is especially dangerous for the health of the heart.

• Insufficient physical activity: Insufficient physical activity increases the risk of hypertension, hypercholesterolemia, diabetes and obesity.

  • Recommended physical activity: At least 150 minutes of moderate intensity or 75 minutes of high intensity per week.

• Unhealthy food: Unhealthy nutrition, rich in saturated and trans fats, sodium and sugar, increases the risk of hypertension, hypercholesterolemia, diabetes and obesity.

  • Saturated fats: Contained in red meat, dairy products with a high fat content and some vegetable oils (for example, coconut and palm).
  • Transjir’s: Contained in processed foods, such as fast food, pastries and margarine.
  • Sodium: Contained in processed foods, canned foods and fast food.
  • Added sugar: Contained in carbonated drinks, sweets and baking.

• Stress: Chronic stress can increase blood pressure and increase the risk of other Risk risk factors.

  • Cortisol: The stress hormone that can increase blood pressure and blood sugar.
  • Inflammation: Stress can cause inflammation in the body, which can damage the blood vessels.

• Alcohol abuse: Alcohol abuse can increase blood pressure, triglycerides and risk of heart failure.

  • Moderate alcohol consumption: For women – no more than one drink per day, for men – no more than two drinks per day.

B. Unmodified risk factors:

• Age: The risk of the SPA increases with age.
• Floor: Men, as a rule, have a higher risk of SVD than women to menopause.
• Family history: The presence of SVD in the family increases the risk of the development of the disease.
• Race/ethnicity: Some racial and ethnic groups, such as African -Americans, have a higher risk of SVD.
• Genetics: Some genetic factors can increase the risk of SVD.

III. Heart diseases: the main types and their features:

SSZ includes a wide range of diseases that affect the heart and blood vessels. Below are the main types of SSZ and their key characteristics.

A. Corny and heart disease (coronary heart):

• Cause: The narrowing of the coronary arteries due to atherosclerosis (the formation of plaques on the walls of arteries).
• Symptoms:
  • Stenocardia: Pain in the chest that occurs during physical activity or stress.
  • Dyspnea: Difficult breathing.
  • Fatigue: A feeling of fatigue and weakness.
  • Myocardial infarction (heart attack): It occurs with a complete or almost complete cessation of blood flow along the coronary artery, which leads to the death of the heart muscle.
    • Symptoms of myocardial infarction: Intensive chest pain, giving in the hand, shoulder, neck or jaw, shortness of breath, sweating, nausea, dizziness.
• Diagnosis:
  • Electrocardiogram (ECG): Recording electrical activity of the heart.
  • Blood test: Determination of the level of heart enzymes (troponin), which are released into the blood if the heart muscle is damaged.
  • Stress test: ECG carried out during physical activity to identify signs of ischemia.
  • Coronarography: X -ray examination of the coronary arteries using a contrast matter to detect narrowing.
• Treatment:
  • Medication: Nitrates (to expand the coronary arteries), beta-blockers (to reduce heart rate and blood pressure), ACE inhibitors (to reduce blood pressure), statins (to reduce cholesterol levels), anti-cargoes (to prevent blood clots).
  • Angioplasty: The procedure in which a spray can be introduced into the narrowed artery to expand it. Often a stent (metal grid) is installed to maintain the artery open.
  • Alcoronarnare shooting (USA): An operation in which a bypass is created for blood flow around the narrowed artery using the patient’s own blood vessels (usually from the leg or chest).

B. heart failure:

• Cause: The heart cannot pump blood enough to meet the needs of the body. IBS, hypertension, heart defects, cardiomyopathy can be caused.
• Symptoms:
  • Dyspnea: Especially with physical exertion or in a lying position.
  • Swelling: Swelling of the legs, ankles and abdomen.
  • Fatigue: A feeling of fatigue and weakness.
  • Cough: Especially at night.
  • Far heartbeat: Tachycardia.
• Diagnosis:
  • Echocardiography: An ultrasound examination of the heart, which allows to evaluate its structure and function.
  • Chest x -ray: To identify signs of fluid stagnation in the lungs.
  • Blood test: Determination of the level of the sodium -reuretic peptide (BNP), which increases with heart failure.
  • ECG: Recording electrical activity of the heart.
• Treatment:
  • Medication: ACE inhibitors, beta-blockers, diuretics (to remove excess fluid), digoxin (to improve the contractility of the heart).
  • Life change change: Restriction of salt and fluid consumption, regular physical activity (under the supervision of a doctor), refusal of smoking and alcohol.
  • Implantable devices: Cardiverter defibrillator (ICD) to prevent sudden death from arrhythmias, resinchronizing therapy (SRT) to improve the coordination of ventricular contractions.
  • Heart transplantation: In severe cases of heart failure.

C. Arrhythmias:

• Cause: Violations in the electrical system of the heart, leading to an irregular heartbeat.
• Types of arrhythmias:
  • Tachycardia: Far heartbeat (more than 100 beats per minute).
  • Bradycardia: Slow heartbeat (less than 60 beats per minute).
  • Atrial fibrillation (FP): The chaotic contraction of the atrial, leading to an irregular and often rapid heartbeat.
  • Gorgery fibrillation (FZ): The chaotic contraction of the ventricles, leading to cardiac arrest.
• Symptoms:
  • Heartbeat: A sensation of a rapid, irregular or strong heartbeat.
  • Dyspnea: Difficult breathing.
  • Dizziness: A feeling of dizziness or loss of consciousness.
  • Pain in the chest: Pain in the chest or discomfort.
  • Fainting: Loss of consciousness.
• Diagnosis:
  • ECG: Recording electrical activity of the heart.
  • Holter monitoring: Continuous ECG recording for 24-48 hours.
  • Echocardiography: An ultrasound examination of the heart, which allows to evaluate its structure and function.
  • Electrophysiological study (Efi): Invasive procedure that allows you to identify the source of arrhythmias and evaluate the effectiveness of various treatment methods.
• Treatment:
  • Medication: Antiarrhythmic drugs (to normalize heart rhythm), anticoagulants (to prevent blood clots during atrial fibrillation).
  • Cardioversion: Electric discharge to restore normal heart rhythm.
  • Ablation: A procedure in which heart cells that cause arrhythmia are destroyed.
  • Implantation Cardio stimulator: A device that regulates the heart rhythm with bradycardia.
  • Implantation cardioverter-defibrillator (ICD): A device that can restore a normal heart rhythm during ventricular fibrillation.

D. Frequencies of the heart:

• Cause: Congenital or acquired defects in the structure of the heart.
• Types of heart defects:
  • Congenital heart defects: Defects present at birth, such as a defect in the interventricular septum (DMZHP), a defect in the attendant partition (DMPP), the braid of the phallo.
  • Acquired heart defects: They develop throughout life, for example, rheumatic heart disease (caused by rheumatic fever), stenosis, or heart valves failure.
• Symptoms:
  • Dyspnea: Difficult breathing.
  • Fatigue: A feeling of fatigue and weakness.
  • Cyanosis: Blue skin and mucous membranes.
  • Noise in the heart: An abnormal sound heard in the auscultation of the heart.
  • Swelling: Swelling of the legs, ankles and abdomen.
• Diagnosis:
  • Echocardiography: An ultrasound examination of the heart, which allows to evaluate its structure and function.
  • ECG: Recording electrical activity of the heart.
  • Chest x -ray: To identify signs of an increase in the heart or stagnation of fluid in the lungs.
  • Catheterization of the heart: Invasive procedure that allows you to measure the pressure in the heart chambers and evaluate the valve function.
• Treatment:
  • Medication: To relieve symptoms and prevent complications.
  • Surgical treatment: To correct defects in the structure of the heart.
  • Cateter procedures: To close some heart defects without surgical intervention.

E. Cardiomyopathy:

• Cause: The disease of the heart muscle, leading to its thickening, stretching or deformation.
• Types of cardiomyopathy:
  • Dilatation cardiomyopathy: An increase in the size of the heart cameras and the weakening of the heart muscle.
  • Hypertrophic cardiomyopathy: Thickening of the heart muscle, especially the interventricular septum.
  • Restrictive cardiomyopathy: Reducing the elasticity of the heart muscle, which makes it difficult to fill the heart chambers with blood.
• Symptoms:
  • Dyspnea: Difficult breathing.
  • Fatigue: A feeling of fatigue and weakness.
  • Swelling: Swelling of the legs, ankles and abdomen.
  • Heartbeat: A sensation of a rapid, irregular or strong heartbeat.
  • Fainting: Loss of consciousness.
• Diagnosis:
  • Echocardiography: An ultrasound examination of the heart, which allows to evaluate its structure and function.
  • ECG: Recording electrical activity of the heart.
  • MRI of the heart: Magnetic resonance tomography of the heart, allowing you to obtain detailed images of the heart muscle.
  • Catheterization of the heart: Invasive procedure that allows you to measure the pressure in the heart chambers and evaluate the valve function.
• Treatment:
  • Medication: To relieve symptoms and prevent complications, such as heart failure and arrhythmias.
  • Implantable devices: Cardiverter-defibrillator (ICD) to prevent sudden death from arrhythmia.
  • Surgical treatment: In some cases, hypertrophic cardiomyopathy to remove part of the thickened heart muscle.
  • Heart transplantation: In severe cases of cardiomyopathy.

IV. Diagnosis of cardiovascular diseases: modern methods and their meaning:

Timely and accurate diagnostics is crucial for the effective treatment of SVD. There are many diagnostic methods that allow you to evaluate the structure and function of the heart, as well as identify risk factors.

A. Non -invasive diagnostic methods:

• Physical inspection: Includes the measurement of blood pressure, listening to the heart and lungs, the assessment of the pulse and the detection of edema.

• Electrocardiogram (ECG): Record of the electrical activity of the heart, which allows to identify arrhythmias, signs of ischemia and other disorders.

  • Standard ECG: Recording at rest.
  • Holter monitoring: Continuous ECG recording for 24-48 hours.
  • Event Monitor: ECG recording only in case of symptoms.

• Echocardiography: An ultrasound examination of the heart, which allows to evaluate its structure and function, including the size of the chambers, wall thickness, valves function and contractility of the heart muscle.

  • Transtorkary echocardiography: The ultrasonic sensor is placed on the chest.
  • Чрасийщетнаша рхокardiography: The ultrasonic sensor is inserted into the esophagus, which allows you to get more clear images of the heart.
  • Stress echocardiography: Echocardiography, conducted during physical activity or after the administration of a drug that imitates physical activity, to identify signs of ischemia.

• Stress test: Assessment of the function of the heart during physical exertion on the treadmill or bicycle ergometer. It can be carried out with an ECG or with visualization (for example, myocardial scintigraphy or stress echocardiography).

• Computed tomography (CT) of the heart: Uses x -rays to obtain detailed images of the heart and coronary arteries.

  • Calcium coronary arteries: It measures the amount of calcium in the coronary arteries, which is an indicator of atherosclerosis.
  • CT angiography of the coronary arteries: Uses a contrast matter to visualize the coronary arteries and detect narrowing.

• Magnetic resonance imaging (MRI) of the heart: Uses magnetic fields and radio waves to obtain detailed images of the heart and blood vessels. Allows you to evaluate the structure and function of the heart muscle, identify signs of inflammation and cicatricial tissue.

• Blood tests:

  • Lipid profile: Determination of cholesterol levels (LDL, HDL, total cholesterol) and triglycerides.
  • Blood glucose: Determination of blood sugar for diabetes.
  • Creatinin and urea: Assessment of kidney function.
  • Electrolytes (sodium, potassium, chlorine): Electrolyte balance assessment.
  • Troponin: The heart enzyme released into the blood if the heart muscle is damaged (used to diagnose myocardial infarction).
  • STRIURETIC PEPTIDE (BNP): The hormone released by the heart with heart failure.

B. Invasive diagnostic methods:

• Catheterization of the heart: The introduction of a thin catheter into a blood vessel (usually in a groin or on the arm) and its advancement to the heart. Allows you to measure the pressure in the heart chambers, evaluate the valve function and conduct coronarography.

• Coronarography: X -ray examination of the coronary arteries using a contrast matter to detect narrowing. It is often carried out during catheterization of the heart.

• Electrophysiological study (Efi): Invasive procedure that allows you to identify the source of arrhythmias and evaluate the effectiveness of various treatment methods.

• Myocardial biopsy: Taking a small sample of the heart muscle for research under a microscope. Used to diagnose cardiomyopathy, myocarditis and other heart diseases.

V. Treatment of cardiovascular diseases: modern approaches and their effectiveness:

Treatment of SVD depends on the type of disease, its severity and the general condition of the patient. There are many methods of treatment aimed at alleviating symptoms, slowing down the progression of the disease and preventing complications.

A. Drug treatment:

• Antihypertensive drugs: To reduce blood pressure.

  • Diuretics: Increase fluid elimination from the body.
  • ACE inhibitors: Block the production of angiotensin II, hormone, narrowing blood vessels.
  • Angiotensin II (sconces) receptor blockers: The action of angiotensin II on the receptors in blood vessels is blocked.
  • Beta blockers: Reduce heart rate and blood pressure.
  • Calcium channel blockers: Expansion blood vessels and reduce blood pressure.

• Drugs that reduce cholesterol levels:

  • Statin: Block cholesterol production in the liver.
  • Cholesterol absorption inhibitors: Reduce the absorption of cholesterol in the intestines.
  • Fibrates: Reduce the level of triglycerides.
  • Niacin: Increases the level of HDL and reduces the level of LDL and triglycerides.
  • PCSK9 inhibitors: They block protein, which reduces the amount of LDL receptors in the liver, which leads to a decrease in the level of LDL in the blood.

• Antiplans and anticoagulants: To prevent blood clots.

  • Aspirin: Antigant, which prevents platelet sticking.
  • Clopidogrel, Prausugrel, Tikagralor: Other anti -agents that more effectively block the function of platelets than aspirin.
  • Varfarin: The anticoagulant that blocks the production of blood coagulation factors in the liver.
  • New oral anticoagulants (PLA): Dabigatran, Rivaroxaban, Apixban, Edoxaban, which block certain blood coagulation factors.

• Preparations for the treatment of heart failure:

  • Diuretics: Increase fluid elimination from the body.
  • ACE inhibitors: Block the production of angiotensin II, hormone, narrowing blood vessels.
  • Angiotensin II (sconces) receptor blockers: The action of angiotensin II on the receptors in blood vessels is blocked.
  • Beta blockers: Reduce heart rate and blood pressure.
  • Antagonists of Aldosterone: The effect of aldosterone, hormone, which helps to retain salt and fluid in the body block.
  • SGLT2 inhibitors: The originally developed for the treatment of diabetes, these drugs also showed effectiveness in the treatment of heart failure.
  • Arnie (angiotensin receptor inhibitor and non -obscene): The combination of sakubitril and Valsartan, which blocks angiotensin II and enhances the effect of sodium -reuretic peptides.
  • Digoxin: Improves the contractility of the heart muscle.

• Antiarrhythmic drugs: To normalize the heart rhythm.

  • Beta blockers: Reduce heart rate and blood pressure.
  • Potassium channel blockers: Amiodarone, dronedaron, sotalol.
  • Sodium channel blockers: Flekainid, Propafenon.
  • Calcium channel blockers: Verapamil, diltiazem.

B. Interventional treatment methods:

• Angioplasty and stenting: Expansion of narrowed coronary arteries using a spray can and installation of a stent (metal mesh) to maintain an open artery.

• Ablation: The destruction of the cells of the heart causing arrhythmias using a catheter spent through a blood vessel to the heart.

• Implantation Cardio stimulator: A device that regulates the heart rhythm with bradycardia.

• Implantation cardioverter-defibrillator (ICD): A device that can restore a normal heart rhythm during ventricular fibrillation.

• Transcate implantation of the aortic valve (TAVI): Replacing the aortic valve through a catheter drawn through a blood vessel to the heart, without the need to conduct an open heart.

• Mitraklip: A device that holds the mitral valve wings to reduce regurgitation (blood reverse) with mitral deficiency.

C. Surgical treatment:

• Alcoronarnare shooting (USA): Creating a bypass for blood flow around the narrowed coronary artery using the patient’s own blood vessels (usually from the leg or chest).

• Replacing or restoration of heart valves: Surgical treatment of heart valves.

• Heart transplantation: Replacing a sick heart with a donor heart.

• Installation of auxiliary circulatory devices (LVAD): A mechanical device that helps the heart pump blood in severe heart failure.

VI. Prevention of cardiovascular diseases: the basis of a healthy lifestyle:

SSZ prevention is a key factor in reducing incidence and mortality. A healthy lifestyle plays a decisive role in preventing the development of SVD and improving the general state of health.

A. Healthy nutrition:

• Limiting the consumption of saturated and trans fats: Saturated fats are found in red meat, dairy products with a high fat content and some vegetable oils (for example, coconut and palm). Transfiders are contained in processed foods, such as fast food, pastries and margarine.
• Increased consumption of unsaturated fats: Unsaturated fats are contained in olive oil, avocados, nuts and seeds.
• Increase in fiber consumption: Fiber is found in fruits, vegetables, whole grain products and legumes.
• Sodium consumption restriction: Sodium is contained in processed foods, canned foods and fast food.
• Restriction of consumption of added sugar: Added sugar is contained in carbonated drinks, sweets and baking.
• Increase in potassium consumption: Potassium is found in fruits and vegetables, such as bananas, oranges, potatoes and spinach.

B. Regular physical activity:

• Recommended physical activity: At least 150 minutes of moderate intensity or 75 minutes of high intensity per week.
• Types of physical activity: Aerobic