Aging and disease cardiovascular system. Age changes of vessels. Prepare

Approximately 30 years in the heart and vessels begin irreversible changes associated with age. The older the person becomes, the more pronounced. After fifty, all systems are aging, which determines the nature of these processes and affects the adaptive properties of the body. The article will discuss what age changes occur in the heart and vessels.

Changes in vessels

People of old age, the morphological and anatomical structure of veins and arteries change.

Most of all transformations in large vascular trunks are observed:

• muscular layer is partially atrophy;
• elasticity decreases;
• intima is becoming sclerotic elements.

Such metamorphoses do not allow the blood vessels to narrow and expand to properly. This, in a complex with a change in nervous regulation (innervation from the CNS, is also weakened), changes the adaptation properties of hemocirculation.

Over time, the number of capillaries per unit of fabric area decreases, and the membrane walls are thicken, which reduces the transport processes and causes hypoxia.

Note. At first, age changes occur in large blood vessels, and then in small (peripheral). Transformations in pulmonary arteries are observed in people of older ages.

Blood circulation

As a rule, systolic pressure (subject to the absence of chronic diseases of the cardiovascular system) with age slightly increases. This is due to the reduction of the elasticity of large vessels and the increase in resistance in distant capillaries. At the same time, the internal volume of large arteries increases, which does not significantly increase blood pressure indicators.

These changes proceed slowly, and some individuals may have a genetic predisposition. However, they do not always lead to the development of diseases and may not have clinical manifestations, however, with a laboratory examination, deviations in hemodynamics are detected.

Such processes are natural. The functional cardiac reserve is gradually reduced, so older people are becoming harder to cope with physical exertion.

The activity of myocardium weakens, there are violations of its functioning and the development of pathologies, for example, heart failure.

Venous pressure

Since the tone of vessels weakens, elasticity is reduced and their diameter increases, the blood pressure in the veins gradually decreases. In old patients, doctors register the reduction in the minute volume of the heart, which is explained by the slowdown in the heart rate and the weakening of heart blows. This causes a decrease in blood ejection and redistribution of peripheral blood circulation.

Note. Despite the overall weakening of blood circulation in the brain and coronary vessels, even most people have pressure on an acceptable level, while it decreases in other internal organs, for example, in liver and kidneys.

Changes in the heart

The main component of myocardial cells is collagen. With age, its number in valves increases, but its quality changes - it becomes less soluble. It becomes the cause of its chemical stability, it becomes tougher, so the elasticity of the tissues is reduced.

When aging the human body in cells, lipofuscin is increasingly postponed around nuclear membranes and processes. With histological examination, this is noticeable in the form of yellow or brown formations. The older man, the greater the substance focuses into the tissue.

Approximately every year its number increases by 0.3% of the entire mass of the heart muscle. Doctors believe that this is obliged to products that are allocated during the elimination of cellular structures (EPS tanks, mitochondria and lysosomes).

Normally, this does not cause any pathological conditions, but with a reduction in cardiac mass and with increasing the number of lipofuscin, a state is developing, which is called brown atrophy.

Important. Often a reduction in cardiac mass is associated with the overall body exhaustion, which is typical of the elderly.

In addition to these processes, calcium deposits and fats are accumulated in the mobile zone of cardiac flaps, the mass of cells and the number of nuclear structures becomes less. This leads to the degeneration of aortic and mitral valves. According to medical statistics, 30% of older people (aged 70 years and older) suffering from heart disease is diagnosed with valve calcification.

In addition to these processes, many different age-related changes are observed that cause a decrease in the contractile ability of myocardium. This is primarily associated with morphological transformations that are combined into the general term "senile heart".

It is observed:

• reduction of adaptation abilities;
• musculature atrophy;
• an increase in the area of \u200b\u200bweaklyestic fabrics;
• reduction of energy generation in mitochondria;
• violation of transmembrane transport of mineral components.

Features of the reaction to physical exertion

Reducing cardiac activity is manifested in the inability to withstand significant physical exertion. First of all, this is the lack of oxygen, the development of ischemic processes and slow-down removal of carbon dioxide and muscle tissue metabolites. The older the person becomes, the more significant the hypertensive response to physical work is expressed, and peripheral vascular resistance in this case undergoes minor changes.

The elderly falls the contractile ability of the heart, the increase in shock volume is reduced, the nervous and endocrine regulation of myocardial activity changes. All this significantly slows down the restoration of the body after exercise, so to prevent complications of the health status of the doctors recommend dosing to play sports or hard work, and if possible, completely abandon the exhaustive physical work.

In addition to these internal natural reasons, the work of the heart in the elderly, other influences indicated in the table are negatively affected.

Table. Indirect factors affecting the work of the cardiovascular system:

To a large extent, they limit their adaptive capabilities and create prerequisites for the development of diseases.

Changes in vessels

The structure of the vascular wall changes with age in every person. Muscular layer of each vessel is gradually atrophized, its elasticity is lost, sclerotic seals of the inner wall appear. It strongly limits the ability of vessels to expand and narrowing, which is already pathology.

First of all, large arterial trunks suffer, especially Aorta. In the elderly and old people, the number of operating capillaries per unit area is significantly reduced. Fabrics and organs cease to receive the amount of nutrients and oxygen they need, and this leads to their starvation and the development of various diseases.

Features of hemodynamics in old age

With age, in the loss of large vessels of elasticity and increasing the peripheral resistance of small vessels, increases (especially systolic). Venous is reduced. This is due to the weakening of the tone, a decrease in the elasticity of venous walls, which leads to the expansion of the total lumen of the venous bed.

In the elderly and old age, the magnitude of the minute volume of the heart decreases (minute volume - the amount of blood emitted by the heart in one minute). This decrease is mainly due to the gentle of heart rate and decrease in the impact volume of the heart. Since with age, the main exchange falls, then the reduction of the minute volume of the heart can be considered as a regularization of the body to reduce the need of tissues in oxygen.

In the elderly and old people against the backdrop of reduced heart emissions, an active redistribution of regional circulation is observed. In this case, the brain and coronary blood circulation almost does not change, and the renal and liver is significantly reduced.

Such a restructuring of the hemodynamic system partially compensates for an increase in energy consumption in the operation of the heart under conditions of increasing the resistance of the heart-related emission associated with an increase in peripheral vascular resistance.

Reducing the contractile ability of the heart muscle

The older the person becomes, the greater the amount of muscle fibers of the heart muscle atrophy. The so-called "senile heart" develops. There is a progressive sclerosis of myocardium, and on the site of atrophied muscular fibers of cardiac tissue develops fibers of non-working connective tissue. The power of heart abbreviations gradually decreases, an increasingly increasing violation of metabolic processes occurs, which creates conditions for the energy-dynamic insufficiency of the heart in conditions of hard activities,

As a result of all the above processes with age, the physical performance of the heart falls. This leads to a limit range of the ability of the body and to reduce the effectiveness of its work.

On the subject of Articles:

Find something interesting:

1. Introduction ________________________________________ 2.

2. Age changes in the SCC in the elderly .__________ 3

3. The role of nurses in the organization of treatment and care

per patients with elderly rheumatism _____ 9

4. Before the nursing process __________________________ 12

5. Literature ___________________________________________ 24.

Introduction

Old age is an inevitable and legitarious stage of the development of the body, one of the periods of its ontogenesis, the same legitimate and inevitable stage of the development of the body, like childhood, youth and maturity, and the disease - a violation of normal life, coming at any age under the influence of harmful factors of external and internal medium. The aging is a long biological process developing long before the appearance of external signs.

Developing as the disease agrees can cause significant changes in the body and change the course of the natural, physiological process. An atherosclerosis has a particularly significant impact on the health and intensity of age-related changes. It is known that there is a lipid deposition in the inner shell of the arteries with the subsequent development of the connective tissue and a decrease in their elasticity, the thickening of the vessel wall, a decrease in its lumen, the occurrence of thromboms. All this leads to circulatory disorder, oxygen starvation of fabrics, violation of metabolic processes. Research recent years have shown that the damage to the vascular wall during atherosclerosis occurs due to complex disorders, both protein-lipid metabolism and neurohumoral regulation and the permeability of the arteries.

Most scientists consider atherosclerosis as a disease that acquires a particularly intense current in a certain age period. At the same time, it is known that age changes are a prerequisite for the development of this pathology. According to A. L. Myasnikova, the age factor naturally changes not only the structure, but also the chemical composition of arterial walls and should be considered as an important condition that promotes the development of atherosclerosis.

It has been established that in the process of aging the body decreases the intensity of oxidative processes in organs and tissues, as well as the functional activity of the range of the internal secretion glands and the hypothalamus, there is a restructuring of the regulation of functions and metabolism. All this undoubtedly affects the development and manifestation of coronary heart disease in people of senior age groups. Therefore, the abuse of age-related changes and interrelations of them with atherosclerotic changes can lead a doctor to improper conclusions when analyzing and interpretation of research results.

Age changes in blood circulation system in old age.

In old age, the heart muscle becomes a flabby. As a result of the loss of elasticity and stretching muscle fibers, the right ventricle and especially its withdrawal cone in old age expands, usually even forming the absorption at the top of the heart. The mouths of hollow veins are also significantly expanding. Entrance to the left ear is expanded. With age, the slope of both hollow veins flowing into the right atria. The structure of the heart varies with age. Endocardia and heart valves change. From the loose shell, endockard turns into a relatively dense. Heart valves from gentle become dense due to fibrous tissue. The thickening (irregularities) are smoothed on their edges, one remains in the semi-luncture. Valve's sash, at first having obscure outlines, acquire a clearer differentiated character. Folding in atrial and ventricular valves become clearly dedicated, additives gradually stand out.

The size of the heart and its weight decreases, but due to the general atrophy of the muscles of the body, the weight of the heart may not fall. Muscular fibers are shortened and drown. They can be degenerated. There is a progressive development and carrying of connective tissue, which has been susceptible to degenerative processes since 60 years: thickening of collagen fibers, loss of their structure and, finally, hyalineization with the subsequent decay. Degenerative changes are observed in old age and in elastic tissue. Heart aging processes are negative in the state of its coronary arteries, which impairs and disrupts the nutrition of its muscles (sclerotic phenomena). Negative phenomena are also observed and in the state of its lymphatic vessels. The usual age-related vessel arteriosclerosis is mostly sclerosis and the hyalineization of the inner shell with the transition to pathology.

Changes in vessels.

The structure of the vascular wall changes with age in every person. The muscular layer of each vessel is gradually atrophized, its elasticity is lost, and sclerotic seals of the inner wall appear. It strongly limits the ability of vessels to expand and narrowing, which is already pathology. First of all, large arterial trunks suffer, especially Aorta. In the elderly and old people, the number of operating capillaries per unit area is significantly reduced. Fabrics and organs cease to receive the amount of nutrients and oxygen they need, and this leads to their starvation and the development of various diseases.

With the age of each person, the minor vessels are increasingly "clocked" with lime deposits, and peripheral vascular resistance increases. This leads to a certain increase in blood pressure. Venous pressure is reduced. The frequency of heart abbreviations is increasing. But the development of hypertension is largely preventing the fact that with a decrease in the tone of the muscular wall of large vessels expands the clearance of the venous bed. This leads to a decrease in the minute volume of the heart (minute volume - the amount of blood emitted by the heart in one minute) and to the active redistribution of peripheral blood circulation. Coronary and heart rate blood circulation usually almost does not suffer from a decrease in the minute volume of the heart, while the renal and hepatic blood circulation is much reduced.

Reducing the contractile ability of the heart muscle .

The older the person becomes, the greater the amount of muscle fibers of the heart muscle atrophy. The so-called "senior heart" develops. There is a progressive sclerosis of myocardium, and on the site of atrophied muscular fibers of cardiac tissue develops fibers of non-working connective tissue. The power of heart abbreviations is gradually decreasing, an increasingly increasing violation of exchange processes occurs, which creates conditions for the energy-dynamic insufficiency of the heart in conditions of hard activities. The threshold of the influence of the sympathetic nervous system on the contractile ability of myocardium increases, there is a decrease in the inotropic effect of catecholamines. Reduce the process of repolarization processes in myocardium (the amplitude of the teeth T per ECG, in I, II, A VI, V3- V6 is positive, and the segment is on the insulation). The depolarization process changes: the QRS complex is expanding, but does not exceed 1 second. The electric axis of the heart deviates to the left. Extlifies electrical systole hearts. The conditions for the spread of excitation in the atria are worsening. Atrioventricular conductivity and the distribution of excitation on the myocardial of ventricles are slowed down. It is characterized by the correct sinus rhythm. There is a thickening of aortic and mitral flaps with progressive degenerative calcification of both valves. The content of interstitial collagen increases. There is a moderate increase in the internal systolic and diastolic diameter of the left ventricle

Neurohumoral regulation

In addition, conditional and unconditional blood circulation regulation reflexes weakened in old age, the inertia of vascular reactions is increasing. Studies have shown that when aging, influences on the cardiovascular system of various brain structures change. In turn, feedback changes: reflexes that are weakened from baroreceptors of large vessels. This leads to a violation of blood pressure regulation.

As a result of all the above processes with age, the physical performance of the heart falls. This leads to a limit range of the ability of the body and to reduce the effectiveness of its work. Under the influence of catecholamines, violations of the rhythm occur, the energy of myocardium suffers. Weakened influence of a wandering nerve on the heart; This is largely due to destructive changes in the nervous apparatus and shifts in the synthesis of acetylcholine. The effective concentration of anabolic type hormones (insulin, sex hormones) is reduced, which contributes to the development of insufficiency to ensure the function of the reduction of myocardium. With age, the sensitivity of the body is growing to vasopressin, other hormonal substances, in particular angiotensule and histamine. Thus, in the regulation of the cardiovascular system with age weakens the role of nervous mechanisms and increases the significance of humoral.

Shifts on the electrocardiogram movement left in 80% of the people of senior age groups.

The emergence of ectopic foci of excitation in old age contributes to the appearance of violated metabolism in the myocardium of foci of violated metabolism, improving the sensitivity of the heart to a row of humoral factors and primarily to catecholaminams. Many researchers are celebrated in old people flickering arrhythmia detected in 22% of cases. It is emphasized that the antodims prevailing the bradyricultural form of arrhythmia. Violation of Rhythm P. Lisap and Cecclech consider usual phenomenon for such people. With this opinion, it is unlikely to agree. In the surveyed practically healthy elderly people without expressed manifestations of the coronary atherosclerosis, the fliccity arrhythmia was not observed, single ventricular extrasystoles were sometimes recorded.

The old people are characterized by a slowdown in the conductivity of the Gisa beam and its legs, elongation of electrical systole. According to a number of scientists, V. D. Mikhailova-Lukashova, V.M. Yakovlev noted the negative teeth of T in 60% of patients. When studying electrocardiograms in the dynamics, it was established that as the body agrees the number of changes increases. As can be seen from the given data, with age there is a significant violation of the ECG. This should determine in a certain way to affect the development and degree of severity of shifts under different forms of ischemic heart disease.

Functional shifts in myocardium

Currently, most researchers converge on the fact that as the body agrees the number of modified balleriograms increases. According to V. Dock and co-authors, with age, functional shifts in myocardium, detected using the balleriography method, increase from 20% to 40 - 45% at 60s. A number of authors indicate that people over 60 years old only in 20% of cases the shape of the cardiogram corresponded to that of young people. E. Bellini change revealed from 90% of patients over 60 years old. Also noted the decrease in the amplitude of the wave j, the strengthening of respiratory oscillations, the increase in the wave L, an increase in the degree of changes in Brown. The magnitude of the IJ segment of the balleriogram reflects primarily the severity of age-related changes in myocardium.

Thus, the given data show that significant changes in the cardiogram occur with age. Among the many reasons that cause it, the elder changes in the heart and reduction of its contractile ability are dominated. When evaluating a contractile capacity by polycardiography, a change in the phase structure of the left ventricle is noted. In the elderly, there is a violation of individual phases and periods of systole hearts, which is due to the change in hemodynamics and the functional state of the heart muscle. So, according to I. N. Bronovts, the voltage phase in people 20- 29 years is 0.0825 seconds, and in persons 60 years and older - 0.104 seconds. Similar shifts in the voltage phase revealed other authors. The noted features are explained by the development of myocardium as diffuse dystrophic and sclerotic disorders aging. According to some researchers, the period of expulsion, the coefficient of the Blumberger and the internal systolic indicator, and the other practically healthy people have found the elongation of the expulsion period, decrease with age.

On the phonocardiogram, old people have a decrease in the amplitude of the I tone in the top of the heart of the heart and an increase in the second tone - over the aorta. The ratio between I and II tone on the top is 1 to 1, while the young it has 2 to 1 or 2.5 to 1. The cause of the decline is due to two factors. First, the dilatation of the left ventricle as a result of a decrease in myocardial tone, which leads to relative deficiency of the mitral valve. As a result, the valve component gradually loses its value. Secondly, the developing age-related myofibrosis reduces the muscular component participation in the formation of I Tone.

The role of nurses in the organization of treatment and care for patients with elderly rheumatism

Rheumatism- infectious-allergic disease, affecting the cordial and vascular system (endocardium, myocardium, less often pericardium) and large joints. As a result, deformations of the valve apparatus of the heart are developing and heart disease is formed. The damage to the joints (mostly large) is rarely observed, only in the active phase of the disease, and when it is eliminated, the deformation of the joints does not remain.

Treatment of rheumatism: old age - in joy!

Rheumatism refers to the type of diseases that we are shy about to speak. We are associated by a non-illegament with "old age," with a rat rocking chair, with elder grinding. We accustomed to believe that rheumatism is the death of people's elderly, which, discovering the disease in themselves, we automatically turn into the ruins.

This is not true.

For successful cure from any ailment, it is important to treat him as a problem that can be solved, and not as an indisputable verdict. Rheumatism can touch everyone: there is nothing to be shy here, it's not worth it and upset. Must be treated.

Forecast

· for life - satisfactory,

· for recovery - doubtful,

· for ability to work - determines the type of heart defect and the development of blood circulation deficiency.

Medical rehabilitation activities.

Treatment of rheumatism is carried out in three stages:

1) treatment of the active phase in the hospital;

2) continuation of treatment after discharge from the hospital in the clinic;

3) Perennial dispensary observation and prophylactic treatment in the clinic.

Indications for hospitalization:

· primary formed diagnosis or suspicion of rheumatism;

· the activity of the process among previously observed patients;

· decompensation of heart defects;

· attachment of secondary infection (pneumonia, septic endocarditis, etc.).

Medical measures include etiological and pathogenetic (Suppression of immune inflammation, correction of immunological disorders) treatment.

Diet.

The diet is recommended to limit the table salt (up to 3-4 g per day) and partly carbohydrates, increasing the amount of protein. It is important to observe the drinking mode: liquids are not more than 1.5 liters per day, and with pronounced heart failure, the reception of the liquid should be limited to 1 liter.

Mode.

Patients with an active rheumatic process are subject to hospitalization. The chamber must be warm, ventilating must. In the first 7 - 10 days of the disease, the patient must observe semiating Mode (physiological shipments are allowed outside the bed). However, in the presence of high activity of the pathological process should be observed bedmode to reduce the load on the cardiovascular system.

Medical rehabilitation.

For The above testimony is carried out in the hospital using the etiological (antibiotic penicillin row), pathogenetic (NSAID) and symptomatic therapy.

In the active phase, with the aim of suppressing streptococcal infection, antibiotic therapy is prescribed. Preference is given to Penicillin or semi-synthetic penicillins (ampicillin, oxacillin), appointed in medium therapeutic doses, intramuscularly, duration up to 10 - 12 days. In parallel, non-steroidal anti-inflammatory drugs of various groups are prescribed: salicylates (Aspirin3 - 4 g / day with a gradual decrease in the dose to 2 g by course to 6-8 weeks), indomethacin of 0.025 g - 3 times a day, up to 4-5 weeks, voltar, etc. with rheumatur, flowing hard as well as In the absence of the effect of the appointed therapy, prednisolone is used, starting with 20-30 mg / day, followed by a decrease in the dose and cancellation of the drug (for 3-4 weeks). Hinoline preparations are used: delagil at 0.25 g / day or plated 0.2 g / day for 3 to 4 months to treat protracted forms of the disease. Traditional is the purpose of antihistamine drugs, ascorbic acidand other vitamins, drugs potassium, Riboxin.

When discharge from the hospital, the treatment course continues for 1-2 months (taking into account the activity of the process and clinical manifestations).

In the presence of a heart defect, symptomatic therapy is carried out, taking into account the clinical manifestations of rheumatism: vitamins, heart glycosides, diuretic drugs, antiarrhythmic drugs, etc.

In the development of blood circulation deficiency, appropriate therapy is carried out.

Physical rehabilitation methods.

Physiotherapy is used to influence pathogenetic mechanisms of the disease:

· inflammatory process,

· immune pathology

· disrupted cardiohymeodynamics.

An important task of applying natural and artificial physical factors is the body's training in various kinds of influences capable of increasing the course of the disease (temperature, physical and other factors), as well as stimulating non-specific reactivity to prevent the recurrence of the disease.

Tactics of treatment determine:

· severity of the inflammatory process (degree of activity),

· the character of the valve heart damage,

· blood circulation deficiency stage

· heart rhythm disturbances

· the presence of lesions of other organs and systems - joints and embracing tissues, nervous system, lungs, kidney, etc.,

· the presence of chronic infection foci,

· related diseases.

In the acute stage of rheumatism, along with medication therapy, which is the main type of treatment, some types of physiotherapeutic effects can be applied.

With protracted pains in the joints in the active and inactive phase, it can be applied:

1. ultraviolet;

2. electrophoresis of drugs;

3. warming up a Soluxe lamp or infrared lamp;

4. UHF;

5. paraffin applications.

6. Balnetotherapy

Physiotherapy.

LFC is shown almost to all sore rheumatism (with the exception of NKII. B art. - only respiratory gymnastics with infamited breathing andIII Art.). In other cases, the morning hygienic and therapeutic gymnastics is carried out to 20 minutes in the standing position, dosage walking, exercises with a load at small and medium mobility.

Socio-labor rehabilitation.

The ability of patients is set to

· the duration of the active process of the disease,

· presence of heart failure

· arrhythmias

· circulatory failure

· professions of the patient.

Regardless of the type of vice and its compensation, the patient is contraindicated with operation in conditions of high or low temperature, high humidity, in drafts, in a night shift, with significant neuropsychic and physical tension.

With I. Art. the activity of the process and the latent course of the disease (with the liquidation of exacerbation) without the presence of defects, patients of mental labor are able-bodied; Patients of physical labor - with restriction: Night shifts, long-term business trips are contraindicated, heavy physical work, etc.

With the definition of the heart of the 1st category of persons - able-bodied, patients of physical labor are subject to employment or can be directed to VTEK, where a disability group may be given to the degree of insufficiency of blood circulation (more oftenIii).

In the activity of the inflammatory processII or III Art. The hospital sheet is issued for the whole time of treatment, and the question of working capacity is determined by the degree of severity of the heart pathology.

In case of insufficiency of blood circulationII. A st. Patients of physical work are disabled by the main profession, while the translation into easier work is possible; Patients of intellectual labor is possible to continue when creating lightweight conditions. In case of insufficiency of blood circulationII. B art. All patients are subject to a guide on VTEK, where they are prescribed independently of the profession.II. A group of disability.

With an inactive rheumatic process, the question of working capacity is solved with all the time listed above.

Conduct operational treatment of heart defect is an indication for the Direction on VTEC -II. A group of disability during the year followed by sampling.

Spa treatment.

In the transition of the disease to the inactive phase, a rehabilitation period is possible in local cardiological sanatoriums (after 2-3 months after an active process is element). Patients with NK not higher can be sent to climatic and balneological resortsI. Art. Sanatorium-resort treatment is not shown at the NKII B and III Art.

Prevention.

Primary prevention of rheumatism:

· maintaining a healthy lifestyle (in children and adults);

· mandatory sanitation of chronic foci of infection;

· full-fledged timely treatment of acute and chronic nasopharynx diseases;

· common hardening.

Secondary prevention and dispensarization.

With primary rheumatar for 3 years - monthly bicyllinotherapy (Bicyllin-5 to 1.5 million units); In the next 2 years - in spring and autumn.

In the absence of heart defect and the activity of the process, during the whole of this time, the patient can be removed from the "d" of accounting or translated into another dispensary group - persons with risk factors.

If there is a vice of the heart - "D" accounting lifelong with seasonal preventive courses of treatment in the spring and autumn period: Bicyllin-5 to 1.5 million unioned or Bicyllin-3 to 600 thousand foods 1 time per week, on the course - 4 injections.

With the intolerance of the antibiotics of the penicillin row, the NSAIDs (methindol, indomethacin, nimesulide, etc.) can be used in the generally accepted dosages of 3 to 4 weeks.

Also, taking into account the clinical manifestations of rheumatism, symptomatic treatment is possible: vitamins, heart glycosides, diuretic drugs, antiarrhythmic drugs, etc.

When the secondary infection is attached (influenza, ORVI, etc.) must be carried out. currentprevention - antibiotics of penicillin row (penicillin, ampicillin, etc.) in generally accepted doses for 10 days.

When progressing the vice shows the consultation of the cardiac surgeon.

Prevention of rheumatism Bicyllin should continue during pregnancy. Specific recommendations on rheumatism prevention are negotiated in special orders for the Ministry of Health, which should be in medical institutions.

Task on the nursing process .

Oleg Nikolayevich Pickkulkuznetsov, turned with complaints of navel pain in the epigastric area after eating, heartburn, weakness, fast fatigue. From the anamnesis it is known that his ulcer is already like 6-7 years. The aggravation usually happens in spring and autumn. For medical help insisted to apply daughter. Lives one, for a long time worried the death of his wife. It feeds when what will cook (replaces the dinner with a conventional sandwich tea, loves salted cucumbers, adzhika), smokes 1 pack a day, as it turned out an amateur to eat alcoholic beverages. He doesn't worry about his health and does not worry, treats calmly to treatment. Objectively: The condition is satisfactory, the patient has removable dentures (which he carefully monitors, as the money has been copied for a long time). The position of the patient is active, walking tenting (walks with the key. There are no rheumatoid arthritis of the knee joints. Height 167 cm. Weight 65 kg, Tel 36.7 s, Skin Covers Pale, Dry, Language is covered with a white bloom, the belly moderately painful in the epigastric Areas. Pulse 70 per minute, satisfactory qualities, AD 150/90 mm.R.T.T. Chdd 18 per minute. Chair unstable with a tendency to constipate. Urination is normal, painless. Above the entire surface of the chest is listened to vesicular breathing, there are changes in voting trembling.When the belly palpation, during exacerbation, it is often possible to identify local pain in the epigastric region, often in combination with moderate muscle resistance of the anterior abdominal wallPercusserly there is also a limited disease zone. Sensity can be noted on the left or right of the spine when pressing it in the field of X thoracic, I lumbar vertebrae.

Revealed syndromes : pain syndrome (pain in the epigastric area)

Nursing process

Contribute to the development of the disease and its exacerbation:

1. Long-term self-propulsively emotional

overvoltage (stress);

2. Genetic predisposition, incentive

the increase in the acidity of gastrointestinal symbol

character;

3. Predastent state: pre-rope,

duodenitis, functional records

duodenal intestine hypersthenic type;

4. Violation of the power mode;

5. Smoking;

6. Consolidated alcoholic projects, some

medical means (aspirin, butadion, indomethacin).

Medical sister also finds the following information :

1. Family history (genetic predisposition);

2. DVIRONICACOLOGICALLATIONS (chronic grustite,

duodenitis);

3. Environmental data (stressing, character

patient works);

4. Distributed Specials (Smoking, Use

alcoholic beverages);

5. ConsumeriatedmedInacomouscies

(acetylsalicylic acid, butadion, indomethacin);

6. Patient nutrition data (incorrect power).

Identify violations of vital needs: there is, relax, have vitality, be healthy, allocate, safe

2 stage of the nursing process

Identify the patient's nursing problems.

True problems : pain in the epigastric area, heartburn, weakness, knowledge deficit about their disease, fatigue,deficiency of knowledge about nutritional features (abusely polyesolene, acute food, power impairment); Smoking, misunderstanding of the need to change your lifestyle, ignorance of complications of ulcerative disease.

Priority problems 1 order: pain in the epigastric area

Priorities2 order: heartburn

Potential problems : gastric bleeding, penetration, perforation, stenosis of the pyloric department, malignation

3 Stage of the nursing process

Problem: pain in the epigastric area

Problem: heartburn

Problem: Weakness

Age changes in vessels and heart largely limit their adaptive capabilities and create prerequisites for the development of diseases.

Changes in vessels

The structure of the vascular wall changes with age in every person. The muscular layer of each vessel is gradually atrophized, its elasticity is lost and sclerotic seals of the inner wall appear. It strongly limits the ability of vessels to expand and narrowing, which is already pathology. First of all, large arterial trunks suffer, especially Aorta. In the elderly and old people, the number of operating capillaries per unit area is significantly reduced. Fabrics and organs cease to receive the amount of nutrients and oxygen they need, and this leads to their starvation and the development of various diseases.

With the age of each person, small vessels are increasingly "clocked" with lime deposits, and peripheral vascular resistance increases. This leads to a certain increase in blood pressure.

But the development of hypertension is largely preventing the fact that with a decrease in the tone of the muscular wall of large vessels expands the clearance of the venous bed. This leads to a decrease in the minute volume of the heart (minute volume - the amount of blood emitted by the heart in one minute) and to the active redistribution of peripheral blood circulation. Coronary and heart rate blood circulation usually almost does not suffer from a decrease in the minute volume of the heart, while the renal and hepatic blood circulation is much reduced.

Reducing the contractile ability of the heart muscle

The older the person becomes, the greater the amount of muscle fibers of the heart muscle atrophy. The so-called "senior heart" develops. There is a progressive sclerosis of myocardium, and on the site of atrophied muscular fibers of cardiac tissue develops fibers of non-working connective tissue. The power of heart abbreviations is gradually decreasing, an increasingly increasing violation of exchange processes occurs, which creates conditions for the energy-dynamic insufficiency of the heart in conditions of hard activities.

In addition, conditional and unconditional blood circulation regulation reflexes weakened in old age, the inertia of vascular reactions is increasing. Studies have shown that when aging, influences on the cardiovascular system of various brain structures change. In turn, feedback changes: reflexes that are weakened from baroreceptors of large vessels. This leads to a violation of blood pressure regulation.

As a result of all the above processes with age, the physical performance of the heart falls. This leads to a limit range of the ability of the body and to reduce the effectiveness of its work.

Food and Cardiovascular Diseases

In medicine there is a wonderful saying: "A man will make his grave with his teeth." The meaning of this saying is that the improper nutrition of the overwhelming part of the population leads to the development of most human diseases and to premature aging.

All systems and organs are important in the human body, but only with a well-coordinated system of their work, you can talk about health. Each cell of our body invisible threads is closely related to millions of other cell cells, and the work of other cells depends on how it works. But any cell remains alive until it occurs in the processes of assimilation (assimilation, nutrition) and dissimulation (slag removal). Similarly, the normal functioning of each cell depends on good nutrition and timely cleansing. If the power of the cell is broken, its functions are disturbed. If the power of the cell group is disturbed, it means that the activity of the organ or system is violated.

In a calm state, a person for normal life is required from 1500 to 2000 kokalorius per day. When performing physical or mental work, the number of cyloalories should be increased to 3-4 thousand. A person receives these kilocaloria (or energy) when combustion in its body of proteins, fats and carbohydrates. The most powerful are fats, which, during combustion, give as much energy as proteins and carbohydrates combined.

With the opening of children who died from various diseases, it was revealed that all children without exception (100 percent) in the vessels there were already sclerotic changes. What does it say about? First of all, incorrect meals from early childhood. Loving parents, grandmothers and grandparents, relatives and acquaintances tried from childhood to stuff a child, then a cake, then ice cream, then snickers or chocolate.

And the children grow rapidly, quickly fully and gain an excessive mass, which leads to excessive fat sediments and violations in the work of the cardiovascular system. With age, fat deposits in tissues and muscles grow, the amount of cholesterol in the blood increases - the phenomena of early atherosclerosis increase. And it is not surprising that coronary vessels are often revealed already at 20 years of age.

Many full people say that their fullness is "hereditary." But it does not happen. The hereditary is not full of completeness, but an increment. If there are 5-6 times a day in the family, without any system and order, if the father, mother and grandmother are constantly abused by greasy dishes, then the children will go along their footsteps. There were parents with full of people, their children will be the same. Here you and heredity!

Our distant ancestors could limit themselves in food, they moved more and worked. Therefore, an ancient physicians have hardly heard about early atherosclerosis.

A few words about posts. The benefits of posts said in the Bible. Previously, our grandparents very accurately followed the biblical covenants and fasted almost weekly.

And the great post, great cleansing from all winter overs, how much benefit it brought people to people! Currently, people have forgotten about posts and joined overeating. This is one of the important reasons for the early appearance of atherosclerosis and ischemic heart disease.

An important drawback of modern nutrition is its monotony. What is mainly a city inhabitant? It is meat, boiled and fried, canned food, bread, sweet baking, sugar, animal fats, potatoes. Fruits and vegetables are standing on one of the last places. But this is exactly what is not done!

How does official medicine advise to eat a modern man?

A.A. Pokrovsky and co-authors group recommend limiting food caloric content due to carbohydrates that are well and quickly absorbed, and cholesterol animals rich in cholesterol. They recommend limiting the diet to the cook salt, butter, margarine, eliminate foods rich in cholesterol (smoked, fat, canned meat, etc.). Animal oils are recommended to replace vegetable oils. In the diet of each person there must be a sufficient number of berries, vegetables, fruits. Food should be fractional (5-6 times a day and gradually). An unloading day is required once a week.

With hypertension, atherosclerosis and ischemic heart disease are not recommended and even prohibited the following products: strong meat broths, fats (beef, pork, barbies), internal organs of animals, caviar, brains, fat.

From sweet dishes It is necessary to exclude: various creams, cakes, sdobu.

Sickle, sharp and sour dishes, smoked, herring are generally contraindicated by sick people and are not recommended healthy.

Cocoa, coffee, chocolate, sugar, alcoholic beverages, beer, ice cream - all these foods will not bring you anything other than trouble. These troubles and health problems will be found not immediately, but with age.

Patients with hypertensive disease and atherosclerosis with chronic heart failure are recommended products with high potassium content: drong, currants, dried grapes, uryuk, prunes, bananas, apricots, parsley sealer, celery, dill (especially dill seed). In this case, it is necessary to dramatically limit the intake of salt, salty and smoked dishes, limit the amount of liquid from the drink.

Ancient Medicine on Cardiovascular Diseases

Monastic recipes

- Prepare a collection:

Valerian root

Grass etars

Flowers lavender

Fennel Fruits

Podmin fruits

Total take on 3 tablespoons, crushing, mix. 1 tablespoon collection to pour a glass of boiling water, insist 1 hour, strain. Drinking 1 tablespoon three times a day before eating at heartbeat and heart neurosis.

- Prepare a collection:

Arnica Rhinestone Flowers -20

Flowers elderberry black -20 g

Rosemary leaves -30 g

Mix everything, crush. 1 tablespoon collection to pour 300 ml of boiling water, insist 1 hour, strain. Drink 1 tablespoon three times a day with myocardial dystrophy.

For Atherosclerosis You can prepare the following fees.

Grass Ruta

Fruits of cumin - 2 tbsp. Spoons

Leaves Barwinka

Fruits ammonic tooth -4 art. Spoons

Valerian root - 3 pt spoons

Flowers hawthorn -3 st. Spoons

White mistletoe grass - 6 tbsp. span

All crushed, mix. 1 tablespoon collection to pour 300 ml of boiling water, boil in a water bath for 15 minutes, cool at room temperature for an hour, strain. Drink 1 tablespoon three times a day before meals.

Timyan Grass - 30 g

Ruta grass - 30 g

Leaves Melissa -40 g

Leaves Melissa - 20 g

Lily of the valley -10 g

Ruta grass - 30 g

Herba Gusina - 30 g

Preparation and application as in the previous recipe.

The grass of the mistletoe is white -4 art. Spoons

Yarrow grass -4 art. Spoons

Cystosir herb - 6 tbsp. span

Fukus grass - 6 tbsp. span

Mix everything, crush. 1 tablespoon collection to pour 300 ml boiling water, insist 2 hours, strain. Drink 1 tablespoon three times a day 30 minutes before meals Atherosclerosis, Accompanied obesity.

For Hypertonic Diseases can be prepared by the following fees.

Peppermint leaves - 6 tbsp. span

Valerian roots - 6 tbsp. span

Flowers chamomile pharmacy -8 st. span

Watch leaves - 8 tbsp. span

Fruits of cumin - 10 tbsp. span

3 tablespoons of collecting pour 500 ml of boiling water, insist the night in a warm place, strain. Drink 1/2 cup three times a day.

Grass Orezitsy

Linden flowers

Fruits of raspberries

Leaves of plantain

Col and stepmother leaves

Birch leaves

Fruits Mordovnik

Liquorice root

Total take 1 tablespoon, mix, crush. 2 tablespoons of collecting pour 500ml boiling water, boil on a water bath for 15 minutes, insist the night in a warm place. Strain and drink 1 tablespoon three or four times a day before meals.

Leaves Melissa

Valerian roots - 4 tbsp. Spoons

Hop cones - 1 tbsp. the spoon

2 teaspoons of collecting pouring a glass of boiling water, insist 6 hours in a warm place, strain. Take 1 tablespoon three times a day before meals.

Flowers clover meadow. 1 tablespoon of dry flowers pour 300 ml of water, insist 1 hour, strain. Drink 100 ml three times a day.

Flowers hawthorn

Fruits hawthorn

White mistletoe grass

Bulb garlic

Grass of the horsetail of the field - 3 tbsp. Spoons

Arnica flowers - 1 tbsp. the spoon

Mix everything, crush. 1 tablespoon of mixture pour 300 ml of boiling water, insist 1 hour, strain. Drink 1/3 cup three times a day before meals.

Grass Vasilisnik

Dog-rose fruit

Fruits and hawthorn flowers

Grass dried

Grass etars

Total take 1 tablespoon, grind, mix. Pour the collection of 500 ml of boiling water, insist 8 hours, strain. Drink during the day.

For Hypotension Monastery herbalists recommend:

Grass ephedra - 2 tbsp. Spoons

Leaves of Chestnut Konsky -2 Art. Spoons

Fruits hawthorn -2 Art. Spoons

Mix everything, crush. 1 tablespoon of mixture pour 300 ml of boiling water, insist 1 hour, strain. Drink on 1 tablespoon 3-4 times a day.

Rhizome Aralia

Rhizome Levzey

Dog-rose fruit

Fruits of hawthorn - 3 tbsp. Spoons

Grass Camera

Calendula flowers

Leaves of plantain

The fruits of rowan blackfoot - 2 tbsp. Spoons 3 tablespoons of collection pour 500 ml of boiling water. Insist in a thermos night, strain. Drink 150 ml three times a day.

Thousands of yarrow

Highlander Highlander

Ruta leaves - 3 tbsp. Spoons

Grass willow goat - 5 tbsp. span

Cora Chestnut Konsky -2 Art. Spoons

Mix everything, crush. 1 tablespoon of mixture pour a glass of boiling water, insist in a thermos of 6 hours, strain. Take three times a day with 200 ml.

Abstract on the topic:

Features of the SCC in the elderly.

Performed: Mingheva Ellira 401g

Checked: Evdokimov V.V.

Arterial hypertension in old age

An increase in life expectation entails an increase in the population of the elderly.
The prevalence of arterial hypertension (AG) increases with age, it is noted about 60% of the elderly. The level of blood pressure is a risk factor, the elimination of which significantly reduces the risk of developing cardiovascular diseases and death, the frequency of which among the elderly is significantly higher than among young people.
With age, blood pressure is raised: the garden is up to 70-80 years, DDA - up to 50-60 years; Subsequently, stabilization or even reduction of DDA is noted. Raising the garden in older people significantly increases the risk of developing cardiovascular complications, such as coronary heart disease (IBS), cerebrovascular diseases, cardiac and renal failure, as well as death from them. In accordance with the results of studies of recent years, the pulse blood pressure (the difference between systolic and diastolic blood pressure) is considered as the most accurate predictor of cardiovascular complications in patients over 60 years of age due to the fact that it reflects the pathological rigidity of the walls of the arteries. The most convincing results of a meta-analyza based on three studies - EWPNE, SYST-EUR and SYST-China. They received evidence that the higher the level of systolic blood pressure and below the level of diastolic blood pressure, i.e., the higher the pulse blood pressure, the worse the forecast for the cardiovascular morbidity and mortality.
Currently, normal pulse blood pressure values \u200b\u200bare not clearly defined, although in most studies there is a significant increase in cardiovascular risk at pulse hell above 65 mm Hg. Art.

Pathogenetic mechanisms of AG in old age
The following structural and functional changes in the cardiovascular system during aging should be noted.
Anatomical changes
A heart:
increase the cavities of the left atrium and left ventricle;
Calcification of rings of mitral and aortic valves.
Vessels:
an increase in the diameter and the length of the aorta;
Thickening the aorta wall.
Physiological changes
A heart:
reduction of adhesiveness of the left ventricle;
Disrupting the diastolic filling of the left ventricle (reduction of early filling and an increase in the filling during the atrial systole).
Vessels:
reduction of elasticity;
an increase in the velocity of the pulse wave;
Raising the garden.

Histoophysiological changes
Increased content in lipid tissues, collagen, lipofuscin, amyloid.
Reducing the amount of myocytes with increasing their size.
Reducing the speed of relaxation of myocytes.
Reducing the sensitivity of β-adrenoreceptors.
Increasing the duration of the reduction of myocytes.

Features of the senior patient examination with ag
In addition to the routine diagnostics, which is carried out by all patients with AG, patients over 60 years old must be examined for the presence of pseudogypertensation, "White Kolata Hypertension", orthostatic hypotension and secondary arterial hypertension.
Much attention should be paid to the correctness of the blood pressure. It should be carried out in the sitting position after a 5-10-minute rest. The level of blood pressure is defined as the average number of two or more measurements.
Sometimes when measuring hell in the elderly, you can get false results due to the "auscultative failure" - the absence of tones for a certain period after I appeared that the garden characterizes. This can lead to a decrease in systolic blood pressure by 40-50 mm Hg. Art. To avoid mistakes and register a tone, appearing to "auscultative failure", it is recommended to pump the cuff to 250 mm Hg. Art. And slowly produce air. The diagnosis of hypertension is set in case the garden\u003e 140 mm Hg. Art. or DD\u003e 90 mm Hg. Art. During several surveys.
AG in the elderly is often accompanied by an increase in the rigidity of the arterial wall due to its thickening and calcification. In some cases, this contributes to the overestimation of blood pressure, since the cuff cannot overcertrine a rigid artery. In such a situation, the level of blood pressure when measuring with the help of a cuff (indirect method) may be 10-50 mm Hg. Art. Above, rather than using an intraarterial catheter (direct method). This phenomenon is called pseudogpertenzia. To diagnose it sometimes helps the sample of the Osler: determining the pulsation at a. Radialis or a. Brachialis distal cuffs after air injection approximately to the patient garden level. If the pulse proves, despite the strong squeezing of the shoulder artery, this indicates the presence of pseudogpertenzes. It should be suspected in cases where, on the background of high digits, other signs of targeting organs are absent. If an elderly person with pseudoguertenzia appointed antihypertensive therapy, he can have clinical signs of excessive decline in blood pressure, although there is no hypotension when measuring it.
High variability of hell is another sign of improving the rigidity of large arteries.

Clinical manifestations of increased blood variability can be:
Ortostatic decrease in blood pressure;
Reduced blood pressure after meals;
enhanced hypotensive response to antihypertensive therapy;
reinforced hypertensive reaction to isometric and other types of stress;
"White Kolata Hypertension".
Patients with complaints with pronounced drops, dizziness and fainting in history or patients with high blood pressure at the reception of the doctor and the lack of signs of targeting the target organs showed outpatient daily monitoring of the blood pressure or measuring blood pressure at home 4-5 times a day. In addition, in the elderly patients with ag often observed disorders of the daily rhythm of blood pressure, which require identification and correction, since they can cause cardiovascular complications.
To diagnose orthostatic hypotension, all patients over 50 years old are shown to measure blood pressure in the lying position, and after 1 and 5 minutes - standing. Normal blood pressure reaction on the transition from the position lying to the standards standing is a slight increase in DDA and a decrease in the garden. Ortostatic hypotension takes place in the case when the garden decreases by more than 20 mm Hg. Art. Or increases DDA by more than 10 mm Hg. Art. The causes of the orthostatic hypotension, as mentioned above, are the decrease in the BCC, the dysfunction of baroreceptors, violation of the activities of the autonomous nervous system, as well as the use of antihypertensive preparations with a pronounced vasodilating effect (A-adrenobloclars and combined A- and B-adrenoblockers). Diuretics, nitrates, tricyclic antidepressants, sedatives and levodopa are also able to exacerbate an ortostatic hypotension.
To reduce the severity of the orthostatic hypotension, it is recommended to follow the following rules:
lie on a high pillow or lift the head of the bed;
rising from the position lying slowly;
Before moving, if possible, perform isometric exercises, for example, compress the rubber ball in hand, and drink at least a glass of liquid;
Take food in small portions.
Another important point in the survey of elderly patients with AG is the exclusion of secondary hypertension. The most frequent causes of secondary hypertension in elderly patients are renal failure, renovascular hypertension. The latter, as a possible reason for increasing blood pressure, is registered with 6.5% of hypertensive aged 60-69 years and less than 2% of patients of 18-39 years.

Treatment of elderly people with arterial hypertension
The purpose of the treatment of elderly patients with AG is a decrease in blood pressure below 140/90 mm Hg. Art.
Nercomer therapy is a mandatory component of the treatment of elderly patients with AG. In patients with mild ag, it can lead to normalization of blood pressure, in patients with heavier hypertension - allows to reduce the amount of antihypertensive drugs taken and their dosage. An irritable treatment is to change the lifestyle.
Reducing body weight in its redundancy and obesity helps reduce blood pressure, improves metabolic profile in these patients.
Reducing the consumption of the table salt up to 100 MKV Na, or 6 g of the cook salt per day, can have a significant impact on the level of blood pressure in the elderly in general, the results of controlled studies show a minor, but stable decline in blood pressure in response to limiting salt consumption to 4-6 g / day.
An increase in physical activity (35-40 minutes per day of dynamic loads, for example, fast walking) also has an antihypertensive effect and has a number of other positive effects, in particular metabolic.
Reducing alcohol consumption per day to 30 ml of pure ethanol (maximum 60 ml of vodka, 300 ml of wine or 720 ml of beer) for men and 15 ml - for women and men with a small body weight also contributes to a decrease in blood pressure.
The inclusion in the food diet with a high potassium content (approximately 90 mmol / day). The influence of potassium to the level of blood pressure is finally proven, however, given its effect on the prevention of strokes and the course of arrhythmias, the elderly patients with the AG recommends the consumption of vegetables and fruits rich in this element.
The enrichment of the edible diet Calcium and magnesium is favorably reflected in the general condition of the body, and calcium is also slowed down by the progression of osteoporosis.
The cessation of smoking and a decrease in the diet of the share of saturated fats and cholesterol contributes to the improvement of the state of the cardiovascular system.
It must be remembered that one of the reasons for the increase in blood pressure in old age may be the treatment of concomitant diseases with non-steroidal anti-inflammatory drugs, so it is necessary to reduce their use.

Drug therapy
In the case where irritable treatment does not allow to normalize hell, it is necessary to consider the appointment of drug antihypertensive therapy.
Patients with a garden level above 140 mm Hg. Art. and accompanying diabetes mellitus, angina, cardiac, renal failure or left ventricular hypertrophy Treatment AG need to start with pharmacotherapy against the background of changing lifestyle.
The mode of receiving medicines should be simple and understandable for the patient, treatment must be started with low doses (twice as smaller than those of young), gradually increasing them to achieve the target hell - 140/90 mm Hg. Art. This approach contributes to the prevention of orthostatic and postprandial (after meals) of the hypotension.
The forced decrease in blood pressure may worsen the brain and coronary blood flow on the background of obliterators atherosclerotic damage to the vessels.
Pharmacotherapy used in elderly patients with AG is not different from the prescribed patient of young age. Diuretics and dihydropyridine calcium antagonists are drugs, effective to prevent stroke and basic cardiovascular complications.
Thus, the algorithm for the conduct of elderly patients with AG is as follows:
establishing a diagnosis (elimination of the secondary nature of hypertension, "White Kolata Hypertension" and pseudogypertensation);
risk assessment, taking into account the availability of related diseases;
irritable treatment;
Drug therapy.
However, it is necessary to remember that only an individual approach to the examination and treatment of elderly patients can improve the quality of their life and the prognosis of a particular patient.

Coronary artery disease

Ischemic heart disease is a damage to myocardium caused by impaired blood flow in coronary arteries. That is why the term coronary heart disease is often used in medical practice.

Usually people suffering from ischemic disease, symptoms appear after 50 years. They occur only during exercise. Typical manifestations of disease are:

pain in the middle of the chest (angina);

feeling of the lack of air and mischieving;

stopping blood circulation due to too frequent heart cuts (300 or more per minute). This often happens the first and last manifestation of the disease.

Some patients suffering from coronary heart disease are not experiencing any pain and feelings of the lack of air even during myocardial infarction.

The greater the person's risk factors, the more likely the presence of the disease. The influence of the majority of risk factors can be reduced, thereby warning the development of the disease and the emergence of its complications. Such risk factors include smoking, high cholesterol and blood pressure, diabetes mellitus.

Diagnostic methods: Registration of electrocardiogram at rest and with a stepped increase in physical exertion (stress test), chest radiography, biochemical blood test (with determination of cholesterol and blood glucose). If severe damage to coronary arteries, requiring surgery, then coronary artwork. Depending on the state of the coronary arteries and the number of damaged vessels, as treatment, in addition to the drugs angioplasty, or an aortocortonary shunting. If you contact the doctor on time, prescribe drugs to help reduce the influence of risk factors, improve the quality of life and prevent the development of myocardial infarction and other complications:

• statins to reduce cholesterol levels;
• beta blockers and angiotensin-converting enzyme inhibitors to reduce blood pressure;
• aspirin to prevent blood clots;
• nitrates to facilitate the cessation of pain in the attack of angina
• do not smoke. It's the most important. In non-smoking people, the risk of developing myocardial infarction and death is significantly lower than that of smokers;
• pink low cholesterol products;
• regularly, every day for 30 minutes, engage in exercise (walking at an average pace);
• reduce your stress level.

Atherosclerosis

Atherosclerosis (from Greek. Athera - cached and sclerosis), chronic disease characterized by a seal and loss of elasticity of the walls of the arteries, by narrowing their lumen, followed by a violation of the blood supply to organs; It is usually amazed (although unevenly) the entire arterial system of the body. A. The older people are sick. External manifestations of the disease are usually preceded by a long-term asymptomatic period; To some extent, atherosclerotic changes have many people of young age. Men are 3-5 times more likely to suffer A. than women. In the development of the disease, a hereditary predisposition is important, as well as the individual characteristics of the body. Promote Development A. Sugar Diabetes, Obesity, Gout, Ball-name Disease, etc. Nutrition with an excessive amount of animal fat plays a significant role as a factor predisposing to A., but not as the root cause A. The known importance in the origin of A. has small physical activity. An important reason should be considered psycho-emotional overvoltage trauming the nervous system, the influence of a strained rate of life, noise, some specific working conditions, etc.

The mechanism of development of the disease consists in violation of lipid metabolism (zero-like substances), especially cholesterol, in changes in the structure and function of the vascular wall, the state of the resulting and anticorant blood systems. In disruption of cholesterol exchange, the content of cholesterol in the blood is increased, which over time becomes an important (albeit no one) in the development of the disease. Apparently, with A. not only reduced the degree of disposal and removal of excess food cholesterol, but also increased its synthesis in the body, exchange disorders are associated with the disorder of its regulation - nervous and endocrine systems.

When A. in the vascular wall, atherosclerotic plaques are formed - more or less dense thickening inner artery shells. Initially, the swelling of the protein substance of the inner shell of the artery occurs. In the future, its permeability increases: cholesterol penetrates the vessel wall. Cutting cholesterol in the walls of the arteries cause secondary changes in the vessels, expressed in the expanding of the connective tissue. In the future, atherosclerotic plaques undergo a number of changes: they can disintegrate with the formation of cashier-like mass (hence the name A.), the lime (calcification) is postponed or a translucent homogeneous substance (hyaline) is formed. The process is progressive. Vessels of vessels are narrowing. Due to the circular location of the plaques, the vessels lose the ability to expand, which, in turn, violates the regulation of the blood supply to organs at strengthened work. The irregularities inside the vessels at A. contribute to the formation of blood clots, thrombov, which aggravate the circulatory disorder up to its complete termination. The development of thromboms also contributes to a decrease in the intensity of anti-refrigerant processes, observed in A. Some researchers The start of development A. is associated with a violation of blood intake, the accumulation of thrombotic masses in the vessel walls, followed by their obesity, cholesterol and the connective reaction.

With the predominance of atherosclerotic changes in the heart vessels, brain, kidneys, lower extremities, in the body experiencing as a result of A. lack of blood supply, disorders arise that determine the clinical picture of the disease. A. Heart vessels is expressed by coronary insufficiency or myocardial infarction. A. Vessels of the brain leads to mental disorders, and with pronounced degrees - to a different kind of paralymp. A. renal arteries are usually manifested by a resistant hypertension. A. Foot vessels may be the cause of intermittent chromotype (see the dendariculture obliterators), the development of ulcers, gangrene, etc.

Treatment and prevention A. Aims to resolve common and cholesterol exchange. At the same time, measures are important to normalize working conditions and life (compliance with the mode of work and recreation, physical education classes, etc.). Nutrition should not be redundant, especially in relation to animal fats and carbohydrates. The diet includes products containing vitamins, vegetable oils. Of therapeutic drugs, some vitamins, hormonal agents, drugs that hovering cholesterol synthesis, contributing to its removal, and other means that prevent blood flowing are anticoagulants, as well as vasodilatory drugs. The treatment is carried out in a strictly individual order with binding medical control.