"Close" heart

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Cramped heartHow often do we use expressions such as “heart snapped” - about a sudden feeling of fear, or “relieved from the heart” - when relief from anxiety comes. But a person who has an attack of heart pain as a result of oxygen starvation will try to convey his feelings at this moment in approximately these words. For greater persuasiveness, he will still bring his hand to his chest and clench his fist tightly.

From this alone, it is possible to unmistakably determine that in this case there was an attack of angina pectoris. Angina pectoris, if translated from Greek, means "cramped heart". But not the heart itself becomes "cramped", but the vessels feeding it with blood.

Changes in the state of the body, as well as in the conditions of the heart, immediately affect the volume of blood in the coronary basin and the speed of its blood flow. In a person at rest, the blood flow through the coronary arteries is about 140 ml per minute. During physical work, it can increase by 7 times. Coronary vessels must be very flexible, elastic in order to respond in a timely manner to each such change. The heart muscle absorbs almost all of the oxygen delivered to it. Therefore, as soon as demand for it rises, blood flow increases. In a healthy person, blood is always delivered to the heart as needed. Loss of elasticity of the coronary vessels, even without a pronounced and persistent narrowing of their lumen, will immediately affect. The heart will receive less blood, and oxygen starvation will come.

When the cardiovascular system is in order, the increased blood flow does not cause heart pain, shortness of breath, or weakness. But with atherosclerosis or with some other diseases, coronary insufficiency is found, that is, insufficient blood supply to the heart muscle.

Cramped heartWe often hear that, they say, the person was healthy and suddenly he had an attack of angina pectoris or, even worse, a heart attack. There is no "suddenly". But there is a relative, or latent, coronary insufficiency, when the coronary arteries only in some cases are not able to cope with increased blood circulation due to either organic lesions or disorders of nervous regulation. Excessive physical stress or a sudden nervous shock, as a rule, intensify the latent coronary insufficiency, which is sometimes even recorded by an electrocardiogram.

What are the vascular changes that cause coronary insufficiency? They are of a twofold nature: organic, when there is a narrowing of the lumen of blood vessels due to atherosclerosis or blockage by a thrombus of the coronary arteries; and functional narrowing of the coronary arteries, coronary spasm.

One can imagine the development of coronary insufficiency with unchanged coronary arteries, when oxygen starvation of the heart muscle occurs with hypertension, pulmonary emphysema, etc.

But the main culprit is still atherosclerosis. After all, coronary insufficiency is caused not so much by mechanical narrowing of the vascular bed as by a change in the walls of blood vessels that have lost the ability to respond appropriately to all kinds of influences.

Shapiro Ya.E.


If there is pain in the heart

Pain caused by ischemic heart disease, including one of its manifestations - angina pectoris, usually appears behind the sternum, sometimes to the left of the sternum, can spread to the entire region of the heart, give to the left shoulder, left arm. The pain can be pressing, constricting, burning. Most often, an attack of pain in the heart occurs at a time when a person does some kind of hard physical work, quickly climbs a mountain or stairs, goes against a strong cold wind.

What explains this pattern? The fact is that in ischemic heart disease, the lumen of the coronary vessels, that is, the vessels supplying blood to the heart itself, narrows due to spasm or damage to them by atherosclerosis. As a result, they cannot provide the myocardium (heart muscle) with oxygen delivered by the blood. Especially the discrepancy between the amount of oxygen that the heart muscle receives, and that which it needs, manifests itself during the period of physical exertion, when the myocardial oxygen demand increases significantly. What should be done if there is pain in the heart?

First of all, immediately stop doing physical work, stop if you were walking, if possible, sit on a bench, at home sit in a comfortable chair, relax, unfasten the belt, bodice, collar. And most importantly, immediately put a nitroglycerin tablet under your tongue. Patients "with experience" always have (should have) this medicine with them. Anyone who has a pain in the heart for the first time can ask for a pill from passers-by, colleagues. In addition, take 30 drops of valocordin or corvalol. If the attack occurs at home, place mustard plasters on the breastbone or heart area.

It is good if the pain can be relieved, but it happens that it does not go away even after taking the medicine. If the pain persists after five minutes, put another pill under your tongue and call an ambulance.

A person who had pain for the first time, even if it was possible to relieve it with a nitroglycerin tablet, must definitely consult a doctor, find out its cause, in order to start treatment. The doctor will prescribe an electrocardiographic examination (and now it is carried out in any clinic), and will offer treatment. If you neglect the first signal of alarm, which is acute pain in the heart, this can lead to serious complications of coronary artery disease.

Some patients, especially young men, often do not admit the thought of the possibility of developing heart disease and consider pain as a manifestation of other diseases, such as sciatica. But only a doctor should determine this. The danger is too great, and measures to prevent cardiovascular catastrophe must be taken in a timely manner.

T. A. Yappo

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