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Cardiosclerosis – the pathology of a cardiac muscle which is characterized by growth of connecting cicatricial fabric in a myocardium, replacement of muscle fibers and deformation of valves. Development of sites of a cardiosclerosis happens on the place of death of miokardialny fibers that involves a compensatory hypertrophy of a myocardium in the beginning, then heart dilatation with development of relative valvate insufficiency. The cardiosclerosis is a frequent outcome of atherosclerosis of coronary vessels, coronary heart disease, myocardites of various genesis, a miokardiodistrofiya.

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Cardiosclerosis

Cardiosclerosis – the pathology of a cardiac muscle which is characterized by growth of connecting cicatricial fabric in a myocardium, replacement of muscle fibers and deformation of valves. Development of sites of a cardiosclerosis happens on the place of death of miokardialny fibers that involves a compensatory hypertrophy of a myocardium in the beginning, then heart dilatation with development of relative valvate insufficiency. The cardiosclerosis is a frequent outcome of atherosclerosis of coronary vessels, coronary heart disease, myocardites of various genesis, a miokardiodistrofiya.

Development of a cardiosclerosis because of inflammatory processes in a myocardium can occur at any age (including, in children's and teenage), against the background of vascular defeats – mainly at patients of middle and advanced age.

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Classification of a cardiosclerosis

Distinguish two morphological forms of a cardiosclerosis: focal and diffusion. At a diffusion cardiosclerosis there is a uniform damage of a myocardium, and the centers of connecting fabric are diffuzno distributed on all cardiac muscle. The diffusion cardiosclerosis is observed at IBS.

Focal (or cicatricial) the cardiosclerosis is characterized by education in a myocardium of cicatricial sites, certain, various in size. Usually development of a focal cardiosclerosis happens owing to the postponed myocardial infarction, is more rare than myocarditis.

The allocated etiologichesky forms of a cardiosclerosis are an outcome of primary disease which caused cicatricial replacement of functional fibers of a myocardium: atherosclerotic (in the atherosclerosis outcome) postinfarction (as a myocardial infarction outcome), miokarditichesky (in the outcome of rheumatism and myocardites); other forms of a cardiosclerosis connected with dystrophy, injuries and other damages of a myocardium are less often observed.

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Etiologichesky forms of a cardiosclerosis

The Miokarditichesky form of a cardiosclerosis develops on the place of the former inflammatory center in a myocardium. Development of a miokarditichesky cardiosclerosis is connected with processes of an ekssudation and proliferation in Strom of a myocardium, and also destruction of miotsit. The Miokarditichesky cardiosclerosis is characterized by existence in the anamnesis of infectious and allergic diseases, the chronic centers of an infection, usually young age of patients. According to the ECG the changes of diffusion character which were more expressed in the right ventricle, violations of conductivity and a rhythm are noted. Borders of heart are evenly increased, HELL is normal or is lowered. Often right ventricular chronic insufficiency of blood circulation develops. Biochemical indicators of blood are usually not changed. The weakened tones of heart, accent of the III tone in a heart top projection are listened.

The atherosclerotic form of a cardiosclerosis usually serves as display of long coronary heart disease, is characterized by slow development and diffusion character. Necrotic changes in a myocardium develop as a result of slow dystrophy, an atrophy and death of the separate fibers caused by a hypoxia and metabolic violations. Death of receptors causes decrease in sensitivity of a myocardium to oxygen and progressing of IBS. Clinical manifestations a long time can remain poor. As the cardiosclerosis progresses, the hypertrophy of the left ventricle, then the phenomenon of heart failure develops: heartbeat, short wind, peripheral hypostases and an exudate in cavities of heart, lungs, an abdominal cavity.

Sclerous changes in sinusovy knot lead to development of bradycardia, and cicatricial processes in valves, tendinous fibers and papillary muscles can lead to development of the acquired heart diseases: mitralny or aortal stenosis, valvate insufficiency. At an auskultation of heart easing of the I tone in top projections, systolic noise (is listened at a sclerosis of the aortal valve - very rough) in an aorta and a top of heart. Left ventricular insufficiency of blood circulation develops, HELL is higher than normal values. At an atherosclerotic cardiosclerosis of violation of conductivity and a rhythm arise as blockade of various degree and sites of the carrying-out system, vibrating arrhythmia and premature ventricular contraction. The research of biochemical indicators of blood reveals increase in cholesterol, increase in level of β-lipoproteid.

The postinfarction form of a cardiosclerosis develops at replacement of the site of the died muscle fibers with cicatricial connecting fabric and carries small - or krupnoochagovy character. Repeated heart attacks promote formation of hems of various extent and the localization isolated or which are closed with each other. The postinfarction cardiosclerosis is characterized by a hypertrophy of a myocardium and expansion of cavities of heart. The cicatricial centers can stretch under the influence of systolic pressure and cause formation of aneurism of heart. Clinical manifestations of a postinfarction cardiosclerosis are similar to an atherosclerotic form.

Rare form of a disease is primary cardiosclerosis accompanying a current of kollagenoz, a congenital fibroelastoz, etc.

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Cardiosclerosis symptoms

The clinical symptomatology of a cardiosclerosis is defined by its morphological and etiologichesky form, prevalence and localization. The focal and moderately expressed diffusion cardiosclerosis quite often proceed clinically asymptomatically, however, the arrangement even of the microscopic centers of a sclerosis on sites of the carrying-out system or near predserdno-sinusovy knot can cause steady violations of conductivity and various arrhythmias of heart.

As the leading manifestations of a diffusion cardiosclerosis serve symptoms of heart failure and violation of sokratitelny function of a myocardium. What the big area of functional tissue of myocardium is replaced connecting with, that the probability of development of heart failure, violations of conductivity and a rhythm is higher. If the phenomena of violation of conductivity and a rhythm prevail, patients note heartbeat, arrhythmic reduction of heart. At development of the phenomena of heart failure short wind, hypostases, heartaches, decrease in endurance to physical activities etc. develop.

The cardiosclerosis proceeds with gradual progressing and alternation of the periods of relative remission which can last up to several years. The health of the patient in many respects is defined by development of the main disease (atherosclerosis, rheumatism, a heart attack) and a way of life.

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Cardiosclerosis complications

The cardiosclerosis can be complicated by the progressing chronic heart failure, formation of aneurism of heart, the predserdno-ventricular blockade, development of ventricular paroksizmalny tachycardia posing a serious threat for the patient's life. The rupture of a wall of aneurism of heart leads to a tamponada of a pericardiac cavity.

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Diagnostics of a cardiosclerosis

At diagnosis of a cardiosclerosis by the cardiologist the previous anamnesis (existence of atherosclerosis, IBS postponed in the past of myocarditis, myocardial infarction, rheumatism etc.), relative stability of heart failure (hypostases, short wind, an akrotsianoz), arrhythmias (vibrating arrhythmia, premature ventricular contraction) is considered. The diagnosis is specified by results of the ECG of which permanent changes, EhoKG, data of MRT of heart are characteristic.

To differentiate cardiosclerosis forms sometimes can be difficult, especially between atherosclerotic and miokarditichesky. For an atherosclerotic form of a cardiosclerosis existence of IBS and a hypertension, results of pharmacological and veloergometrichesky tests, ECGs changes testifies. The probability of diagnostics of a miokarditichesky cardiosclerosis is higher at disorders of warm activity at patients of young age, against the background of or after the postponed infectious diseases, at difficult violations of a rhythm and conductivity, lack of focal defeats in a myocardium according to the ECG.

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Treatment of a cardiosclerosis

Therapy at a cardiosclerosis is directed to elimination of displays of the main disease, improvement of metabolic processes in a myocardium, elimination of symptoms of heart failure and violations of conductivity and a rhythm.

Treatment of a cardiosclerosis is carried out by diuretic medicines, peripheral vazodilatator, antiarrhytmic means. Restriction of physical activities is shown to all patients with a cardiosclerosis. In the presence of aneurism of heart surgical treatment can be shown, at heavy violations of conductivity - implantation of an electropacemaker.

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Forecast and prevention of a cardiosclerosis

Change of a condition of the patient and his working capacity at a cardiosclerosis are defined by expressiveness and the nature of display of pathology. If the cardiosclerosis is not burdened by violations of a rhythm of heart and blood circulation, its current is more favorable. Emergence of vibrating arrhythmia, insufficiency of blood circulation, ventricular premature ventricular contraction worsen the forecast. Considerable hazard to life of the patient is posed by existence of aneurism of heart, ventricular paroksizmalny tachycardia and total predserdno-ventricular block.

Early diagnosis, timely and active therapy of myocardites, coronary insufficiency, atherosclerosis is necessary for prevention of a cardiosclerosis.

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Cardiosclerosis - treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!

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