ІХС progressive angina code according to ICD 10. ІХС

• Pharmacological diya
• Pharmacokinetics
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• lykarska vzaєmodiya
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• Sucking of tablets Betaloc ZOK
• Vidgooks
• Parts of food and advice on them
• Prices in online pharmacies
• visnovka

Betalok - for purposes of hypertension, ischemic ailments of the heart (angina pectoris) and heart failure. It is also used for the prevention of infarction and prevention of migraine (headache) attacks. For classification, it is assigned to beta-blockers of the 2nd generation. Take the tablets Betalok slid 2-4 times for dob, yak signify the drug. On this day, the stinks are old. Betalok ZOK is a preparation of a combined vivilnennya, which can be taken 1 time for a supplement. Likas are more popular in the Russian regions. It is more efficient and affordable. The lower description of this is shown until the end of the day, the proof, the addition, the side effects, etc.

Betalok ZOK: Instructions from ZoSuvannya

To be surprised also by the video about ІХС and angina pectoris

Know how to take control of heart failure

Price for the drug Betaloc ZOK virobniztva AstraZeneca / ZiO-Zdorov'ya

Prices for an analogue of the drug Betalok ZOK - tablets Egilok Z

Note. Virobnik Lika Egilok S - Egis company, Ugorshchina.

Sucking of tablets Betaloc ZOK

Betalok ZOK - leaks, which can be applied to a group of beta-blockers. Vono lowering the heart rate and reducing the amount of blood, like pumping my heart with my skin blow. Mechanism of diya is a preparation for blocking adrenaline and other hormones, which stimulates the heart intensively. The managers of the tsomu, navantazhennya on the heart to fall, to fall in the first and second infarction. Also Betalok normalizes the rhythm, as the heart beats back often or irregularly.

If you most often recognize:

• arterial hypertension;
• b_l at the breasts - dovgostroke lіkuvannya, ale not for a shy lodging;
• heart failure - in singing vypadki, as well as there is no contraindication.

• A great way to find a way of being hypertensive (fast, easy, healthy for health, without "cheeky" like and dietary supplements)
• Hypertonic ailment - the folk way of vilikuvatisya from her at 1 and 2 stages
• Causes of hypertension and as a result. Analyzes for hypertension
• Effectively treating hypertension without leaks

In some cases, the drug cannot be used:

• you have already had an allergy to Betaloc, the only beta-blockers or additional speech tablets;
• bradycardia - low pulse rate;
• systolic "upper" arterial vise lower than 100 mm Hg. Art.;
• There are other cardiological contraindications.

Do not admit your own Betaloc ZOK, or some beta-blockers on your own!

It is not possible to take a quick rap to accept the goals without delighting in the liquor. As the doctor says, you don't need to take Betalok ZOK anymore, you need to reduce the dose in steps, and not just kidati. You can get your arterial grip.

Important! Betalok - what is the difference between the appearance of tablets between myself

In a given hour, it is recommended to use the drug Betaloc ZOK until it is consumed, as it should be consumed 1 time for doba. It has been brought to its effectiveness in case of hypertension, heart failure, for the prevention of infarction. Winning the development of atherosclerosis. We offer Betaloc tablets, in which metoprolol tartrate is used, the best beta-blockers are used for the effective efficiency. The stench is also worse to be carried by ailments. Oh, it’s not a matter of vikoristovuvati;

The drug Betaloc ZOK (metoprolol succinate) is recommended until it is consumed. Serving tablets Betaloc (metoprolol tartrate) - mute.

Betalok can wicklikati drowsiness, spoiled or nudotu. For the first time, they do not need to drive a car, but they are not safe robots. Check out a few days, while the body adapts. As soon as you see the fatalities, you are overwhelmed, immediately sit down to see. Inappropriate feelings may be due to alcohol intake, overheating, physical pressure, cold high temperature... If you accept Betalok at the same time with the same signs of hypertension, then the hypothesis can become an arterial grip to decrease overly.

ailing

sundown

arterial hypertension	50-100 mg 1 time per doba. Consider in combination with other drugs in vise, most often with sechoginnyms (indapamid, hydrochlorothiazide), as well as calcium channel blockers - dihydropyridine (amlodipin).
angina	100-200 mg 1 time per doba. Often used in combination with antianginal drugs.
Stable chronic heart failure of the II functional class	The pochatkova dose is 25 mg per dobu. After two tension, it is possible to increase the amount of up to 50 mg for additional and if necessary, to increase the skin condition. An acceptable dose for a trivial drug is 200 mg per doba.
Stable chronic heart failure III and IV functional class	Pochatkova dose - 12.5 mg per dobu. Dali її pick up individually. At the same time, it is known from the visual of the drug, that with the help of the drug, the symptoms of heart failure in people with ailments may become degraded. If tolerated, the dose of Betalok ZOK should be used for skin 2 conditions to reach the maximum dose of 200 mg per dose.
Loss of heart rhythm	100-200 mg per dobu
Adopting therapy for myocardial infarction	200 mg per dobu
tachycardia	100-200 mg per dobu
Prevention of migraine attacks (headache)	100-200 mg per dobu

If the squeeze goes down, or the pulse falls below 45-55 beats in khilina - reduce the dose to the drug Betalok LOK or supportively. However, in most patients, organisms adapt in an hour, and it is good to tolerate average therapeutic doses. As soon as the hypotonia grows on the cob, the pressure drops, and in an hour the new growth begins to grow. For patients who have become ill with nirok, as well as for people who have been kidnapped, it is not necessary to take a dose of the drug. The robots can use them with the recommendations indicated in the table. With important liver disease, you can reduce the dose.

Betalok ZOK needs to be accepted every day, without omissions, at the same hour. Drink the pill in those days, if you feel okay. Bazhano mother home tonometer. Regularly adjust your arterial vise - skin day or once every 3-7 days. It is necessary to work with the rules. For more details, read the article "Vimіryuvannya arterіalny vise: pokrokova technіka".

Vidgooks

Judging from vidgukiv, Betalok ZOK is kind enough to help with hypertension and heart arrhythmia, and the side effects of the disease are ridko. Also, the price of the drug is even more affordable, in proportion to the larger new beta-blockers. To that, for more than 10 rocky years, the popularity of the middle of the class and the children is won.

Tablets are only a part of the complex of entry for hypertension, prevention of infarction and insult. If you don’t come to respect the transition to a healthy way of life, then the camp of your judges will continue to pogirshuvatisya. I daresay, through a little rock to navigate some of the necessary lines, you won't be able to reduce your grip on control. When it ends - all the good things are ... Throw firing - it's far from the only thing that needs to be done. Take care of your habits, you will be able to experience unique conflicts on robots and in the family. Regular physical activity is also required, but on a new occasion.

Diya lіkіv on the skin ludina indivіdually. One more beautiful supplement is Concor, or the more cheap tablets Bisoprolol, іnshim - Betalok lok. In any vipadku, likami number 1 of arrhythmia and hypertension є magnesium. Tom scho The main reason zhvoryuvan - deficiency of magnesium in the body. Try Vitamin B6 magnesium tablets. With a high ymovirnistyu, stench help you change the dose of a beta-blocker, or find a way to see it from your reception.

The cardiologist is just going to take care of you. And even when the upper vice is adjusted, it can also be a signal about problems with nirkami. You will need to read the article "Causes Hypertension and Yak You Usunuti", and then take care of it, as it says there. Zokrema, create an analysis of blood and slaughter, which will transform the robot into nirok.

More "live" children who take Betalok ZOK, read here.

Parts of food and advice on them

They designated Betalok ZOK with arrhythmia. Nachebto dopomagaє, but all one is not cool. Mati Raptovo died from her heart in the 47th rock. How can you get rid of it, except for taking pills?

Heart problems come from a deficiency living talk, Yake is happy for her robot. In pershu cherga, tse magnesium. Try at once with the "cheeky" liks to take supplements, which are pererakhovani lower. With a high ymovirnistyu, in a dozen hour you can change from the intake of a beta-blocker, having lost the deprivation of natural resources.

Overturned effective and optimal for the price of an additive for normalization of the vice:

• Magniy + Vitamin B6 from Source Naturals;
• Taurine from Jarrow Formulas;
• Ribbed fat from Now Foods.

Read the report about the methodology in the article “Likuvannya of hypertension without leaks”. Yak substitute supplements from hypertension from the USA Bring your grip back to normal without awkward side effects, such as failing NOLIPREL and the smallest "chemical" tablets. Fill the robot with a heart. Become calm, wake up from anxiety, sleep at night, yak child. Magnesium with Vitamin B6 work miracles with hypertension. You will be in perfect health, good luck to one-year-olds.

Do you want to take Betaloc tablets from panic attacks?

If you still accept the goals, or if you recognize the panic attacks, then so. Self-consciously - dumb. If you have a vipad, try a motherfucker, or if you have a lot of fun. Also magnesium with vitamin B6 and psychotherapy. You have fear public reports That good training is helpful. Chiplyatsya for beta blockers - the rest on the right.

I was assigned bisoprolol, albeit sertsebittya vin dopomagaє nasty. At the lowest rate, the pulse rate is up to 100-120 beats per chilin. Wouldn't it be easy to switch from bisoprolol to Betalok?

Maloimovirno, it is possible to change one beta-blocker for one. I want everything individually. Transmission may be delayed as long as genetic pre-release becomes widely available. And before quietly drinking and drinking, pick up liquids only by the method of samples and grains. For any type of person, try to add to the "cheeky" liking to the heart for the additional magnesium-B6 and coenzyme Q10. It is 100% not awkward and it is effective for a large patient to appear as a great.

The cardiologist said accept Betalok, biprol or Concor. Whichever of them vibrate - see, move, yourself. What kind of drug is more sparing for Sudin?

Suvorі everyday life of vіtchiznyanoy medicine ... Let us admit, the liking as vіberіt. And do you want to signify yourself? It is also practical jewelry art. Zanadto low dose - no help. Zanadto visoka - there will be a hypotonia ... If you do not have contact with a cymbal, change from one to another. Dodam, biprol and Concor is one and the same bisoprolol, albeit virobniks. To this and the price of leaks in the pharmacy is given.

tour parts no pain in the area of ​​the heart. Zrobiv EKG - a lykar saying, it's okay, ale Betalok ZOK, having recognized all one thing. I'm afraid of an infarction. What is it, why is it, why is it risik?

If you already have є 40 rockyv, then you are right, you are going to be turbulent. Infarction can be affected by rapt - and graft ...

1. To add to the liking, take the natural ones, as described here. The stench is important for a change of heart, it’s like a hypertension, but more, it’s a grip of pressure.
2. If you are overwhelmed, then go to the low-carb day of Atkins.
3. Once every 3 months, give blood tests for cholesterol, triglyceride, C-reactive protein. The last analysis Those who have been reinsured are on the list.
4. Ideally, take care of the relaxation of the big children from the satisfaction.

visnovka

Metoprolol is a second generation beta-blocker, dating back to the 1980s. However, yogo dosi often indicate to patients with hypertension and heart-and-heart ailments. Betalok ZOK - tse tablets, such as metoprolol succinate. Pharmacies also sell special Betaloc tablets, without "ZOK", as revenge on metoprolol tartrate.

In the given hour, it is recommended to vicoristovuvati only the drug Betaloc ZOK. It’s possible to take one pill for a dose, it’s really effective in case of hypertension, ischemic ailments of the heart and some types of heart failure. Betalok tablets, which are like metoprolol tartrate, should be taken 2-4 times for doba. The stinks of being old-fashioned, so sacrifice for the effectiveness of those beta-blockers.

The head, as you know from the statistics, is how Betalok ZOK and the wondrous Betalok are seen from among themselves. Tablets, like metoprolol tartrate, are recommended to be changed to a larger drug. Betalok ZOK can be called the leader of the middle of beta blockers. Competitive drugs - bisoprolol, carvedilol, nebivolol - can turn it around in terms of efficiency. Protect, lykarі dosі actively assign metoprolol succinate to their patients. To that, it’s good, brothers, win big-mensh extra help, the price of the new one is addicted and the good deed is good.

• Beta blockers: general information
• sechogіnnі lіki
• Faces of hypertension for lithuanians

Heart attack: reasons, signs that vidi, persha help that nobility

Under the name "heart attack", there can be a wide range of pathological stances, enveloped by ailments of hearts and Sudins, which periodically or systematically make a mistake about themselves with a certain rank, invoke unimpressed on those who are constantly receiving ailments. Tse - attack angina pectoris, not safe for life, disturbed rhythm (arrhythmia), hypertensive crisis with arterial hypertension and in. Some heart attacks are trapped in people, in general, not even worse than sick, or not especially healthy, the nervous system of which is especially sensitive to any kind of injection. It is up to the whole group to have patients diagnosed with vegetative-sudin dystonia with powerful panic attacks and adaptations.

Attacks, pains in the heart, and then I can see the rhythm of the healthy people.

Attack of the heart, but the reasons for the decline

Call people with a heart attack to call everything that is superfluous to the intensely trivial (20-30 minutes and more).

The reason may be:

• Myocardial infarction, which, as a rule, is preceded by ІХС, angina pectoris is unstable;
• Thromboembolism of the legacy artery (BODY), it is not easy to develop as a legacy of a slightly destructive way of life in a kidnapped person, thrombophlebitis of venous sudin nig;
• Migrating arrhythmia;
• Aortic aneurysm
• Heart deficiency, which was formed as a result of a weakening of the fast-feeling health of the heart, could be caused by a decline in the heart-vascular system (arterial hypertension, atherosclerotic cardiosclerosis, aortic malformations).

All of them can be addicted to one more, if they are isolated, but not on the skin they are asymptomatic or atypical, so understanding the "heart attack" is so widely used and good, even people, but there are no medical problems of understanding ...

I’m sure I’m not safe for life, when I’m going to become, I’m not sure I’m going to be a doctor, it’s just necessary for the good nobility to have symptoms of a heart attack. Life can also be found in the skin of us in a situation, if a person needs additional help, but the conscience is not allowed to go through, even myocardial infarction on the cob of its development (until the diagnosis is established) of the heart can be called.

Happy heart attack

Pain in case of heart attack, the basis of which is the bend of the myocardial bone, but it is caused by a clotting of the heart with a thrombus, or a sharp spasm of the arterial vessels, which is more severely damaged blood loss of the heart (ischemia), up to triviality. On top of that, the stench is especially intense, and the attack is stopped by nitroglycerin, either lykarsky zasobiv through the mouth, as a rule, does not give the effect, do not lie down the country’s serpent, access to fresh food, salty and vidpochinok.

If I am in pain, stretching out a heart attack, in the absence of any reason, it can be superfluous, or it may turn out to be some of the following symptoms:

1. Feel fear and anxiety (panic attack), like a snarl of a patient to take a stupid pose with a view of a zhahu in his eyes.
2. Strong heart rate i / abnormal heart rhythm.
3. Unacceptable views behind the sternum, in the hands, in the area of ​​the back and shoulders.
4. Seeing instability, bad-headed attacks, out-of-the-box weakness.
5. Zapamorochennyam, tediousness, vagoyu in the epigastria, as it got stuck, one of the stoves and / or blues.
6. Pitlivistyu, blіdіstu abo cyanosis (cyanosis) of shkіrnyh curves, perhaps, lower temperatures of kіntsіvok.

Do not take a note of respect for such a heart attack, which I will call "a certain infarction," which is practically inconvenient, without any symptoms, and you can eat from the skin with us, however, in a big world until a child is on guard.

How robbit in case of heart attack?

The most ailing one is more beautiful than nothing, bazhano poklikat someone, but a ludin who gave a first help with a heart attack.

In some situations, it is necessary for mothers to respect the condition of myocardial infarction;

• Vimіryuvannya pulse (number of beats, rhythm, napovnennya, vpruga) and arterial vise (with the presence of a tonometer);
• Nitroglycerin pid language;
• Termynovy call by phone 103, fixing the "heart attack", even in case of infarction, and those similar camps, you can get rid of the same chillin.

Zrozumilo, problems with the heart can catch a man in any kind of a miracle, a device for vimіryuvannya vise and nitroglycerin, that the best help with a heart attack is guilty of falling in that, as if they were "earlier about" a sick medical student.

Viklik 103 - heart attack

People who wicked "shvidku" from the drive of the heart attack, it is not possible to zvynuvatiti in the fact that they do not take on their right and make a diagnosis. For whatever kind of attack, it’s okay to get out of it, and the words say magic diyu: The dispatcher of the station knows that a catastrophe has become, the important camp of a sick person does not tolerate perversion, for that cardiobrigade is needed. Some of the same words scatter life, so the pre-riverine will be shortly tinkered with extreme vapors, as in the first time it is important to diagnose.

The threat to the life of the people is carried by the heart's lack of heart: an attack of a bad heart, which protects against the type of heart asthma, can be quickly transformed into a pack of legends, or grows into a cardiogenic shock in the context of extensive myocardial infarction. An attack of tachycardia with a gallop rhythm, as a rule, will add to the manifestation of breath. Patients who suffer from a chronic heart failure, I know that I want to attack the heartbreak and the painful perception of the hospitable instability, the superfluous, the drinking, the cyanosis, and the needlessly »In most cases, attack at night. It goes without saying, for people who have come to terms, and the appearance will be the mother of the significance of a heart attack, which is a vimag of a non-guilty wiklik "shvidkoi".

Video: help in case of attack - myocardial infarction

The attack of the heart, which is not inviting in frequency and rhythm, but is responsible for the least heart pathology, is not often brought to the attention of heart attacks and is not safe for the life of the country. Ailments, which often come to the attack of arrhythmias, may take to buy licks, they know the stench, if they themselves cannot be taken to extremes, for taking arrhythmia attacks with their own forces (taking antiarrhythmic blockers, β-blockers). Ale ... bout any, if the situation is to go to the control of a sick person, it’s a wicked “shvidku”, so that he can deal with an attack at a patient’s home.

How to be afraid with arrhythmias?

There is a change in the appearance of arrhythmias, not safe and not even worse, for example, about the breakdown of the rhythm, like blinking arrhythmia, Chuli, which is not all, it is rich. First, the blame for the attack of arrhythmia of such a kind of a sick man, a blame, that it is more terrible to be seen from his heart, we will reduce the decisions of this kind of malice for medical aid... Until then, the whole camp, as a rule, was in the state of the hospital. Silently, having called the telephone number 103, you will be able to tell the people that they have a heart attack.

To know the attack of arrhythmia can be a "shvidkoy" one for the help of antiarrhythmic wounds, the most beautiful and beautiful to the relatives. Here, an individual pidhid is required, drugs that adapt the rhythm, fail to show and contraindicate, and the only algorithm to reverse all arrhythmias is not. In such cases, you can use verapamil, which is to be administered internally, and at the same time supply food about hospitalization in specialization of hospital.

If you are afraid of a tachycardia attack, then the patient himself will cope with it for the help of β-blockers, for example. However, the self-dependence of this is possible, since there is a reason for the establishment of diagnoses and it is indicated that there is a problem, in the least, it is necessary to turn to a drug.

A fairy tale in the nature of many experiences

In some way, it is even more important to separate the heart, and, apparently, the heart attack is most of the views The most important, including the cardial, the less obvious, all the same:

Gender, vik, atherosclerosis

Singingly, angina pectoris is introduced to the most frequent "right-handed hearts", more than half of the people are suffering from ailments, which may cause problems of the heart-vascular system. Atherosclerosis of arterial vasgal, and coronary arteries, zokrem, є the main reason for the development of angina pectoris, a clinical viraz, which can be caused by heart attacks.

Heart deficiency in patients with atherosclerosis is formed when there is a disproportion in the consumption of heart meat in oil and blood circulation in the arterial vessels of the heart. It is especially brightly twisted, as soon as the person will be taken away from the physical development, and the heart is brought up to the best of its ability, so that the fabrics and the body will be protected with the necessary words. The situation will be accelerated by the lack of everyday nobles, for the addition of some organisms and biomass to compensate for the impaired blood flow. Krym, a negative effect is given by officials, who negatively infuse hearts into the artery:

• At the phase of systole (fast myocardium), the heart muscle of the stench is nailed, and the blood flow is difficult in them.
• Zbilsheny kintseviy diastolic volume, grip in LSh (lіviy shlunochok), the speed of the myocardium is reduced to produce the grip of the middle of the heart meat until it pivots.

Symptoms of a heart attack are associated with a form of coronary insufficiency. Through the disruption of the balance between transport and blood and the need for heart meat in new, myocardium begins to see the senses of hunger and in the minds of hypoxia appears to be in the heart. It is a great memory for people to enter a group of patients with myocardial infarction (become, vik, vaga, overwhelming new signs, hypercholesterolemia, atherosclerosis).

Attack with constant vessels

Slide to respect that signs of an attack of angina pectoris are not affected in people, but may not be judged by the heart.

"Shop for the heart" can be in the same vipad:

1. The production of physiologically active speeches (catecholamines) and accumulation in the myocardium during psychomotional and / or abnormally physical stimulation of the heart has been intensified, intensively accelerating the heart. In the minds of myocardium on the heart, myocardium of the vimag of the pre-datal ossification is sour, which cannot be delivered through the spasm of the sudin and the impairment of the blood flow, wicked with catecholamines. Prior to these active speeches, the title “hormone to fear” is called adrenaline, which is the only way to provoke the children themselves - lovers of the kind of extreme extremes. With a strong heart attack, attacks of bad health and angina pectoris, the second hormone of supra-noreal diseases is norepinephrine, which is called "the hormone of lute", which is actively synthesized during stress. People who suffer from vegetative-vascular dystonia, even more known paroxysms, zooming into the sympathoadrenal system. Smells are suspected to be susceptible to symptoms and to a panic attack: the judgment is clean, the heart is healthier, and signs of an attack of angina pectoris are evident.
2. In addition to the sympathoadrenal system, activation of factors is observed, which helps to reduce hemostasis. If in the processes of laryngeal disease and contraction of the larynx, there are no changes in the mind for the formation of disseminated intravascular laryngeal disease (ICE), as the coronary insufficiency will be even more likely, as there is a lack of heart disease.
3. If there is blood flow along the microcirculatory bed, there is a transition on your road, then you will go to the bypass along the inner vessels (collaterals). The whole pristine mechanism is based on the type of non-transferable circumstances and especially the accusations of women, which are programmed by nature (vaginism, canopy), and the cholovic becomes to be considered a factor. The woman will seize the colaterals, however, up to an hour before the time of menopause, the hormonal function is not extinguished. Pislya 60 years of age to correct an infarction in the first world of offense. Lack of development of kolaterals (everyday nobles) reduces the organism's energy, and the heart attack is more common among such people in the context of the patients, for whom everything is in order in the whole plan. Obviously, young women of reproductive age play.

If people are to be spared, then before the hour of the heart attack of the rapt's gostr's coronary insufficiency, you can turn on the mechanisms to compensate for blood circulation and by yourself to overcome the formation of ischemic disaster. When you try to fix yourself up to the surroundings, you open up in reality, and also, in the term order, new ones emerge. Krim tsyogo, myocardium will be replenished to improve the hopefulness of the well-being of the arterial blood. However, the "coronary supply" is not bottomless, and when the symptoms of a heart attack are present, they become more and more swelling.

Myocardium otrimuє shelter of coronary (vintsevich) Sudin hearts. In case of a coronary heart disease, the heart mucus does not vytacha blood and is transferred by it sourness. The ischemia of the heart is seen with transplanted consumption in sourness over accessibility. Judge your heart with a lot of crying may atherosclerotic symptoms.

See and see and see

• • for the first time;
  • progressively;

• • dibnovognischevy.

• atherosclerotic IXC;
• heart aneurysm;

Riziku factories

1. Alcohol implantation.
2. Hіpodynamії.

ICD code for progressive angina

Classification of the IXC for the international classification of the disease

Ischemic ailment of the heart is a pathology of the heart meat, tied to a shortage of blood supply and an overgrowth of hypoxia. Myocardium otrimuє shelter of coronary (vintsevich) Sudin hearts. In case of coronary heart disease, the heart mucus does not vytacha blood and is transferred by it sourness. The ischemia of the heart is seen with transplanted consumption in sourness over accessibility. Judge your heart with a lot of crying may atherosclerotic symptoms.

Diagnosis of ІХС enlargements among people older than 50 years. With the advancement of pathology, it is more common to develop.

See and see and see

Classify ischemic ailments at the stage of clinical manifestations, dryness to vasodilating drugs, stiffness to physical effects. Form IXC:

• Rapt coronary death will be tied to the damaged myocardial conduction system, so as to rapid rapid arrhythmia. When there is a reanimation of an attack, or failure, a heart attack when it is confirmed by eyewitnesses, or a death, when an attack occurs in the intervals of six years, as a result of this ear, to put the diagnosis "first of a heart attack." With a successful reanimation of the patient, the diagnosis is “ rapt death with successful reanimation ".
• Angina pectoris is a form of ischemic ailment, when there is a baking bile in the middle of the breasts, and, more precisely, behind the breastbone. For ICD-10 (international classification, 10 glance illnesses) angina pectoris is classified as I20.

May also include pidvidiv:

• Stenocardia is spongy, or it is stable, when there is a decrease in the rate of heart muscle soreness. In the case of hypoxia (kisneve hunger), the diagnosis is severe and spasm of the coronary arteries. Stable angina pectoris as a result of unstable disease physical options one and the same intensity, for example, walking for a distance of 300 meters with a large croc, and buying nitroglycerin preparations.
• Unstable angina pectoris (code for MKH - 20.0) is nasty to buy bad nitroglycerin, attack the pain often, the tolerance of the new option is reduced in a sick person. The form is given to grow on tipi:
  • for the first time;
  • progressively;
  • early postinfarction abo pislyaoperatsіynі.
• Vasospastic angina pectoris, viclikana spasm of sudin without atherosclerotic changes.
• Coronary syndrome (syndrome X).

  According to the international classification 10 (ICD-10), angiospastic angina (Prinzmetal's angina, optional) is reported 20.1 (Angina with confirmed spasm). Angina pectoris - ICD code 20.8. Unspecified angina pectoris assigned code 20.9.

• Myocardial infarction. The attack of angina pectoris, which is more than 30 minutes and is not controlled by nitroglycerin, ends with an infarction. Diagnosis of infarction, including analysis of EKG, laboratory dosage the level of markers for the reduction of heart meat (fraction of enzymes of creatine phosphokinase and lactate dehydrogenase, tropomyosin, etc.). At the end of the battle you see:
  • transmural (velikovnischevy) infarction;
  • dibnovognischevy.

  Behind the international classification of 10, the infarction is shown to the code I21, one can see the following: a vast infarction of the lower stage, anterior stage and other localizations, not specified. The diagnosis "repeated myocardial infarction" was assigned the code I22.

• Postinfarction cardiosclerosis. Diagnosis of cardiosclerosis behind the help of electrocardiograms is based on the deteriorated conduction in cases of cicatricial changes in the myocardium. The form of ischemic ailment is given to occur not earlier than 1 month from the moment of infarction. Cardiosclerosis - scarring changes, which have occurred on the malignant muscle as a result of heart mellitus infarction. The stench is molded rough with good cloth... Cardiosclerosis is not safe for the great part of the provincial system of the heart.

Інші forms ІХС - codes I24-I25:

1. Painless form (according to the old 1979 rock classification).
2. Gostra sertseva lack of development on myocardial infarction, or in case of shock stuns.
3. Loss of heart rhythm. With ischemic lesions, the blood supply of the wired system of the heart is destroyed.

Code I24.0 for MKH-10 was assigned to coronary thrombosis without infarction.

Code I24.1 for MKH - Dressler's postinfarction syndrome.

Code I24.8 for 10 glance ICD - coronary deficiency.

Code I25 according to ICD-10 - chronic ischemic ailment; including:

• atherosclerotic IXC;
• transfers of infarction and postinfarction cardiosclerosis;
• heart aneurysm;
• coronary arteriovenous fistula;
• asymptomatic ischemia of the heart meat;
• chronically unspecified ІХС and інші forms of chronic ІХС trivial more than 4 years.

Riziku factories

Debilitation before ischemia is reduced in case of onset factors of ІХС risk:

1. Metabolic, albeit X syndrome, in case of damage to carbohydrates and fats, changes in cholesterol levels, low insulin resistance. People with type 2 diabetes are included in the group of heart-and-heart disease, Including, for angina and infarction. If the girth of the waist is 80 cm, then the result will be respectfully set to health and food. Timely diagnostics and treatment of a diabetic child to complete the prognosis of a disease.
2. Palinny. Nikotin sounded the judgment, quickening the hearts of speed, increased the need for heart meat in blood and sour.
3. Pechinkovy ills. With a liver ailment, the synthesis of cholesterol increases, so it can be increased to an increased amount of fat on the walls of the vessels, with more oxidized and heated arteries.
4. Alcohol implantation.
5. Hіpodynamії.
6. To a gradual change in calories.
7. Emotional stress. When zaborushennya, the need for an organism in sourness is increased, and the heart's ointment is not a blame. Moreover, with trivial stresses, cortisol and catecholamines are seen, coronary heart disease sounds, and cholesterol is violated.
8. Loss of lipid exchange and atherosclerosis of coronary arteries. Diagnostics - implantation of lipid spectrum of blood.
9. Syndrome of oversized obstruction of the small intestine, which will ruin the liver and cause avitaminosis of folic acid and vitamin B12. With a large increase in cholesterol and homocysteine ​​levels. Remaining porous peripheral blood circulation and pitting on the heart.
10. Syndrome of Icenko-Cushing, which is associated with hyperfunction of supra-nirkoval locomotion, or with the intake of drugs in steroid hormones.
11. Hormonal disorders of the thyroid gland, yachnikiv.

Men over 50 and women during menopause are most often sick before attacks of angina pectoris and infarction.

Rizik factor ІХС, which will help to overcome the ischemic ailments of the heart: uremia, diabetics, legeneva lack. Cover ІХС damage in the wire system of the heart (blockade of the sinoatrial university, atrioventricular university, the lower part of the Gis bundle).

The current ІХС classification allows doctors to correctly assess the country of the sick and to live the necessary visits for the first time. For the skin form, which is the code in the ICD, it is broken down by its own algorithms for diagnostics and treatment. If it is not possible for children to develop ailments, the drug can help patients more effectively.

Myocardial ischemia: causes, symptoms, diagnosis, treatment

Ischemia of the myocardium form the basis of ischemic ailments of the heart (IXS) - the most advanced pathology of the cardiovascular system in humans. According to the statistics, it is only half the number of people who are abducted and one third of females, and the mortality rate of older forms of ischemia reaches 30%.

The ailment is not small for geographic cordons, it is widened in the regions, where it grows, and in the developed regions with a high level of medicine. The trivial hour of the IXC can be asymptomatic, depriving the mind of giving itself to the nobility with unacceptable views in the region of the heart.

The great significance of painless ischemia of the myocardium. The disease does not manifest itself as richly rocky, albeit a vast infarction of the heart and raptus bend. For deyakim danimi, the form of pathology of the enemy is up to 20% of practically healthy people, ale yak mayut factori riziku.

Causes and types of ischemia of the heart

About the reasons, such as to produce to ischemic changes of the heart, not feeling lynivies. Among the main factors in risiku include:

• Pohiliy vіk;
• To become a cholovicha;
• Spadkov's smartness (family dislipidemies);
• kurnnya;
• Disorder of pathology, such as diabetes, hypertension, vagina;
• Disruption of the lipid spectrum;
• Hіpodynamіyu.

Patients of the kidnapped veterinarian are the main contingent of cardiological views. It’s not vipadkovo, even dystrophic processes occur in the vessels, there’s a problem, there’s a problem of pathology. It is obvious that we will stop at the hour of ischemia, showing obvious signs of “rejuvenation”, especially among the inhabitants of the great places.

Women, due to hormonal peculiarities, are less sick to heart, so as estrogens produce their own kind of infusion, however, approximately up to 70 years, if the menopause is insisting, indicators of sickness in them will adapt to such people. The prevalence of estrogens is greater in the early development of atherosclerosis and, apparently, ischemic ear of the heart in choloviks.

The destruction of fatty metabolism of the wikik is added on the walls of the arteries of the young devices, which will slow down the blood flow and produce to the sour hunger of the tissues of the heart. This phenomenon is significant for obesity and obesity diabetes. Hypertension with crises when the internal whistle of arteries is reduced and fat is circularly deposited in them, as well as a significant deficiency in blood flow.

Pererakhovani factories to produce before the appearance of non-mediated reasons for the lack of sourness in the heart: atherosclerosis, spasm of the nerves, thrombosis.

The types of myocardial ischemia, according to the International Classification of ailments, are as follows:

1. Angina.
2. Myocardial infarction.
3. Breaking the rhythm of the heart.
4. Raptov's death is coronary.
5. Cardiosclerosis as a result of heart infarction suffered earlier.
6. Sertseva's lack.

Angina pectoris is the most common form of ischemia of the heart, as it is diagnosed in most people with kidney disease, and does not show scarg (asymptomatic form). The onset of pain is not to blame for soothing, especially in individuals who may cause atherosclerosis to cause atherosclerosis in patients who are ill and sick to the risk of risk.

Infarction is a necrosis of the myocardium, if the gostra does not produce acidity until the cardiomyocytes die, the heart is damaged due to the high risk of a fatal result. Infarction is one of the most important and non-vascular manifestations of ischemia. Pislya for the suppression of necrosis in the diagnosis of post-infarction cardiosclerosis.

When there is a significant community of necrotic to talk about large-focal infarction, it often penetrates the whole heart meat (transmural infarction). Small midseeds of necrosis can perebuvati under the shells of the heart. The subepicardial ischemia of the vertebral column is accompanied by the endocardial (epicardium), the subendocardial - to the middle, the endocarditis.

All forms of ischemia are early enough to produce up to the presence of compensatory mechanisms, structural changes and an unhealthy increase in heart failure. Such patients have a high risk of thromboembolic acceleration from lesions of the brain, nirok, kintzivok. Especially often thrombosis occurs with subendocardial form of ischemia, if the inner ball of the heart is involved.

To become a special form of becoming ill is so called transient, or painless, nim, ischemia of the heart meat. You can see that in about half of the patients with the IXC, there are not any symptoms, the problems in the cells of the myocardium are nevertheless observed and it is possible to detect them, for example, for the help of the EKG.

The past ischemia of the heart is quite often observed in the middle of hypertension, kurts, ailments persistent lack heart. In all, without a vignette of patients, with a certain form of pathology, it means the defeat of the magistral heart of the heart, many important atherosclerosis, a great length of the cases of sound. Until now, it is not clear why the diagnosis of painless ischemia is associated with a significant lesion of the sudin, or, perhaps, tied with a good development of the collateral blood flow.

How do you find yourself in your heart with ischemia?

The main familiarity of the IXC is the pain syndrome, which is a disease in case of chronic interruption of ailments, as well as in case of hospitality forms. In the basis of pain, there is the development of nerve receptors by metabolic products, which are established in the minds of hypoxia. Heart without interruption, pumping colossal bloodsheds, so vitratic sisnu and lively speeches are very high.

The blood goes up to the heart muscle along the coronary vessels, and the colateral blood flow in the heart of the intercourse, in case of severe arteries, the myocardium is affected. Atherosclerotic plaque, thrombus, rapid spasm of the vertebral column open up the interstitial space for blood flow, at the same time the cells of the cells are inadequate for proper shelter, there are more and more characteristic structural changes in the myocardium.

In cases of chronic ischemia of the myocardium, develop in atherosclerosis, heart disease "hunger" gradually, stimulation of clitin fibroblasts is stimulated on the whole, to create tissue growth of carcinogenic fibers. Obtaining the conductive nerve bundles with arrhythmia.

Sudden catastrophes with thrombosis, discoloration of plaques, spasms of supernatant and rapid blood flow through the vessels, the roof does not reach the heart meat, and the myocardial ischemia "wiggle" into the infarction - necrosis of the heart. Frequently, on the other hand, there are many chronic cases of illness.

The most important changes you want to reestablish in half of your heart, so as you see it, it is much more new, but not right. The community of myocardium is greater here, and good blood circulation is required for its sake. The ischemia of the stem of the lilac louse is called to become the basis of the IXC, and immediately the basic podіya "rots out" in the case of necrosis of the heart meat.

Show ischemia myocardium

Clinical signs of the ischemia of the heart to lie down at the level of the battle of arteries and options for overcoming pathology. The most widespread type of ischemia is angina pectoris, if the pain occurs at the time of physical pain. For example, the ailment got through the gatherings, got through, and the result is a beating in the breasts.

Symptoms of angina pectoris are:

• Beel in the area of ​​the heart, behind the sternum, my hand, The interscapular region, is susceptible to or appear in case of physical imposition;
• Zadishku at shvidk_y walking, emots_ynyh re-entangled.

Even if the symptoms are trivial until the first time, they are known to take nitroglycerin, they are diagnosed with navantazhennyah, then talk about angina pectoris. When scarg appears spontaneously, in calmness Ide about angina pectoris calm. Strengthening pains, decreasing stiffness up to navantazhennya, rotting effects from the drugs taken can be familiar with progressive angina pectoris.

Myocardial infarction - even more important is the form of ischemia, as it manifests itself with baking, strong retrosternal pains, and is accompanied by necrosis of cardiomyocytes. The patient is restless, there is a fear of death, it can be psychomotor zabudzhennya, zadishka, cyanosis of the shkiri, there can be interruptions to the rhythm of the heart very quickly. In some cases, necrosis is not typical - with pain in the abdomen, but without pain.

The second manifestation of ischemia of the heart can be arrhythmia - blinking, deterioration of conductivity in viglyadi blockades, tachycardia. At the same time, patients see interruptions in the heart's performance, stronger than a heart, or a feeling of being overwhelmed.

The most insecure option for ischemic ailments of the heart is raptus heart death, as you can step on the attack of angina pectoris, necrosis, arrhythmia. The patient is impressed by the testimony, the heart and soul. Tsei stan vimag of non-blind reanimation visits.

At the far stages of ischemia, the heart grows signs of its deficiency, there is a cyanosis of the skin and mucous membranes, a lot of stuff on the pictures, because of the time to accumulate in the empty ones. Patient skarzhitsya for weakness, very bad, Take the zmusheniy napivsidyachi or sitting position.

Diagnostics and treatment of myocardial ischemia

Diagnostics of ischemic ailments of the heart will be based on scarg, peculiarities of overcoming ailments, the link of symptoms to new options. Likar to carry out a hearing loss, it is not uncommon for wheezing through congestive lesions, palpation of the liver may indicate improvement in chronic heart failure. Auscultation of the heart gives the ability to diagnose the presence of additional noises, breakdown of the rhythm.

A reliable sign that it is allowed to make a diagnosis when looking around, it is not, that laboratory and instrumental tests are carried out beforehand. The patient will recognize a biochemical analysis of the blood from the preliminaries of the lypid spectrum, it is necessary to carry out the EKG, including the new tests (veloergometry, treadmil). Great information can be taken out during the Holter monitoring.

on EHC signs Ischemia vvazayut a decrease in ST segment elevation more than 1 mm. You can restore arrhythmia, blockade carrying out impulses. Large-focal infarction is characterized by the appearance of a large Q wave, a change of the T wave at the sharpest stage in the next stage, negative wine in the state and during the period.

With the help of laboratory confirmation of heart infarction, a number of dosages should be carried out. So, zagalny analiz blood will show an improvement in SHOE, leukocytosis, which can be said about an ignition of a necrosis. The analysis of bilkovy fractions allows you to establish the improvement of the actions of them (ALT, AST, KFK, troponin, myoglobin and in.). Varto mean that such informative indicators, such as the level of troponin, myoglobin, heart fraction of the KFK, are far from being used by all installations through the availability of possession, so ailments need to be asked for additional help from private clients.

To clarify the standard of coronary arteries, conduct coronary angiography, CT with contrast, MSCT, scintigraphy, especially necessary for painless ischemia.

Likuvannya ischemia of the heart to lie down as a form of illness, I will become a patient, congenital pathology. With the growing types of IXC, it is easy to see, but in principle, all one thing becomes unimportant.

The main areas of heart ischemia therapy:

• Amalgamation of physical and emotional support for saving sufficient physical activity (walking, gymnastics is feasible);
• Diet, adjusted for the normalization of fatty and carbohydrate metabolism (also, for atherosclerosis - mixing food fats, carbohydrates, mixing in races of fruits, vegetables, dairy products, ribs); a decrease in weight in case of obesity for a meal; a decrease in calorie content;
• Drug therapy, which includes diuretics, beta-blockers, calcium antagonists, nitrate for pain attacks, antiaggreganti.

Drug therapy is the most important and obstructive component of myocardial ischemia treatment. The change of likars' habits is taken individually, and the patient is guilty of unreasonably taking into account all the recommendations of the cardiologist.

Antiaggreganti treat all ailments on ischemic ailments of the heart. The high efficiency of acetylsalicylic acid in small doses has been brought, on the basis of which it is safe for trivial drug use (thrombotic ac, aspirin cardio, Cardiomagnil). In some cases, anticoagulants (warfarin) are prescribed, in case of myocardial infarction, heparin is administered.

Beta-adrenergic blockers are also used in the main group of patients with myocardial ischemia. The stench allows you to change the frequency of your very heart and soul need for painting, to promote life to your patients. Naybilsh widening - metoprolol, bisoprolol, carvedilol.

Looking at the deterioration of the lipid spectrum, statins and fibrosis are recognized, which reduce the number of atherogenic cholesterol fractions (LPNSH, LPDNShch) and increase anti-atherogenic (LPVShch). Vikoristovytsya lovastatin, simvastatin, clofibrat, fenofibrat.

Nitraty (nitroglycerin) is effective for pain attack. Їх zastosovyt in tablet form or in іn'єktsіynyh forms. As a side effect є lowering the arterial grip, zamorochennya and obscurity, for that the hypotonics of the varto will be borderally protected.

Diuretics are necessary for the development of a child, which can be used for myocardium. Vikoristovuyutsya loops (furosemid), tiazidny (indapamid) sechoginny.

Angibitories of the ACE are included in the majority of schemes for the treatment of myocardial ischemia, some of the stench does not just create an arterial grip on normal values, but it is a spasm of arterial vascular disease. Lizinopril, capropril, enap are meant.

In case of arrhythmia, antiarrhythmic drugs are indicated. In the case of tachycardia, there will be beta-blockers, in the case of other forms - amiodarone, cordarone.

With an important lesion of the coronary arteries, if drug treatment do not lead to a bazhany result, vdajutsya to surgical corrections of judicial changes. Vikoristovuyutsya endovascular techniques (balloon angioplasty, stenting), as well as more radical surgery - coronary artery bypass surgery.

The prognosis for ischemia of the heart is serious, more of the ailments become invalids, as and earlier, a high risk of acceleration and fatal result. I will look at the wide breadth of both the ischemia and the officials, and I will produce it before they appear, as well as the high level of inconvenience among the children, the problem does not impair the relevance, but the respect for the fahivts is focused on effective ways Likuvannya and Prevention of Grave Disease.

Video: ischemic ailment of the heart, program "Pigulka"

Video: heart ischemia - main moments

Replacement of cicatricial tissue of the heart and th valves - postmyocardial cardiosclerosis. The reduction of the heart tissue can increase the size of the mother's steps: from microtraumas to great scars.

Diagnostics of the disease has slipped quickly, and the problem will be resolved quickly. Koduvannya ailments according to ICD 10: atherosclerotic ailments of the heart.

Cause the slaughter of robots of the heart-vascular system, in medicine, it is caused by the main etiological manifestations:

1. Postmyocardial cardiosclerosis. To develop through an affirmation in the heart of the flame.
2. Atherosclerotic cardiosclerosis. To develop on the stage of atherosclerosis of coronary artery disease.
3. Postinfarction (myocardial) cardiosclerosis. Developing for myocardial infarction.

Spostering postmyocardial atherosclerosis in people from 20 to 40 years. Tse tie up with the manifestation of infectious, chronic and allergic processes in the body. Wear the diffuse nature of the exercise.

Atherosclerotic cardiac sclerosis ICD 10 is observed only in people with ischemic heart disease. Zagvoryuvannya is characteristically moveable and trivial with the development of the first symptoms.

To get through the lack of adequate blood to the myocardium through lesions of the coronary vasculature. Vidmirannya klin of myocardium to produce to the destructive speedy function of the heart and development of nabutykh vad. Atherosclerotic cardiac sclerosis ICD 10 maє diffuse lesion on all surface of the tissue.

cause sickness

So, myocardial cardiosclerosis is confirmed by myocarditis. The dissection of myocarditis occurs on aphids of ignition and infectious processes.

On the skin, you will experience the degradation of vimagaretelny skinning, and you will not allow the inconveniences in the heart.

The transfer of myocarditis has all the chances to lead to myocardial effusion according to ICD 10. The firing process of the tissue on the myocardium will change completely. Ce і is the phenomenon of cardiosclerosis.

For types of wines, go to:

• Diffuse. So, as a substitute for scar tissue, it expands over the entire area of ​​the myocardium. It has been reported that also the substitution is made to prevent sickness from being sick.
• Vognishchevy. At the same time, the singing of the heart is earned. Vognischa urazhennya cardiosclerosis ICD 10 May change in size.

Diagnostics and treatment

Below you can see the clinics of Moscow and St. Petersburg where you can turn for help.

I20.0 code for MKH-10: angina pectoris, scho tse i yak likuvati

Such figures are to be found on the title side of the picture of the patient, who will help the likars shvidshe zorієntuvatisya in a specific situation.

This is a kind of pathology

Angina pectoris is carried to clinical forms of ischemic ailments of the heart (IXC). It is a discomfort, which is characterized by large visions behind the breastbone, which are observed with physical nurturing, stress, and strong emotions.

To factors for the development of ailments include:

1. Reasons not to lie down among the people themselves:
2. vik;
3. recession.
4. To lie directly from the patient:
5. obesity;
6. kurnnya;
7. a little rude way of life;
8. wrong food.
9. Pathology problem:
10. Hypertensive ailment;
11. Diabetes mellitus;
12. Hypercholesterolemia (alterations instead of "trash" fractions of cholesterol in the blood).

How to see in the heart with angina pectoris

The basis for the development of any form ІХС є is an atherosclerotic plaque in the heart. With "clean" coronary arteries, angina pectoris does not develop.

The main mechanisms to summarize cool picture, To be built before the onset of points:

1. Blockage of the lumen of the heart with atherosclerotic plaque.
2. Local abo diffuse spasm of the arteries.
3. Microsudinny postcards.
4. Disruption of the normal functioning of the heart

If a lyudin is engaged in physical tasks, or if he is in the camp of a strong emotional shock, the heart of the victor has a need for sourness.

With the urahuvannya of the descriptive mechanisms, the posed arteries, it is not possible to fit in with the zimm of the enterprises. Due to such an imbalance between the need for acidity and unhealthy heart disease, a classic pain syndrome for angina pectoris develops - “angina pectoris”.

Classification

In cardiological practice, angina pectoris spills into two types:

Such a key classification of ma more important for the selection of adequate therapy, it is carried out on an outpatient basis or stationary.

When the diagnosis is formulated, the drug is ordered into a functional class. This kind of help is due to the seriousness of the illness.

Functional class (FC) of angina pectoris according to the international classification of the Canadian Society of Cardiologists.

Functional class Characteristics of a complete physical installation

I Sertsev - turbuyut at great navantazhennya. The specific physical activity is not suffering.

May II, there is little interconnection of physical activity. For the detection of attacks to reach the physical appearance at the sight of a quick walk more, less than 500 m along the equal distance, go more, less than one descent

III Spite the turn of the decrease in the specific physical activity. Attack provokuyutsya by walking mensh, below 500 meters, or when pidyomi for one pass of descent.

IV An important form, which is characterized by the appearance of pain syndrome in to the minimum and in peace

diagnosis formulation

The ICD angina code is I20.0.

With a stable form, the diagnosis of a viglead is by the next rank:

ІХС: angina pectoris I-IV FC.

How unstable is spontaneous:

ІХС: progressive angina pectoris with exit in angina pectoris I-IV FC.

key picture

The main scargo of ailments є vidchuttya squeezing, a vice behind the sternum. Pain syndrome ma typi signs:

1. Localization: behind the breastbone, in half of the breastbone. It is possible to insert the blade into the lower slot.
2. Triviality up to 10 min.
3. The attack is to be bought independently in calmness, or in case of stagnation of nitrats of a short episode.
4. Supravodzhutsya zagalnye manifestations - zadishka, tediousness, zamorochennyam. Often, people are faced with fear.

It is also a sign of a decrease in prasezdatnosti, a swelling stomp, and a weakness.

diagnostics

Diagnostics come in include:

• z'yasuvannya skarg at the sick man;
• anamnesis of life and development of ill health, development of factors in the development;
• dany of an ob'ktive look;
• laboratory and functional conditions.

There are national clinical recommendations, the "gold standard" of IXC diagnostics - coronary angiography (CAG). The essence of the procedure is in the visualization of the heart by the introduction of contrasting speech. When great atherosclerotic plaques are detected, CAH can be used as a clinical operation.

Additional methods (ultrasound of the heart, EKG, Holter Dosage) give doctors the ability to detect angina pectoris. The stench is unspecific.

Trochi about coronary angiography

The name of the whole procedure is correct - translucent transluminal coronary angioplasty without stent placement. To be applied to radiopaque methods of dosage.

Conducted in special angiographic operations for the masses of the sick. Allergological anamnesis will be found in advance. Behind the patient's camp at CAG sposterig the doctor is an anesthesiologist-resuscitator.

In the course of the procedure, puncture a puncture of the stegnous or interchangeable artery. Through new, introduce a special guide to the heart. Illness at all does not see a large number of witnesses.

We can then introduce a contrasting speech and, behind the aid of an angiographer, support them on the coronary artery monitors. At the same time, there may be a spasm of the sudin, which leads to pain in the chest. The attack is short-lived, to pass independently, or by writing additional nitrates.

This method allows the assessment of the progression of the sudins, the presence of atherosclerotic plaques in them, and the debridement.

If, if there is any further obstruction (occlusion) of the coronary artery, then stent. For cich purposes, according to the guide, before the required task, introduce a special attachment, such as an increase in education, and a new one. This type of expansion is called stents.

When the procedure is carried out for ailing indications, the post-treatment regime. Yaksho KAG was carried out through a puncture on stegnova artery, Then suvoro zaboronyaєatsya get up and finish with a stretch. Such a start is an effective prevention of bleeding.

lykuvannya

The main goals of therapy are:

Lіkuvannya stenocardії springs always includes a complex of entries:

1. General recommendations:
2. vidmova vid kurinnya;
3. decrease in mass tila;
4. іnformvannya patient in special schools ІХС;
5. correct eating;
6. healthy sleep;
7. treatment of concomitant pathology.
8. Medication signs:
9. aspirin - Cardiomagnil, cardiASK;
10. beta-adrenergic blockers - Concor, betaloc ZOK, nebilet, carvedilol, nperten;
11. statini - atoris, Torvakard, Krestor, vazilip;
12. іngіbіtori APF - enap, diroton, pretarium, perіneva, lizinoton, ampіlan.

This drug is also called ABCD therapy. When diagnosed in people with angina pectoris, all perakhovani groups of drugs are recognized instantly! In case of intolerance to liquor, there is a symptom of a specific skin disorder. Take the drugs as needed!

Before them, there are nitrati of short diy - nitroglycerin, nitrosorbid, nitromint, nitrospray.

The stench is sublingual (pid language). The effect is to develop practically immediately.

1. Hirurgic involvement:
2. CAG with stent installation (expansion of the coronary artery);
3. aortocoronary bypass.

Likuvannya progresuyuchey angina pectoris pass obov'yazkovo in the minds of the stationary, so as such a camp roznuyuєtsya yak preinfarction.

accelerating

The most dreadful and ugly inherits є:

prophylaxis

Prophylactic come directly to the detection of factors in the risk, їkh usunennya and free diagnostics of the disease. For cich purposes it is widely used in the polyclinic practice of medical examination of ailments. Plus, there are a lot of programs є hunting for young groups of population, repairing for 18 years.

Proceeding, manifestation and elimination of angina pectoris is necessary for the participation of a cardiologist and therapist. We are sick of all the recommendations є an important part of the gambling process. For the whole it is necessary to explain to the patients the reasons for such numerical characteristics. It is inadmissible to engage in self-abuse of the sickness. Tse can bring to sums of inheritance.

Angina [angina pectoris] (I20)

angina pectoris:

• growing
• naprugi, vpershe vinikla
• springs progressively

Intermediate coronary syndrome

angina pectoris:

• angiospastic
• Prinzmetal
• wracked with spasm
• option

Coronary flow syndrome

Ischemic chest pain

The Russian International Classification of ailments of the 10th glance (ICD-10) has adopted a single normative document for the incidence of illness, the reasons for the infestation of the population to the medical establishments, the causes of death.

ICD-10 was introduced into the practice of protecting health in the entire territory of the Russian Federation in 1999 by the order of the Ministry of Health of Ukraine dated 27.05.97. No. 170

A new look (ICD-11) is planned by WHO in 2017 2018 roci.

Іf changes and additions of the VOOZ rr.

Processing and transfer zmin © mkb-10.com

Designated ІХС and angina pectoris in ICD 10

ІХС and angina pectoris in the ICD-10 may have their own time. There is a feeling of ailment, in the basis of which there is a breakdown in the process of a surge of blood to the throat of the heart. Such ailments are called ischemic ailments of the heart. Okreme mіsce in the whole group of stenocardia loans, so as the signaling, the sick person is not safe. By itself, the ailment does not lead to a lethal result, albeit an ailment, which may be fatal inheritance.

In the international documentation of the IXC loans of categories from I20 to I25. I20 - stenocardia, which is called angina pectoris. If it’s not stable, then number 20.0 will be used. In general, you can be visceral, as well as angina pectoris, both in the first place, and in the progressive stage. For an ailment, a yak characterized by more and spasms, the number 20.1 is set. In general, sickness can be angiospastic, variable, spasmodic, or Prinzmetal's syndrome. If the pathology is not specified, then the code 20.9 will be found.

As soon as the patient has a state of myocardial infarction, then the patient has I21. These include the clarifications of the ailment gostry or the establishment of a month (ale not more). Deyakyuyuyuyuyuyutsya deyakі pobіchnі efekti pіslja infarct, as well as transfers in the last ailment, chronic, trivially more mіsyatsya, as well as more. Moreover, post-infarction syndromes should not be included in the whole dose.

If the patient has repeated myocardial infarction, then the tserezdil I22. Such a cipher is used for all types of myocardial infarction, which can be localized in any mission, ale, for 28 dB from the moment of the first attack. These include recurrent, recurrent and progressive appearance. Ale viklyuchatsya chronicle camp. For those who work in the process, an acceleration of the myocardial infarction will be distributed I23.

Classification includes and іnshі forms of a hospitable ischemic heart disease. All information about the price can be found in the section I24. If the patient has a thrombosis of the coronary type, which does not lead to myocardial infarction, then the number 24.0 is written. If thrombosis occurs in a chronic form, or more than 28 dB. For Dressler's syndrome, the number 24.1 is vikory. Rashta form of a stately ischemic ailment of the heart is written under the number 24.8, and if the disease is not specified, then the code 24.9 is victorious.

For chronic forms of ischemic ailments, the code I25 is selected. If the patient has atherosclerotic disease of the heart and blood vessels, then the number 25.0 is written. If only atherosclerosis of the heart, then 25.1. If myocardial infarction is transferred to the last, then the number 25.2 is written. For heart aneurysms, use the code 25.3. If the patient has an aneurysm of the coronary arterial vessel, then number 25.4 is used. However, the form of the disease is invented. If the patient has a cardiomyopathy of the ischemic type, then the number 25.5 is victorious. If the ischemia progression without visible symptoms, the diagnosis is made with the code 25.6. Rashta form ischemic ailments of the heart with a chronic interruption is written with the number 25.8, and if the camp of the sick person is not specified, then the code 25.9 is victorious.

Angina pectoris - a type of sickness of the heart. The quality of the ailment is specific, so it is possible because of the special features. Pathology develops through those that change the rush of blood to the heart, as the coronary artery sounds. Due to the fact that some of the process of damage, you see різні form ailments.

As soon as the patient has a heart tissue tissue, step by step ruin, then a necrosis. In this vypadku there can be extensions, transmural or superficial infarction. If the myocardium does not collapse, then such a camp is called ischemia. Here you see angina pectoris and calmness. For the first form, it is characteristic to win at important physical navantages. The form of angina pectoris is unstable and stable. If you feel comfortable with angina pectoris, then you won’t be able to navigate without physical problems. Є 2 main pidvidi - angina pectoris vasospastic and Prinzmetal.

Angina pectoris itself:

1. 1. Straining. It is characterized by the appearance of pains to crush the character in the retrosternal area, if the person has an intensive physical development. More can go to the left side of the breast plate, left hand, shoulder area, shia. Yak tilki is so inappropriate views, It is necessary to pinpoint whether it is necessary to implement it. In a dozen hour, the pain syndrome will self-pass. Dodatkovo can take nitrati. If the pathological stump does not pass, then the angina pectoris is stable.
2. 2. Calm down. Pain syndrome behind the sternum appears when people are in peace. Tse vidbuvaєtsya in two vipadkas. Persistently, as a reflex spasm a vessel of the coronary type. Tse є the cause of ischemic ailment. In other words, it is necessary to treat Prinzmetal's angina pectoris. There are some special types, like winykas, through those that enlighten the arteries of the coronary type to be overturned. For example, it can also be seen through a plaque.
3. 3. Unstable. Such a term means either angina pectoris, I will progress step by step, or calm angina pectoris, like є minlivaya. As long as the pain syndrome does not come out of control with the use of nitrates, the pathological process does not come under control, but it is not safe at all.

For such pathologies, the symptoms are characteristic:

• perceived pressure behind the breastbone and on the left side of the breastplate;
• perebіg ailments manifest themselves by attacks;
• inappropriate symptoms occur sharply, and not only with physical problems, albeit in a calm state;
• attack trivaє zazvychay for pivgodini, and if more, then the whole infarction;
• assimilation of symptoms of attack Nitroglycerin or other analogous ones on the basis of nitrates.

The key moment in the development of ischemic heart disease is the tense of enlightenment in arteries of the coronary type. Tse can provoke such factors:

• atherosclerosis of the heart;
• Rise of atherosclerotic type plaque and confirmation of thrombi;
• spazmuvannya arteries, scho to reduce the diameter of the education;
• parts of stress and constantly nerves of stress;
• overmіrnі navantazhennya in the physical plan;
• kurnnya;
• more often and less implantation of alcohol;
• hypertension;
• hypertrophic changes in the myocardium;
• changes in elasticity of blood-bearing vessels.

Lіkuvannya transfer medication therapy. In important cases, surgical involvement is required. For the development of blood, preparations from a group of anticoagulants are used. For example, go to Fraxiparin, Heparin, Warfarin. Also necessary antiaggreganti - tse Aspecard, Aspirin, Klopidogrel, Tiklopidin.

For the expansion of enlightenment in the sound arteries, the vicorists must be nitrate. For example, nitroglycerin, izosorbid. Inodi vikoristovuyutsya beta-adrenergic blockers and blockers of calcium channels. For usunennya atherosclerosis, medications are used, which are injected into the processes of lipid metabolism. For example, Atoris, Atorvastatin, Lovastatin are recognized. In yakosti metabolic lіkuvannya vicorisation of vitamins, ingibitories of ACE and cardioprotectors.

What is the progress of angina pectoris and what are the ways to get rid of?

Bile in the area of ​​the heart may be a symptom of deciduous illness. Progressive angina is one of the ailments, the yak often manifests itself on aphids of ischemic ailments of the heart and atherosclerosis. by ourselves the most insecure heritage maybe zupinka heart.

Likuvannya progresuyuchay angina pectoris in a special way, so as the name of the ailment zrozumilo, so there is a special development. Symptoms of the disease, as well as symptoms and symptoms, are reported in the statistic.

Progressive angina pectoris and її lіkuvannya

Angina pectoris is one of the manifestations of ischemic ailments of the heart (IXC). I am aware of the "progressive stenocardia", but also, I do not know everything, but I do not know anything about the skin.

Progressive angina is a type of unstable form of angina. I have given the form of angina pectoris in the patient not likuvati, the ailment will start progressing, carrying the nasty inheritance behind him.

For the international classification of ailment MKH-10, progressive angina is ma code 120.0.

The clever picture of the ailment is swirled, and it is worth noting that, when the first scarg is unsuccessful, it should be noted.

signs

Symptoms of progressive angina pectoris are not uncomfortable. I am familiar with the head in the area of ​​the heart. The appearance of ailments in the chest can be found in the case of those who are ill, all the symptoms of progressive stenocardia are lower in this case:

• more attacks grow more often and more;
• attack vinikayut with insignificant physical navantazhennyah;
• before the hour of the attack, there is a sight of smell;
• tediousness can grow into blues;
• the area of ​​large views grows shirsh;
• drown it out, it is necessary to add a dose of the drug, the amount of dosing is not necessary;
• the attack may not be caused by stress, but it may manifest itself for no reason in the camp of calm;
• v EHC results Likar mark the changes.

Important! Progressive angina pectoris can be found by people from the know-how at night, if it becomes more weak. Nichni attacks through intensities are carried over to the next level more importantly, as they fall at the moment of physical nurturing.

Ailments can be characterized by і nshim, lack of swelling, symptoms. Food is most important, for which it is necessary to be respected before I look at the doctor.

cause development

The reasons for the development of progressive angina are not so abundant. The most popular ones are:

1. There is a shortage of myocardium sisny (through the rotten throughput the building of the heart).
2. Pohiliy vik.

Important! Progressive angina pectoris in people from 55 to 60 years of age develop more often, but not in the first category.

Factories, through which risik vyniknennya is growing:

• implantation to alcohol, nikotin - shkіdlivі calls, which are not unpleasantly known only on the robotic heart;
• obesity;
• Diabetes mellitus;
• menopause;
• recession.

Take care of your health is necessary. Yaksho lyudin see from shkіdlivyh ringtone- this does not mean that I will be able to turn on the mother's ability to develop angina pectoris. Alle, find out the problem in a moment, and do not ruin it, it is real!

Classification of progressive angina

The classification of sickness is not of great importance, since one form can be counter to the skin patient in a way. Spiraling on the price, you can see the development stages of progressive angina pectoris:

• recently wined in napruz;
• in peace and tranquility;
• I will calm down in the camp.

Also, the classification of periodicity and the nature of pain attacks:

• attack more often;
• attack more often and more often;
• attack trapyayutsya every hour, a little bit more and more;
• the yak will attack in the camp, and in the camp I will calm down.

The second classifications of progressive angina pectoris are not possible.

lykuvannya

Be-yak get sick in a special way to the trip. Heartburn is especially respectful to take care of, and take a course of medications and other recommendations individually for skin problems.

Important! In case of pain in the heart, it is categorically not recommended to engage in self-care. It is necessary to turn up to a qualified fakhivtsya.

Why can there be a development of progressive angina pectoris, reports are published in the statistics.

Serpent to the way of life

1. Victory in the implantation of alcohol and nikotin.
2. Do not allow overwhelming physical navantazhennya, ale or not viklyuchati, in which attacks do not appear.
3. Take care of physical culture.
4. Dotrimuvatisya emots_yny spok_y.
5. Do not allow it to be overridden.
6. Enjoy more food on a fresh meal.
7. Dotrimuvatisya ratsion kharchuvannya.

Those people, who have no way to touch the spelled out points, will be before they see it, and they will not become such a hospitable person. It is also a healthy way of living after the residual reduction of progressive angina pectoris.

drug therapy

Medicine is not at a standstill. Everyday we go to wine and go through vip testing all new and new lines, designated for free ailments. The range of vibration for the heart is simply unimaginable. Progressive angina is not a blame.

Vivchivshi all the results of obsozhennya, the likar warehouse is a classic picture. Spiraling on the backward camp of the patient, the doctor has worked out the plan of the disease. Zvychay in the medication course include such drugs, such as:

• Lіki, scho to lower the arterial grip, bring the normal rhythm of the heart. Prescribed drugs on the heart change, the myocardium ceases to need a great deal of sourness, and as a result, a number of painful attacks will speed up.
• Save yourself, how will you develop atherosclerosis. Do not allow attacks in part and in stavati.
• Aspirin abo analogs. Decrease in thrombosis, which allows minimizuvati rizik zupinki heart.
• Likki, zdatnі lіkuvati bіl pіd hour to attack. Most often, nitroglycerin or analogous drugs are used for vicorist purposes.

Boo and so, put the patient in the hospital for a lick. This is necessary in order that in the event of the destruction of the sick person's camp they could immediately operate.

Lіkuvalna fіzkultury

Exercise therapy for people with a sick heart can bring cinnamon. Yak is not marvelous, physical design can be correct. With progressive angina pectoris, physical culture is quicker than the number of attacks and periodicity.

Important! Viconuvati physical rights are required only for the signs of a doctor and during his control.

The complex is to take a child's sleep from the backwardness, to the aspiration of arrhythmia. The most effective will be the advancement of:

• floating;
• walking;
• lizhі;
• The complex is individually folded to the right.

If there are any physical illnesses for an hour, it is necessary to turn up to the doctor, so as overwhelmingly on the job, you can only destroy your health.

Dikhalnaya gymnastics

Non-traditional methods of treatment are sometimes even more effective. For example, dichny gymnastics with progressive angina pectoris can help to reduce the frequency of pain attacks.

Dikhally right can be found in yogis. We will paint with a specific illness like this:

• Sit on the stiletto, I'll put it on, you need to think about some moment, speech, people, etc. If this is the result of reaching, poke a glib inhale with your nose in 3 seconds, tweak the action for a couple of seconds, letting you see it with your mouth for 5 seconds. Three times a day busy stretching two times to allow the speed of a few attacks of pain.

Clearing the correct dichati in a relaxed stance є even with a brown nose is not only when the heart is sick, but for the outward development of physical health to the body.

promptly lykuvannya

An extreme approach to the development of progressive angina pectoris є promptly involved... Until the operation vdaayutsya, if the methods of treatment turned out to be ineffectual.

There are two types of operative treatment for angina pectoris:

1. Aortocoronary shuntuvannya is seen as a vessel, such as the enemies of the cholesterol plaque.
2. Angioplasty - a special tube is inserted into the urazhenu vessel, and the vessel grows.

As soon as the medication may not bring coryste to the disease, it will be efficiently involved promptly. Ridko trap so that the operation does not help the patients, in such a way you can miss a heart transplant.

liveliness

The products of food for the purpose are such elements, yak bіlok, kalіy and magnіy. Harchuvatsya slid 5 - 6 times a day in small portions. Instability in їzhі, її irregular reception, can lead to a seizure of vagi.

Important! Vidmova from fatty їzhі is necessary.

• fresh fruits, berries and vegetables;
• seafood;
• meat bile (ham, іndichka);
• beans;
• greens tea.

It is possible to adapt a trace of fatty, fermented milk products, as well as the implantation of malt.

Dotrimannya dієti to allow stitches behind the vagoya, shake off from the borrowed kilograms, or to turn on the power of their dial.

prophylaxis

Uninvolved on those who like progressive angina pectoris on the current day to finish it efficiently, more beautiful than a sickness.

Prophylactic come in, scho allow you to change the risk of getting sick:

1. Competently planning your day. It is important to correctly implement your goals on the visibility of singing establishments, uniquely overturned.
2. The winyat of his own food for a significant amount of cholesterol.
3. Busy cards right.
4. Pomirnі physical navantazhennya.
5. Vidmova from a loud call.

It is important to provide a stable approach to the cardiologist and other doctors for health improvement. The recommended frequency of prophylactic visits to high schools is once per day. Be-yak zhvoryuvannya more beautifully get ahead, nіzh lіkuvati.

visnovok

It is not easy to diagnose "progressive angina pectoris", not virok. It is only a small part of such problems to end unpleasantly for the patient. Most of the same, with a timely forecast and emerging ill, do without prompt involvement.

Characterized by attacks of raptus pain in the chest area. In most cases, the disease was accompanied by atherosclerosis of the coronary arteries and the development of myocardial blood loss, loss of blood loss in case of significant physical abnormalities.

Likuvannya sickness in monolaser therapy vigilantes to be healthy in an extraordinary period; In the period of time, the government has shown treatment in a complex with medications.

The laser terapіya іshemіchnoї hvorobi sericite spryamovana on znizhennya psihoemotsіynoї zbudlivostі, vіdnovlennya balance vegetativnoї regulyatsії, pіdvischennya aktivnostі eritrotsitarnogo component krovі, usunennya defіtsitnogo of coronary krovopostachannya away lіkvіdatsієyu metabolіchnih mіokarda torn down, normalіzatsіya lіpіdnogo spectrum krovі Zi znizhennyam rіvnya atherogenic lіpіdіv. Krіm, when provedennі farmakolazernoy terapії dіyu on organіzm laser generally produces vipromіnyuvannya to znizhennya pobіchnih efektіv medikamentoznoї terapії, zokrema pov'yazanih of imbalance lіpoproteїdіv at priyomі b-i blokatorіv pіdvischuє chutlivіst to vikoristovuvanih medicated zasobіv in rezultatі vіdnovlennya strukturnoї that funktsіonalnoї aktivnostі aparata klіtini receptor.

The tactics of laser therapy include the zone of ligamentous flow і zones and secondary vibration, up to the number of which the projection zone of the aortic arch і zones and the final vibration is located, which is switched on after 3-4 procedures, which are positioned in the projection of the heart.

Small. 86. Projected zones and areas of the heart. Umovni poznachennya: pos. "1" - a projection of the livny atrium, pos. "2" - the projection of the lіvnogo sluchnok.

The optimization of the heart is important for the victories of pulse infrared lasers. The mode of optimization is based on the values ​​of impulse tension in the range of 6-8 W and at a frequency of 1500 Hz (as a result of myocardial weakening due to a decrease in its pretty fallowness), exposure of 2-3 chilini on the skin field. The number of procedures on the course treatment should be no less than 10.

In the world of suppression of the main manifestations of discomfort, before the recipe, the injection is switched on to the reflex zones: the area of ​​segmental energy on the level Th1-Th7, the receptor zones in the projection internal surface shoulder and front, hollow surface of the hand, sternum area.

Small. 87. The projection zone flows into the area of ​​segmental energy Th1-Th7.

We cut the laser injection on the zone and the additional injection

Angina pectoris is stable

Angina pectoris is stable: Short description

stable angina springs- one of the main manifestations of ischemic ailments of the heart. The main and the most typical manifestation of angina pectoris is a retrosternal bile, which is caused by physical stress, emotional stress, when going out into the cold, walking against winter, in a calm atmosphere of ryaty intake.

pathogenesis

As a result of an inconsistency (imbalance) with the need for myocardium in blood and its delivery by vintsevic arteries in the case of atherosclerotic ulceration, the diagnosis of vintsevic arteries is noted :. Ischemia of the myocardium (clinically manifested by chest pain). Destruction of the fast-feeling function of the heart meat. Variations of biochemical and electrical processes in the heart. When there is a sufficient amount of acidity, the acid cells switch to an anaerobic type of oxidation: glucose drops to lactate, the internal pH changes, and the energy supply in cardiomyocytes changes. In the first place there are subendocardial balls. The function of the membranes of cardiomyocytes is destroyed, so that the internal concentration of ions in sodium is reduced to a decrease in the internal concentration of ions. Falsely from the trivial ischemia of the myocardium, snakes can be werewolves and non-reversible (myocardial necrosis, i.e., infarction). Post-mortem pathological changes in myocardial ischemia: impaired myocardial weakening (impaired diastolic function) - impaired fast myocardium (impaired systolic function) - EKG symptoms - pain syndrome

Classification

Canadian Heart - Court Association (1976). Class I - "a specific physical attack not to attack angina pectoris." I don’t feel pain when walking or walking on gatherings. Attack z'yavayutsya with a strong, fast, or trivial pressure in the robot. Class II - "easier to be interconnected with specific activity." More wake up when walking, for a quick walk on descents, walking uphill, walking or walking on descents when it is cold, in the cold, against the weather, during emotional stress or stretching out the deciduous years of awakening. Walking to a distance of more than 100 200 m along an equal distance, for more than 1 exit spill along descents with a normal fit and in normal minds. Class III - "the meaning of interconnected physical activity." Walking on an equal footing, or for 1 retreat spill with a normal croc in normal minds, provoke an angina attack. Class IV - "the unhappiness of being physical without discomfort." Winning attacks can be done in peace

Angina pectoris is stable: Signs, Symptoms

KLINICHNI SHOW

Skargi. Characteristics of pain syndrome. Localization of pain - retrosternal. Mind the diagnosis of pain - physical pain, strong emotions, strong reception, cold, walking against the weather, cold. Young people do not have so many titles, the phenomenon of "passing through the bile" (the phenomenon of "warm-up") - a decrease or less pain in the case of an increase or a preservation of pain (in the presence of the appearance of a magical colateral). The triviality of pain - from 1 to 15 minutes, has a growing character ("crescendo"). Yaksho b_l is more than 15 min. Umovi for pain - for physical pain relief, taking nitroglycerin. The nature of the pain with angina pectoris (squeezing, flaring, etc.) diagnostic value, Oskіlki rich in what lies in the form of physical and intellectual spontaneity of the patient. Irradiation of pain - as in livi, so in the right of the breast cancer and shia. Classical irradiation - in the left hand, the lower slit.

symptoms- tediousness, blues, increased pity, swelling of stamina, slowness, frequent heart rhythm, increased arterial pressure.

Equivalency of angina pectoris: zadishka (h - for impaired diastolic debility) і increased stomachability when nasalized (s - for decreased heart wikidus in case of impaired systolic function of the myocardium due to insufficient supplies skeletal cells sour). Symptoms, whether in any way guilty of change, when a provocative factor (physical pressure, hypothermia, curvature) is brought in, or for nitroglycerin.

Physical data. With an attack of angina pectoris - the blishness of naughty crooks, mischievous (children are "bewildered" in one position, oskilki be-as-strong as they can), delicacy, tachycardia (richer, arrhythmic) Can vislukhovuvatisya extrasystoles, "rhythm to gallop." systolic murmur, which is due to the lack of the mitral valve as a result of dysfunction of the papillary mucosa. On the recorded hour, an attack of angina pectoris of the EKG can occur to the end of the end portion of the lumbar complex (T wave and ST segment), as well as disruption of the heart rhythm.

Angina pectoris is stable: Diagnostics

laboratory data

- additional value; Allow visually depriving the manifestation of dislipidemies, revealing a defect and a number of factors in the risk of disease (DM), for the reasons of pain syndrome ( fired up, Blood ailments, thyroid ailments).

instrumental data

EKG before the attack of angina pectoris: impaired repolarization in the viglyadi of the change of T waves and reduction of the ST segment upward (subendocardial ischemia) or downward from the isolinia (transmural rhythm of the serum)

Dobove monitoring of the EHC allows the appearance of painless and painless episodes of the myocardium in the minds of the sick, and it is also possible to disrupt the rhythm of the heart by stretching out.

Veloergometriya abo tredmіl (navantazhuvalnaya test with a one-hour restoration of the EKG and AT). Sensitivity - 50-80%, specificity - 80-95%. The criterion of a positive test for a test in bicycle ergonomics - changes in the EKG in a horizontal depression of the ST segment more than 1 mm, triviality more than 0.08 s. Moreover, with nasal tests, it is possible to reveal signs that are associated with an unfriendly prognosis for ailments of angina pectoris :. typical pain syndrome. depression of the ST segment more than 2 mm. Saving ST segment depression for more than 6 mins for repairing new options. the appearance of depression of the ST segment at a frequency of the heart system (HR) less than 120 per quiline. the appearance of ST depression in decilkokh introductions, the beginning of the ST segment in allinductions, with aVR. the visibility of the arterial grip, or a decrease in the amount of people on the physical basis. arrhythmias of the heart (especially low-pitched tachycardia).

EchoKG in calmness allows the rapidity of the myocardium and to carry out differential diagnostics of pain syndrome (heart defects, Leheneva hypertension, cardiomyopathy, pericarditis, mitral valve prolapse, hypertrophilic arterial hypertension)

Stress - EchoKG (EchoKG - an assessment of the collapse of the segments of a lone slut in case of an increase in heart rate as a result of the introduction of dobutamine, transesophageal EKS, or for the introduction of physical intervention) is a more accurate method of repairing a deficiency. The changes in the local rapidity of the myocardium override other manifestations of ischemia (due to changes in the EKG, pain syndrome). Sensitivity to the method - 65-90%, specificity - 90-95%. On the basis of veloergometry, stress - EchoKG allows the lack of vintsev arteries in case of severe one judgment. Shown for stress - EhoKG є :. atypova angina strains (the presence of equivalents in angina pectoris or a lack of description by the patient of pain syndrome). Difficulty or unwillingness to submit sample tests. uninformativeness of veloergometry in case of typical angina pectoris. the appearance of changes on the EKG with nasal tests - for the blockade of the lower bundle of His, is a sign of hypertrophy of a lingering slunk, a sign of Wolff-Parkinson-White syndrome with a typical type of angina pectoris. positive stress test during veloergometry in young women (since the IMF is low).

Coronary angiography is the "gold standard" in diagnostics of the IXC, which allows the detection, localization of the steps of the vintsev arteries to emerge. Shown (recommendation of the European Association of Cardiologists; 1997) :. angina springs in the visce of the III functional class in case of a daytime effect of lykarskoy therapy. angina springs of I-II functional class of ІМ. angina strains with a blockade of the lower branch of the Hisa in the presence of signs of ischemia for the data of myocardial scintigraphy. important sluggish arrhythmias. stable angina in people with ailments, who can have an operation on the vessels (aorta, stegnova, sleepy arteries). myocardial revascularization (balloon dilatation, coronary artery bypass). Clarification of diagnoses for key and professional (for example, for people) mirkuvan.

Scintigraphy of the myocardium is a method of visualization of the myocardium, which allows the appearance of ischemia. The method is informative if the EKG assessment is uncomfortable at the connection with the blockade of the heath's bundle.

diagnostics

In typical cases, stable angina pectoris is diagnosed on the basis of a detailed anamnesis collection, a detailed physical condition of the patient, an EKG record in a calm state and a further critical analysis of the data. Vvazhayut, scho ci vidi obezhennya (anamnesis, examination, auscultation, EKG) are sufficient for diagnostics of angina pectoris in case of classical manifestation in 75% of cases. In case of summaries in diagnostics, after the second, additional monitoring of the EKG, new tests (veloergometry, stress - ExoKG) should be carried out, if there are obvious minds - myocardial scintigraphy. At the final stage of diagnostics, coronary angiography is required.

Differential diagnosis

Slid mothers on uvaz, scho syndrome of pain in the chest can be a manifestation of a number of illnesses. Do not go into oblivion, but overnight there can be a number of reasons for pain in the chest wall. Zakvoryuvannya heart-vascular system. ІМ. angina... Інші reasons. Potentially ischemic walking: stenosis of the aortic throat, lack of aortic valve, hypertrophic cardiomyopathy, arterial hypertension, legeny hypertension, anemia is abnormal. neischemic: aortic enlargement, pericarditis, mitral valve prolapse. Zagvoryuvannya shlunkovo-intestinal tract. Ailment to the stravohode - spasm to the stravohode, stravohidny reflux, cutting the stravohode. The ailment of the shlunk is a twisting ailment. Zakvoryuvannya thoracic wall and ridge. Anterior chest syndrome. Syndrome of the anterior mucous membrane. Rib chondritis (Tietze's syndrome). The ribbing of the ribs. Operizuyuchy lichen. Zagvoryuvannya legends. Pneumothorax. Pneumonia with pleural lesions. BODIES with a manifestation of an infarction of the lung, or without it. Entrapment of pleurisy.

Angina pectoris is stable: Methods of treatment

lykuvannya

The aim is to improve the prognosis (prevention of IM and rapid heart death) and reduction of the turn (weakening) of symptoms of illness. Stagnate non-drug, drug (drug) and surgical methods lykuvannya.

Non-drug treatment - pouring into the factor of the ІХС risk: come in with a change in the display and decrease in weight, increase in temperature, sufficient physical activity when there is a lack of evidence. It is also necessary to normalize the level of AT and to correct the reduction in carbohydrate metabolism.

Lykarska therapy - consistency of three main groups of drugs: nitrate, b - adrenergic blockers and blockers of major calcium channels. Dodatkovo priznachayut antiagreganti.

Nitraty. With the introduction of nitrates, the systemic venomatosis is observed, as it leads to a decrease in the flow of blood to the heart (a decrease in the anterior pressure), a decrease in the grip in the chambers of the heart and a change in the pressure of the myocardium. Neutrality also viklikayut the reduction of arterial grip, change the definition of blood flow and the replacement of the post. In addition, there is a significant expansion of the great vintsevic arteries and the improvement of collateral blood flow. A whole group of drugs is used on nitrate short-dose (nitroglycerin) and nitrate-prolonged diet (isosorbid dinitrate and isosorbid mononitrate).

To suppress the attack of angina pectoris, nitroglycerin is used (tablet form sublingually at a dose of 0.30.6 mg and aerosol form - spray - at a dose of 0.4 mg, also sublingually). Nitrati short diy relieve pain after 1 5 min. Repeated doses of nitroglycerin for stopping an attack of angina pectoris can be victorious with a 5-hour interval. Nitroglycerin in tablets for sublingual ingestion absorbs its activity in 2 ms from the moment the test tube is opened due to the volatility of nitroglycerin, which requires regular replacement of the drug.

For prevention of attacks of angina pectoris, often more than 1 p / day, vicoristoyt nitrate trivial diy (izosorbid dinitrate and izosorbid mononitrate). Izosorbid dinitrate in a dose of 10-20 mg 2 4 r / dob (inodi up to 6) 30-40 minutes before the transfer of physical preparation. The retard form isosorbid dinitrate - in a dose of 40 120 mg 1 2 r / day until the transfer of physical preparation. Izosorbide mononitrate in a dose of 10-40 mg 2 4 r / day, and retard form - in a dose of 40 120 mg 1 2 r / day, also 30-40 minutes before the transfer of physical preparation.

Tolerance to nitrate (loss of sensitivity, sound). Regular consumption of nitrates in a stretch of 1 2 times and more can lead to a change or an antianginal effect. The reason is the change in the approval of nitrogen oxide, the acceleration of its activation from - for the increase in the activity of phosphodiesterases and the promotion of the education of endothelium - 1, which will lead to the development of a sudominal sound. Prevention is an asymmetric (eccentric) sign of nitrates (for example, 8 years old and 15 year days for izosorbid dinitrate or 8 years old for izosorbid mononitrate). This rank will provide a free period of triviality more than 6 to 8 years for the renewal of the sensitivity of the shipbuilding company to the period of nitrate. As a rule, a non-recurrent period is recommended to patients for an hour of minimal physical activity and minimal incidence of painful attacks (on an individual basis). In the last few years in the prevention of tolerance to nitrates, the donors of sulfhydryl groups (acetylcysteine, methionin), іngіbіtorіv APF(Captopril et al.), Angiotensin II receptor blockers, diuretics, hydralazine, however, the frequency of tolerance to nitrates on the other hand changes in an insignificant world.

Molsidomin- close one day before nitrates (nitro-containing vasodilator). When the molsidomin is moistened, it transforms into an active speech, which transforms into nitrogen oxide, then in a kintsev bag to produce until the smooth juices of sudin are weakened. Molsidomin should be consumed in a dose of 2 4 mg 2 3 r / day or 8 mg 1 2 r / dobu (prolonged form).

b - adrenergic blockers. Antianginal effect of reduction in myocardial consumption in blood pressure and decrease in myocardial speed. For the treatment of angina pectoris:

Nonselective b - adrenergic blockers (dyut on b1 - і b2 - adrenorecetori) - for the treatment of angina pectoris, propranolol at a dose of 10-40 mg 4 r / day, nadolol in a dose of 20-160 mg 1 r / dob;

Cardioselective b - adrenergic blockers (for b1 - adrenergic receptors of the heart) - atenolol at a dose of 25-200 mg / day, metoprolol 25-200 mg / dob (in 2 priyomi), betaxolol (10-20 mg / dobu), bisoprolol (5 - 20 mg / add).

The remaining hour became vikoristovuvati b - adrenergic blockers, viklikayut expansion of peripheral sudins, for example carvedilol.

Blockers of large calcium channels. Antianginal effect of polygens in the setting of vasodilatation (including the 1st vintsev arteries), decreased consumption of myocardium in acid (in representatives of the food group verapamil and diltiazem). Stagnate: verapamil - 80 120 mg 2 3 r / day, dilt_azem - 30-90 mg 2 3 r / day.

Prevention of IM and rapid heart death

Clinical studies have shown that the intake of acetylsalicylic acid at a dose of 75-325 mg / day significantly reduces the development of IM and raptus heart death. We are sick with angina pectoris acetylsalicylic acid in case of a daytime, there are contraindications - viral ailments, liver ailments, increased bleeding, intolerance to the drug.

Positively on the prognosis of ailments of stable angina pectoris infusion is also a decrease in the concentration of non-alcoholic cholesterol and LDL cholesterol behind the additional hypo-polydemic conditions (simvastatin, pravastatin). In the given hour, the optimal levels for zagalnye cholesterol are not more than 5 mmol / l (190 mg%), for LDL cholesterol not more than 3 mmol / l (115 mg%).

surgical treatment

When the tactics of surgical treatment of stable angina pectoris are identified, a number of factors are required: the number of vintsevic arteries, the fraction of the wickedness of the lingual dimple, the presence of a concomitant CD. So, in case of one - two-vessel lesion with a normal fractional vikida of the lilac shlunochyy to repair the revascularization of the myocardium through the translucent transluminal coronary angioplasty and stenting. With the presence of two triple-vessel striations and a decreased fraction of the wikidus of the lymph node less than 45%, or the presence of the concomitant CD, the coronary artery bypass surgery (div. Takozh Atherosclerosis of coronary arteries) should be performed.

Through the angioplasty (balloon dilatation) - the expansion of the small balloon artery, which is sounding atherosclerotic by the atherosclerotic process, under a great grip with visual control before the hour of angiography. Successful procedures are reached in 95% of cases. When performing angioplasty, you can accelerate: the mortality rate becomes 0.2% with repeated lesions і 0.5% with multivessel lesions, IM in 1% of cases, the need for coronary artery bypass grafting is in 1% of cases; ... restenosis (in 35- 40% of patients with a stretch of 6 months after dilatation), as well as developing angina pectoris (in 25% of patients, 6-12 months).

In parallel with the expansion of the education of the vintsevoy artery, it will be an hour to stop the stenting - implantation in the place of the stenting (the thinnest rattled skeletons, which will prevent restenosis).

Coronary artery bypass is the stem of the anastomosis between the aorta (aka the internal thoracic artery) and the lower (distal) muscle of the anastomosis for the renewal of effective blood circulation of the myocardium. Yak graft vikoristovuyt dilyanka of the pediatric vein stegna, liva and the right of the internal thoracic artery, the right of the shlunkov - omental artery, the lower epigastric artery. Indicated for coronary artery bypass surgery (recommendation of the European Society of Cardiologists; 1997). Fraction of wikidu of livi shlunochka less than 30%. Determination of the stovbur of the left vintsevo artery. The only thing is the coronary artery. Dysfunction of the lithium louse in the presence of three vessels, especially when the anterior mid-lumbar artery is affected in the proximal viddil. When carrying out coronary bypass surgery, it is also possible to accelerate - IM in 4 5% of cases (up to 10%). Mortality becomes 1% with repeated lesions і 4 5% with multivessel lesions. Before the decrease in the rate of coronary artery bypass grafting, restenosis can be observed (in case of venous grafts in 10-20% of cases, the first rate is 1% and 2% each for 5-7 years). In case of vicious arterial transplants, shunts become unacceptable in 90% of patients over a span of 10 years. Stretching 3 rock angina new in 25% of patients.

forecast

stable angina pectoris with adequate therapy and caution for ailments is evidently susceptible: the mortality rate of the warehouse is 2 3% in the case of a fatal IM developing in 2 3% of the ailments. Mensch spriyatlivy prediction mayutsya patsієnti Zi znizhennyam fraktsії vikidu lіvogo shlunochka, Klas temple funktsіonalnim stabіlnoї stenokardії naprugi, hvorі Pokhil vіku, patsієnti of mnogososudіstim urazhennyam vіntsevih arterіy, stenosis main Stovbur lіvoї vіntsevoї arterії proximal stenosis perednoї mіzhshlunochkovoї gіlki lіvoї vіntsevoї arterії.

Clinical protocol for diagnostics and treatment of illnesses "ІХС: stable angina pectoris"

I. Introductory part:

1. Name:ІХС: stable angina pectoris

2. Protocol code:

3. Cody for MKB-10:

4. Fast, as vikoristovyu in the protocol:

AH - arterial hypertension

AA - antianginal (therapy)

AT - arterial vise

CABG - aorto-coronary bypass

ALT - alanine aminotransferase

AT - abdominal obesity

ACT - aspartate aminotransferase

BKK - blockers of calcium channels

GP - foreign practice medicine

VPN - upper prikordonna norm

VPU - Wolff-Parkinson-White syndrome

HCM - hypertrophic cardiomyopathy

GLSH - h_pertrophy of the lіvnogo slunochka

DAT - arterial vise

DLP - dislіpіdemiya

SHE - shlunochkova extrasystole

ІХС - ischemic ailment of the heart

ІМТ - index of oil

ІКД - insulin short acting

TIM - Tovshchina to the complex of Intima-Media

TSH - glucose tolerance test

U3DG - ultrasound dopplerography

FA - physical activity

FC - functional class

FR - factori riziku

COPD - chronic obstructive disease

CHF - chronic heart failure

HDL cholesterol - high-grade lipoprotein cholesterol

LDL cholesterol - low-grade lipoprotein cholesterol

4KB - through the coronary

Heart rate - heart rate is very fast

EKG - electrocardiography

EKS - electrocardiostimulator

EchoKG - echocardiography

VE - hilinniy ob'єm dikhannya

VCO2 - the amount of carbon dioxide, which is seen in one hour;

RER (Responsive Ratio) - VCO2 / VO2 performance;

BR - dichny reserve.

BMS - stent without lykarsky pokrittya

DES - stent with lykarskiy pokritty

5. Date of release to the protocol: 2013 rik.

7. Participants of the protocol: medical therapists, cardiologists, intervention cardiologists, cardiologists.

8. Ordering for the duration of the conflict of interest:Відсутнє.

9. Viznachennya.

ІХС- tse goste or chronic heart disease, wiklican changes or changes in blood delivery to the myocardium at the end of a malignant process in the coronary vessels (designation of the BOOZ 1959).

angina- the most important syndrome, which appears to be almost uncomfortable or painful in the chest cleft, to crush the character, as it is localized most often behind the chest and can be seen in the left hand, shia, lower slit, epigastric region. Be provoked by physical problems, going out into the cold, clear reception, emotional stress; to pass in calm or to be absorbed by taking nitroglycerin sublingually with a stretch of decilkoh seconds or khviliin.

II. METHODS, APPROACHES I DIAGNOSTIC PROCEDURES I

10. CLINICAL CLASSIFICATION:

Table 1. - Classification of the severity of stable angina pectoris as before the classification of the Canadian Association of Cardiologists (Campeau L, 1976)

Coronary flow syndrome

Ischemic chest pain

The Russian International Classification of ailments of the 10th glance (ICD-10) has adopted a single normative document for the incidence of illness, the reasons for the infestation of the population to the medical establishments, the causes of death.

ICD-10 was introduced into the practice of protecting health in the entire territory of the Russian Federation in 1999 by the order of the Ministry of Health of Ukraine dated 27.05.97. No. 170

A new look (ICD-11) is planned by WHO in 2017 2018 roci.

Іf changes and additions of the VOOZ rr.

Processing and transfer zmin © mkb-10.com

ІХС unstable angina pectoris ICD code 10

Classification of the IXC for the international classification of the disease

Ischemic ailment of the heart is a pathology of the heart meat, tied to a shortage of blood supply and an overgrowth of hypoxia. Myocardium otrimuє shelter of coronary (vintsevich) Sudin hearts. In case of coronary heart disease, the heart mucus does not vytacha blood and is transferred by it sourness. The ischemia of the heart is seen with transplanted consumption in sourness over accessibility. Judge your heart with a lot of crying may atherosclerotic symptoms.

Diagnosis of ІХС enlargements among people older than 50 years. With the advancement of pathology, it is more common to develop.

See and see and see

Classify ischemic ailments at the stage of clinical manifestations, dryness to vasodilating drugs, stiffness to physical effects. Form IXC:

• Rapt coronary death will be tied to the damaged myocardial conduction system, so as to rapid rapid arrhythmia. When there is a reanimation of an attack, or failure, a heart attack when it is confirmed by eyewitnesses, or a death, when an attack occurs in the intervals of six years, as a result of this ear, to put the diagnosis "first of a heart attack." With a successful reanimation of the patient, the diagnosis is "rapid death with a successful reanimation."
• Angina pectoris is a form of ischemic ailment, when there is a baking bile in the middle of the breasts, and, more precisely, behind the breastbone. For ICD-10 (international classification, 10 glance illnesses) angina pectoris is classified as I20.

May also include pidvidiv:

• Stenocardia is spongy, or it is stable, when there is a decrease in the rate of heart muscle soreness. In the case of hypoxia (kisneve hunger), the diagnosis is severe and spasm of the coronary arteries. Stable angina pectoris on the basis of unstable disease in case of physical changes of the same intensity, for example, walking for a distance of 300 meters with a small amount of small blood sugar.
• Unstable angina pectoris (code for MKH - 20.0) is nasty to buy bad nitroglycerin, attack the pain often, the tolerance of the new option is reduced in a sick person. The form is given to grow on tipi:
  • for the first time;
  • progressively;
  • early postinfarction abo pislyaoperatsіynі.
• Vasospastic angina pectoris, viclikana spasm of sudin without atherosclerotic changes.
• Coronary syndrome (syndrome X).

  According to the international classification 10 (ICD-10), angiospastic angina (Prinzmetal's angina, optional) is reported 20.1 (Angina with confirmed spasm). Angina pectoris - ICD code 20.8. Unspecified angina pectoris assigned code 20.9.

• Myocardial infarction. The attack of angina pectoris, which is more than 30 minutes and is not controlled by nitroglycerin, ends with an infarction. Diagnostics of infarction includes analysis of EKG, laboratory monitoring of markers of heart meats (fraction of enzymes in creatine phosphokinase and lactate dehydrogenase, tropomyosin, etc.). At the end of the battle you see:
  • transmural (velikovnischevy) infarction;
  • dibnovognischevy.

  Behind the international classification of 10, the infarction is shown to the code I21, one can see the following: a vast infarction of the lower stage, anterior stage and other localizations, not specified. The diagnosis "repeated myocardial infarction" was assigned the code I22.

• Postinfarction cardiosclerosis. Diagnosis of cardiosclerosis behind the help of electrocardiograms is based on the deteriorated conduction in cases of cicatricial changes in the myocardium. The form of ischemic ailment is given to occur not earlier than 1 month from the moment of infarction. Cardiosclerosis - scarring changes, which have occurred on the malignant muscle as a result of heart mellitus infarction. The stench is molded with rough fabric. Cardiosclerosis is not safe for the great part of the provincial system of the heart.

Інші forms ІХС - codes I24-I25:

1. Painless form (according to the old 1979 rock classification).
2. Gostra sertseva lack of development on myocardial infarction, or in case of shock stuns.
3. Loss of heart rhythm. With ischemic lesions, the blood supply of the wired system of the heart is destroyed.

Code I24.0 for MKH-10 was assigned to coronary thrombosis without infarction.

Code I24.1 for MKH - Dressler's postinfarction syndrome.

Code I24.8 for 10 glance ICD - coronary deficiency.

Code I25 according to ICD-10 - chronic ischemic ailment; including:

• atherosclerotic IXC;
• transfers of infarction and postinfarction cardiosclerosis;
• heart aneurysm;
• coronary arteriovenous fistula;
• asymptomatic ischemia of the heart meat;
• chronically unspecified ІХС and інші forms of chronic ІХС trivial more than 4 years.

Riziku factories

Debilitation before ischemia is reduced in case of onset factors of ІХС risk:

1. Metabolic, albeit X syndrome, in case of damage to carbohydrates and fats, changes in cholesterol levels, low insulin resistance. People with type 2 diabetes mellitus are included in the group of heart disease, including angina and infarction. If the girth of the waist is 80 cm, then the result will be respectfully set to health and food. Timely diagnostics and treatment of a diabetic child to complete the prognosis of a disease.
2. Palinny. Nikotin sounded the judgment, quickening the hearts of speed, increased the need for heart meat in blood and sour.
3. Pechinkovy ills. With a liver ailment, the synthesis of cholesterol increases, so it can be increased to an increased amount of fat on the walls of the vessels, with more oxidized and heated arteries.
4. Alcohol implantation.
5. Hіpodynamії.
6. To a gradual change in calories.
7. Emotional stress. When zaborushennya, the need for an organism in sourness is increased, and the heart's ointment is not a blame. Moreover, with trivial stresses, cortisol and catecholamines are seen, coronary heart disease sounds, and cholesterol is violated.
8. Loss of lipid exchange and atherosclerosis of coronary arteries. Diagnostics - implantation of lipid spectrum of blood.
9. Syndrome of oversized obstruction of the small intestine, which will ruin the liver and cause avitaminosis of folic acid and vitamin B12. With a large increase in cholesterol and homocysteine ​​levels. Remaining porous peripheral blood circulation and pitting on the heart.
10. Syndrome of Icenko-Cushing, which is associated with hyperfunction of supra-nirkoval locomotion, or with the intake of drugs in steroid hormones.
11. Hormonal disorders of the thyroid gland, yachnikiv.

Men over 50 and women during menopause are most often sick before attacks of angina pectoris and infarction.

Rizik factor ІХС, which will help to overcome the ischemic ailments of the heart: uremia, diabetics, legeneva lack. Cover ІХС damage in the wire system of the heart (blockade of the sinoatrial university, atrioventricular university, the lower part of the Gis bundle).

The current ІХС classification allows doctors to correctly assess the country of the sick and to live the necessary visits for the first time. For the skin form, which is the code in the ICD, it is broken down by its own algorithms for diagnostics and treatment. If it is not possible for children to develop ailments, the drug can help patients more effectively.

Angina pectoris: how can it be manifested?

Coronary judges, for the help of which there is bloodletting of the heart, it is not fast for atherosclerotic changes. The stench is sounded through the presence of cholesterol plaques, and the stench is delivered quickly to the myocardium. As a result, ischemic ailment of heart meat develops. Angina pectoris is the head symptom of the gastric hypoxia. Manifesting the syndrome is tied with the inflow of singing factors. Most of the attacks can be made up to physical prices.

So also angina pectoris 2 FC?

Angina pectoris 2 fc is a symptomatic complex, such as a symptom in response to a severe lack of symptoms. You can be stable and unstable. The first vipad about stable ischemic angina pectoris 2 FC.

There are signs of Lyudin seeing at the moment of intensive physical nurturing, if more sourness is needed in the heart. In a quiet camp, when there are provocative officials, there is no attack.

I know the steps of the activity, in order to change the self-esteem of the ailing one, to go overboard.

Angina pectoris is unstable to develop at any hour, just because of physical activity. It is possible to turbuvati a sick person to visit a quiet camp. The form of pathology is very important, as it is not safe for people to live quickly. Vaughn will practically bring people around in side-by-side situations, shy of being undead to self-service.

Angina pectoris can be carried to different functional classes. It is accepted to see chotiri of such class. For the skin, they are characterized by their own signs, I will show their particularities. Of great importance is the pathology of the fourth class (4 fc), fc 1 may not have any symptoms and appear deprived in the process of obesity. Фк 3 - a transitional phase between amid and rotational destructions.

Most often medical people are brought to the mother on the right from angina pectoris of another functional class (code according to ICD.8 "In the form of angina pectoris"), as it develops stably with singing minds. Symptomatology at the stage of the stage can already be manifested, we can see that we are confused in some physical problems, the quality of life is visibly deteriorating. If you have a whole syndrome, it is good to be prophylactic and control, and serious acceleration can be done.

Diagnosis "ІХС angina pectoris fc 2 class" є by a drive for setting up one of the groups of invalids in a sick person.

cause

The main reason for the development of stable angina pectoris is 2 FC as a symptom of IXC is the manifestation of atherosclerosis of the coronary arteries. Win the sound of judgment, overshooting the blood circulation in the heart. Bolovy attack trap, if there is an inconsistency between the needs of myocardial tissue in the blood and health of blood-bearing nobles to satisfy the demand.

Є y іnshі pathology, іsdatnі viklicati stenocardialny attacks. Prior to them, it should be mentioned:

• hypertensive ailment;
• aortic stenosis;
• Diabetes mellitus;
• obesity;
• postinfarction period with development of cardiosclerosis;
• tachycardia;
• cardiomyopathy with hypertrophic heart chambers;
• p_advishenii vise in the vessels of the legends;
• coronarite.

An attack of ischemia vineyards, if the need for sourness and supplemental vitality of the heart grows. This situation can be represented by the following list:

• Strong emotions, give wikid adrenaline. Tsey hormone zvuzhuє sudini, zbuzhu myocardium, pіdvischuє vise. Blood is pumped more intensively.
• Nurturing on the fabrics is supervised by biochemical reactions, such as supervising the great kilkosty kisny. The frequency of heart beats during growth, the grip of blood in the middle of the growth, and accelerated ischemia.
• Re-distribution of provocation, expansion of the slunk and intestines. Smell to stamp on the legends of fabrics, people are important. At the same time, a large part of the blood resources is recalled to the organs of the herbal system, to take active reprocessing of the given. There are three reasons why my heart is not in touch.
• Cooling the organisms provoking the sound of the sudin and the fungus in the grip of the vigor, as well as the hypoxia of the head mucus of the circulatory system.
• Vipalyuvannya cigarettes veda until accelerated sertsebittya, norepinephrine wicked into the roof, the arterial grip pidnimayatsya. Heart of pratsyuє intensive.
• If the person is lying down, the roof of the tide is up to the myocardium, and the senses are faster and faster. Until then internal organizations Slightly zsuvayutsya, squeezing a dodatkovy grip on the heart and the heart of the lungs.

Clinical symptoms

Angina pectoris fc 2 vyavlyayut for specific signs:

Risky pains in the breasts are evil. The stench to crush, ryzhuchy, baking character. At the heart of the wine is importance. Bіl grows into lіva half of the body (arm, shoulder, shoulder blades), penetrating into the area of ​​shia, lower slit, vuh. You may feel pain in your back.

1. triviality to attack severe pain from 3 to 5 hilin.
2. Winikak is zadishka, vigorously gliboko zitkhnyuti. Such a symptom can be equivalent to pain syndrome in angina pectoris or supra-juvati.
3. A sharp lack of strength.
4. Panika, in the face of imminent death.
5. The desire is to move.
6. The rhythm of heart beats breaks down.
7. Sposterіgayuyutsya drop in the tonometer displays.
8. Do not get involved in the possibility of tediousness or blues.

Make sure to show your judgment in singing minds, as for the skin functional class you will be your own.

Features of angina pectoris 2 FC

2nd functional class of angina pectoris is given the following features:

• Lyudin forcibly bears one descent spill.
• At the same time, half a kilometer, with a small amount of crocs, there is an acute discomfort.
• Bіg, navіt povіlny, provoking an attack.
• Emotional reaction has been adjusted and presented a potential problem.
• Unfavorable weather think in viglyadі vіtru, plank, snow, frost may wipe out the loss of self-esteem.
• In some cases, the rancovity is swung up to the development of uncomfortable symptoms.

Current diagnostic methods

Viyaviti angina pectoris allow for numerical views and doslіdzhen:

• The patient's experience is based on the nature of the pain and minds. Possibility of declining schism appears. To evoke a way of life and the appearance of provocative officials.
• The laboratory for the advancement of biological information is necessary for the establishment of for any reason and acceleration of ischemia. Allowing the assessment of the development of atherosclerosis. Obviously, a coagulogram and a lipidogram are performed.
• In an informative way of diagnostics є EKG. Shown znimayutsya before the hour of the attack. Achievementally, the monitoring of the EKG by Holter with a pull, allows the diagnosis of ischemia to occur without any symptoms. Vikoristovuyutsya navantazhuvalny test for piece provocation of pathogenic symptomatology from the record of showing by cardiographers.
• Angiorgaphic dosage of coronary artery disease. The introduction of contrasting speech and X-ray promenade is stagnant.
• Computer tomography (multispiral method) is required for the removal of the trivial image of the heart.
• Doppler ultrasound diagnostics of sudin periphery. Conducted for the detection of atherosclerosis.
• EchoKG in pre-installation with physical restructuring of fast-feeling health of the myocardium in a stressed mill.

lykuvannya

Angina pectoris is not a self-inflicted illness. Vaughn is a sign of coronary insufficiency. Same pathology and demand for lіkuvati. Outside the usunennya of non-gates in the vessels, which leads to ischemia, you can only take an operative way. To that, the medication fight against angina pectoris is directly related to the suppression of attacks and the reduction of the frequency of those diagnoses, or it is impossible to prevent people from being diagnosed with a disease.

Naybilsh implantable drugs for angina pectoris:

1. Rise of shelter, reduce the development of antiplatelet thrombi: "Aspirin", "Dyppridamol".
2. Shvidko expands the education of sudin, recognizes the gostry attack, diminishes the blood flow from the nitrate group - drugs inconvenient help: "Pentacard", "Nitrolong", "Nitroglycerin".
3. Change instead of cholesterol in statini organizm: "Atoris", "Torvakar".
4. Supplementing the lowering of the price tag at the heart of the beta blocker. The stench is poured into the frequency of the heart rhythm, normalizing: "Bisoprolol", "Concor".
5. Capture, as you change the penetration of the calcinates into the tissue. Tse cause to nobility a spasm of judgment and blood flow. Apply drugs: "Amlodipin", "Diltiazem".
6. Reduce the grip of blood on the walls of the vessels, expanding them, blockers of the APF: "Enalapril", "Ramipril", "Captopril".

Krim lykarskoy therapy, need to properly eat (less fat and carbohydrates, more fruits, vegetables, ribs), go in for physical culture with a small step on the stage of training for cyclists to train volunteers

Methods of operative treatment:

It is the installation of a stent (metal frame) in the middle of a ringed artery for polishing and passage, or a balloon angioplasty with a special expandable balloon inserted into the vessel. Offensive procedures are minimally invasive.

In the course of the operation, the surgeon should carry out an additional blood-bearing path (shunt), bypassing the urazhene dilyanka. As a material for the shunt, a part of the judgment is taken, taken from other organs (for example, from references). this kind surgical engagement folding, the procedure goes from connecting the patient to the system of piece blood circulation. The first option is to see the operation on the heart.

Tastes ІХС, angina pectoris 2 FC

Angina pectoris is a spill of another functional class, in general, it does not carry a fatal threat to people. Folded mobility, ale in small vypadki. When a patient is leading the wrong way of life, he doesn’t follow the proponated recommendations, he doesn’t accept the signs of the brand. Competently carrying out the treatment and the behavior of the sick person is adequate to help him to finish his life with the smallest neighbors. Chances on the outside of the dungeon are given to the people by the operas of the pooled Sudins.

• Blinking arrhythmia and vidi break the rhythm of the heart.
• Raptova bend of the patient as a result of the pinching of the heart.
• Gostra form of myocardial infarction.
• Progression of angina pectoris of another functional class, development of unstable form of pathology.
• Lack of myocardium of the chronic type.

Lyudin, with the diagnosis of "angina pectoris 2 fc" can be rozrahovuvati on the rejection of 3 groups of invalidity.

ІХС і angina pectoris syndrome fc 2 is widened і to complete an anxiety medical visnovok. Look at the development of serious damage in the area of ​​coronary blood circulation. It is important not to notice the symptoms of an attack. Perche їkh povava is a signal for the term animal feed to the liquor. Self-reliance can lead to fatal results. methods folk medicine You can only add basic therapy. With a free diagnosis and consumption of medication injected, it is possible to survive from angina pectoris to an old age.

Angina pectoris code for MKH-10

Attack the IXC stressful situations and physical naukazhen, for whom the need for heart in sourness grows, are called angina pectoris. Manifestation of ailment with pain, discomfort, almost sorrow and pain behind the sternum. Angina pectoris is a code for MKH-10 mostly in people of older age, children and young people up to 30 years old, sick before angina attacks, store less.

Classification of disease

FC 1 - it is normal to be carried over normally, often stop thinking about being ill. Attack the pain of trapelling lichen when overworked.

FC 2 - deyake of interdigitation of activity, bіl і slow-motion trail when going on the abducted area and going down, in the cold, with a vivid wind, stimulating an emotional character.

FC 3 - attacks of angina pectoris trap to navit with a small navantazhenny - zvychayny walking, pidyomi one on top.

FC 4 - be-yake navantazhennya - simple hands wicked attack, how will you find yourself in peace.

Angina pectoris code for MKX-10 is designed to be stable and unstable. First, it is more beautiful to surrender to control and abuse, as it is to attack transmissions when the singing officials are present. An attack of unstable angina pectoris code for MKH-10 is trawled on the "rivnoe mice";

Causes of angina pectoris

The main reason is atherosclerosis, so that atherosclerotic plaques stick to the walls of the bladder, which step by step get rid of the enlightenment and the lack of blood circulation in the heart, and that means that it is more sour than hunger.

Victory atherosclerosis of the onset of factors:

1. Slump.
2. Arterial vise adjustment.
3. Obesity.
4. Wrong food - zbіlshu rіven nasty cholesterol in the blood.
5. Hypodynamia.
6. Kurinnya.
7. Ailments nirok - nephrosis and nirkova deficiency.
8. Hypothyroidism is a shortage of hormones in the thyroid gland.
9. Acceptance of drugs - steroids, oral contraceptives.
10. Diabetes mellitus - to see the destruction of the metabolic processes in the body, the vitrification and the development of the scars of the vessels, as well as the formation of scars and the formation of plaques.

Signs of an attack of angina pectoris:

1. Bil.
2. Changes in heart rate and heart rate.
3. Zblіdnennya abo cyanosis of shkіrny curvatures.
4. Stronger cold perspiration.
5. Weakness.
6. Triviality.
7. Zadishka.

The triviality of the attack is not more than a quarter of a year.

Yak znyaty attack

1. Zupiniti any rukh, as much as possible, doesn’t lie down.
2. Place a tablet for nitroglycerin, if the attack is strong, then it is possible two, or not more than five pieces, or in vinyatkovy vypadki, if the help is not available.

As long as the reception of nitroglycerin does not affect the attack and the symptomatology continues to grow, then it is necessary to have a non-stop message of "good help", so as to indicate about the diagnosis of myocardial infarction.

diagnostics of angina pectoris

1. EKG - bazhano znyati pіd hour to attack.
2. Nautazuvalny probes.
3. Ultrasound heart.
4. Holter dobovy monitoring.
5. Biochemistry of blood.
6. Coronary angiography.
7. Myocardial scintigraphy.

The patient's experience is carried out, the hearing of his heart is heard, the history of the ailment can be discerned.

Medication for the treatment of angina pectoris

1. Nitrate - nitroglycerin - for suppressing an attack, and other drugs together with organic nitrates - for preventing an attack.
2. Aspirin is a razridzhu shelter, which will lie down її suvannya on the vessels.
3. Hypolypidemic problems - produce an anti-firing effect, do not allow plaques to accumulate and minimize thrombosis.
4. Beto-andrenoblokіratori - to change the tension in a lіvom slunochka.
5. Antagonizing calcium - expanding the artery, lowering the arterial vise and adding it to the heart.

Krim medicines in the complex people zasobi, Yaki include herbs, brown vitamins and warehouses.

promptly lykuvannya

As conservative therapy does not give significant results, then the sick person should be given surgical treatment:

• Coronary artery bypass - to impose an anastomosis on the site of blockage of the artery, so that a routine path for blood is prepared, which will help blood to the heart.
• Coronary angioplasty - enlargement of the artery and installation of a stent, which can prevent recurrent stenosis.

Patients will be taught a change in the way of life: education from a home, a physical culture, an understanding of a schoolyard, normalization of a vagina, a problem of uniqueness of stress and stress. All the while giving the body the power to endure the task more easily, to reduce the frequency of attacks.

I20.0 code for MKH-10: angina pectoris, scho tse i yak likuvati

Such figures are to be found on the title side of the picture of the patient, who will help the likars shvidshe zorієntuvatisya in a specific situation.

This is a kind of pathology

Angina pectoris is carried to clinical forms of ischemic ailments of the heart (IXC). It is a discomfort, which is characterized by large visions behind the breastbone, which are observed with physical nurturing, stress, and strong emotions.

To factors for the development of ailments include:

1. Reasons not to lie down among the people themselves:
2. vik;
3. recession.
4. To lie directly from the patient:
5. obesity;
6. kurnnya;
7. a little rude way of life;
8. wrong food.
9. Pathology problem:
10. Hypertensive ailment;
11. Diabetes mellitus;
12. Hypercholesterolemia (alterations instead of "trash" fractions of cholesterol in the blood).

How to see in the heart with angina pectoris

The basis for the development of any form ІХС є is an atherosclerotic plaque in the heart. With "clean" coronary arteries, angina pectoris does not develop.

The main mechanisms, which summarize the key picture, are built before the next points:

1. Blockage of the lumen of the heart with atherosclerotic plaque.
2. Local abo diffuse spasm of the arteries.
3. Microsudinny postcards.
4. Disruption of the normal functioning of the heart

If a lyudin is engaged in physical tasks, or if he is in the camp of a strong emotional shock, the heart of the victor has a need for sourness.

With the urahuvannya of the descriptive mechanisms, the posed arteries, it is not possible to fit in with the zimm of the enterprises. Due to such an imbalance between the need for acidity and unhealthy heart disease, a classic pain syndrome for angina pectoris develops - “angina pectoris”.

Classification

In cardiological practice, angina pectoris spills into two types:

Such a key classification is less important for the selection of adequate therapy, as it is carried out on an outpatient basis or on a stationary basis.

When the diagnosis is formulated, the drug is ordered into a functional class. This kind of help is due to the seriousness of the illness.

Functional class (FC) of angina pectoris according to the international classification of the Canadian Society of Cardiologists.

Functional class Characteristics of a complete physical installation

I Sertsev - turbuyut at great navantazhennya. The specific physical activity is not suffering.

May II, there is little interconnection of physical activity. For the detection of attacks to reach the physical appearance at the sight of a quick walk more, less than 500 m along the equal distance, go more, less than one descent

III Spite the turn of the decrease in the specific physical activity. Attack provokuyutsya by walking mensh, below 500 meters, or when pidyomi for one pass of descent.

IV An important form, which is characterized by the appearance of pain syndrome in case of minimal nurturing and in calm

diagnosis formulation

The ICD angina code is I20.0.

With a stable form, the diagnosis of a viglead is by the next rank:

ІХС: angina pectoris I-IV FC.

How unstable is spontaneous:

ІХС: progressive angina pectoris with exit in angina pectoris I-IV FC.

key picture

The main scargo of ailments є vidchuttya squeezing, a vice behind the sternum. Pain syndrome ma typi signs:

1. Localization: behind the breastbone, in half of the breastbone. It is possible to insert the blade into the lower slot.
2. Triviality up to 10 min.
3. The attack is to be bought independently in calmness, or in case of stagnation of nitrats of a short episode.
4. Supravodzhutsya zagalnye manifestations - zadishka, tediousness, zamorochennyam. Often, people are faced with fear.

It is also a sign of a decrease in prasezdatnosti, a swelling stomp, and a weakness.

diagnostics

Diagnostics come in include:

• z'yasuvannya skarg at the sick man;
• anamnesis of life and development of ill health, development of factors in the development;
• dany of an ob'ktive look;
• laboratory and functional conditions.

There are national clinical recommendations, the "gold standard" of IXC diagnostics - coronary angiography (CAG). The essence of the procedure is in the visualization of the heart by the introduction of contrasting speech. When great atherosclerotic plaques are detected, CAH can be used as a clinical operation.

Additional methods (ultrasound of the heart, EKG, Holter Dosage) give doctors the ability to detect angina pectoris. The stench is unspecific.

Trochi about coronary angiography

The name of the whole procedure is correct - translucent transluminal coronary angioplasty without stent placement. To be applied to radiopaque methods of dosage.

Conducted in special angiographic operations for the masses of the sick. Allergological anamnesis will be found in advance. Behind the patient's camp at CAG sposterig the doctor is an anesthesiologist-resuscitator.

In the course of the procedure, puncture a puncture of the stegnous or interchangeable artery. Through new, introduce a special guide to the heart. Illness at all does not see a large number of witnesses.

We can then introduce a contrasting speech and, behind the aid of an angiographer, support them on the coronary artery monitors. At the same time, there may be a spasm of the sudin, which leads to pain in the chest. The attack is short-lived, to pass independently, or by writing additional nitrates.

This method allows the assessment of the progression of the sudins, the presence of atherosclerotic plaques in them, and the debridement.

If, if there is any further obstruction (occlusion) of the coronary artery, then stent. For cich purposes, according to the guide, before the required task, introduce a special attachment, such as an increase in education, and a new one. This type of expansion is called stents.

When the procedure is carried out for ailing indications, the post-treatment regime. Yaksho KAG was carried out through a puncture on the stegnova artery, then it was suvoro to get up and get up with a stretch. Such a start is an effective prevention of bleeding.

lykuvannya

The main goals of therapy are:

• the improvement of the reduction of the majority of visions;
• prevention of development of unsatisfactory acceleration;
• polishing the forecast and the quality of life.

Lіkuvannya stenocardії springs always includes a complex of entries:

1. General recommendations:
2. vidmova vid kurinnya;
3. decrease in mass tila;
4. іnformvannya patient in special schools ІХС;
5. correct eating;
6. healthy sleep;
7. treatment of concomitant pathology.
8. Medication signs:
9. aspirin - Cardiomagnil, cardiASK;
10. beta-adrenergic blockers - Concor, betaloc ZOK, nebilet, carvedilol, nperten;
11. statini - atoris, Torvakard, Krestor, vazilip;
12. іngіbіtori APF - enap, diroton, pretarium, perіneva, lizinoton, ampіlan.

This drug is also called ABCD therapy. When diagnosed in people with angina pectoris, all perakhovani groups of drugs are recognized instantly! In case of intolerance to liquor, there is a symptom of a specific skin disorder. Take the drugs as needed!

Before them, there are nitrati of short diy - nitroglycerin, nitrosorbid, nitromint, nitrospray.

The stench is sublingual (pid language). The effect is to develop practically immediately.

1. Hirurgic involvement:
2. CAG with stent installation (expansion of the coronary artery);
3. aortocoronary bypass.

Likuvannya progresuyuchey angina pectoris pass obov'yazkovo in the minds of the stationary, so as such a camp roznuyuєtsya yak preinfarction.

accelerating

The most dreadful and ugly inherits є:

prophylaxis

Prophylactic come directly to the detection of factors in the risk, їkh usunennya and free diagnostics of the disease. For cich purposes it is widely used in the polyclinic practice of medical examination of ailments. Plus, there are a lot of programs є hunting for young groups of population, repairing for 18 years.

Proceeding, manifestation and elimination of angina pectoris is necessary for the participation of a cardiologist and therapist. We are sick of all the recommendations є an important part of the gambling process. For the whole it is necessary to explain to the patients the reasons for such numerical characteristics. It is inadmissible to engage in self-abuse of the sickness. Tse can bring to sums of inheritance.

Ischemic ailment of the heart is a pathology of the heart meat, tied to a shortage of blood supply and an overgrowth of hypoxia. Myocardium otrimuє shelter of coronary (vintsevich) Sudin hearts. In case of coronary heart disease, the heart mucus does not vytacha blood and is transferred by it sourness. The ischemia of the heart is seen with transplanted consumption in sourness over accessibility. Judge your heart with a lot of crying may atherosclerotic symptoms.

Diagnosis of ІХС enlargements among people older than 50 years. With the advancement of pathology, it is more common to develop.

See and see and see

Classify ischemic ailments at the stage of clinical manifestations, dryness to vasodilating drugs, stiffness to physical effects. Form IXC:

• Rapt coronary death will be tied to the damaged myocardial conduction system, so as to rapid rapid arrhythmia. When there is a reanimation of an attack, or failure, a heart attack when it is confirmed by eyewitnesses, or a death, when an attack occurs in the intervals of six years, as a result of this ear, to put the diagnosis "first of a heart attack." With a successful reanimation of the patient, the diagnosis is "rapid death with a successful reanimation."
• Angina pectoris is a form of ischemic ailment, when there is a baking bile in the middle of the breasts, and, more precisely, behind the breastbone. For ICD-10 (international classification, 10 glance illnesses) angina pectoris is classified as I20.

May also include pidvidiv:

• Stenocardia is spongy, or it is stable, when there is a decrease in the rate of heart muscle soreness. In the case of hypoxia (kisneve hunger), the diagnosis is severe and spasm of the coronary arteries. Stable angina pectoris on the basis of unstable disease in case of physical changes of the same intensity, for example, walking for a distance of 300 meters with a small amount of small blood sugar.
• Unstable angina pectoris (code for MKH - 20.0) is nasty to buy bad nitroglycerin, attack the pain often, the tolerance of the new option is reduced in a sick person. The form is given to grow on tipi:
  • for the first time;
  • progressively;
  • early postinfarction abo pislyaoperatsіynі.
• Vasospastic angina pectoris, viclikana spasm of sudin without atherosclerotic changes.
• Coronary syndrome (syndrome X).

According to the international classification 10 (ICD-10), angiospastic angina (Prinzmetal's angina, optional) is reported 20.1 (Angina with confirmed spasm). Angina pectoris - ICD code 20.8. Unspecified angina pectoris assigned code 20.9.

• Myocardial infarction. The attack of angina pectoris, which is more than 30 minutes and is not controlled by nitroglycerin, ends with an infarction. Diagnostics of infarction includes analysis of EKG, laboratory monitoring of markers of heart meats (fraction of enzymes in creatine phosphokinase and lactate dehydrogenase, tropomyosin, etc.). At the end of the battle you see:
  • transmural (velikovnischevy) infarction;
  • dibnovognischevy.

  Behind the international classification of 10, the infarction is shown to the code I21, one can see the following: a vast infarction of the lower stage, anterior stage and other localizations, not specified. The diagnosis "repeated myocardial infarction" was assigned the code I22.

• Postinfarction cardiosclerosis. Diagnosis of cardiosclerosis behind the help of electrocardiograms is based on the deteriorated conduction in cases of cicatricial changes in the myocardium. The form of ischemic ailment is given to occur not earlier than 1 month from the moment of infarction. Cardiosclerosis - scarring changes, which have occurred on the malignant muscle as a result of heart mellitus infarction. The stench is molded with rough fabric. Cardiosclerosis is not safe for the great part of the provincial system of the heart.

Інші forms ІХС - codes I24-I25:

1. Painless form (according to the old 1979 rock classification).
2. Gostra sertseva lack of development on myocardial infarction, or in case of shock stuns.
3. Loss of heart rhythm. With ischemic lesions, the blood supply of the wired system of the heart is destroyed.

Code I24.0 for MKH-10 was assigned to coronary thrombosis without infarction.

Code I24.1 for MKH - Dressler's postinfarction syndrome.

Code I24.8 for 10 glance ICD - coronary deficiency.

Code I25 according to ICD-10 - chronic ischemic ailment; including:

• atherosclerotic IXC;
• transfers of infarction and postinfarction cardiosclerosis;
• heart aneurysm;
• coronary arteriovenous fistula;
• asymptomatic ischemia of the heart meat;
• chronically unspecified ІХС and інші forms of chronic ІХС trivial more than 4 years.

Riziku factories

Debilitation before ischemia is reduced in case of onset factors of ІХС risk:

1. Metabolic, albeit X syndrome, in case of damage to carbohydrates and fats, changes in cholesterol levels, low insulin resistance. People with type 2 diabetes mellitus are included in the group of heart disease, including angina and infarction. If the girth of the waist is 80 cm, then the result will be respectfully set to health and food. Timely diagnostics and treatment of a diabetic child to complete the prognosis of a disease.
2. Palinny. Nikotin sounded the judgment, quickening the hearts of speed, increased the need for heart meat in blood and sour.
3. Pechinkovy ills. With a liver ailment, the synthesis of cholesterol increases, so it can be increased to an increased amount of fat on the walls of the vessels, with more oxidized and heated arteries.
4. Alcohol implantation.
5. Hіpodynamії.
6. To a gradual change in calories.
7. Emotional stress. When zaborushennya, the need for an organism in sourness is increased, and the heart's ointment is not a blame. Moreover, with trivial stresses, cortisol and catecholamines are seen, coronary heart disease sounds, and cholesterol is violated.
8. Loss of lipid exchange and atherosclerosis of coronary arteries. Diagnostics - implantation of lipid spectrum of blood.
9. Syndrome of oversized obstruction of the small intestine, which will ruin the liver and cause avitaminosis of folic acid and vitamin B12. With a large increase in cholesterol and homocysteine ​​levels. Remaining porous peripheral blood circulation and pitting on the heart.
10. Syndrome of Icenko-Cushing, which is associated with hyperfunction of supra-nirkoval locomotion, or with the intake of drugs in steroid hormones.
11. Hormonal disorders of the thyroid gland, yachnikiv.

Men over 50 and women during menopause are most often sick before attacks of angina pectoris and infarction.

Rizik factor ІХС, which will help to overcome the ischemic ailments of the heart: uremia, diabetics, legeneva lack. Cover ІХС damage in the wire system of the heart (blockade of the sinoatrial university, atrioventricular university, the lower part of the Gis bundle).

The current ІХС classification allows doctors to correctly assess the country of the sick and to live the necessary visits for the first time. For the skin form, which is the code in the ICD, it is broken down by its own algorithms for diagnostics and treatment. If it is not possible for children to develop ailments, the drug can help patients more effectively.

Ischemic cardiomyopathy is a pathology caused by a deficiency of myocardial cells, myocardial cells. In the International Classification, ailments (ICD-10) are considered to be a group of ischemias, and not to types of cardiomyopathies. Ailments are characterized by changes in the heart meat, as well as the development of atherosclerosis of the vine arteries, and manifestations of chronic heart failure. Symptoms of the other types of cardiomyopathies in the whole day.

difficult terminology

The ischemic form of cardiomyopathy is ambiguous. At the hour of the first solution, I will name it:

• 1965 rik - T. Harrison, describing the ischemic breakdown of the regional myocardial speed, the posture of the cicatricial, having propelled the understanding of the “asynergy of the myocardium”;
• 1969 rіk - N. rafteri viv for the whole pathology of myocardium the term "ischemic lack of ability", sharpening respect for one of the main key syndromes pathology - heart failure;
• 1979 rik - V. Bursh describing the spike of vipads in CHF, as a result of an infarction. At the same time, meaning that the ischemic form of the disease can be respected with the help of the right cardiomyopathy with the luring manifestations.

Expertise of the All-round organization of health protection brought the pathology to specific cardiomyopathy. And in the editorial office of the ICD-10 won, there is a middle of the sickness system and blood circulation, one of the types of ischemic ailments of the heart (IXC).

the essence of pathology

Progression of illnesses of atherosclerotic plaques. Wicked by them, the ringing of the vintsev vessels should be brought to hypoxia - the heart of the vidchuvє is the lack of sourness and the necessary living words. The myocardium cannot, by and large, visually quickly function, since the empty heart meat gradually grows.

The process can be supervised by structural and geometric changes of shlunochkiv (fibrosis and hypertrophy). There are obvious signs of chronic ischemia of the heart. It leads to myocardial apoptosis - a programmed bend of the clitin, which provokes a lack of heart activity.

Classification of the affliction of the first legacy

Ischemic cardiomyopathy provoking the draining of the walls of the heart chambers (dilatation hypertrophy). For the localization of the pathological process, two forms are seen:

• symmetrical - equitably grow in and out of the heart of the heart;
• asymmetric - changes are seen in one of the heart's views.

When there is adequate therapy for ischemic cardiomyopathy, it should be noted that there is a serious acceleration:

• the battle of the provincial nobles of the heart;
• viniknennya extrasystoles;
• fibrillation of the anterior;
• myocardial infarction;
• lack of heart.

There is a great prognosis for the health and life of a sick person.

Reasons for the development of pathology

The main reason for the development of pathology is atherosclerosis, which is the enemy of coronary heart disease. Stenosis of the arteries is abnormal within the internal myocardial spasms - manifest ІХС trigger the process of myocardial sleep ("sleepiness"). The heart is intrigued by the function. It is difficult to pump blood to provoke the development of angina pectoris, vicious heart attacks. Frequently, ischemic cardiomyopathy manifests itself in the event of myocardial infarction, and sometimes in recurrent necrosis. Among the number of factors that provoke the development of the disease, you see:

• hypertension;
• problems with the exchange of words (endocrine pathology, menopause, waste vagi, obesity);
• ominous spirits;
• kurnnya;
• high concentration of cholesterol in the blood;
• genetic strength;
• abducted vіk.

It is not common for the manifestation of ischemic cardiomyopathy with the triviality of hormonal disorders.

symptomatology of pathology

Symptoms of ischemic cardiomyopathy are nonspecific. Symptoms of heart failure are associated with the development of an illness:

• arrhythmias;
• accelerated irregular heart rate;
• squeeze more visibility in the breasts;
• p_dvischena stomatomy;
• head beel;
• zamorochennya;
• zbіlshennya masi tila;
• swelling;
• sleeplessness;
• vologic cough;
• zadishka.

In the world of progressing pathology, the growth of hearts is promoted.

diagnostics come in

Additional indications of the building, note the signs of congestive manifestations of the heart-vascular system and also on the physical examination. But for the formulation of an accurate diagnosis, specific conditions are recognized:

• Clinical analyzes of blood and blood (identification of specific pathologies);
• biochemical assessment of the blood warehouse (analysis of indicators of cholesterol, triglycerides, singing hormones);
• EKG (detection of arrhythmias, myocardial hypertrophy);
• EchoKG (visualization of quick-feeling functions of the heart);
• X-ray (viznachennya zbіlshennya tіnі heart);
• coronary angiography (assessment of changes in vintsevic vessels, detection of atherosclerotic plaques, improvement of other coronary arteries);
• scintigraphy of the myocardium (radioactive thallus accumulates in the middle of the myocardium).

Inodi dodatkovo priznachayut MRI or biopsies. Differentiation of disease from other types of cardiomyopathies, including from idiopathic and alcoholic.

principle of therapy

In case of a disease of ischemic cardiomyopathy, persh for all needs to be injected on the main reason for the diagnosis - ischemia of the heart. For a sick person it is necessary to look at the way of life. It is recommended for you to start taking children to lower cholesterol, sodium and fatty foods, see them from the mouth, you can see them physically right.

Drug treatment

Likarskі zasobi zasosovyut for reducing the symptoms of ailments, improving the robotic heart and improving development faster. Falsely from the path of illness, it is recognized:

• beta-blockers (to lower blood pressure and pulse rate);
• antagonism of calcium (expanding the arteries and reducing the grip of blood);
• Ingibitorium aldosterone and diuretics
• anticoagulants (thrombosis pereshkozhayut);
• to control the pulse rate and rhythm.

One of the patients is used for the apparatus procedure (plasmapheresis).

surgical injection

Prior to operative methods of therapy for ischemic cardiomyopathy, consider:

• installation of a heart stimulator, defibrillator (stabilization of the heart rhythm);
• angioplasty (anti-stenosis of the sudin);
• stentuvannya (installation of "rozshiryuvachiv" arteries);
• atherectomy (updating the education of arteries).

Inodi zasosovuyut coronary shuntuvannya, as it allows to polishit the rush of blood to the heart. In case of serous heart disease, an organ transplant is required.

Help folk medicine

In case of ischemic forms of cardiomyopathy, conservative treatment is not often carried out with additional phytotherapy. Widely zasosuvannya knew:

• viburnum (vitamins C and A, pectin, tanning speech, phytoncidi, micro- and macroelements, organic acids);
• satin lyonu (amino acids, fatty acids, glucosides, efir, vitamini groups B, E, A, F, C);
• hare cabbage (organic acids, folic acid, carotene, rutin, vitamins C, A);
• oats (vitamins B, amino acids, micro- and macro-elements, beta D-gluconate);
• zhovtushnik (flavonoids, glucosides, organic and fatty acids).

Lіkuvannya vasob folk medicine transferє a reduction in the grip, normalization of the rhythm of the heart and deprivation of manifestation of lack of heart. Yogo to carry out under the control of an approved lykar.

come in prophylaxis

The first is the prevention of the transmission of the disease. For the whole it is necessary:

• seen from the teeth of the teeth;
• zbalansuvati kharchuvannya;
• after the appearance of metabolic breakdowns;
• Hearts and Viruses get caught up in the hour.

As soon as there is a lack of strength before the development of cardiomyopathies, it is necessary to try to get an ultrasound scan of the heart on a regular basis. Come on second prophylaxis on the basis of progression of pathology and happy... Before entering the secondary prevention of ischemic cardiomyopathy, consider:

• visualization of intensive sports training and important physical robots;
• Regularly review of the cardiologist and presentation of the EchoKG;
• reception of drug-related drugs;
• control of oil;
• adequate response to stressful situations;
• organizing a balanced daily routine;
• systematic control of the level of glucose and cholesterol in the blood.

When diagnosing ischemic cardiomyopathy, self-care is unacceptable.

Ischemic cardiomyopathy manifests itself periodically. Ale if you get sick without therapy, you can provoke a fatal result. It is important, however, that the pathology of the bull was detected earlier. And the time "lull" of the cardiomyopathy is not guilty of being a drive for the recovery.

Chim is not without a legeneva hypertension and yak vilykuvati

1. Classification of disease
2. potential acceleration
3. LH predictions

Legeneva hypertension (LH) is a syndrome of small ailments, common by a characteristic symptom - the development of an arterial vise in the legenevian artery and the introduction of an attachment to the right heart slurry. The internal ball of the sudin grows and overshoots the normal blood flow. Put the schob into the legends of the shelter, the snake of the snakes can do it quickly.

So, anatomically, the organ is not attached to such an increase (with PH, the grip in the system of legenevic arteries grows up to 25-30 mm Hg. Art.)

According to the localized classification for the coding of medical diagnoses, the breakdown of the all-important organization of health protection, the code of burial for MKH-10 (the rest of the glance) - I27.0 - the first priority of the legeneva.

The opposite is important, due to the decrease in physical abilities, heart and legacy lack. LH - incapacitation rіdkіsne (altogether 15 vipadkіv per milion chol.) пізніх stage If lyudin is guinea, yak see cancer - everything is for pivroku.

Such common ailments are called "siritsky": lіkuvannya road, lіkіv few (economically unimaginable їkh vipuskati, who are happy - less than 1% of the population). Ale tsya statistics are not enough, as soon as the close people got involved.

The diagnosis of "Legendary hypertension" is established, if the parameters of the grip in Legenevian vessels at navantazhenny reach the marks of 35 mm Hg. Art. In the norm of blood, the grip in the legends is 5 times lower, lower in the body as a whole. The price is necessary, the shelter has become saturated with sour, due to carbon dioxide. When the grip in the vessels of the legends is pushed, you won’t stand up to the muslin, and the brain is simply hungry and switched on.

LH - foldable, versatile pathology. In the course of manifesting all of the clinical symptoms, the battle and destruction of the cardiovascular and legene systems are observed. Particularly active and neglected forms (idiopathic LH, LH with autoimmune disorders) lead to dysfunction of systems with imminent death.

LH can be a soluyuchoi (primordial) form of ailment, or it can be formulated into the infusion of іnshoi pershoprichini.

The reasons for the diagnosis of LG are not reported. For example, in the 60s of the last century in Europe, it meant growing ill, uncontrolled intake of oral contraceptives and pills for thinning.

With the deteriorated function of the endothelium, the change of mind can be served by the genetic strength of the inflow of the most aggressive bureaucrats. In case of skin infection, it is necessary to produce up to the destruction of the exchange processes in nitrogen oxide, change of the court tone (appearance of spasms, heat), the growth of the internal walls of the vessels with one-hour speedy education.

The increase in the concentration of endothelium (speech, the sound of the judgment) is explained either by the hardened secretion in the endothelium or by the decrease in its drop in the legends. Signs characteristic of idiopathic LH, inborn childish heart, systemic ailments.

Violation of the availability of nitrogen oxide, decrease in the synthesis of prostatics, decrease in the amount of calories - be it the release of provoking arterial spasm, growth of arteries, damage to the blood flow of the leg artery.

Pidvischuvati vise in legendary arteries building and such officials:

• Heart of the pathology of the developmental walking;
• Chronic ailments of the disease (such as tuberculosis or bronchial asthma);
• vasculitis;
• Destruction of communication processes;
• BODIES AND INSHI PROBLEMS OF Sudin Legends;
• Trivale perebuvannya in a high-mountainous place.

The exact cause of LH is not established, the ailment is diagnosed as pervinnu (vrodzhenu).

Classification of disease

For the degree of severity, there are 4 stages of LG:

1. The first step is not to supervise the second meat activity. Hypertonic vitreous rhythm of life without the sight of dullness, obscenity, weakness, sickly appearances in the sternum, important backwardness.
2. At the onset of the stage of physical mobility of the ailing one. The quiet camp is not a wicked one, but with the standard new assignments, there is a backlash, a lack of strength, a deterioration in coordination.
3. At the third stage of the development of ailments, all significant symptoms are manifested in hypertension with insignificant activity.
4. The rest of the stage is characterized by swirling symptoms of stagnation, large symptoms, weakness in the quiet stage.

pershi clinical symptoms LH viyavlyayutsya only after the dvorozovogo vyvishchennya vise in the legenevs. The key sign of ailment is a trick with its peculiarities, which allows you to see it as a sign of ailments:

Some of the symptoms of PH are also associated with larger patients:

• Witness and weakness;
• Neutrality and disruption of the heart rhythm;
• Unscented dry cough;
• Nabryaki nіg;
• Able to see in peck, tied with growth;
• Bil in the breasts from the extended artery;
• A hoarse note in the voice tied to the laryngeal nerve.

Most often, hypertensives take counseling with scargs for a post-life problem, so that life is slowed down. So, as in the first LH, there are special signs, which give the ability to diagnose LH in to the first, Nemaє, routine is carried out in a complex way - with the participation of pulmanology, cardiologist and therapist.

LH diagnostic methods:

If there are no pardons, LH diagnoses deprivation as a result of the implementation of the complex diagnostics of judges. The drive for the visit to the polyclinic can be:

• Appearance of zizdishki zіvichnoy navantazhennyam.
• More visible in the sternum of a non-noisy wake-up call.
• Permanently be seen nevilikovnym vtom.
• Feel the swelling of the lower pictures.

At the first stages of becoming ill, one is prompted for a proponated therapy. Key organizers when choosing a scheme for identifying guilty ones:

• Revealing and revealing the cause filthy self-respect patient;
• Reducing the grip in the courts of the legends;
• Increased blood clotting in arteries.

potential acceleration

The negative inheritance of the need for evidence:

• Sertsev's lack. The right half of the heart does not compensate for the viciousness of the navantazhennya, the whole pogirshu camp of the patient.
• BODY - thrombosis of the artery of the lung, if the judgment is overturned by blood clots. Tse is not just a critical camp - є a real threat to life.
• Hypertensive crisis and accelerated in the form of a lung filling will reduce the quality of the sick person's life and often lead to a lethal result. LH stimuli gostru i chronic form lack of heart and legends, which clutter the life of hypertension.

LH can develop yak in a mature vіtsі, so they do not. Tse will be explained by the peculiarities of the lungs of a newborn. When you appear on the light in the arteries of the lungs strong drop vise, obumovaniya by launching the lungs і rush of blood.

The factor і the cause of PH in newborns. Yaksho with the first breath circulatory system I do not lower the grip in the vessels, I do not reduce the decompensation of the leg blood flow with the symptoms characteristic of PH.

Diagnosis of "legeneva hypertension" is established in the infant, as the grip in the yogi of the vessel reaches 37 mm Hg. Art. Clinically, the type of LH characterizes the rapid development of cyanosis, important zadishka. For the new-born, it is a critical camp: death insist on insisting for a few years.

The development of LH in children sees 3 stages:

1. At the first stage of movement, the grip of the Legeny arteries is one of the abnormalities, varying symptoms in the child is mute. When navantazhennyah can be a zadishka, ale to find a pediatrician don’t wait for the animal to respect, explain the problem of detraining of the child’s body.
2. At the other stage, the heart wikid changes, showing flared clinical symptoms: hypoxemia, stagnation, syncope. The vice in the vessels of the legends is stable to the temples.
3. For the diagnosis of right gastric insufficiency, the ailment goes into the third stage. Uninvolved on high vise in the artery, heart wikid, supervascular venous congestion and peripheral ridges, rapidly falling.

Skin stage can be trivial from 6 months to 6 months - from minimal hemodynamic changes to a fatal result. And all of them go in for the children of the young age more effective, not for the older ones, so as the process of remodeling the Sudden Legends in children can be easily reversible and can be reversed.

LH predictions

The prognosis for hypertension of the lungs in a large number of cases of unpleasantness: 20% of those diagnosed with LH ended in an early death. An important factor is the type of LH.

In the case of a second form, which develops as a result of autoimmune diseases, the statistics of the most recent: 15% of patients go through lack of time for a few rocks in order to establish a diagnosis. On the triviality of life of the central category of hypertensives, inject indicators of average AT in the lungs. It’s okay to settle down at 30 mm Hg. Art. і і і і і іn і і і і і і і і і і і і іkуvіdє, come in, the triviality of life will speed up to 5 years.

Important furnishings will be the hour of coming to the legendary lack and heart. Fogging vision appears to be idiopathic (primary) hypertension of the lungs. Vaughn in the region is easy to fall into love, and the average triviality of life for the whole category of ailments is 2.5 rock.

To bring up to the minimum risk the development of the bed of a sinister ailment, to help simply come in:

As a child in school, she is not so hospitable, for the grandmother has an unviable zeal, do not send a visit to the doctor. modern drugsі methods of treatment allow a significant change in the classroom; manifest ailment, polypathy, life is painful, improvement and triviality. The earlier it was found sickness, the more accurate it was to see all the orders of the doctor, the greater the chance to overcome the sickness.