Information about cardiovascular insufficiency: is there a reason for concern? Overfatigue: symptoms, treatment in children and adults, how to recover Fatigue of the heart muscle

Pain in the chest area is accompanied not only by heart disease, but also by pathologies of other origins. These could be injuries, diseases of the spine, respiratory system, digestive or nervous system, and others. In any case, only a doctor can recognize this with the help of instrumental studies.

However, every person who encounters such a symptom is looking for an answer to the question: “How to understand that the heart hurts?” You need to know this so as not to miss the moment and seek help in time, for example, in case of myocardial infarction. It is important to understand how the heart hurts; the symptoms can be different. It is necessary to learn to distinguish cardiac pain from non-cardiac pain. To do this, you need to have an idea of ​​the nature, intensity and duration of pain, as well as other manifestations of certain diseases characterized by unpleasant sensations in the chest area.

Early signs of a heart attack

As already mentioned, chest discomfort can have various causes. Heart disease is determined by certain characteristic signs. You should know that the “core” often does not experience any unpleasant sensations. At the same time, a person with other pathologies may complain that it is difficult for him to breathe or his heart hurts. However, these symptoms will have nothing to do with cardiac diseases.

The very first signals indicating that a major organ is not in order usually arrive several months or years before a heart attack. All people need to have an idea of ​​how the heart hurts. Symptoms of the onset of the disease are usually the following:

1. Compressive, pressing pain behind the sternum, radiating to the back, arm, neck, jaw, especially to the left side. Accompanied by shortness of breath, sweating, nausea.

2. Pain occurs after exertion, physical or psychological, and goes away with rest and after taking nitroglycerin.

3. Shortness of breath occurs during exertion, even during everyday work that is not too hard, while eating, or while lying down. On the eve of an attack, a person may sleep sitting or suffer from insomnia.

4. Increased fatigue from normal work can haunt a person several months before the attack.

5. Men may suffer from erectile dysfunction for several years before being diagnosed with coronary artery disease.

6. Edema is one of the characteristic signs of cardiac dysfunction. At first they are insignificant, but gradually become more noticeable, especially visible in the rings on the fingers and on the shoes. If edema appears, it is necessary to undergo examination by a cardiologist or therapist.

7. Sleep apnea, or stopping breathing during sleep, and snoring can signal a predisposition to a heart attack.

How does your heart hurt? Symptoms of coronary diseases

Myocardial infarction

Signs of a heart attack may vary. The classic clinical picture of a heart attack usually unfolds as follows:

a feeling of heaviness, pressing or squeezing pain in the center of the chest, behind the sternum and in the arm;

irradiation of pain to the left arm, neck, lower teeth, throat, back;

dizziness, sweating, pale skin, nausea, sometimes vomiting;

a feeling of heaviness in the stomach, a burning sensation in the chest, reminiscent of heartburn;

fear of death, anxiety, severe weakness;

unstable and rapid pulse.

A heart attack can occur in another way. There may be no symptoms, which is the insidiousness of the disease. A person may complain of discomfort in the chest area, or may not experience any sensations - this is a silent heart attack. An extensive heart attack in its symptoms resembles acute heart failure: shortness of breath, suffocation, blue lips and fingertips, loss of consciousness.

A heart attack lasts about half an hour and cannot be stopped with nitroglycerin.

Coronary artery disease is manifested by attacks of angina pectoris. In this case, how does the heart hurt? Symptoms are usually the following:

rapid heartbeat;

• interruptions in heart function;

  irregular pulse;

  dizziness;

• sweating;

  weakness.

With cardiac ischemia, patients complain of discomfort in the chest: pressure, heaviness, fullness, burning. The pain can radiate to the shoulders, shoulder blade, arms, neck, lower jaw, throat. It usually occurs during physical and emotional stress and goes away with rest.

With angina at rest, pain can occur at any time. Often in this case, the heart hurts at night. This form is unfavorable.

Inflammatory heart diseases

Pericarditis

Pain is the main symptom of pericarditis, or inflammation of the outer lining of the heart. It is felt in the middle of the chest, sometimes radiates to the back, neck, arm, and intensifies when swallowing, inhaling, coughing, and also in a lying position. There is some relief when sitting or bending forward. Patients' breathing is usually shallow. As a rule, this is a dull or aching pain in the heart area, but sometimes it can be sharp and cutting. With pericarditis, low-grade fever and rapid heartbeat are observed.

Myocarditis

With inflammation of the heart muscle, up to 90% of patients complain of pain. This is a stabbing, pressing or aching pain in the heart area, which does not depend on physical activity, but can intensify a day after exercise. It does not go away with nitroglycerin.

Heart valve diseases

With valve pathologies, the symptoms do not in any way reflect the severity of the disease. A person may not have any complaints, but still be seriously ill. Signs may be as follows:

difficulty breathing, shortness of breath during daily activities and during exertion, as well as when lying down;

discomfort (heaviness, pressure) in the chest during exercise, inhaling cold air;

dizziness, general weakness;

rhythm disturbances: irregular pulse, rapid heartbeat, interruptions in heart function.

With valve diseases, heart failure can develop with characteristic symptoms: swelling of the legs, bloating, weight gain.

Cardiomyopathy

Almost all patients with this diagnosis have pain. It is especially pronounced in hypertrophic cardiomyopathy. Pain changes as the disease progresses. At first it is long-lasting, has nothing to do with physical activity, does not stop with nitroglycerin, and is localized in different places. Subsequently, spontaneous pain or attacks are observed after exercise, which are relieved by nitroglycerin, although not always. The nature of the pain varies. It has a specific localization or occupies a large area, is present constantly or only during exercise, goes away from nitroglycerin, but may not go away.

Arrhythmia

There are many types of arrhythmias characterized by disturbances in heart rhythm. In some of them, pain in the heart is noted, which radiates to the left side of the body and to the arm.

Heart defects

Heart defects, congenital or acquired, may not manifest themselves for years, but may be accompanied by pain. As a rule, these are constant aching, stabbing or cutting pains, which are accompanied by swelling of the legs and increased blood pressure.

Mitral valve prolapse

The pain usually occurs in the left side of the chest and is not associated with stress. It is pressing, pinching or aching in nature and does not go away with nitroglycerin. In addition, night and morning headaches, dizziness, lightheadedness, rapid heartbeat, and a feeling of lack of air are possible.

Aortic stenosis

With this pathology, there is a feeling of constriction in the chest, shortness of breath during exercise, muscle weakness, fatigue, and palpitations. With the development of coronary insufficiency, shortness of breath at night, dizziness, fainting with a sudden change in body position, attacks of cardiac asthma and angina pectoris occur.

Pulmonary embolism

This dangerous condition requires urgent help. Severe pain in the heart area, which intensifies with inspiration, is an early sign of pulmonary embolism. Unlike angina, the pain does not radiate to other places. The patient develops cyanotic skin, a sharp drop in blood pressure, and suffers from severe shortness of breath and palpitations. Nitroglycerin will not help in this case.

Aortic diseases

Excruciating, sudden, bursting chest pain - aortic dissection. Intense pain can lead to loss of consciousness. The patient requires urgent medical attention.

With a thoracic aortic aneurysm, mild, less often severe, throbbing or aching pain in the chest and back is noted. When an aneurysm ruptures, the patient experiences unbearable tearing pain, shock and death are possible if help is not provided in time.

Non-heart diseases

1. Intercostal neuralgia. It is often mistaken for heart pain, but in reality there are significant differences. With intercostal neuralgia, the pain is stabbing, sharp, intensifying with deep inhalation and exhalation, turning the body, sudden movements, coughing, laughing, sneezing. It may go away after a few minutes, but can last up to several hours or days. The person accurately indicates the location of the pain, its localization is pinpoint, on the left or right side of the chest between the ribs. With angina, it is burning, aching, but not sharp, does not depend on the position of the body, the exact location cannot be indicated, it is usually shown on the entire chest.

2. Thoracic and cervical osteochondrosis. It is easily confused with angina pectoris. It seems to a person that his heart hurts, his arm, usually the left, and the area between the shoulder blades go numb, the pain radiates to the back, upper abdomen, and intensifies with breathing and movement. It especially resembles a heart attack if it occurs at night, and the person experiences fear. The main difference from angina pectoris is that nitroglycerin does not help.

3. Diseases of the central nervous system. In this case, patients complain that their heart often hurts. As a rule, patients describe their condition differently. The pain can be constant and short-term, aching and sharp. With neuroses, various autonomic disorders are usually present: irritability, anxiety, insomnia or drowsiness, heat or chilliness in the extremities, dryness or increased moisture of the skin, muscle pain, stomach pain, headache. Usually people with neuroses very colorfully and in detail describe numerous symptoms that objectively do not correspond to the true state of the person. At the same time, “core people” are very stingy in describing their feelings. It can be difficult to distinguish cardioneurosis from cardiac ischemia, since there are no changes on the ECG.

4. Disturbances in the gastrointestinal tract. Pain caused by pathologies of the digestive system, longer lasting than heart pain, is accompanied by nausea, vomiting, heartburn, and depends on food intake. Acute pancreatitis is sometimes mistaken for a heart attack: severe pain with nausea and vomiting. Pain from spasms of the gallbladder and ducts can radiate to the left side of the chest, so it seems that the heart hurts. What to drink to find out for sure? If antispasmodics helped, then problems with the gastrointestinal tract.

5. Lung diseases. Pneumonia may cause heart-like pain. With pleurisy, acute pain occurs, it is limited, and intensifies when coughing and inhaling.

What to do?

This is the first question that comes to mind when someone feels chest pain. If there is a suspicion that your heart still hurts, that is, an attack of angina or a heart attack, you need to act as follows:

First of all, you need to calm down and sit down. Panic will only make the condition worse.

Try changing your body position. If it feels better, it may not be your heart that hurts. If the pain has not subsided, but continues to increase and is of a squeezing or pressing nature, it is possible that this is angina pectoris.

You need to open the window in the room to let fresh air in.

Nothing should restrict breathing, so the collar of clothing must be unbuttoned or undressed to the waist.

Place one nitroglycerin tablet under your tongue; if you have angina, the pain should subside fairly quickly. If it does not go away after 15 minutes, take another tablet and call an ambulance. If it is a heart attack, nitroglycerin will not help.

Conclusion

Even if the attack was stopped, the next day you need to go to the hospital for examination. And, of course, there is no need to self-medicate.

Constant fatigue, pain in the heart area

Asked by: Olya

Female gender

Age: 23

Chronic diseases: not specified

Hello. I am 23 years old. For about 2 years now I have noticed chronic lack of sleep, terrible apathy, and sometimes irritability. My dream became to sleep 24 hours a day! And still it seems to me that I won’t get enough sleep and rest. I started following a schedule: I go to bed at 10 and get up at 6. But no matter how much I want to, it’s very difficult for me to get up. I feel terribly tired all day. It seems to others that I'm just lazy. When I come home from work, all I can do is have a snack and go to sleep. Yes, I can gather all my strength and do something, but in reality at the same time I have a breakdown and fall asleep on the go. Three weeks ago I started having a stabbing sensation in the area of ​​my heart. "Pricking" sharply and sharply in several places when turning, during physical. Load. Then this stabbing pain went away, but during the day it became just an aching pain, sometimes it gets stronger, sometimes it hurts slightly. And now for another 4 days the temperature is 37.2-37.7. And I also noticed one strange thing - my heart sometimes begins to beat faster, as if I had risen to the 5th floor. The condition is such that no one can see or hear me. And so that I don’t see or hear anyone. This makes me very sad. I really want to be happy and have fun. I've been waiting for a trip to the sea for two years! We arrived at the seaside, but I didn’t even have the desire to “get to the seaside”! - “Just let me rest!” - that was my mood. Please tell me, this could be some kind of disease or, as others say, it’s a figment of my imagination, I just want to appear sick. But I put so much effort into doing everything and getting everything done and still seem cheerful and cheerful: (

Pain in the heart area for 2 weeks, periodic presyncope Hello, please tell me what to do. We don’t have a cardiologist, so all our hope is in you. A little over 2 weeks ago I had a stressful situation. Since then, my heart has been hurting almost non-stop. The pain is mostly squeezing, sometimes it feels like a knife is being stuck into the heart. Feeling of slight numbness in left arm. Occasionally there is pain under the left shoulder blade. There is a pre-fainting feeling: weakness sets in, you want to sit up quickly. At night I take the sedative Doctor Passit. I take validol under the tongue throughout the day. Validol helps for a while, then the pain returns. Thanks in advance, I will be very grateful

3 answers

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Hello. You know, modern medicine takes your complaints as a basis, and then conducts examinations to make the correct diagnosis.
Can’t you really visit a doctor, get examined, and, if necessary, see the necessary specialists? It seemed to me that you were rather puzzled by the state of your health. So it’s time to take practical steps. And, in answer to your question, I will say - everything is possible, but there is no need to guess, but you need to take care of yourself together with a doctor.
Good luck.

Valery 2016-05-17 13:01

Hello. I get tired easily to the point of exhaustion after five to ten steps. Increasing pain in the area of ​​the heart. After taking nitroglycerin, the pain subsides until exercise. At times there are sharp tremors of the heart, as if it is “jumping out” of the chest. Constantly sweating with the slightest exertion. I take Concor, my blood pressure drops, and it’s also bad. Thank you.

Hello.
You don’t write your age; whether the pain is related to physical activity is also unclear. My advice to you is, don’t delay it, but go and get examined by a cardiologist. Afterwards you will receive qualified treatment.
Good luck.

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Update: December 2018

Constant fatigue, apathy, and decreased performance are attributed to changing weather conditions, lack of sleep, and lack of vitamins. Doctors say: chronic fatigue is a direct path to depression and decreased immunity. Let's look at overwork in detail: causes, symptoms and treatment. We'll tell you how not to neglect yourself and quickly regain strength.

Overwork used to be understood as a condition associated with a prolonged lack of proper rest. Today, overwork is considered as the body’s reaction to constant or excessive irritants of a mental, mental, and physical nature.

The discrepancy between the severity and duration of work and rest time triggers this process. Unfavorable living conditions, constant stress, poor nutrition aggravate and perpetuate the condition.

Depending on the causes, physical, nervous, and mental fatigue are distinguished: the last two types are similar in manifestations and often accompany each other. It is possible that both physical and mental fatigue with mixed symptoms develop.

Fatigue is a physiological state of the body, and overwork is pathological!

Fatigue

Overwork is preceded by fatigue, the symptoms of which are a signal for a person. Fatigue is a shift in the psychophysiological state of the body and leads to a temporary decrease in labor efficiency. Fatigue from light loads, decreased performance, mood swings, longer time for recovery and rest indicate fatigue. It's time to stop doing the work, reduce the intensity, take a break.

Physical fatigue

Develops gradually. At first, mild fatigue and mild pain in the muscles occur. The symptoms go unnoticed, the person continues physical labor or sports, does not reduce the load, which leads to the height of physical fatigue.

Symptoms of physical fatigue:

• constant feeling of fatigue, after sleep, rest, massage;
• increasing muscle pain: at rest, with tension;
• restless sleep: waking up for no reason, difficulty falling asleep;
• disturbance of the emotional background: apathy, lethargy or irritability;
• discomfort, pain in the area of ​​the heart;
• tachycardia;
• decreased appetite;
• white coating on the tongue;
• trembling of protruding tongue;
• weight loss;
• in women - menstrual irregularities.

Symptoms of overwork appear at work. It is impossible to fulfill one’s professional duties fully and efficiently.

Treatment

Available means and methods that speed up recovery from fatigue.

Bath

An ancient Russian way to eliminate fatigue, recover from hard physical labor, increase performance, and strengthen the immune system. Frequency – 1-2 times a week, after the session – massage. You should not visit the bathhouse immediately after exercise, if you are feeling unwell, have acute illnesses, or have a number of other contraindications.

Baths

Water helps to “wash away” fatigue and the heavy burden of the day.

• oxygen bath. Indicated for physical fatigue, after injuries, and for diseases of the musculoskeletal system. Procedure time - 7 minutes, per course - 15 procedures, daily;
• vibrating bath. Activates protective and restorative mechanisms, blood circulation, stabilizes metabolism, eliminates muscle fatigue. Procedure time – 3-5 minutes, per course – 15 procedures, daily;
• bubble bath(with air bubbles passing under high pressure, water temperature 37 C). Promotes relaxation and eliminates nervous tension. Procedure time – 10 minutes, per course – 10-15 procedures;
• pine bath. Has a calming effect and eliminates physical fatigue. Procedure time – 10 minutes, 2 times a week, can be done regularly;

Shower

If you don’t have time to take medicinal baths, a regular shower will help:

• a hot shower with water temperature + 45 C has a tonic effect;
• a warm rain shower soothes, refreshes, and eliminates muscle pain;
• cascade shower increases muscle tone;
• A contrast shower supports the body's performance and speeds up recovery.

Massage

A universal procedure that has a positive effect on the central and peripheral nervous system, heart, blood vessels, digestion, and metabolism. Duration of massage: 10 minutes for each leg, 10 minutes for the back and neck, 10 minutes for the upper limbs, 10 minutes for the abdominal area and chest.

What to do if there is no time for all these procedures?

• Eliminate excessive stress, do not give up your usual physical activities completely. Change activities, take a short vacation.
• Walk outdoors every day.
• Eliminate nervous tension as much as possible (don’t live with other people’s problems, don’t get nervous over trifles, etc.) see;
• Review your diet: saturate your menu with fruits, vegetables, herbs, and lean meats.

Mental fatigue

Often interpreted as ordinary fatigue. People take vacations, go to the sea, but their condition does not improve. Leads to the condition:

• continuous work at the computer (more than 8 hours a day);
• periods of increased mental stress (reporting period, etc.);
• a large amount of information received in a short time;
• being under stress;
• dissatisfaction with work, salary, etc.

Symptoms:

Worsening of the condition is accompanied by vomiting, nausea, severe irritability, nervousness, loss of concentration, and memory impairment. There are frequent acute respiratory infections and acute respiratory viral infections.

There are 3 stages of development of mental fatigue:

• Easy. Problems falling asleep even when very tired, feeling tired after a night's sleep, decreased physical and mental performance.
• Average. Added: heaviness in the heart area, anxiety, fatigue. Hand trembling with little physical activity. Heavy sleep with frequent awakenings, nightmares. Disorders in the digestive system: loss of appetite, pale facial skin, reddened sclera of the eyes. In men - decreased libido and potency. In women - menstrual irregularities.
• Heavy. Neurasthenia manifests itself - increased excitability, irritation, lack of sleep at night, drowsiness during the day, disruption of the functioning of all organs and systems.

Stages 2 and 3 of fatigue require treatment.

Treatment

The main principle of treatment is to reduce stress of all types that led to the condition. How to recover from mental fatigue?

• First stage. Full rest for 1-2 weeks, including walking in the fresh air, proper nutrition. Relaxing baths and aromatherapy sessions (mint,) will help. After this period, you can gradually add intellectual and physical activity, excluding overload. Recovery occurs within 2 weeks.
• Second stage. Complete refusal of any intellectual activity: work with documents, reports, projects. Relaxing auto-training, massage, and relaxation in a sanatorium are useful. Recovery occurs within 4 weeks.
• Third stage. Hospitalization in a specialized medical institution: dispensary or specialized sanatorium. The first 2 weeks are rest and relaxation, the next 2 weeks are active sports. Intellectual loads can be introduced after 4 weeks in very measured doses. Full recovery takes 4 weeks.

When the first signs of mental fatigue develop, there is no need to wait for progression. Take a short vacation for 2-5 days, change the type of activity, engage in active recreation, auto training. Other methods of relaxation are also suitable: a warm bath, yoga, outdoor recreation. Give up coffee and alcohol, normalize your wakefulness and rest patterns, and eat well. It is important to improve your sex life.

You should not prescribe medication to yourself: this may worsen the condition, because... For mental fatigue, drug therapy is not indicated. Medicines are prescribed in severe cases, with the development of severe depression and neurosis.

Nervous fatigue

Stress, emotional overload, negative emotions do not leave their mark on the body and lead to nervous fatigue. The first symptoms of nervous fatigue:

• persistent fatigue;
• insomnia at night and drowsiness during the day;
• pessimism;
• anxiety;
• increased sensitivity to external stimuli;
• tachycardia, blood pressure surges;
• general symptoms of fatigue: fever, pain in the legs, arms, back, discomfort in the stomach and intestines;
• exacerbation of chronic diseases.

The person becomes impatient, irritable, anxious, and unsure of himself. Self-esteem falls, problems arise in the sexual sphere, memory deteriorates, and the mood is consistently depressed.

During nervous fatigue there are three stages:

• hypersthenic: fussiness, irritability, understanding that there is a problem, but the inability to cope with it. Poor control over emotions, provoking quarrels and conflicts. Headache, muscle pain, insomnia, decreased ability to work;
• annoying weakness: hot temper, pessimism, anxiety. Heart pain, shortness of breath, allergic reactions;
• hyposthenic: apathy, lack of interest in life, depressed mood, indifference.

Treatment is similar to mental fatigue. It is important to rule out the factors that led to the condition.

Overwork in children

This dangerous condition leads to health problems. Overwork is most often preceded by severe fatigue. Causes:

• babies: violation of the daily routine, problems with breastfeeding;
• preschoolers: stressful situations, dysfunctional family environment, excessive attempts by parents to develop their children in every possible way, to raise geniuses;
• younger schoolchildren: physical and mental stress, overload with lessons, short sleep at night;
• senior schoolchildren: hormonal changes, high intellectual load, conflicts with peers.

The first symptoms of overwork in children are not pronounced, which complicates the diagnosis. Please pay attention to:

• moodiness/tearfulness for no apparent reason;
• restless sleep, screams in sleep, erratic swinging of legs and arms;
• impaired concentration during activities or games.

There are three stages of overfatigue in children (classification according to S.L. Kosilov):

In addition to the above, common signs of fatigue are characteristic: insomnia, daytime sleepiness, poor appetite, irritability, moodiness, unreasonable fears, weakness and headaches. Children lose interest in learning and fall behind. Psycho-emotional disorders are often associated: unpleasant facial expressions, antics, mimicking others, aggression. Obvious symptoms of overwork in teenagers: they begin to snap, become rude, and ignore the comments and requests of adults.

Treatment of overfatigue in children

If you do not begin to correct this condition in a timely manner, everything can turn into neurosis, vegetative-vascular dystonia, and insomnia. An integrated approach is needed; it is better to contact a pediatrician and a psychologist, who will prescribe sessions of auto-training, psychotherapy, massage, and vitamin supplements. In parallel follows:

• adjust nutrition. No fast food, nutritious and regular meals;
• increase feasible physical activity and: sports, swimming, physical therapy;
• spend more time outdoors: active walks 1.5-2 hours a day.

Prevention of overwork

Overwork is not a disease, but the approach is the same: it is easier to prevent it than to correct it later. By following simple recommendations, you can remain active throughout the year, and a vacation will be enough to recuperate.

• Get plenty of rest on your weekends.
• Don’t overload your brain with TV, heavy music, or other people’s problems.
• Change your activities: if your main work is physical, don’t neglect books at home, and vice versa.
• Do feasible sports: walking, jogging, morning exercises, swimming pool, cycling.
• Visit relaxing treatments: bathhouse, sauna, swimming pool, massage.
• Avoid drinking alcohol at the first sign of fatigue. Instead of relaxing, you yourself will introduce toxic substances into the body and aggravate the situation.

Think carefully about your vacation. I want to do everything at once. But if you have 3-4 days off, it’s better to go out of town with your family, relax in nature, rather than go abroad for new experiences.

Parents must provide:

• supply of fresh air to housing: regular ventilation of premises;
• daily walks: regardless of the weather, even if it’s raining outside, you can breathe fresh air under a canopy;
• good nutrition: more vegetables, fruits, herbs, natural meat and dairy products;
• quiet time before bed: reading a book, putting together a puzzle, coloring;
• adherence to daily routine: A child’s nightly sleep should be at least 9-10 hours.

Knowing the symptoms of overwork, modern approaches to treatment and prevention, it is easy to prevent the transition of a borderline state into a disease. If left untreated, the acute condition will develop into chronic fatigue - nervous or physical exhaustion, the symptoms of which are more serious. Social complications, health problems, and communication problems arise. The quality of life suffers greatly, and long-term serious illnesses are possible.

Take overwork seriously - it is not just fatigue, but a protracted pathological condition that can lead to illness. Follow a daily routine, alternate periods of activity and rest, avoid overwork and overload.

The term “coronary heart disease” includes a number of diseases that are based on one cause - vascular atherosclerosis. But if previously heart pain and nitroglycerin were the lot of people of the older generation, now ischemia does not bypass the younger generation either.

This development of the situation is currently influenced by many factors, primarily stress and the environment. The modern lifestyle involves physical inactivity and a diet rich in fat. Hereditary predisposition and the prevalence of smoking among all age categories also contribute. Currently, coronary heart disease (CHD) is the cause of mortality in 40–60% of cases of the total number of diseases

Unfortunately, IHD rarely manifests itself only as symptoms of ischemia. More often it is combined with arterial hypertension, cardiac arrhythmias, heart failure, and cerebrovascular insufficiency. But the basis of all these diseases is atherosclerosis.

The modern concept of treatment for patients with coronary artery disease is based on the recommendations of the European Society of Cardiology and includes the following areas (A-B-CDE therapy):

A spirin and Antianginal therapy (prescribing aspirin and antianginal drugs);

But a significant number of patients report side effects of drug therapy, manifested by increased fatigue, headaches, swelling, impotence, and depression.

62% of patients suffering from coronary artery disease rate their quality of life as “unsatisfactory” or “poor”, only 17% of patients do not experience angina attacks, 82% of patients change their lifestyle to prevent angina attacks: avoid physical activity, outdoor activities and emotional stress, sleep a lot or relax without leaving home.

How to improve the quality of life of such patients, prevent the development of cardiovascular accidents and extend the period of active life? One of the ways to optimize conservative therapy may be the additional use of natural drugs of non-synthetic origin.

In order to normalize metabolic processes in the myocardium, homeopathic medicines are becoming increasingly used in outpatient medical practice. These drugs are devoid of toxic effects on the body, and their mechanism of action is aimed at adequate stimulation of physiological defense mechanisms. The positive effect of such therapy in patients with diseases of the cardiovascular system is described in the works of domestic and foreign scientists.

According to the concepts of homeopathy, health is a state of dynamic equilibrium of the body with the external and internal environment. When balance is disturbed, disease occurs. Currently, there are 2 directions in homeopathy.

Classical homeopathy - uses the totality of all physical, mental and constitutional symptoms to select an individual homeopathic medicine. The main “dogmas” of homeopathy (law of similarity, modality, small doses) were formulated by Christian Friedrich Samuel Hahnemann in 1796.

Complex homeopathy is focused on the patient’s diagnosis. A complex homeopathic remedy is a medicinal combination of several unidirectional homeopathic remedies. To use these remedies, a short diagnosis-oriented history is sufficient. Due to their safety and ease of use, complex products are particularly suitable for sale in the OTC market.

Homeopathic medicines with effects on the cardiovascular system are produced by various homeopathic pharmaceutical manufacturers. Let's consider one of them - Pumpan (Richard Bittner GmbH, Austria).

To ensure the greatest effectiveness, Pumpan should be taken orally in its pure form or diluted in a tablespoon of water 30 minutes before or 1 hour after a meal, keeping it in the mouth for some time before swallowing (tablets - until resorption).

The components of the drug dilate the coronary arteries, improving blood supply to the myocardium, reduce ventricular ectopic activity, the frequency and intensity of angina attacks. Pumpan improves myocardial contractile function and increases exercise tolerance. At the same time, it improves the rheological properties of blood and indicators of lipid metabolism, microcirculation and metabolism of cardiomyocytes, reduces lipid peroxidation, increases diuresis, improves systemic and intracardiac hemodynamics in heart failure.

Numerous studies by domestic and foreign scientists have found that when Pumpan is added to standard therapy, angina attacks are observed less frequently, indicators of intracardiac hemodynamics improve, indicators of the mental sphere and patients’ adaptation to the environment are normalized. The drug increases the body's adaptive capabilities, reduces the need for drugs for basic therapy of arterial hypertension, chronic ischemic heart disease, and chronic heart failure.

Thus, Pumpan is an effective treatment for various forms of coronary artery disease, including when it is combined with arterial hypertension, as an integral additional component against the background of traditional drug treatment.

What diseases and what degree of heart failure cause disability?

Heart failure is a disorganization of the structure and dysfunction of the heart, which results in an unsatisfactory supply of O2 to the body tissues while maintaining the filling of the heart chambers. At the same time, for satisfactory oxygenation of tissues, it is necessary to increase the pressure inside the organ cavities.

What diseases cause AHF?

Heart failure can be acute or chronic. Acute cardiac inaccessibility is a violation of the ability of the myocardium to contract, a drop in heart volume, which is expressed by gross pathological phenomena, including cardiogenic shock, the appearance of fluid in the lung cavity, and disseminated intravascular coagulation syndrome.

The acute form includes such manifestations as shortness of breath of a cardiac nature due to the lightning-fast occurrence of congestive processes in the lungs up to the development of cardioshock (a sharp drop in blood pressure, oliguria, etc.), primarily caused by acute damage to the muscle fibers of the heart (in most cases this is acute coronary syndrome).

It may also occur due to excessive parenteral fluid administration.

First of all, this is acute myocardial infarction. Acute infectious-inflammatory and dystrophic heart diseases can also cause it. May occur due to complicated hypertensive crisis, pulmonary embolism, prolonged status asthmaticus, emphysema. Or due to volume overload (increase in the specific gravity of the bcc). Another important reason is intramyocardial hemokinetic changes, rupture of the interventricular septum or the onset of aortic, bicuspid or tricuspid insufficiency (interseptal infarction, rupture or separation of the mamillary muscles, perforation of the valve leaflets in infective endocarditis, traumatic injury). With increasing stress (sports or mental stress, increased blood flow during an orthostatic test). On recuperated heart muscle in patients with persistent congestive heart failure.

Chronic heart failure is more often diagnosed among the population. This form is characterized by the occurrence of exacerbations. During the period of exacerbation, the intensity of all symptoms increases.

Moreover, in the domestic literature there are also systolic and diastolic variants of the form of the disease.

The pathological component of HF is contractile heart failure (for the systolic variant).

Clinical classification of HF

1 First degree (onset of the disease). Heart failure of the 1st degree is characterized by a persistent feeling of shortness of breath, interruptions in the functioning of the heart only during minor physical activity. Early on, patients do not notice such symptoms, as is correct. 2 The second degree is characterized by severe circulatory disorders (congestion in the pulmonary blood flow) with low load, episodes at rest. CH 2 is divided into two periods: A and B. “A” is characterized by impaired breathing and interruptions in the heart during moderate physical stress, which is manifested by a dry hacking cough, possibly with blood, manifestations of fluid stagnation in the lungs, palpitations, etc. There is an initial stagnation in the systemic circulation. At this stage, performance has already been sharply reduced and disability is given. In stage B, it is already difficult for the patient to breathe at absolute rest. The activity of the heart is significantly impaired, cyanosis occurs. Significant congestion in the lungs. A dry cough accompanies the patient almost constantly. The swelling is significant and dense, up to anasarca. Patients become completely incapacitated. For such heart diseases, disability is prescribed. 3 The third degree is the final stage of the disease. Irreversible changes occur in organs and tissues, severe changes in metabolism, and cachexia. At this stage, the above-mentioned symptoms are accompanied by severe pain in the heart area and irreversible changes of a sclerotic nature. Possible development of liver cirrhosis and pulmonary sclerosis. At this stage, treatment is not effective. With such heart diseases, disability is definitely given.

In clinical practice, heart failure includes the following symptoms:

• Dyspnea.
• Swelling is predominantly of the lower extremities (often around the ankles) and in the paraorbital area.
• Fatigue, weakness. It is even difficult for the patient to perform light physical labor (cleaning the house, washing dishes, walking, etc.) in advanced cases.
• Nocturnal attacks of the cardiac form of status asthmaticus.
• Night hacking cough.
• Wheezing (wheezing).
• Weight gain or loss (in complicated cases).
• Feeling of “fullness” in the stomach.
• Loss of appetite.
• Nervous disorders, including: depression, apathy, mood swings and lability.
• Feelings of heartbeat.
• Fainting attacks.
• Forced position in the patient's bed.

CH diagnosis

Diagnosis of heart failure is a complex issue in medical practice. Especially in the early stages. Since the symptoms and signs are not entirely specific. They can occur in any condition of fluid retention in the body.

The most reliable signs of the disease include:

• Visible swelling with pulsation of the veins of the neck.
• By “listening” (auscultation), the doctor can determine the presence of fine rales in the lungs and crepitus, which indicates the presence of “water” in the lungs. It is also possible to detect the so-called “gallop rhythm” and systolic murmur over the projection area of ​​the heart.
• When “tapping” (percussion) a shift in the size of the heart to the side is revealed, the cause of which is a long-term pathological process in the myocardium.
• The doctor may pay attention to the presence of a lot of edema in the periphery (swelling in the lumbar region, legs, genitals).
• Often in this group of patients an increase in the frequency of contractions of the heart muscle is detected.
• When palpating the pulse, a violation of its rhythm and completeness is determined.
• The patient's breathing is frequent and shallow.
• Cachexic constitution.
• Ascites, and even anasarca (complete swelling of the body including organs and cavities).

For a more detailed diagnosis of pathology, a clear research algorithm is used:

• Echocardiographic examination helps to assess the size of the myocardium, changes in cavities, the condition of the organ valves and the functional parameters of the ventricles.
• Electrocardiography allows you to determine the rhythm and quality of the system.
• Biochemical blood test. Mandatory determination of electrolyte composition (Na, K, Ca), the ratio of urea levels in the patient’s blood and urine, ferritin, transferrin, iron, and iron-binding function. It is important to determine the quality of the liver and kidneys; for this we determine the level of bilirubin and calculate GFR based on the level of creatinine.
• Thyroid function should also be assessed. To do this, we determine the level of thyroid hormones in the blood. This is especially important when prescribing diuretics and anticoagulant substances to the patient.
• General clinical blood test. To exclude anemia and inflammation.
• One of the necessary methods used to make a diagnosis is to determine the amount of natriuretic hormone in the blood.
• A chest x-ray can provide answers to a number of important questions that help exclude congestive diseases of the pulmonary system. Also, based on improvements in the X-ray picture, one can judge the effectiveness of treatment.

In difficult cases, additional techniques are used:

• Magnetic resonance imaging allows evaluation of structure and function. There are a number of contraindications for MRI that should always be taken into account. This method is the most accurate for assessing the volume, mass and contractility of the heart chambers. MRI is also an alternative option if the quality of the echocardiogram is unsatisfactory. Also, its value is that it is used for diagnosis of infiltrative or infectious heart diseases.
• Single photon emission CT helps assess myocardial viability.
• Coronary angiography. It can be used to determine whether the patient has damage to the coronary arteries. Used only for serious indications.
• Transesophageal echocardiography is prescribed if it is impossible to conduct a standard version of the ECG (the reasons for this may be obesity, diseases of the lung tissue, patients on mechanical ventilation)
• Positron emission tomography can detect organ ischemia
• Computed tomography is used for non-invasive diagnosis.
• It is possible to use catheterization of myocardial sections when applying transplantation of an organ or its parts.
• Heart tissue biopsy
• Holter screening is indicated for pathologies likely related to rhythm and conduction system problems. During the procedure, monitor the rhythm, correctness and frequency of the ventricles.
• There are also special tests using physical activity.

Treatment

Treatment of AHF is a complex algorithm of actions. First of all, we make sure that there are no severe rhythm disturbances. If a patient experiences acute coronary syndrome, the treatment will benefit from emergency restoration of blood circulation in the coronary vessels. This can be achieved using systemic specialized thrombolysis. Its implementation is already possible at the pre-hospital stage of providing care to the patient.

It is important to provide the patient with access to enriched and humidified O2. We administer it through a nasal catheter. The injection rate is no more than 8 milliliters per minute.

The algorithm is also selected based on the location of the problem. To treat acute right ventricular failure, correction of the pathological conditions that led to it is carried out. In most cases, these are pulmonary embolism, status asthmaticus, etc. The condition itself does not require treatment. The reason that caused this status is eliminated exclusively.

In case of combined AHF (that is, with damage to both the right and left ventricles), it operates according to the above algorithm.

If the patient is additionally diagnosed with cardiogenic shock, then therapy with inotropic drugs is mandatory.

A more complex issue is the management of acute left ventricular failure.

First of all, the patient is prescribed nitro-containing drugs. In practice, this is nitroglycerin under the tongue in a dose of half a milligram. The patient must be given an elevated position of the head end. But if there is fluid in the lungs, you need to lower your legs. These techniques are very effective for low blood pressure.

The “gold standard” for AHF is a diuretic such as furosemide. Due to the dilation of the veins, a few minutes after the administration of the drug, unloading of the cardiovascular system occurs, which is enhanced due to the forced diuretic effect of the drug. It is used parenterally, diluted, in a dose of about twenty milligrams. The dose is increased in the presence of congestion in the chest to 3 grams.

If the patient has severe forced breathing, severe excitation of the central nervous system, narcotic painkillers are prescribed, including morphine (it relieves the load on the heart, reduces the contractility of the respiratory muscles, inhibits the functioning of the respiratory center, and also reduces mental arousal. Used in doses of about five milligram (pre-dissolved in an isotonic solution).But this drug has a number of contraindications: disturbance of breathing rhythm, pre-existing depression of the respiratory center, obstruction of the respiratory tract, “bull” heart, cerebral edema, poisoning.

Stagnation in the pulmonary circulation at normal blood pressure is relieved by the administration of nitrate drugs. In this case, blood pressure indicators must be monitored. With this degree of heart failure, there is also a need for the administration of anticoagulants.

It is worth noting that with increasing symptoms of pulmonary edema, glucocorticosteroid therapy is prescribed.

It must be remembered that one of the most valuable actions in the treatment of this condition is adequate pain relief.

When treating CHF, one achieves:

• Prevention of the development of symptomatic chronic heart failure.
• Elimination of signs of disease.
• Slowing down the progress of the disease by protecting the heart and other organs (brain, kidneys, vascular system).
• Improving quality of life indicators.
• Reducing the frequency of patient hospitalization.
• Improving disease prognosis data.

If there are symptoms of the disease, they are eliminated using various methods. Methods that contribute to this:

• Balanced diet.
• Correct dosed physical activity.
• Favorable emotional environment for psychological rehabilitation.
• Adequate pharmacotherapy.
• Physiotherapy.
• Surgical interventions according to strict indications.

Prevention of heart disease

The current view on the prevention of heart failure involves reducing the impact on the patient’s life activity of a combination of factors such as:

• Arterial hypertension.
• Obesity.
• Insulin resistance.
• Violation of the lipid spectrum of the blood.
• Metabolic disorder.

It is worth remembering that the heart is a kind of “engine” of life, the stop of which is fatal for the body. It is easier to prevent its “breakdown” than to restart it in the future.

The heart and blood vessels in the human body act as an “engine”, “pump” and “pipeline” through which all organs are supplied with oxygenated blood. They work without breaks, day and night. Stopping this mechanism even for a minute can lead to serious life-threatening complications. Heart failure occurs when the contractile function of the heart is impaired, or overwork from hard work.

What happens in a “tired” heart

The heart muscle needs a lot of nutrients and oxygen. The cells contain fibers of the protein actomyosin, which provide stretching and contraction of the myocardium under the influence of the reinforcing nerve. Thus, the central nervous system is involved in the regulation of heart contractions. Energy is needed to replenish and renew actomyosin. The lack of a sufficient amount of kilocalories leads to a decrease in muscle performance and the development of congestive heart failure. The contractions of the heart become slower and weaker, and it does not empty completely, as it is not able to push all the blood into the aorta and pulmonary artery.

First, a compensatory reaction is activated - thickening of the muscle. When “reinforcement” does not arrive, muscle tissue becomes flabby. Overflow of the chambers leads to a wave of stagnation “behind the heart.” Insufficiency in the left sections causes blood retention in the pulmonary circulation, in the lung tissue. With isolated insufficiency of the right sections and general muscle weakness, venous blood is retained in large veins, the liver, and throughout the systemic circulation.

All tissues receive “poor quality” blood and experience oxygen starvation. The bone marrow is stimulated and additional blood cells are produced. This puts even more strain on the heart, aggravating heart failure.

Scientists attribute a major role in the progression of the disease to the renal mechanism: renal blood flow decreases 4 times, this causes sodium retention, and with it water, which leads to venous congestion and edema.

Causes

All causes leading to impaired contractility of the heart muscle can be divided into two groups: primary and secondary. The primary ones include those that cause toxic damage when:

acute and chronic myocarditis (rheumatism); poisoning with toxic substances and toxic poisons, internal products of tissue breakdown (sepsis, severe infectious diseases); endocrine disorders (thyrotoxicosis, diabetes mellitus); anemia (anemia); damage to the nervous system, brain injuries, stroke .

Secondary causes are understood as those that do not directly affect the heart muscle, but create mechanical conditions for fatigue and oxygen starvation. This group includes:

hypertension; atherosclerosis of large vessels; acquired and congenital heart defects; adhesions around the heart, compressing blood vessels.

The division may be conditional. For example, if, against the background of hypertension, a person gets sick with influenza pneumonia. You can read more about the causes of heart failure here.

Classifications

There are several classifications of heart failure. They reflect the severity of clinical signs, duration of the disease, and the degree of functional disorders. The most commonly used terms are “acute heart failure” and “chronic or congestive heart failure.”

Acute - develops quickly, sometimes in a few minutes with myocardial infarction, pulmonary artery thrombosis, hypertensive crisis, acute nephritis. In these diseases, heart failure can worsen the condition and lead to death.

Congestive failure - develops over years, accompanies the underlying disease, clinically manifests itself in attacks of the left ventricular type, right ventricular type (rarely) or mixed.

Since Soviet times in Russia, doctors have continued to use Strazhesko’s classification, which reflects the stages of the disease:

1st degree - proceeds covertly, objective signs can be detected only during physical activity; 2nd degree is subdivided into “2a” - the patient’s complaints are accompanied by objective research data (expansion of the boundaries of the heart, with left ventricular failure, congestion in the lungs, with right ventricular failure - enlarged liver, edema on the extremities); “2b” - all symptoms are expressed sharply in the form of total damage, although they are not irreversible, blood circulation can be restored under the influence of treatment; third - irreversible dystrophic processes develop in all organs with damage to their functions.

Characteristic swelling of the fingers

According to the International Classification of Diseases (ICD - 10), the following code names for the condition are defined:

I50.0 Congestive heart failure. I50.1 Left ventricular failure. I50.9 Heart failure, unspecified.

The New York Heart Association classification (NYHA) defines four functional classes (FC) of the body’s physical capabilities during the development of heart failure:

Class I - there is no shortness of breath and weakness during normal work. Class II - moderate shortness of breath and weakness appear, requiring restrictions in physical activity. Class III - there is a pronounced limitation of ordinary physical activity. Class IV - shortness of breath is observed at rest, the ability to work is impaired.

American cardiologists consider this approach more understandable for sick people.

Symptoms appear when moving

It is much more important during the treatment process to determine the form and duration of heart failure. This is determined by clinical symptoms and during diagnostic testing.

Diagnostics

It is not difficult to make a diagnosis for this disease, as the symptoms accompany the disease.

With left ventricular failure, congestion occurs in the blood vessels of the lungs. The patient is worried about shortness of breath, attacks of suffocation (cardiac asthma) at night, cough with blood in the sputum, and palpitations. Diagnostics includes examination of the patient, auscultation of heart sounds (listening), ECG examination, ultrasound of the heart, and radiographic photographs. This makes it possible to establish an expansion of the borders of the heart to the left, an enlargement of the left ventricle, a disruption (slowdown) of blood movement through the cavities of the heart, a characteristic “gallop rhythm,” and signs of congestion in the lungs. Similar phenomena are observed in the severe stage of hypertension, chronic kidney damage, syphilitic damage to the aorta, myocardial infarction, and cardiac aneurysm.

Failure of the right heart in isolated form practically does not occur. It joins the stagnation of the left ventricle and aggravates all the symptoms.

This is what engorged neck veins look like

Due to the slowing of blood flow through the veins, the patient has visible swollen neck veins, sometimes on the face. The main symptom is an enlargement of the liver to a large size. A tense capsule makes palpation of the edge of the liver painful. Characteristic symptoms include bluish lips, ears, fingers and toes, swelling in the legs, and an enlarged abdomen (ascites).

The acute form of insufficiency occurs most often in two variants:

cardiac asthma - with nocturnal attacks of suffocation, cough with foamy sputum mixed with blood; cardiogenic shock - caused by the rapid shutdown of a large section of the heart muscle (for example, during myocardial infarction). The condition can be fatal. Blood pressure drops and nutrition of all organs practically stops; the brain is of particular importance.

Both emergencies require treatment in the intensive care unit.

Basic remedies

Several types of drugs are used in the treatment of heart failure:

cardiac glycosides - a group of drugs from Digitalis, it has been proven that they restore the contractility of myocardial cells, supply the necessary energy to the heart; diuretics - the removal of excess fluid eases the load on a tired heart, swelling disappears; beta blockers - a large group of drugs that allows you to maintain blood pressure normal level, preventing an increase and mechanical obstruction to the work of the heart; drugs containing potassium - lead to normal electrolyte balance of cells, allow actomyosin fibers to fully contract; medications that reduce the myocardial oxygen demand; vasodilator drugs - are necessary to improve the conditions for the delivery of nutrients.

All of the listed remedies are highly effective drugs. Only a trained physician can use and dose them correctly. If the attending physician has warned the patient about the need to change the dosage in certain conditions, then this can be done independently. In other cases, you cannot prescribe or stop medications without the participation of a doctor; this can cost your life.

You can read more about treatment methods for this pathology here.

How to prevent heart failure

The consequence of heart failure is irreversible changes in all organs, leading to death. This complication is easier to prevent than to treat. Prevention comes down to early detection and treatment of diseases such as rheumatism (full treatment of sore throats and examination after illness), prevention of the atherosclerotic process (blood cholesterol control, diet), timely treatment of infectious diseases, control of excess weight, dosed rest and physical activity.

Walking and physical therapy help maintain the tone of the heart muscle.

Vegetables and fruits on the menu should be 400 g daily

The diet consists of limiting one-time large intake of food and liquid (the diaphragm rises, which serves as an additional mechanical obstacle to the heart). It is better to eat little by little, several times a day. Drink no more than 1.5 liters of liquid. When swelling appears in the legs, you should focus on the amount of urine excreted. Limiting salt intake to 5 g per day (a teaspoon) helps relieve swelling and relieve congestion. In stages 1–2 of the disease, nutritionists recommend salt-free fasting days twice a week. To improve the nutrition of the heart muscle, the diet should contain enough vitamins (vegetables, fruits) and minerals (potassium, magnesium, calcium).

It has been established that the required amount of potassium can be obtained from the following products: raisins, dried apricots, peaches, baked potatoes, Brussels sprouts, bananas, buckwheat and oatmeal, nuts.

Patients with initial manifestations of heart failure are not allowed to smoke or drink strong alcoholic beverages. The daily routine should be reconsidered. Get rid of overload at work, night shifts. Spend your vacation outdoors or in a sanatorium.

You should always remember that cheerful people recover faster.

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3. Cough. A persistent cough or shortness of breath may be a symptom of heart failure - a result of fluid buildup in the lungs. In some cases, people with heart failure even cough up bloody sputum.

4. Dizziness. Heart attacks can cause dizziness and loss of consciousness. A potentially dangerous heart rhythm disorder known as arrhythmia may also occur.

5. Fatigue. You may feel unusually tired during a heart attack and in the days and weeks that follow. This symptom is especially common among women. Constantly feeling tired may be a sign of heart failure.

Of course, you may feel tired or fatigued for other reasons. How can you differentiate fatigue associated with heart disease from other types of fatigue?

"If you're feeling unwell and constantly tired, don't try to figure it out on your own based on information you found online or in a book," says Goldberg. "Wasting time is dangerous."

6. Nausea and lack of appetite. During a heart attack, it is common for people to feel nausea or vomiting. And bloating associated with heart failure can interfere with appetite.

7. Pain in other parts of the body. In most heart attacks, pain begins in the chest and spreads to the shoulders, arms, elbows, back, neck, jaw or abdomen. But sometimes there is simply no pain in the chest - there is only pain in other parts of the body. The pain may appear and disappear.

Men who have a heart attack often feel pain in their left arm. In women, the pain will most likely be felt in both arms, or between the shoulder blades.

8. Fast or intermittent pulse. Doctors say there's no need to worry if your heart rate sometimes jumps. But a fast or intermittent pulse—especially when accompanied by weakness, dizziness, or difficulty breathing—could be a symptom of a heart attack, heart failure, or arrhythmia. Left untreated, some types of arrhythmias can lead to stroke, cardiac arrest, or sudden death.

9. Shortness of breath. People who experience shortness of breath at rest or with minimal exercise usually have a lung disease such as asthma or chronic obstructive pulmonary disease. But shortness of breath can also indicate a heart attack or cardiac arrest. For semolina lovers, we would like to recommend preparing cutlets with semolina. Read more at naem.ru.

"Sometimes when people have a heart attack, they don't feel pressure or pain in their chest, but they experience shortness of breath," Goldberg says. "It's like they just ran a marathon without moving." During a heart attack, shortness of breath is often accompanied by chest discomfort, but the attack can also occur before or without chest discomfort.

10. Sweating. Cold sweats are a common symptom of a heart attack. “You can be sitting in a chair and suddenly you feel yourself breaking out in a sweat, as if you had just worked out physically,” says Fried.

11. Edema. Heart failure can cause fluid to accumulate in the body. This can cause swelling (often in the feet, ankles, legs or abdomen), as well as sudden weight gain and sometimes loss of appetite.

12. Weakness. In the days before a heart attack, and during one of them, some people experience severe, unexplained weakness. "One woman told me that she couldn't even hold a piece of paper between her fingers," McSweeney says.

Tired heart diagnosis

Chronic heart failure

CHRONIC HEART FAILURE

Chronic heart failure (CHF) is a disease with a complex of characteristic symptoms (shortness of breath, fatigue, decreased physical activity, edema, etc.) associated with inadequate perfusion of organs and tissues at rest or during exercise.

ICD-10 CODE

• I50.0 Congestive heart failure

New York Heart Association classification of CHF by severity.

• I functional class. Normal physical activity does not cause fatigue, palpitations, shortness of breath or angina. This functional class occurs in patients with heart disease that does not lead to limitation of physical activity.
• II functional class. Patients feel well at rest, but normal physical activity causes fatigue, shortness of breath, palpitations, or angina. This functional class occurs in patients with heart disease that causes slight limitation of physical activity.
• III functional class. This functional class occurs in patients with heart disease that causes significant limitations in physical activity. Patients feel well at rest, but light (less than normal) exercise causes fatigue, shortness of breath, palpitations, or angina.
• IV functional class. This functional class occurs in patients with heart disease, due to which they are unable to perform any physical activity without discomfort. Symptoms of heart failure or angina occur at rest; With any physical activity, these symptoms intensify.

The classification of CHF by the Society of Heart Failure Specialists (Russia, 2002) is presented in Table. 1.

Table 1. Classification of CHF by the Society of Specialists in Heart Failure (Russia, 2002)

Functional classes of CHF

(may change during treatment)

(do not change during treatment)

HISTORY AND PHYSICAL EXAMINATION

The most common complaints of patients with CHF (in descending order of frequency): shortness of breath, fatigue, palpitations, peripheral edema, cough, wheezing in the lungs, orthopnea, swollen jugular veins, hepatomegaly, cardiomegaly.

LABORATORY RESEARCH METHODS

• General blood test (determining the level of hemoglobin, the number of red blood cells, leukocytes and platelets).
• Biochemical blood test (study of the concentration of electrolytes, creatinine, glucose, activity of liver enzymes in the blood).
• General urine analysis.

INSTRUMENTAL RESEARCH METHODS

The criteria for diagnosing diastolic heart failure are given below (the first two criteria must be present).

• Symptoms and signs of heart failure.
• Normal or slightly impaired left ventricular systolic function (left ventricular ejection fraction equal to or greater than 45-50%).
• Detection of left ventricular relaxation disorders using echocardiography.

In patients with CHF, it is possible to use various options for a stress test: a 6-minute walk test, bicycle ergometry, treadmill, including a blood gas analysis. In routine practice, in the absence of special equipment, a walking test for 6 minutes can be used to assess physical tolerance and objectify the functional status of patients.

• The patient must walk continuously for 6 minutes, moving between two points located at a known distance.
• The patient can stop at will.
• The distance covered by the patient in 6 minutes correlates with other performance indicators.
• The parameters for assessing the 6-minute walk test are given in Table. 2.

Table 2. Parameters for assessing the 6-minute walk test

according to New York classification

Other studies (daily ECG monitoring, determination of the neurohormonal profile, radioisotope study) do not occupy an important place in the diagnosis of CHF. A test widely used in developed countries for the diagnosis of CHF - determination of the level of brain natriuretic peptide - is not yet available in outpatient clinics in the Russian Federation.

INDICATIONS FOR CONSULTATION WITH OTHER SPECIALISTS

• Unknown etiology of heart failure.
• Systolic blood pressure less than 100 mm Hg.
• The creatinine content in the blood is more than 150 µmol/l.
• The sodium content in the blood is less than 135 mmol/l.
• The potassium content in the blood is more than 6.0 mmol/l.
• Severe heart failure.
• Valvular heart defects as a cause of heart failure.

• Diet.
• Physical activity regimen.
• Psychological rehabilitation, organization of medical supervision, schools for patients with CHF.
• Drug therapy.
• Electrophysiological methods of treatment.
• Surgical, mechanical methods of treatment.

• Prevention of the development of clinically significant CHF (at the stage of asymptomatic cardiac dysfunction).
• Elimination of symptoms of CHF.
• Slowing the progression of the disease.
• Improving quality of life.
• Reducing the number of hospitalizations.
• Improved prognosis.

INDICATIONS FOR HOSPITALIZATION

• If treatment on an outpatient basis is ineffective for patients with functional class IV CHF, severe fatigue and decreased performance, as well as when diuretics are ineffective.
• When planning parenteral administration of diuretics, vasodilators or drugs with a positive inotropic effect under the control of hemodynamic parameters, requiring catheterization of the pulmonary artery.
• In patients with very low cardiac output who require positive inotropic therapy.

Hospitalization is necessary in the presence of life-threatening rhythm disturbances or arrhythmias that worsen the course of CHF.

• Limiting the intake of table salt, and the more, the more pronounced the symptoms of the disease and congestion.
  • Functional class I - do not eat salty foods (limit up to 3 g of table salt per day).
  • Functional class II - do not eat salty foods and do not add salt to food (limit up to 1.5 g of table salt per day).
  • III-IV functional class - do not eat salty food, do not add salt to food, eat foods with reduced salt content and cook food without salt (limit less than 1 g of table salt per day).
• Limiting fluid intake is relevant only in extreme situations in a decompensated state, in which intravenous administration of diuretic drugs is necessary. In normal situations, it is not recommended to increase the volume of fluid to more than 2 liters per day.
• Food should be high in calories, easily digestible and contain sufficient amounts of vitamins and protein.

• There is no evidence that vaccination is beneficial. It is advisable to use vaccines against influenza and hepatitis B.
• Staying in high altitude, high temperatures, and humidity conditions is not recommended. It is advisable to spend your vacation in a familiar climate zone. When choosing transport, preference should be given to aviation.
• Smoking is strictly and absolutely contraindicated for all patients with CHF.
• Sexual activity. The use of phosphodiesterase-5 inhibitors (sildenafil, etc.) is not contraindicated, except in combination with long-acting nitrates.

All drugs for the treatment of CHF can be divided into three main categories: basic, additional and auxiliary (Table 3).

Table 3. Drugs for the treatment of chronic heart failure

• ACE inhibitors
• beta blockers

• Diuretics (for edema)
• Spironolactone (for III-IV functional classes)
• Cardiac glycosides (in combination of CHF with atrial fibrillation; in CHF refractory to treatment)
• Angiotensin II receptor antagonists (if intolerant to ACE inhibitors)
• Warfarin (for atrial fibrillation)

• Vasodilators
• Calcium channel blockers
• Antiarrhythmic drugs
• Acetylsalicylic acid
• Statins
• Non-glycoside inotropes

*** Impact on prognosis unknown; their use is determined by the clinical picture.

ACE inhibitors

• ACE inhibitors are indicated for all patients with CHF (of any etiology and stage of the process, including asymptomatic left ventricular dysfunction).
• ACE inhibitors improve the clinical picture, quality of life, slow the progression of the disease, reduce morbidity and improve the prognosis of patients with CHF, i.e. allow you to achieve all goals in the treatment of CHF.
• These drugs are considered the most reasonable way to treat CHF with preserved systolic heart function.
• The failure to prescribe ACE inhibitors cannot be considered justified and leads to a deliberate increase in the risk of death in patients with CHF.

In table Figure 4 shows the doses of the ACE inhibitors most studied in the treatment and prevention of CHF, used in Russia.

Table 4. Angiotensin-converting enzyme inhibitors prescribed for the treatment of chronic heart failure

Initial dose for arterial hypotension

• The need for diuretics and vasodilators and their dosages should be assessed.
• Excessive diuresis should not be allowed before starting treatment; Diuretics should be discontinued 24 hours before the first use of ACE inhibitors.
• Therapy should be started in the evening, when the patient is in a horizontal position, to minimize the risk of arterial hypotension.
• It is recommended to start treatment with small doses and increase them to maintenance levels.
• If there is a significant deterioration in renal function (an increase in the concentration of creatinine in the blood by more than 30% of the initial value), it is necessary to reduce the dose by half, and if there is no improvement, discontinue the ACE inhibitor.
• Prescription of potassium-sparing diuretics should be avoided at the beginning of treatment, especially in patients with high blood potassium levels (more than 5.0 mmol/l); however, this does not contradict the recommendations for the combined use of ACE inhibitors with high doses of spironolactone during the period of decompensation and the combination of ACE inhibitors with small doses of aldosterone antagonists during long-term treatment of CHF.
• It is recommended to avoid prescribing NSAIDs.
• It is necessary to monitor blood pressure and electrolyte levels in the blood 1-2 weeks after each dose increase.

beta blockers

• Beta blockers should be prescribed to all patients with CHF who do not have the usual contraindications for this group of drugs.
• Beta blockers should only be used in addition to ACE inhibitors.
• Beta blockers in addition to ACE inhibitors are indicated in all patients with asymptomatic left ventricular dysfunction after myocardial infarction.
• It is advisable to prescribe beta-blockers to patients whose condition has been stabilized (there are no signs of stagnation, there is no need for parenteral therapy).
• Only four beta-blockers are recommended for the treatment of CHF: bisoprolol, carvedilol, metoprolol succinate (slow-release) and nebivolol.
• Treatment with beta-blockers for CHF should begin with 12.5% ​​of the therapeutic dose. Doses are increased slowly (no more than once every 2 weeks) until the optimal dose is achieved (Table 5).
• If heart failure worsens, arterial hypotension or bradycardia develops during dose titration, the following algorithm should be followed.
• If heart failure worsens, it is necessary first of all to increase the dose of diuretics and ACE inhibitors, and if necessary, temporarily reduce the dose of the beta-blocker.
• In case of arterial hypotension, it is indicated first of all to reduce the dose of vasodilators, and if necessary, temporarily reduce the dose of the beta-blocker.
• In case of bradycardia, you should reduce the dose or discontinue drugs that reduce heart rate, if necessary, reduce the dose of the beta-blocker or discontinue the latter if there are clear indications.
• Always consider the possibility of re-prescribing a beta-blocker or increasing its dose after stabilization of the condition.
• If inotropic support is necessary during circulatory decompensation in patients on constant beta-blocker therapy, the calcium sensitizer levosimendan is considered the drug of choice, since its hemodynamic effect does not depend on the degree of beta-adrenergic receptor blockade.
• Contraindications to the use of beta-blockers for CHF include severe bronchial asthma and/or chronic obstructive pulmonary disease, symptomatic bradycardia, and arterial hypotension.

Table 5. Beta blockers for the treatment of chronic heart failure

Some patients may be treated with non-recommended beta-blockers (most often atenolol or short-acting metoprolol tartrate). In table Figure 6 shows a scheme for transferring to recommended drugs.

Table 6. Scheme for transferring patients with chronic heart failure from atenolol and metoprolol tartrate to recommended beta-blockers

• CHF III-IV functional class.
• Heart failure of unknown etiology.
• The presence of relative contraindications: bradycardia, arterial hypotension, poor tolerance of low doses of beta-blockers, concomitant chronic obstructive pulmonary disease.
• History of discontinuation of beta blockers in the past due to adverse reactions or exacerbation of heart failure.

Aldosterone antagonists (spironolactone)

• Aldosterone antagonists are prescribed in addition to ACE inhibitors and beta-blockers for patients with CHF of functional class III-IV.
• The recommended dose of spironolactone for chronic use for CHF is 25 mg/day.

• These drugs are indicated only for patients with functional class III-IV CHF.
• Treatment should be started only if the potassium level in the blood does not exceed 5.0 mmol/l and the creatinine concentration is less than 1.7 mg/dl.
• The recommended dosage of spironolactone for long-term use is 25 mg/day.
• Monitoring of potassium and creatinine levels in the blood every 4-6 weeks is indicated.
• If, after initiation of treatment, the blood potassium level exceeds 5.0-5.5 mmol/L, the spironolactone dose should be reduced by 50%, and if the potassium level is more than 5.5 mmol/L, spironolactone therapy should be discontinued.
• If after a month of therapy symptoms of heart failure are still severe, the dose of spironolactone should be increased to 50 mg/day (provided normokalemia). After increasing the dose of spironolactone, monitoring the concentration of potassium and creatinine in the blood after 1 week is indicated.

Diuretics

• Treatment with diuretics is started only with clinical signs of stagnation (stage II A, functional class II).

Table 7. Diuretics for chronic heart failure

Algorithm for prescribing diuretics depending on the severity of CHF

• Functional class I and II without edema - no need to treat with diuretics.
• Functional class II (stagnation) - thiazide diuretics or loop diuretics are indicated (in small doses).
• Functional class III (decompensation) - loop diuretics are prescribed (possibly in combination with thiazide diuretics) + aldosterone antagonists (dosemg/day).
• III functional class (maintenance treatment) - loop diuretics (dose titration) + spironolactone (in doses per day) are recommended.
• IV functional class - loop diuretics + thiazide diuretics + aldosterone antagonists are indicated.

Cardiac glycosides

• Cardiac glycosides are indicated for atrial fibrillation and symptomatic heart failure, regardless of the degree of cardiac dysfunction.
• Cardiac glycosides do not improve the prognosis, but help reduce the number of hospitalizations among patients with CHF and left ventricular systolic dysfunction in sinus rhythm.
• The main drug from the group of cardiac glycosides for the treatment of CHF is digoxin.
• The dose of digoxin for the treatment of CHF should not exceed 0.25 mg/day.
• A dose of digoxin of 0.125-0.25 mg/day is taken in one dose daily, without skipping.
• It is not recommended to use a loading dose of digoxin.
• Predictors of success in treating patients with CHF with glycosides are low left ventricular ejection fraction (less than 25%), cardiomegaly, and non-ischemic etiology of the disease.

Angiotensin II receptor antagonists

• Angiotensin II receptor antagonists and ACE inhibitors are equally effective in reducing mortality and morbidity in CHF.
• Angiotensin II receptor antagonists should be used as an alternative to ACE inhibitors if the latter are intolerant.
• The triple combination (ACE inhibitor + beta-blocker + angiotensin II receptor antagonist) is not considered optimal. Only if a beta-blocker is intolerant should one switch to a combination of an ACE inhibitor + angiotensin-II receptor antagonist.

In table 8 shows angiotensin II receptor antagonists for the treatment of CHF.

Antiplatelet agents and anticoagulants

• Indirect anticoagulants (warfarin) should be prescribed to all patients with CHF and atrial fibrillation.
• Regardless of heart rhythm, indirect anticoagulants should be given to all patients with CHF who have suffered thromboembolic complications and/or with the presence of a floating thrombus in the left ventricular cavity.
• Indirect anticoagulants cannot be replaced with antiplatelet agents (acetylsalicylic acid, clopidogrel, ticlopidine) to reduce the risk of thromboembolic complications.
• For secondary prevention after myocardial infarction, either acetylsalicylic acid or indirect anticoagulants should be used (but not in combination due to the high risk of bleeding).
• Prescription of acetylsalicylic acid should be avoided in patients with frequent re-hospitalizations due to worsening CHF.
• Therapy with indirect anticoagulants should be carried out under close monitoring (once a month) of the international normalized ratio (INR). A safe and effective INR range is 2.0-3.0.

Vasodilators

• It is recommended to prescribe nitrates in the presence of proven coronary artery disease and angina pectoris, which is controlled with nitrates.
• Calcium channel blockers (dihydropyridine series - amlodipine or felodipine) can be used in the following clinical situations: the presence of resistant angina pectoris, concomitant persistent arterial hypertension, pulmonary hypertension, severe valvular regurgitation.

Antiarrhythmic drugs

• For CHF, only life-threatening and clinically manifested ventricular arrhythmias should be treated.
• Antiarrhythmic drugs of classes I and IV are contraindicated in patients with CHF.
• Beta blockers are the drug of choice for antiarrhythmic treatment.
• If beta-blockers are ineffective, class III drugs (amiodarone, sotalol) are indicated.
• The drug of choice for the treatment of ventricular arrhythmias in patients with moderate CHF (functional class I-II) is amiodarone.
• In patients with severe CHF (III-IV functional class), amiodarone should not be used.
• The most justified method of preventing sudden death in patients with CHF and life-threatening arrhythmias is the installation of an implantable cardioverter-defibrillator.

Treatment of atrial fibrillation in patients with CHF

• There is no difference in the effect on mortality and morbidity between the tactics of maintaining sinus rhythm and the tactics of heart rate control. The feasibility of restoring and maintaining sinus rhythm is determined by the doctor.
• Amiodarone is considered the most effective antiarrhythmic drug for maintaining sinus rhythm.
• To control heart rate during atrial fibrillation, the combination of a beta blocker + digoxin is most effective.

• NSAIDs.
• Tricyclic antidepressants.
• Antiarrhythmic drugs of classes I and IV.
• Calcium channel blockers (verapamil, diltiazem, short-acting dihydropyridine drugs).
• Glucocorticoids. They are prescribed for symptomatic indications in cases of persistent arterial hypotension and severe edema syndrome to facilitate the initiation of treatment with ACE inhibitors, diuretics and beta-blockers.

Patients should be informed of the importance of monitoring body weight daily during treatment for heart failure. The patient should weigh himself daily and record the result. If body weight increases by more than 2 kg in 1-3 days, the patient should contact a doctor.

Patients should be encouraged to adhere to a low-salt diet and limit fluid intake. It is recommended to reduce table salt consumption to 3 g/day or less. In addition, you need to make sure that the patient fully understands all the details of his drug regimen.

The patient should be given the following information.

• How and when to take medications.
• A clear list of recommendations, including the name, dose and frequency of taking each drug.
• The most common side effects of medications taken and the need to consult a doctor if they occur. Family members of patients with heart failure should be encouraged to learn cardiopulmonary resuscitation skills.

The mortality rate of patients with clinically significant heart failure within 1 year reaches 30%. The five-year survival rate of patients with CHF does not exceed 50%. The risk of sudden death in patients with CHF is 5 times higher than in the general population.

Throughout her life, a woman's heart beats up to 3 billion times. However, we underestimate this effort and do not take care of it properly. And doctors are sounding the alarm. The statistics are truly grim, since women suffer from coronary insufficiency and apoplexy 10 times more often than from breast cancer. Every day, 250 women in the world die due to diseases of the circulatory system!

You should contact your doctor immediately if you feel pain in the chest area. Also, the help of a specialist is necessary if you are worried about cardiac arrhythmia or often feel tired. The doctor will measure your blood pressure and prescribe tests, such as an ECG or echocardiography of the heart. If necessary, your physician will refer you to a cardiologist.

Unexpected pain in the chest, and the woman slowly sinks to the floor - this is how a heart attack is depicted in movies. Although in life, heart disease can manifest itself differently. The fact that our heart is in danger can be indicated, for example, by innocent pain in the stomach or even the elbow.

Myocardial infarction in women

Myocardial infarction has always been considered a “male” disease. But it turned out that women suffer from it as often as men, with the only difference being that they get sick at a later age. Until menopause, the last period in their lives, their hearts are protected by female sex hormones - estrogens.

When your heart starts to hurt, it can be difficult to notice. After all, the ailments that appear may be absolutely not typical for the circulatory system. Sometimes the symptoms resemble fatigue, neurosis, indigestion and even joint diseases.

Let's look at 7 signs and symptoms that indicate your heart needs help.

You need to be able to recognize warning signs in time. You should be especially careful when some unusual ailment recurs after some time. Actually, this is a sign that your heart needs professional help.

SIGNAL SYMPTOM No. 1 Shortness of breath and fatigue

Usually you use the elevator. But when you are forced to take the stairs, you feel tired, having only climbed to the second floor. You get tired when cleaning the house, washing the floor, you spend most of the time in a sitting position, and it is insufficient activity and poor physical shape that explain fatigue and shortness of breath. In addition, you also have cigarettes, fatty foods, lunches at fast food establishments on your conscience...

But don't write it off so easily! Shortness of breath is often a signal of coronary insufficiency. During physical activity, the heart needs more oxygen - its lack leads to the appearance of symptoms of this disease, including shortness of breath. Another sign may be severe pain in the chest area, and here it is not far from a heart attack.

How to reduce risks?

One of the proven ways to protect against coronary insufficiency is movement. During physical activity, blood vessels dilate, allowing more oxygenated blood to flow to the heart. Walking, running, cycling and swimming are good for preventing coronary artery disease.

However, if you previously led a sedentary lifestyle, your heart needs to be gradually accustomed to stress and an active lifestyle. It is worth asking your doctor what type of exercise is most suitable for you.

Plan your physical activity in such a way as to gradually increase the number of movements. To begin with, it is enough to exercise twice a week for a quarter of an hour, then for 30 minutes, then three times a week for half an hour, etc.

SIGNAL SYMPTOM No. 2 Nausea and abdominal pain

Another week has passed, full of urgent matters that needed to be resolved. You're tired, but it's finally time for that much-desired weekend laziness. This is when pain appears in the area above the stomach. You feel sick, sweat, and feel nauseous. You think it's just simple indigestion. We are sure that we probably ate something stale. Therefore, take out activated carbon or mezim from the first aid kit.

Meanwhile, the cause of pain may not be the stomach, but the heart! Sometimes even a heart attack manifests itself this way! It is usually associated with severe chest pain and numbness in the left arm. Although this does not always happen. The female heart reacts especially atypically - a heart attack can occur even without symptoms.

Why is this happening? The thing is that in women the diaphragm is located higher than in men. The lower part of the heart, located just on the diaphragm, is located closer to the stomach. Therefore, unpleasant sensations appear in this area. Sometimes a heart attack, in addition to pain over the stomach, is indicated by a feeling of fear and anxiety. It happens that only an ECG study shows that you have already suffered a myocardial infarction.

How to reduce risks?

If you are at risk for myocardial infarction (elevated blood sugar and cholesterol, increased weight, hypertension), you should slow down your pace of life. Learn to relax. Don't put off your planned vacation - remember that your heart also needs a break. Always try to squeeze in at least 30 minutes of rest during the day.

Try to be in the fresh air, as it has a beneficial effect on the heart and strengthens it. Remember: you need to sleep at least 7-8 hours a day. During this time, the body has time to recover, and along with it, your heart.

SIGNAL SYMPTOM No. 3 Swelling of the legs

By evening, your ankles and calves are swollen, and your shoes are tight. But by morning everything goes away. You think it's because of the weather or because you walk a lot. However, heart failure can also manifest itself this way. When the heart fails to pump blood, it pools in the veins of the legs, then when the pressure in them increases, the blood leaks into the tissues, causing the ankles to swell.

At first this happens only in the evening, but as the disease begins to progress, the legs swell in the morning. Swelling appears in other places, for example above the knees. A characteristic feature of edema caused by heart failure is that it is symmetrical, that is, it appears on both ankles or calves at the same time. Confirmation of the presence of edema is the dimple that appears in the place where we press with a finger.

How to reduce risks?

Excess salt in food leads to a deterioration in circulatory function and increased blood pressure, and thus to manifestations of heart failure. Therefore, it is necessary to reduce its consumption. A healthy adult needs approximately 5-6 grams (i.e., a teaspoon) of salt per day.

Avoid canned and smoked foods, salty sticks, chips and nuts, and fast food products.

When cooking, replace salt with herbal seasonings. Choose mineral water with low mineralization. When shopping, read labels and check the sodium chloride content, i.e. salt: the less, the better.

SIGNAL SYMPTOM No. 4 Headache

You feel great, radiate energy and good mood, but sometimes you are bothered by a throbbing headache, especially in the morning. You are looking for reasons in bad weather and lack of sleep. Or maybe you just need to measure your blood pressure first?

A headache, especially a throbbing one, is a symptom of high blood pressure. Although often it does not manifest itself at all. Not treating it is dangerous, as it can lead to myocardial infarction and even apoplexy. Optimal pressure values ​​should be within 120/80 mmHg. If it exceeds 139/89 mm, doctors talk about hypertension.

How to reduce risks?

To prevent hypertension, limit your intake of animal fats and avoid fatty meats, cheese and fried foods. Prepare dishes from sea fish more often - it is rich in polyunsaturated fatty acids, which protect blood vessels and normalize blood pressure. The menu should also include vegetables and fruits. Don't forget to add garlic to your dishes, as it lowers blood pressure.

SIGNAL SYMPTOM No. 5 Pain in elbows and wrists

Do you often have pain in your elbow or wrist that extends all the way to your shoulder? Its peculiarity is that it increases with high blood pressure, for example, when you walk quickly or climb stairs. You may have injured your hand while carrying a bag of groceries. But if these unpleasant sensations do not disappear (especially on the left side), be vigilant! After all, they can mean so-called heart attack pain. Sometimes they are accompanied by increased sweating, a feeling of panic or unconscious fear.

How to reduce risks?

Think about what could be causing your heart to be in bad shape. Perhaps you are used to relieving stress with a cigarette? If so, know that one of the common causes of myocardial infarction in women is smoking. Try to get rid of this bad habit. Anti-nicotine patches, chewing gum, and special prescription medications will help.

SIGNAL SYMPTOM No. 6 Urination at night

Do you get up several times a night to go to the toilet? Maybe you caught a cold or drank too much tea in the evening? Maybe so. However, developing heart failure also gives the same symptoms. At night, when you lie down, the flow of blood to the kidneys increases, and the need to urinate more often appears. During the day, this desire is suppressed due to stagnation of blood in the veins.

How to reduce risks?

Circulatory problems may result from untreated infections. Flu, pneumonia, bronchi, etc. are especially dangerous for the heart. Therefore, do not neglect even the common cold, try to cure every infection. Don't carry viruses on your feet!

SIGNAL No. 7 Chest pain

Do you have a tense, nervous life, constant worries and not enough time for anything? Do you feel like when you run to the bus stop, you feel a pressing, burning pain in your chest? At the same time, there is a feeling of heaviness in the chest. This pain only lasts a few minutes. You stop, take a deep breath, and the pain goes away. “It’s probably stress,” you explain to yourself and continue to live at high speed.

Such chest pain may be a symptom of heart failure or angina. When the heart is poorly supplied with blood and does not receive enough oxygen, a characteristic feeling of tightness appears in the chest.

How to reduce risks?

To reduce the risk of an attack of suffocating pain, you must control your stress.

Stop constantly worrying and thinking about problems at work. Organize your day so that you can get everything done. If necessary, ask loved ones for help.

In stressful situations, you can take medications with magnesium or eat foods rich in this element, which strengthen the nervous system and blood circulation.

Include buckwheat and oatmeal, cocoa and nuts in your diet. After all, it is not only tasty, but also very good for the heart.

SIGNAL No. 8. Pulse disturbance

This symptom always accompanies heart disease. When the heartbeat is more than 80 beats/min. doctors note tachycardia, and at 60 beats/min. - bradycardia. Often the normal rhythm is replaced by an accelerated one. Arrhythmia appears after the heart is unbalanced.

How to reduce risks?

If violations occur, you need to undergo a comprehensive examination to identify the causes of the problem.

SIGNAL No. 9. Disease on the face

Heart disease affects not only a woman’s well-being, but also her face. If they have problems with the heart and blood vessels, they experience pale skin, a blue tint around the lips and nose, and dark circles around the eyes.

SIGNAL No. 10. Angina pectoris

Occurs due to lack of oxygen for the myocardium. So, a pressing sensation appears behind the sternum. Angina pectoris can go unnoticed for a long time, and therefore often becomes chronic. Women experience throbbing or stabbing pain in the chest.