Big heart like a rag diagnosis. How to keep your heart healthy? Prognosis and possible complications

Heart failure occurs very often in medical practice, either as a leading, main diagnosis, or as an additional, but very significant one. In both cases, treatment significantly improves the patient's general condition. That is why it is so important to find out whether the patient who contacts us has this problem. Fortunately, solving this problem is not that difficult. At least, you can get closer to solving it already during the initial examination of the patient, without having any additional laboratory or instrumental examinations.
Let's start with INQUIRY. The first and main point is shortness of breath. But often patients understand by this word not only the unpleasant feeling of lack of air during physical activity, which even a healthy person experiences with a fairly heavy load. Thus, some patients call shortness of breath tightness behind the sternum, that is, angina pectoris (angina pectoris). It is clear that an erroneous interpretation of the complaint will lead to completely incorrect treatment. Therefore, in order not to mistake what is actually angina for shortness of breath, you need to ask: “How do you breathe during shortness of breath - do you puff, puff, or do you seem to be choking, but your breathing is calm? Is it noticeable from the outside that you are suffocating? Sometimes the patient answers such a question: “No, it’s just pressing, there’s not enough air,” and very characteristically he brings his hand to the sternum and clenches it into a fist. This is truly a precious piece of evidence: in this case, “shortness of breath” is the equivalent of angina. In other cases, additional questioning reveals that by the word shortness of breath the patient understands dissatisfaction with inhalation: “the air does not pass into the depths of the lungs.” This sensation makes you take convulsive breaths or forcefully yawn in order to “push” the air deeper. This is a purely neurotic symptom.
Most often, shortness of breath occurs as a result of heart or lung disease. To find out what the cause of shortness of breath is - pulmonary or cardiac, you should definitely ask whether changes in the weather affect shortness of breath and, in general, whether the same amount of load always causes shortness of breath. If shortness of breath is caused by organic heart disease, then it usually occurs for quite a long time at the same level of exertion; the deterioration occurs very gradually. Let's say that when climbing the stairs, a patient is forced to stop on the third floor each time to catch his breath and rest. On the contrary, in pulmonary diseases, where shortness of breath is most often associated with diffuse bronchial obstruction (bronchial asthma, chronic bronchitis, emphysema), the size of the bronchial lumens changes quickly and often, both spontaneously (even over several hours) and under the influence of such frequent "cold" diseases. Therefore, on some days the patient easily runs up to the bus stop, and it happens that walking slowly around the room causes shortness of breath. This symptom “does not happen day after day” (B.E. Votchal) indicates the predominance of a functional, easily reversible mechanism of shortness of breath. It is clear that neither the prevalence of myocardiosclerosis, nor the degree of myocardial hypertrophy, nor the magnitude of valvular damage can fluctuate so quickly. So, shortness of breath, in which “one day at a time,” immediately forces one to pay special attention to the lungs, while a clear connection with a certain amount of load is more likely to be characteristic of heart diseases.
The next, extremely important question: “Does your chest squeak or whistle when you are short of breath?” Patients perfectly hear those sounds that we call dry wheezing and which indicate not the accumulation of mucus in the bronchi, as is often written in textbooks, but a narrowing of the bronchial lumens. Indeed, as soon as the patient takes a breath from a pocket inhaler, within a minute - two wheezes disappear completely or significantly decrease, often without any coughing up of sputum. The mechanism for the occurrence of these wheezing is exactly the same as when whistling: only at a certain degree of contraction of the lips into a tube does a whistling occur, which will instantly stop if the hole becomes even a little larger. Whistles and squeaks undoubtedly indicate narrowing of the bronchi and, therefore, difficulty in the passage of air into the lungs. This is what causes the feeling of shortness of breath. A positive answer reliably confirms the pulmonary (more precisely, broncho-obstructive) origin of shortness of breath or, in any case, indicates the importance of this mechanism in the occurrence of shortness of breath in a given patient.
With heart failure, water metabolism is disrupted long before visible edema appears. The kidneys begin to selectively retain sodium and water, although they still remove all toxins well, including dyes (urobilin, etc.). As a result, urine becomes concentrated and its color more saturated. Therefore, it is useful to ask: “What color is your urine - straw-yellow or like strong tea?” Dark urine in combination with shortness of breath is a strong argument in favor of heart failure.
During night sleep, when the heart works in more favorable conditions of complete rest, urine output increases, which is manifested by nocturia. Therefore, it is worth asking whether the patient gets up at night to urinate. However, this question helps less often: for example, in an elderly man, nocturia may be a consequence of benign prostatic hypertrophy.
A horizontal position during sleep greatly facilitates the outflow of edematous fluid that accumulates in the legs during the day. Therefore, the right ventricle has to pump an increased amount of blood into the lungs, and the left ventricle, which most often suffers from heart failure, does not have time to absorb all this excess. As a result, the lungs become filled with blood and shortness of breath occurs. To reduce it, the patient instinctively prefers to sleep in a semi-sitting position or, at least, on a high headboard, on two pillows. This leads to the appearance of another important sign of heart failure - orthopnea. That is why it is so important to always ask the patient how he likes to sleep - on one pillow, or does he lie higher - on two or even three pillows?
The last question in this series is about the effect of diuretics. Their widespread use has led to the fact that many patients use them on their own initiative, “at random.” In this case, you must definitely ask: “How much urine came out after the diuretic pill?” And how did you feel the next day - better, worse or no change? Increased diuresis, after which the patient notes at least temporary relief of shortness of breath, is an indisputable sign of heart failure. By the way, if a patient says that after taking a diuretic he felt unwell due to weakness, this may indicate the occurrence of hypokalemia. This detail must be remembered so that when prescribing your own therapy, limit yourself to potassium-sparing diuretics or, in any case, use furosemide or disothiazide in smaller doses than usual.
What does EXAMINATION provide for diagnosing heart failure? The neck veins are what you need to look at first. In a healthy person, if he is standing, they are in a collapsed state and are almost invisible; even in a lying position on a low head, these veins are only slightly outlined, because the blood is not retained in them and flows freely into the heart. But if the right ventricle is weakened, it does not have time to pump blood further to the lungs. Stagnation forms - first in the right atrium, and then higher. As a result, the jugular veins - these pressure gauges inserted into the right atrium - swell, stretch and become clearly visible. To get a better look at them, you need to place the patient on a couch with the head of the bed slightly raised and ask him to turn his head slightly to the side. In this position, the veins on the side of the neck become especially prominent. If the neck veins are swollen even in an upright position of the patient, this means very high venous pressure and severe heart failure.
In patients with heart failure, acrocyanosis can be seen. A weakened heart has difficulty pushing blood through the vessels. It moves more slowly and, therefore, manages to give more oxygen to the tissues than usual. As a result, the blood loses its scarlet color and becomes dark cherry. That is why the areas furthest from the heart (fingers, tip of the nose, ears, lips), where the slowdown in blood flow is especially pronounced, acquire a bluish tint and are cold to the touch. On the contrary, with pulmonary failure, all the blood entering the systemic circle is undersaturated with oxygen. Therefore, all tissues, both peripheral and close to the heart, are stained bluish; this is diffuse or central cyanosis. With such cyanosis, the fingers and tip of the nose are warm.
Let's move on to PALPATION. By placing our palm flat on the heart area, we immediately receive several valuable information. Displacement of the apical impulse outward from the left midclavicular line and (or) its hypertrophy, detection of systolic or diastolic tremor - all these findings make the assumption of heart failure very likely. With the help of palpation, you can also detect a sign that directly indicates the poor condition of the heart muscle. This tactile sensation corresponds to the pathological III tone. This phenomenon is so important and so often overlooked that it deserves detailed consideration. A healthy myocardium, even during the period of diastolic relaxation, maintains a certain tone. To make this concept clear, feel the calf muscle in yourself and in a patient who has been bedridden for a long time. In the first case, you will feel elastic elastic resistance, in the second - flabby tissue devoid of any tone. In the same way, the walls of a healthy ventricle offer, although small, some resistance to the flow of blood from the atrium; they slowly recede under the influence of this pressure, and the ventricle fills gradually. The diseased myocardium loses this diastolic tone. Therefore, when at the beginning of diastole a stream of blood from the atrium rushes into the ventricle, it simply throws away the flabby wall, like a rag, and it slaps against the chest wall. This is an additional, diastolic impulse. Of course, this impulse is not as strong as the systolic one, but it is quite noticeable. You feel the palpating arm rise slightly and rather slowly, then it falls again, and only after that does the usual energetic, jerky systolic impulse occur. If you try to depict these events graphically, you will get something like an ECG, where a small and flat P wave is followed by a high and pointed R wave. This first soft diffuse lifting movement BEFORE the systolic impulse is the hand-tangible equivalent of the pathological third heart sound, a sure sign of its failure . If it is not there, then the palm lies quietly and does not experience any movement until a systolic impulse occurs. What has just been said explains, by the way, why the third tone, by its very nature, is a very low and quiet sound. That is why it is sometimes better detected by touch with the hand rather than with the ear.
Palpation of the liver is also very useful for diagnosing heart failure. If the heart does not pump blood well, then it accumulates, first of all, immediately upstream, directly in front of the heart - in the neck veins and, especially, in the liver, since its capacity is enormous - up to several liters. At the same time, it swells and sometimes increases so much that its lower edge drops to the navel, or even lower. It is important to emphasize that congestive liver swelling often occurs long before the appearance of peripheral edema in the legs and lower back, and is therefore an earlier symptom. If heart failure occurs suddenly (myocardial infarction, acute rhythm disturbance, pulmonary embolism), then rapid stretching of the liver capsule causes severe pain in the right hypochondrium, nausea and vomiting. Palpation of such a liver is painful. If, in addition, the edge of the liver protrudes from under the ribs, then, having discovered the dense anterior surface of the liver with a palpating hand, the doctor can mistake this resistance for muscle tension in the abdominal wall and diagnose acute cholecystitis based on the combination of all these signs.
Meanwhile, in order not to get into trouble, you don’t need to have gray hair at the temples or many years of medical experience. The numerous signs that have just been discussed (shortness of breath, oliguria, swelling of the neck veins, palpation of the heart) allow in most cases to understand the true cause of pain in the right hypochondrium. In addition, with acute congestive swelling of the liver, its entire edge becomes uniformly painful around the entire perimeter, while with acute cholecystitis the pain is concentrated mainly or exclusively in the area of ​​the gallbladder. Techniques for palpation of the liver and gallbladder are described in the “Palpation of the abdomen” section.
A few words about palpation of edema. It would seem that it could be simpler - poke your finger into the shin above the ankle and if you get a hole, that means there is swelling. That's the point: don't poke! Place the end phalanx of the index finger with the entire palmar surface (not the nail end!) on the back of the foot or on the lower third of the leg and smoothly, slowly begin to press the finger, gradually increasing the pressure. By acting this way, you will not only relieve the patient from painful sensations, but - and this is the main thing - you will give the edematous fluid time to escape from under the finger through narrow interstitial crevices. After removing your finger after two or three seconds, stroke the skin in this place: if a dent has formed, it will immediately become noticeable.
In bedridden patients, swelling should be looked for not on the legs, but on the sacrum or slightly higher. Even if you sit the patient down just to listen to the lungs from behind, be sure to check for swelling in the lower back. Such a gesture should become simply automatic.
There is another very important palpation sign that directly proves poor myocardial contractility - alternating pulse. With it, every second shock is weaker than the first. A similar thing happens with bigeminy, but the alternating pulse differs in that with it all the intervals between beats are the same: there is no rhythm disturbance here, this is a very important difference! In its expressed form, it is quite rare, but it is an indisputable sign of severe heart damage, and therefore it is important in prognostic terms. The French say: Coeur alternée - coeur condamnée (an alternating heart is a doomed heart). By the way, alternation is not necessarily combined with peripheral edema, so if it is not noticed, then the seriousness of the situation can be underestimated.
Weak degrees of alternation are easier to detect not by palpation of the pulse, but by measuring blood pressure. To do this, you just need to slowly reduce the pressure in the cuff and, having reached the first systolic shocks, stop. If the pulse alternates, you will notice that every second impulse does not produce a Korotkov tone, although the pressure gauge needle trembles. And only when the pressure in the cuff decreases by another 5 - 10 mmHg. Art., the number of audible blows will immediately double: now both strong and weak blows will be heard. There is no point in specifically looking for an alternating pulse in every heart patient - this is not such a common phenomenon. But if you do not forget about its possibility when routinely measuring blood pressure, then you will not miss the fact of the non-simultaneous appearance of Korotkov sounds and will receive important information.
AUSCULTATION of the heart gives only one, but extremely important sign of myocardial weakness. This is a pathological third tone. The term “pathological” is used because, for unknown reasons, the third tone is sometimes heard in completely healthy people, especially young people. But the physiological third tone is heard, firstly, much louder and more clearly than the pathological one; secondly, and this is the main thing, the general condition of the people in whom it occurs is so good that there is not the slightest reason to think about heart disease (they easily run, play sports, etc.). As for the pathological third tone, it is a very quiet, dull, low sound. After reading such a description, a young doctor may think that only a virtuoso of auscultation can detect it. But that's not true. This does not require particularly musical or sensitive ears. All you need is attention and compliance with some rules of auscultation.
Usually, when auscultating the heart, we hear a two-part rhythm: ta-ta, ta-ta, ta-ta... But sometimes it seems that the rhythm is not entirely two-part, as if there is some other element or a hint of it: ta-ta- p, ta-ta-p, ta-ta-p... If you pronounce the sound “p” softly, quietly, without straining your lips, but simply closing them, you will get a good imitation of the pathological third tone. This sound is very low. Therefore, to hear it, it is better to use the stethoscope head of a combined phonendoscope (in the form of a funnel or bell, without a membrane) and apply it very easily, without pressure, to the skin. The fact is that tightly stretched skin, just like the membrane of a phonendoscope, perceives predominantly high frequencies and “cuts” low ones: compare the sound of the same string when it is stretched tightly or loosely. By the way, this circumstance can be used in case of doubt. If you are not sure whether there is actually a third tone, or whether it just seems, press the head of the stethoscope firmly against the chest wall - the rhythm will immediately become undeniably two-part, without any hint of anything additional. Then release the pressure again - the rhythm will again become suspiciously three-fold.
The mechanism of formation of this tone was discussed earlier: it is caused by a push of the flabby wall of the ventricle against the chest wall under the pressure of blood entering the ventricle during diastole. Therefore, the best position for searching for the third tone is lying on your back. In this position, the heart moves away from the anterior chest wall, and the conditions are created for the ventricular wall to slap against the chest in diastole. On the contrary, in the vertical position of the patient, the heart is more closely attached to the chest wall, so that the amplitude of its movement during diastole is reduced. Typically, heart failure forces the heart to pump faster to maintain cardiac output at an acceptable level. In conditions of such tachycardia, the presence of an additional, third tone creates a three-part rhythm, a gallop rhythm - a precious sign of a weakening myocardium.
If cardiac failure is suspected, a physical examination of the lungs is also very helpful. In the most common variant, namely, when the left ventricle is weakened predominantly, blood stagnation occurs behind it, that is, in the small circle. There may not be peripheral edema yet, but the lungs are already filled with blood. As a result, plasma begins to leak into both the alveoli and the pleural cavity. Hydrothorax is formed. Therefore, the first thing to do if we suspect heart failure is to look for dullness in the posterior lower parts of the lungs. The task is made easier by the fact that during cardiac decompensation, for some reason, fluid accumulates mainly in the right pleural cavity. During percussion, therefore, it turns out that the lower border of the right lung is higher than on the left. At first, this difference is small, and is often not paid attention to, and if they are noticed, they explain it simply by the unequal position of both domes of the diaphragm, or by hepatic dullness. Auscultation helps verify these assumptions. If you gradually move the head of the phonendoscope down from the angle of the scapula, the volume of vesicular breathing usually does not change. But, as soon as we reach the true lower border of the lung, this noise immediately weakens, and a little lower it completely disappears. If there is fluid in the pleural cavity, then the layer at the bottom is naturally thicker than at the top. Where there is a lot of fluid, the lung is compressed more tightly and expands less easily when inhaling; the higher, the thinner the layer of fluid, and therefore the excursion of the lung tissue is freer. As a result, when moving the phonendoscope downwards, we find a gradual weakening of vesicular breathing during hydrothorax. This is especially noticeable if you alternately listen to the lungs on the right and left of the spine at the same level.
When blood stagnates in the lungs, plasma leaks not only into the pleural cavity, but also into the alveoli. Therefore, during auscultation, we hear in the area of ​​dullness not only weakened vesicular breathing, but also crepitus or fine rales (“congestive rales”). It is important to emphasize that these congestive wheezes do not disappear after a few deep breaths, unlike what happens when previously hypoventilated areas are straightened out. So, with left ventricular failure, we often have a characteristic triad: dullness of percussion sound at the base of the right lung behind, weakening of vesicular breathing there and fine bubbling rales.
As we can see, even the simplest clinical examination (questioning, examination, palpation, percussion and auscultation) provides a sufficient number of reliable signs that allow us to confidently answer such an important question for the doctor, whether the patient has heart failure. Of course, such a preliminary, purely clinical diagnosis directly at the patient’s bedside does not at all exclude the use of additional instrumental and laboratory methods (ECG, X-ray, ultrasound, etc.) for clarification and confirmation. But even such a seemingly primitive diagnosis makes it possible to immediately and decisively take initial therapeutic measures and, thereby, alleviate the patient’s condition, without waiting for the results of more complex studies...

In cardiology, cardiomyopathies (CM) are the most difficult to diagnose. Doctors relatively rarely encounter this category of patients. In the structure of the incidence of cardiovascular diseases, CMPs occupy a small percentage. Often the diagnosis is made late, when conservative drug therapy is ineffective.

Due to the expansion of the arsenal of laboratory and instrumental research methods, the number of patients with an established nosological diagnosis is increasing. The pathology occurs in 3–4 people out of 1000. The most common are dilated cardiomyopathy (DCM) and.

What is dilated cardiomyopathy?

So, dilated cardiomyopathy - what is it? DCM is a damage to the muscle tissue of the heart, in which the cavities expand without increasing the thickness of the wall and the contractile function of the heart is impaired.

The cavities of the main pump of the body are the left, right atria and ventricles. Each of them increases in size, the left ventricle is larger. The heart takes on a spherical shape.

The heart becomes like a “rag,” flabby, stretched. During diastole (relaxation), the ventricles fill with blood, but due to the weakening of the force and speed of myocardial contractility, cardiac output decreases. This leads to progressive heart failure. The most common cause of death in dilated cardiomyopathy is arrhythmia (blockade in the bundle branch systems), leading to cardiac arrest. Dilated cardiomyopathy is indicated in the diagnosis as a code according to ICD 10 - I42.0.

Causes of dilation of the heart chambers

Factors that trigger a pathological cascade of reactions include infections (viruses, bacteria) and toxic substances (alcohol, heavy metals, drugs). But trigger factors can act only in conditions of disruption of the body’s immune defense mechanisms. These conditions include:

• existing autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus);
• immunodeficiency syndrome (congenital and acquired diseases).

An important role in the pathogenesis of dilated cardiomyopathy is played by changes in the genome of the cardiomyocyte. Some patients receive a defective genotype by inheritance, and some acquire it through mutations.

Like any disease, dilated cardiomyopathy can develop only in the presence of favorable conditions for the pathological process, a combination of many causes. In late stages of DCM, it is impossible to determine the cause, and there is no need to do so. Therefore, 80% of dilated cardiomyopathies are considered idiopathic (i.e., of unknown origin).

But if the patient has chronic diseases at the time of discovery of the pathology, then they are considered to be the cause of damage to the heart tissue and expansion of the chambers of the heart. In this case, the diagnosis will sound like secondary dilated cardiomyopathy.

Pathogenesis

1. The affected myocardium cannot properly conduct impulses and contract at full strength.
2. According to the Frank-Starling law, the longer the muscle fiber, the stronger it contracts. The heart muscle is stretched, but due to damage it cannot contract fully.
3. Therefore, dilated cardiomyopathy is characterized by a decrease in the volume of blood expelled during systole, leaving more blood in the chamber cavity.
4. In response to a lack of blood flow in tissues, hormones of the renin-angiotensin-aldosterone system (RAAS) are activated. Hormones constrict blood vessels, increase blood pressure, and increase the volume of circulating blood
5. To compensate for oxygen starvation of peripheral tissues, the heart rate increases - the Wainbridge reflex.
6. What is indicated in points 3, 4 and 5 increases the load on cardiomyocytes. As a result, dilated cardiomyopathy is accompanied by an increase in the volume of muscle mass, i.e., myocardial hypertrophy. The size of each muscle fiber increases.
7. The mass of cardiac tissue increases, but the number of feeding arteries remains unchanged, this leads to a lack of blood supply to cardiomyocytes - to ischemia.
8. Lack of oxygen aggravates destructive processes.
9. Many cardiac myocytes are destroyed and replaced by connective tissue cells. Dilated cardiomyopathy is accompanied by processes of fibrosis and sclerosis of the heart muscle.
10. Areas of connective tissue do not conduct impulses and do not contract.
11. Arrhythmia develops, leading to the formation of blood clots.

Taken together, disturbances in electrical conductivity and the appearance of arrhythmogenic areas, intracardiac thrombus formation, all increase the risk of sudden cardiac death in dilated cardiomyopathy.

Symptoms of the disease

At first, patients have no idea about their illness. Compensation mechanisms mask the pathological process. Cases of sudden death have been described when increased stress on the heart occurs (psycho-emotional stress, excessive physical activity) against the background of an imaginary “complete physical well-being”.

But for most people suffering from dilated cardiomyopathy, the clinical picture develops gradually. Patients' complaints can be divided into syndromes:

• - feeling of a sinking heart, rapid heartbeat;
• ischemic - pain in the area of ​​pain in the sternum, radiating to the left side;
• left ventricular failure - cough, feeling of lack of air, frequent congestive pneumonia;
• right ventricular failure - swelling of the legs, fluid in the abdominal cavity, enlarged liver;
• increased pressure - squeezing pain in the temples, a feeling of pulsation in the back of the head, flashing spots before the eyes, dizziness.

In dilated cardiomyopathy, symptoms progress, inevitably leading to death.

Treatment

First of all, a person with an established diagnosis needs to change his lifestyle.

1. Be sure to avoid drinking alcohol. Alcohol and its metabolic products are cardiotoxic substances that destroy cardiomyocytes.
2. Patients who smoke should quit cigarettes. Nicotine constricts blood vessels, aggravating cardiac ischemia.
3. Dilated cardiomyopathy involves avoiding salt. It retains water in the body, increases blood pressure and stress on the heart.
4. As with other cardiac diseases, you should adhere to a low-cholesterol diet, consume vegetable oils, freshwater fish, vegetables and fruits.

Physical activity is selected by the attending physician based on clinical and instrumental examination data.

Signs of dilated cardiomyopathy

Drug treatment

It is most often not possible to influence the cause of the disease. Therefore, treatment of dilated cardiomyopathy is pathogenetic and symptomatic:

1. To stop the processes of wall stretching and sclerosis, angiotensin-converting enzyme inhibitors and sartans are used. These drugs eliminate the influence of RAAS hormones - dilate the arteries, reduce the load on the heart, improve nutrition, and promote the reverse development of hypertrophy.
2. Beta-blockers - slow down the rhythm, block ectopic foci of excitation, reduce the effect of catecholamines on heart tissue, and reduce the need for oxygen.
3. In the presence of stagnation, diuretics are used, and diuresis, potassium and sodium levels in the blood must be monitored.
4. If there are rhythm disturbances, such as a permanent form of atrial fibrillation, then it is customary to prescribe cardiac glycosides. These medications lengthen the time between contractions and the heart stays in a state of relaxation longer. During diastole, the myocardium receives nutrition and is restored.
5. Prevention of blood clot formation is mandatory. For this purpose, various antiplatelet agents and anticoagulants are prescribed.

Treatment of dilated cardiomyopathy is daily and lifelong.

Surgery

Sometimes the patient’s condition is so advanced that life expectancy is predicted to be no more than one year. In such situations, a heart transplant operation is possible.

More than 80% of patients tolerate this operation well; according to studies, 5-year survival is observed in 60% of patients. Some heart transplant patients live 10 years or more.

Alternative types of surgical intervention are the introduction of a cardiac casing or cardiac tie. These methods prevent further stretching of the heart.

If there is emerging valve insufficiency, annuloplasty is performed - the stretched valve ring is sutured, and an artificial valve is implanted.

Surgical treatment of dilated cardiomyopathy is actively developing and new possibilities of surgical interventions are being explored.

Dilated cardiomyopathy in children

Cardiopathy is observed in patients of all ages. The disease is hereditary, but can develop with infectious, rheumatic and other diseases. Thus, dilated cardiomyopathy in children can manifest itself both from the moment of birth and during physical growth.

It is difficult to diagnose a child: the disease does not have a specific clinic. In addition to complaints typical of adults, symptoms such as:

• growth and development delays;
• breast refusal in newborns;
• sweating;
• cyanosis of the skin.

The principles of diagnosis and treatment of pediatric cardiomyopathies are the same as in adult practice. When choosing medications, emphasis is placed on the admissibility of their use in pediatrics.

Prognosis and possible complications

As with any disease, the prognosis of life depends on the timeliness of diagnosis. Unfortunately, dilated cardiomyopathy has a poor prognosis.

The five-year survival rate of persons suffering from this pathology ranges from 30–50%. The quality and life expectancy are affected by prescribed treatment and surgical interventions.

Bad prognostic signs are:

• elderly age;
• left ventricular ejection fraction less than 35%;
• rhythm disturbances - blockades in the conduction system, fibrillation;
• low blood pressure;
• increase in catecholamines, atrial natriuretic factor.

There is evidence of ten-year survival in 15%-30% of patients.

Complications with cardiomyopathy are the same as with other cardiac diseases. This list includes thromboembolism, pulmonary edema.

Possibility of sudden death

It has been proven that half of patients die from decompensated chronic heart failure. The other half of patients are diagnosed with sudden death.

The probability of sudden death with dilated cardiomyopathy is 35% of all patients with an established diagnosis.

The causes of death are:

• cardiac arrest, for example, with ventricular fibrillation;
• pulmonary embolism;
• ischemic stroke;
• cardiogenic shock;
• pulmonary edema.

Sudden death can occur both in a person with a diagnosis and in people who are unaware of their pathology.

Useful video

For more information about dilated cardiomyopathy, watch this video:

Conclusion

1. Dilated cardiomyopathy is a disease caused by a defect in the structure of cardiomyocytes.
2. The disease is progressive, with a poor prognosis, is hereditary, can be detected at any age, and has no specific symptoms.
3. With adequate and timely treatment, the quality and life expectancy of patients improves. For some patients, heart transplant surgery is possible, which significantly changes the patient’s lifestyle for the better.
4. Despite the treatment methods used, statistics indicate a five-year survival rate of only 30% of patients, and the likelihood of sudden death is high.
5. Unfortunately, it happens that dilated cardiomyopathy is first identified by a pathologist.

To be remembered

“The autopsy showed that Viktor Prokopenko’s heart was like a rag: squeezed out, flaccid, with a large scar in the middle. And he looked like a completely healthy person."

The national trainer passed away 40 days ago.

On August 18, at the age of 62, the honored coach of Ukraine and Russia, Viktor Evgenievich Prokopenko, died. Death overtook him offensively early, unexpectedly, instantly... Unfortunately, the ranks of elite coaches, nurtured by the Soviet school - original, self-sufficient - are thinning. Viktor Prokopenko has a bright path behind him. As a footballer, he played for Odessa Chernomorets and Shakhtar Donetsk. He played 83 matches in the USSR championships and scored 13 goals. He also played for the USSR Olympic team. He headed the Odessa Chernomorets and was named the best coach in the history of the club. Under his leadership, the team twice won the Ukrainian Cup (1992, 1994), twice won bronze medals in the Ukrainian Championship (1993, 1994). In 2000, Viktor Evgenievich led Shakhtar to the group stage of the Champions League for the first time. And it was from this moment that the Donetsk team and Dynamo Kiev began an exciting battle for the championship on equal terms. Since 2004 he worked as Shakhtar's sporting director. Viktor Prokopenko also contributed greatly to the club’s championship successes and its victories in the Ukrainian Cup during this period. Since 2006, he has been a deputy of the Verkhovna Rada of Ukraine.

EX-CAPTAIN AND FORMER PRESIDENT OF “CHERNOMORTS” VYACHESLAV LESCHUK: “IT SEEMED VICTOR WAS SLEEPING AND COULD BE AWAKENED”

Yes, we called each other in the morning and met at our mutual friend Pyotr Khlystov’s. He is a dealer, owner of a Toyota auto center. There we gathered - as usual, when Victor came to Odessa. At 11 o’clock we watched the “Free Kick” program on NTV. We drank tea and talked.

- About what?

I can't remember exactly now. Non-binding conversations: they exchanged opinions about what they saw and heard.

- Did you have any premonitions?

Nothing like that, no phrases that would reveal that something was bothering him. He, as always, was calm, cheerful, and joked. He wanted to get his hair cut - Peter offered him his master. We got into the car and went there. Upon returning, we watched the second half of the Russian championship match CSKA - Saturn. Again they talked about everything and nothing. At about three o'clock in the afternoon, Victor got into his Mercedes, and I headed home on foot: I live nearby.

I come to my place and immediately receive a call from Larisa, Victor’s wife: “Vitya is unconscious, call an ambulance!” Through Peter, I called a private medical company and explained how to get to where Victor lived: not everyone knows this newly developed area. And I went there myself. I caught up with the ambulance and settled in behind. On the way, Larisa called and, crying, said: “Vitya has died.” It was approximately 15.40. 20 minutes later we entered the house. I looked at Victor - it seemed that he was sleeping and could be woken up. I didn't believe that this was the end. Larisa said that death occurred when he was taking a shower...

Having examined Victor’s body, the doctors threw up their hands: they say, even if they were nearby, they would hardly be able to help him with anything. By all indications, a blood clot had broken off and blocked the pulmonary artery. The heart stopped instantly.

- Was this confirmed during the autopsy?

I have not read the expert report. We then had a lot of problems related to the funeral. They said that he seemed to have acute heart failure...

- He didn’t smoke or drink. What was the cause of the disease?

We didn’t talk about it with him, and he never complained about his health.

- You’ve been friends for probably 30 years?

Even more. I was invited to Chernomorets Odessa in mid-1968, and he joined the team after Stepa Reshko from Lokomotiv Vinnytsia at the end of the year. I was a kid, and he was already considered a mature player. He was a battering ram striker, fearlessly entered into power combats, and skillfully played with his head. Height - 186 centimeters, and then there were few tall strikers.

While he was single, we lived together in a dormitory at the Chernomorets training base (head coach Sergei Shaposhnikov also lived here). And a couple of years later, when the team was relegated from the major leagues, our paths diverged. Then there was cholera in Odessa, and we played our last games away, in Kyiv. He went to Donetsk, I joined the army. I returned to Chernomorets in ’73, he returned in ’74. We played together for a couple more years, and then he went to study at the Higher School of Coaches in Moscow.

Do you think, besides the physical reasons for his death, there could have been others - moral, psychological, which very often cripple a person? After all, Viktor Prokopenko’s vocation is head coach, not sports director, and it’s even more strange that he went into politics...

We have a lot of strange things going on, so... I don’t think that the cause of his death should be sought in his removal from the post of coach. The Shakhtar club did not have the position of sports director; it was created under Viktor Prokopenko. Rinat Akhmetov mainly talked only with him about football and consulted on various issues. Victor assured that working with him was both a pleasure and a learning experience.

- Did he receive calls with an offer to lead another team?

Maybe there were, but I don’t know anything about it. Calls now, as you understand, mean nothing. And Victor, if he decided to be a sports director or a politician, then that’s all he lived for. And it’s unlikely that I was looking for another job at the same time.

- How do you remember Viktor Evgenievich?

Throughout his life, he always radiated confidence and cheerfulness. Few people knew that Victor had long been a believer, since the times of the Union. I went to church and observed all religious rituals. I fasted. Once in all that time, I went into church with him for company, watched as he lit candles and prayed.

Our generation was promised that we would live under communism. And now we also believe that we will live with great football in Ukraine. That one day Shakhtar Donetsk will win the Champions League. Victor also dreamed about this.

VIKTOR PROKOPENKO’S WIDOW LARISA: “DURING 40 YEARS OF OUR LIFE TOGETHER, I HAVE NEVER SEEN MY HUSBAND SICK”

We were together for 40 years, and it seems to me, all 200. And they passed like one day. We just want to live and be happy... We spend our whole lives living in suitcases, on the road, in hotels. I remember Kherson, where he began coaching the local Lokomotiv in 1973. Daughter Tanya was little, all the football players nursed her. And in the room where we were placed there was barely room for a crib. There was a kerogas gas, a large saucepan in which I cooked borscht for the whole team.

This is our youth, and everything was easily tolerated: moving, everyday instability. He never allowed me to shoulder the burdens of life. If I was sick, or the children, or my relatives, Victor took care of everything first of all. It’s hard to believe that for all 40 years a person ran home as fast as he could after work, and not somewhere else. But that's how my husband was.

Our children in Volgograd are son Evgeniy and daughter Tatyana. Everything is fine with my son, he graduated from police school, got married, and has a child. And my daughter’s husband was killed; she, unfortunately, is alone. It seems like they found the killer, but what's the point? Victor doted on his granddaughter Vika, but he couldn’t get enough of his grandson - he will only be one year old.

Was your husband worried because he stopped being a coach? Do you think it was better to sit on these coaching benches? When I turned on the TV and watched the team he coached play, I couldn’t stand what it was like for him...

And all the same, I tell you, as if in confession, not once in these years have I seen Victor hold his heart or swallow any pills. He never took medication at all. The only thing is that as a player he had injured menisci. I haven't drunk or smoked for the last 15 years. We took care of him as best we could. If I had noticed anything, I would have raised the alarm.

Doctors believe he suffered a heart attack on his legs. “This can’t be! - I say. “I’ve been with him all the time lately.” If they separated, it wasn’t for long.” They explain: “There are forms that do not cause pain.”

I calculated: he died on the day of the Transfiguration, and the 40th day falls on the Exaltation of the Cross of the Lord. They say that even in monasteries people ask for death on such holidays and are awarded one.

STEFAN RESHKO: “VICTOR KEPT ALL HIS EXPERIENCES TO HIMSELF”

A bright, sharp mind. He was well-read, erudite, well prepared. He knew how to reason and analyze. He admitted his mistakes and did everything to correct them. He defended his opinion. If there were complaints against him, he explained his gaming vision, why he did it this way and not otherwise.

He was cheerful, humorous, as they say, a soul-man. Loved company. After the defeats, of course, everyone was despondent, but he could still raise their tone and cheer them up. He said, for example: “We lost, well, life doesn’t end there. We need to rethink everything, figure it out and move on.”

- How did you end up on the same team?

In 1967, after serving in Germany, where he played for the Northern Group of Soviet Forces, Victor came to Lokomotiv Vinnitsa, where I was already playing. He and I immediately became friends and lived in the same room. Lokomotiv was in the first league, but we were constantly fighting for the top spot. The team included Troyanovsky, Levchenko, and other football players who went through the Dynamo Kyiv school. Playing with such technical masters, Victor, of course, felt that he needed to seriously train in order to be on the same level with them. And he worked additionally after classes on feints, on strikes, on heading. We often stayed as a couple.

When I was invited to Chernomorets Odessa, I did everything so that he would go there too. I convinced coach Sergei Shaposhnikov that Prokopenko is a decent guy, disciplined, strict.

- Was it not a surprise to you that he ended up becoming an excellent coach?

He had enough intelligence, in this regard he was always at his best. In addition, Victor graduated from the Higher School of Coaches in Moscow and gained more theoretical knowledge.

He raised Chernomorets and did a lot for Shakhtar. I have always said and continue to say that I liked Shakhtar’s game when Victor coached the team - it was so light and fresh. Yes, we didn’t manage to win the championship, we were just a little short. Maybe the rigor in the game that Lobanovsky and other coaches had. But Prokopenko preached attacking, liberated, spectacular football.

And this despite the fact that at that time he did not have such colossal material support as the team has now...

Well, of course. There weren’t so many foreign players with him either. He worked with players at a lower level than today. The current Shakhtar and Dynamo have higher-class performers. What can I say: coaching is hard work, constant stress. Less “physics”, more hassle. In appearance, Victor seemed reserved. He could, of course, jump up from the bench and wave his hand to suggest something to the players, but he did not allow himself such emotional outbursts as some coaches. He kept everything to himself - hence the heart problems.

Doctors I know told me: “The autopsy showed that Viktor Prokopenko’s heart was like a rag: squeezed out, flaccid, with a large scar in the middle.” And he looked like a completely healthy person.

- He worked in different teams. And what, the coaches didn’t undergo medical examinations anywhere?

I myself am surprised that at Shakhtar Donetsk, where the most modern medical equipment is available, Prokopenko’s heart problems were not detected. Most likely, he did not love himself enough to take care of his health. Apparently, he didn’t expect that his heart could fail.

I spoke to his widow Larisa at the funeral. She lamented: “It seemed like a normal life had begun for me: Vitya quit coaching, began to travel less, was at home more often, just to live, but now you need it - everything ended.”

Kucherevsky left earlier, now Prokopenko. These are, in general, coaches who should be in the main positions. And they were taken a little bit and pushed aside, made sports directors. Is this not the reason for the tragedy of both?

Kucherevsky had an accident - although, they say, his heart also failed. That is, football (like all professional sports) is such a stressful sport that the heart wears out ahead of time. But I don’t think they retired because they stopped being head coaches. Prokopenko, being the sports director at Shakhtar, was not responsible, of course, for the result, but he was generally involved with all teams - the first, second, and third, and participated in organizing this process. He was in the club, no one left him.

Viktor Prokopenko is known for witty, aphoristic phrases in a purely Odessa spirit, although he was born in Mariupol. For example: “I haven’t drunk for a long time, but I spill it!” What do you remember?

He could create something of his own out of any joke, the “fools.” He loved the sea; from the windows of his house in Odessa it is clearly visible. And once he said: “Life is given to a person once, and in order not to be excruciatingly painful, it must be lived by the sea.”

LEONID BURYAK: “WITHOUT PROKOPENKO AND OTHER TEAM COACHES, THERE WOULD NOT BE BLOKHIN’S COACHING SUCCESS”

Victor was a coach in Russia and Ukraine. Hand on heart, I can say: when he coached Shakhtar, it was the strongest team in the club’s history.

Our paths crossed all the time. We met abroad, in Kyiv, in Donetsk, when Dynamo Kiev and Shakhtar Donetsk played. We sat in the stands and exchanged glances as the match progressed. He was happy when his team played good football, and was worried if it had a slump in the game.

He was the first coach of the Ukrainian national team. Then many leading football players remained in Russia, and it was necessary to create a new team. No results were required from her. I already had a different situation: the national team was given the task of advancing from a difficult group to the final tournament of the European Championship. Unfortunately, we did not fulfill it. At the same time, I think the team had its own identity, it won at some stage and showed high-quality football.

Then Oleg Blokhin led the team and led it to the final tournament of the World Championship. But I think that the result that he achieved would not have happened if it were not for the work of the former coaches of the main team - Viktor Prokopenko, Anatoly Konkov, Jozsef Szabo, Valery Lobanovsky, and mine too.

In my memory, Viktor Prokopenko remains a man infinitely devoted to football. But everyone chooses their own path. The position of sports director, which he held and which I now hold, is very interesting: you are in the thick of the club’s football events all 24 hours a day. Of course, the responsibility is 10 times less than that of a coach, but the work is still exciting. And I have no doubt that Viktor Prokopenko made any choice he made according to the call of his heart, without regretting anything later. He said this himself.

Upon learning of his death, without hesitation, I got into the car and drove to Odessa to pay tribute to the man who did so much for Ukrainian football. And he could do even more. Ukraine has lost a very strong specialist. At the funeral meeting, Raisa Bogatyreva said very touching words and asked Viktor Evgenievich for forgiveness for the fact that we were not entirely attentive to him...

P.S. A year and a half ago, in an interview, Viktor Prokopenko, who held the post of sports director, when asked if he was drawn to coaching again, answered in his characteristic spirit: “Who knows? I don’t understand some colleagues who pompously declare that they cannot live without football. What if tomorrow, God forbid, a war breaks out? What kind of football will we be talking about? Let's take machine guns and go dig trenches. You can’t go against fate...”

A heart attack kills. Such a failure can lead not only to disability, but also to death. And all because the heart is constantly in continuous operation, supplying blood to the organs. As soon as blood flow to the heart muscle (myocardium) is interrupted, coronary heart disease (CHD) occurs. Its manifestations can be different, ranging from angina pectoris to heart attack. But the results are sad: it is IHD that is one of the causes of mortality, and the area affected by it forces us to recognize this disease as the problem of our century.

However, it can be prevented within 30 days by paying attention to the signals that the heart sends. Even if some of them appear infrequently, this is already a reason to think about the state of your internal “battery”. The occurrence of more than five attacks per day indicates an urgent need to consult a doctor.

Fatigue indicates a lack of blood supply, and weakness indicates the risk of a heart attack.

Let's start with those unclear manifestations that are usually ignored, taking them for moments of weakness. But they are the markers of the disease.

Symptom No. 1. Fatigue. You just got out of bed and already feel overwhelmed. You get to work and are only thinking about how to relax. And you return from it completely exhausted. And every day you feel more and more tiredness accumulating.

• An alarming symptom that indicates heart failure. Fatigue occurs due to lack of blood supply to the brain, lungs and heart.

Symptom No. 2. Weakness. Many patients who suffered a heart attack admitted that shortly before they experienced such weakness that they were unable to hold a sheet of paper in their hands. The feeling of powerlessness that is characteristic of the flu is an alarming signal.

• The symptom indicates the risk of myocardial infarction in the near future.

Symptom No. 3. Mood swings. Many people experienced a feeling of causeless anxiety before ending up in a hospital bed. Doctors advise to be careful about this condition, as it is one of the common symptoms.

• Severe anxiety or even fear of death may indicate an impending heart attack.

Straight to the heart: swelling of the legs and severe shortness of breath threaten heart attacks

Symptom No. 4. Shortness of breath. If climbing to the third floor causes severe shortness of breath, as if after an hour-long marathon, and minor physical activity is accompanied by a lack of air, it’s time to consult a cardiologist. Shortness of breath often accompanies a heart attack and can cause chest pain.

• Impaired blood flow reduces its supply to the lungs, which causes shortened breathing.

Symptom No. 5. Dizziness. The brain needs plenty of blood flow to function properly. As soon as an insufficient amount of blood enters the brain, this affects the condition of the entire body.

• Heart attacks are accompanied by dizziness or loss of consciousness. Therefore, heart rhythm disturbances are very dangerous.

Symptom No. 6. Cold sweat. It suddenly hits you when you are just sitting in a chair and suddenly begin to become covered in drops, as if you had just spent two hours in the gym.

• An alarming symptom indicating an approaching heart attack.

Symptom No. 7. Rapid pulse. Rare pulse surges, as a rule, do not cause concern to doctors. But an irregular or rapid pulse, especially if it is accompanied by shortness of breath, dizziness, and weakness, indicates an arrhythmia.

• Arrhythmia can cause a heart attack or even sudden death.

Symptom No. 8. Chest pain appears suddenly and disappears in the same way. It is not surprising that many people ignore such manifestations and do not realize the full danger of the situation. They come to their senses when the affected area extends to the arms, back, and shoulders.

• The most common symptom indicating an impending heart attack.

• A persistent cough indicates heart failure.

Heart problems do not always manifest themselves in a typical picture, as we are used to seeing in movies: a person grabs his chest in the area of ​​the heart with his hand and falls unconscious. Often, completely unexpected symptoms can be signs that something is wrong with the heart. Moreover, they may not even be associated with the chest area. We will tell you what symptoms you need to pay attention to in order to prevent a heart attack or detect a serious heart disease in time.

The most common symptom of heart-related diseases. By “chest discomfort” we mean not only pain, it can be various unpleasant sensations, etc.

For any unpleasant symptoms localized in the chest area, the doctor must first rule out heart disease. There are several such diseases:

• Angina pectoris.

Angina is characterized by severe pain, most often described by patients as a burning sensation, a feeling of constriction in the middle of the chest, accompanied by a fear of death. Symptoms may occur during physical or emotional stress. The attacks last no longer than 15 minutes and go away after rest and taking heart medications.

• Myocardial infarction.

Pain with necrosis of the heart muscle is more pronounced than with angina pectoris, and may be accompanied by weakness, nausea, and a feeling of doom. This pain is not relieved by taking heart medications. If pain in the chest area lasts more than 15 minutes, you should call an ambulance.

It is also important to remember that in some cases, myocardial infarction can occur without any pain at all. This happens, for example, with diabetes. Doctors associate this course of a heart attack with changes in nerve fibers (diabetic neuropathy). More often, “painless” heart attacks develop in women.

• Pulmonary embolism.

Pulmonary embolism due to a thrombus if medical care is not provided is fatal. This condition can be suspected by the sudden appearance of severe pain in the chest, which intensifies with movement and coughing. The pain syndrome is accompanied by shortness of breath. Sometimes a cough may be observed, and blood may be found in the sputum.

• Dissecting aortic aneurysm.

Aortic aneurysm is a pathological protrusion in the aortic wall that develops for many reasons (atherosclerosis, hypertension, congenital defects of the vessel wall). Dissection of an aneurysm occurs when a thin stretched wall in the area of ​​the protrusion (aneurysm) is torn. In this case, blood flows between the layers of the wall and further delamination of the vessel, or a breakthrough of all layers of the wall with massive internal bleeding. The condition is dangerous due to the rapid onset of death.

The pain in this condition is very severe, the nature of the pain can be described as “tearing”, “tearing”, “burning”. At the same time, it can be difficult for the patient to determine its location; the pain can change its position, radiating to the neck, arms, legs, stomach or back. The patient may become agitated or lose consciousness. Pallor of the skin is characteristic due to blood loss, and blueness of the upper body is due to developing cardiac tamponade (blood in the pericardial sac)

Of course, in most cases, heartburn and abdominal pain signal diseases of the gastrointestinal tract. But in some situations these may be signs of a developing myocardial infarction. It has been noted that such forms of heart attack are more often detected in older women. Heartburn or acute abdominal pain is recorded with a heart attack developing on the diaphragmatic surface of the heart. The condition may be accompanied by vomiting, diarrhea, and nausea. There have been cases when patients with acute abdominal pain were taken for surgery with a diagnosis of “acute abdomen”. During the operation, no pathology was detected in the abdomen, and further clinical picture and examinations confirmed the presence of an infarction in the heart muscle.

There are atypical forms of myocardial infarction, when pain sensations are detected in completely different parts of the body, which contradicts our ideas about the location of the heart.

• A sudden sore throat may indicate the development of a laryngopharyngeal form of myocardial infarction;
• The pain may cover the entire left hand or be localized only at the tip of the little finger;
• Sharp pain in the lower jaw occurs with the mandibular form of myocardial infarction;
• The upper vertebral form of infarction occurs with localization of back pain in the cervicothoracic spine.

Atypical forms of cardiac muscle infarction often develop in patients who are elderly, have a large number of concomitant diseases, exhaustion, and previous heart attacks.

If pain suddenly occurs in the above-mentioned parts of the body, you should call a doctor. A comprehensive examination will confirm or refute the diagnosis of a heart attack.

Shortness of breath is an early symptom of heart failure. Patients note that they began to “suffocate” with little physical activity or walking, which had not happened before. Later, shortness of breath may occur at rest.

Shortness of breath is accompanied by almost all heart diseases leading to the development of heart failure (arterial hypertension, coronary heart disease, myocarditis, heart defects). This symptom is associated with the inability of the heart to perform its functions in full: the contractility of the heart muscle decreases, the pressure in the pulmonary vessels increases, spasm of small arteries occurs, and gas exchange disorders develop. Many organs suffer from a lack of oxygen, a signal goes to the brain to the respiratory center, oxygen starvation is compensated by deep inhalations and exhalations, which is manifested by shortness of breath.

In severe cases of chronic heart failure, shortness of breath occurs even at night. A person wakes up at night from an attack of suffocation, he is bothered by a cough and fear of death. This symptom is called “cardiac asthma.” The condition is dangerous because pulmonary edema may develop during one of these attacks, and then without emergency treatment the patient may die.

Unreasonable and sudden weakness can develop several days before a heart attack. The weakness can be so pronounced that patients, describing it, say: “I didn’t have the strength to hold a piece of paper between my fingers.”

Weakness at the slightest physical exertion is a symptom of chronic heart failure (CHF). In severe CHF, weakness and shortness of breath can also be observed at rest.

In children, symptoms such as weakness and shortness of breath occur with congenital heart defects. A striking example of this is the symptoms of a severe heart defect - tetralogy of Fallot. Such children cannot actively play like ordinary children; active play causes them to experience an attack of suffocation. When there is difficulty breathing, the child squats down - in this position it becomes easier for him, as the load on the heart is reduced. After the attack, severe weakness occurs.

It would seem, what does snoring have to do with heart disease? Every fifth man snores. But research by scientists has shown that snoring, being one of the components of obstructive sleep apnea syndrome (OSA), can contribute to the development of heart disease. OSA is characterized by pauses in breathing during sleep, alternating with loud snoring. Close relatives of the snorer may notice that his snoring stops for a while, there is complete silence for a moment, after which the loud sound of snoring resumes. Moments of silence are apnea - short-term stops in breathing. In severe forms of OSA, there can be up to 400 such stops per night. This leads to oxygen starvation of organs, which contributes to the development of hypertension, myocardial infarction, stroke, and sudden death.

A relatively young branch of medicine - somnology - deals with various breathing disorders during sleep. If among your relatives there are people with “habitual” snoring, then they need to be examined. Especially if the snorer has other risk factors:

• Age over 40 years;
• Diabetes;
• Excess body weight;
• Arterial hypertension;
• Smoking.

The patient will need to undergo examination - polysomnography. This can be done in any department that deals with sleep problems. Somnology centers, offices and sleep laboratories operate in many large cities. The study is a recording of indicators of respiratory function, heart function, brain function, muscle movements of the eyeballs, facial muscles and limbs, and allows you to monitor blood oxygen saturation. This study is carried out during night sleep.

Based on the results obtained by polysomnography, the severity of the disease is determined and the question of the method of treatment is decided: conservative or surgical.

Excessive sweating in hot weather or during physical activity is not a deviation. You should be concerned if sweat appears suddenly and is not associated with the above factors. This may be a symptom of a heart attack. At the same time, the sweat is cold, sticky, and is often accompanied by a psycho-emotional disorder - the patient worries about his life, it seems to him that he will die.

In such a situation, you should immediately call an ambulance.

We are accustomed to the fact that cough is a symptom of a disease of the respiratory system. But sometimes it can indicate heart problems. Thus, a persistent cough that cannot be treated with medications may indicate the development of heart failure. Most often it appears at night, accompanied by difficulty breathing, and streaks of blood can be seen in the sputum. After clearing the throat, the person feels better.

A sudden attack of suffocation with a strong cough and the release of foamy sputum indicates one of the atypical types of myocardial infarction - the asthmatic variant. More often, this picture is observed when the zone of necrosis is localized in the area of ​​the papillary muscles of the heart.

Edema can appear with various diseases of the kidneys, endocrine organs and heart. In the latter case, edema occurs when it ceases to cope with its function and blood stagnation develops. The liquid part of the blood exits through microscopic holes in the walls of the venous vessels - edema forms. The first place you notice them is on your feet. At first, they form in the evening and form in the area of ​​​​the feet and legs. Often they are not given due attention. Minor swelling is attributed to fatigue and increased stress on the limbs during the day. But as heart failure progresses, swelling also increases. At first, the swelling “rises” higher in the limbs, and then can spread to other parts of the body and internal organs. In severe cases of chronic heart failure, fluid accumulates in the body cavities - abdominal, pleural. The belly can grow to gigantic sizes.

A rapid heartbeat can develop during times of excitement, stress, or increased physical activity. This is fine. The appearance of such a symptom at rest is a reason to seek medical help, as this is a sign that all is not well with the heart.

Myocardial infarction can also be caused by rhythm disturbances. In this case, they speak of an arrhythmic form of myocardial infarction.

If you notice any of the above symptoms, you should contact a cardiologist to rule out pathology of the heart and blood vessels.

What causes the mobilization of the heart's capabilities when increased demands are placed on it? On the one hand, by increasing the frequency of contractions, on the other hand, by increasing the volume of blood ejected with each systole. Which of these factors is more important and how do they combine with each other? This is very clearly visible when comparing the work of the heart of trained and untrained people.

With moderate physical activity, in both cases the heart performs approximately the same work, but in an untrained subject it copes with its task mainly due to a significant increase in the frequency of contractions, and in a trained person - due to a very significant increase in the volume of blood ejected at each systole (stroke volume ). It is clear that the second method is more profitable, since the lower the speed of heart contractions, the less energy is spent on its work, the more time the heart has to rest. This means that it will not get tired so quickly; finally, the work of the heart is more efficient because the more the heart muscle is stretched (i.e., the greater the volume of blood in its cavities), the greater the force of its contraction. In well-trained athletes, under extreme stress, the stroke volume of blood can reach 200-250 ml, i.e. a full glass of blood. In such people, at rest, the stroke volume is often about 100 ml instead of 60 ml and, accordingly, the heart contracts less frequently (40-45 times per minute). This is no coincidence, because the size of the heart of such highly trained athletes undergoes a gradual beneficial increase (it has nothing to do with the enlargement of the heart that occurs in sick people). Of course, not everyone sets themselves the goal of achieving high athletic achievements, but everyone wants to be healthy, and the fulfillment of this completely natural desire is available to everyone. Properly organized physical work and reasonable exercise and sports play a vital role in strengthening the heart and increasing its performance. This is explained by the fact that the load falling on the heart is associated mainly with the activity of the muscular system. Therefore, properly structured muscle training is also a good heart workout. Physical inactivity or insufficient physical activity has a detrimental effect on the performance of all body functions and, in particular, on the condition of the heart.

At any age and even with any disease (!), the movement factor is a powerful source of health. Of course, this does not mean that any form of gymnastics is suitable for every person. Of course not! It is necessary to take into account the individual characteristics of the body, age, and state of health. To do this, you need to use the advice of a doctor and the recommendations of experienced physical education methodologists. Attempts at self-medication, as well as unreasonable enthusiasm for various systems of gymnastic exercises by completely healthy people (for example, yogi gymnastics!), often lead to completely undesirable results. However, both healthy and sick people, including heart patients (!), can quite successfully improve their health, taking advantage of the healing effects of physical exercise, if they are guided by the advice of relevant specialists.

Unfortunately, in life we ​​often meet people who not only do not protect and strengthen their hearts, but also cause direct harm to it. We mean primarily those who abuse alcohol. Perhaps not everyone knows that under the influence of alcohol, the fibers of the heart muscle die irrevocably. Instead of active muscle tissue, connective tissue fibers are formed that are not capable of contractile activity. The juicy, red, elastic myocardium of a healthy heart becomes flabby, like a rag, acquires a grayish tint, and loses its strength. A thick layer of fat is deposited under the outer lining of an alcoholic’s heart, making it difficult for his already weakened heart to function...

To be remembered

“The autopsy showed that Viktor Prokopenko’s heart was like a rag: squeezed out, flaccid, with a large scar in the middle. And he looked like a completely healthy person."

The national trainer passed away 40 days ago.

On August 18, at the age of 62, the honored coach of Ukraine and Russia, Viktor Evgenievich Prokopenko, died. Death overtook him offensively early, unexpectedly, instantly... Unfortunately, the ranks of elite coaches, nurtured by the Soviet school - original, self-sufficient - are thinning. Viktor Prokopenko has a bright path behind him. As a footballer, he played for Odessa Chernomorets and Shakhtar Donetsk. He played 83 matches in the USSR championships and scored 13 goals. He also played for the USSR Olympic team. He headed the Odessa Chernomorets and was named the best coach in the history of the club. Under his leadership, the team twice won the Ukrainian Cup (1992, 1994), twice won bronze medals in the Ukrainian Championship (1993, 1994). In 2000, Viktor Evgenievich led Shakhtar to the group stage of the Champions League for the first time. And it was from this moment that the Donetsk team and Dynamo Kiev began an exciting battle for the championship on equal terms. Since 2004 he worked as Shakhtar's sporting director. Viktor Prokopenko also contributed greatly to the club’s championship successes and its victories in the Ukrainian Cup during this period. Since 2006, he has been a deputy of the Verkhovna Rada of Ukraine.

EX-CAPTAIN AND FORMER PRESIDENT OF “CHERNOMORTS” VYACHESLAV LESCHUK: “IT SEEMED VICTOR WAS SLEEPING AND COULD BE AWAKENED”

— Yes, we called in the morning and met at our common friend Pyotr Khlystov’s. He is a dealer, owner of a Toyota auto center. There we gathered - as usual, when Victor came to Odessa. At 11 o’clock we watched the “Free Kick” program on NTV. We drank tea and talked.

- About what?

- I can’t remember exactly now. Non-binding conversations: they exchanged opinions about what they saw and heard.

— Did you have any premonitions?

“Nothing like that, no phrases that would reveal that something was bothering him.” He, as always, was calm, cheerful, and joked. He wanted to get a haircut - Peter offered him his master. We got into the car and went there. Upon returning, we watched the second half of the Russian championship match between CSKA and Saturn. Again they talked about everything and nothing. At about three o'clock in the afternoon, Victor got into his Mercedes, and I headed home on foot: I live nearby.

I come to my place and immediately receive a call from Larisa, Victor’s wife: “Vitya is unconscious, call an ambulance!” Through Peter, I called a private medical company and explained how to get to where Victor lived: not everyone knows this newly developed area. And I went there myself. I caught up with the ambulance and settled in behind. On the way, Larisa called and, crying, said: “Vitya has died.” It was approximately 15.40. 20 minutes later we entered the house. I looked at Victor - it seemed that he was sleeping and could be woken up. I didn't believe that this was the end. Larisa said that death occurred when he was taking a shower...

Having examined Victor’s body, the doctors threw up their hands: they say, even if they were nearby, they would hardly be able to help him with anything. By all indications, a blood clot had broken off and blocked the pulmonary artery. The heart stopped instantly.

— Was this confirmed during the autopsy?

— I haven’t read the expert report. We then had a lot of problems related to the funeral. They said that he seemed to have acute heart failure...

— He didn’t smoke or drink. What was the cause of the disease?

“We didn’t talk about it with him, and he never complained about his health.”

— You’ve been friends for probably 30 years?

- Even more. I was invited to Chernomorets Odessa in mid-1968, and he joined the team after Stepa Reshko from Lokomotiv Vinnytsia at the end of the year. I was a kid, and he was already considered a mature player. He was a battering ram striker, fearlessly entered into power combats, and skillfully played with his head. Height is 186 centimeters, and then there were few tall strikers.

While he was single, we lived together in a dormitory at the Chernomorets training base (head coach Sergei Shaposhnikov also lived here). And a couple of years later, when the team was relegated from the major leagues, our paths diverged. Then there was cholera in Odessa, and we played our last games away, in Kyiv. He went to Donetsk, I joined the army. I returned to Chernomorets in ’73, he returned in ’74. We played together for a couple more years, and then he went to study at the Higher School of Coaches in Moscow.

- Do you think, besides the physical reasons for his death, there could have been others - moral, psychological, which very often cripple a person? After all, Viktor Prokopenko’s vocation is head coach, not sports director, and it’s even more strange that he went into politics...

“We have a lot of strange things going on, so... I don’t think the cause of his death should be sought in his removal from the post of coach. The Shakhtar club did not have the position of sports director; it was created under Viktor Prokopenko. Rinat Akhmetov mainly talked only with him about football and consulted on various issues. Victor assured that working with him was both a pleasure and a learning experience.

— Did he receive calls with an offer to lead another team?

“Maybe there were, but I don’t know anything about it.” Calls now, as you understand, mean nothing. And Victor, if he decided to be a sports director or a politician, then that’s all he lived for. And it’s unlikely that I was looking for another job at the same time.

— How do you remember Viktor Evgenievich?

“Throughout his life, he always radiated confidence and cheerfulness. Few people knew that Victor had long been a believer, since the times of the Union. I went to church and observed all religious rituals. I fasted. Once in all that time, I went into church with him for company, watched as he lit candles and prayed.

Our generation was promised that we would live under communism. And now we also believe that we will live with great football in Ukraine. That one day Shakhtar Donetsk will win the Champions League. Victor also dreamed about this.

VIKTOR PROKOPENKO’S WIDOW LARISA: “DURING 40 YEARS OF OUR LIFE TOGETHER, I HAVE NEVER SEEN MY HUSBAND SICK”

We were together for 40 years, and it seems to me, all 200. And they passed like one day. We just want to live and be happy... We spend our whole lives living in suitcases, on the road, in hotels. I remember Kherson, where he began coaching the local Lokomotiv in 1973. Daughter Tanya was little, all the football players nursed her. And in the room where we were placed there was barely room for a crib. There was a kerogas gas, a large saucepan in which I cooked borscht for the whole team.

This is our youth, and everything was easily tolerated: moving, everyday instability. He never allowed me to shoulder the burdens of life. If I was sick, or the children, or my relatives, Victor took care of everything first of all. It’s hard to believe that for all 40 years a person ran home as fast as he could after work, and not somewhere else. But that's how my husband was.

Our children in Volgograd are son Evgeniy and daughter Tatyana. Everything is fine with my son, he graduated from police school, got married, and has a child. And my daughter’s husband was killed; she, unfortunately, is alone. It seems like they found the killer, but what's the point? Victor doted on his granddaughter Vika, but he couldn’t get enough of his grandson - he’ll only be one year old.

Was your husband worried because he stopped being a coach? Do you think it was better to sit on these coaching benches? When I turned on the TV and watched the team he coached play, I couldn’t stand what it was like for him...

And all the same, I tell you, as if in confession, not once in these years have I seen Victor hold his heart or swallow any pills. He never took medication at all. The only thing is that as a player he had injured menisci. I haven't drunk or smoked for the last 15 years. We took care of him as best we could. If I had noticed anything, I would have raised the alarm.

Doctors believe he suffered a heart attack on his legs. “This can’t be! - I say. “I’ve been with him all the time lately.” If they separated, it wasn’t for long.” They explain: “There are forms that do not cause pain.”

I calculated: he died on the day of the Transfiguration, and the 40th day falls on the Exaltation of the Cross of the Lord. They say that even in monasteries people ask for death on such holidays and are awarded one.

STEFAN RESHKO: “VICTOR KEPT ALL HIS EXPERIENCES TO HIMSELF”

- Bright, sharp mind. He was well-read, erudite, well prepared. He knew how to reason and analyze. He admitted his mistakes and did everything to correct them. He defended his opinion. If there were complaints against him, he explained his gaming vision, why he did it this way and not otherwise.

He was cheerful, humorous, as they say, a soul-man. Loved company. After the defeats, of course, everyone was despondent, but he could still raise their tone and cheer them up. He said, for example: “We lost, well, life doesn’t end there. We need to rethink everything, figure it out and move on.”

— How did you end up on the same team?

— In 1967, after serving in Germany, where he played for the Northern Group of Soviet Forces, Victor came to Lokomotiv Vinnitsa, where I had already played. He and I immediately became friends and lived in the same room. Lokomotiv was in the first league, but we were constantly fighting for the top spot. The team included Troyanovsky, Levchenko, and other football players who went through the Dynamo Kyiv school. Playing with such technical masters, Victor, of course, felt that he needed to seriously train in order to be on the same level with them. And he worked additionally after classes on feints, on strikes, on heading. We often stayed as a couple.

When I was invited to Chernomorets Odessa, I did everything so that he would go there too. Convinced coach Sergei Shaposhnikov that Prokopenko is a decent guy, disciplined, strict.

— Was it not a surprise to you that he ended up becoming an excellent coach?

“He had enough intelligence, in this regard he was always at his best. In addition, Victor graduated from the Higher School of Coaches in Moscow and gained more theoretical knowledge.

He raised Chernomorets and did a lot for Shakhtar. I have always said and continue to say that I liked Shakhtar’s game when Victor coached the team - it was so light and fresh. Yes, we didn’t manage to win the championship, we were just a little short. Maybe the rigor in the game that Lobanovsky and other coaches had. But Prokopenko preached attacking, liberated, spectacular football.

- And this despite the fact that he did not then have such colossal material support as the team has now...

- Well, of course. There weren’t so many foreign players with him either. He worked with players at a lower level than today. The current Shakhtar and Dynamo have higher-class performers. What can I say: coaching is hard work, constant stress. Less “physics”, more hassle. In appearance, Victor seemed reserved. He could, of course, jump up from the bench and wave his hand to suggest something to the players, but he did not allow himself such emotional outbursts as some coaches. He kept everything to himself - hence the heart problems.

Doctors I know told me: “The autopsy showed that Viktor Prokopenko’s heart was like a rag: squeezed out, flaccid, with a large scar in the middle.” And he looked like a completely healthy person.

— He worked in different teams. And what, the coaches didn’t undergo medical examinations anywhere?

“I myself am surprised that at Shakhtar Donetsk, where the most modern medical equipment is available, Prokopenko’s heart problems were not detected. Most likely, he did not love himself enough to take care of his health. Apparently, he didn’t expect that his heart could fail.

I spoke to his widow Larisa at the funeral. She lamented: “It seemed like a normal life had begun for me: Vitya quit coaching, started traveling less, was at home more often, just to live, but now you need it - everything was cut short.”

— Kucherevsky left earlier, now Prokopenko. These are, in general, coaches who should be in the main positions. And they were taken a little bit and pushed aside, made sports directors. Is this not the reason for the tragedy of both?

— Kucherevsky had an accident - although, they say, his heart also failed. That is, football (like all professional sports) is such a stressful sport that the heart wears out ahead of time. But I don’t think they retired because they stopped being head coaches. Prokopenko, being the sports director at Shakhtar, was not responsible, of course, for the result, but he was generally involved with all teams - the first, second, and third, and participated in organizing this process. He was in the club, no one left him.

— Viktor Prokopenko is known for witty, aphoristic phrases in a purely Odessa spirit, although he was born in Mariupol. For example: “I haven’t drunk for a long time, but I spill it!” What do you remember?

“He could create something of his own out of any joke, the fools.” He loved the sea; from the windows of his house in Odessa it is clearly visible. And once he said: “Life is given to a person once, and in order not to be excruciatingly painful, it must be lived by the sea.”

LEONID BURYAK: “WITHOUT PROKOPENKO AND OTHER TEAM COACHES, THERE WOULD NOT BE BLOKHIN’S COACHING SUCCESS”

Victor was a coach in Russia and Ukraine. Hand on heart, I can say: when he coached Shakhtar, it was the strongest team in the club’s history.

Our paths crossed all the time. We met abroad, in Kyiv, in Donetsk, when Dynamo Kiev and Shakhtar Donetsk played. We sat in the stands and exchanged glances as the match progressed. He was happy when his team played good football, and was worried if it had a slump in the game.

He was the first coach of the Ukrainian national team. Then many leading football players remained in Russia, and it was necessary to create a new team. No results were required from her. I already had a different situation: the national team was given the task of advancing from a difficult group to the final tournament of the European Championship. Unfortunately, we did not fulfill it. At the same time, I think the team had its own identity, it won at some stage and showed high-quality football.

Then Oleg Blokhin led the team and led it to the final tournament of the World Championship. But I think that the result that he achieved would not have happened if it were not for the work of the former coaches of the main team - Viktor Prokopenko, Anatoly Konkov, Jozsef Szabo, Valery Lobanovsky, and mine too.

In my memory, Viktor Prokopenko remains a man infinitely devoted to football. But everyone chooses their own path. The position of sports director, which he held and which I now hold, is very interesting: you are in the thick of the club’s football events all 24 hours a day. Of course, the responsibility is 10 times less than that of a coach, but the work is still exciting. And I have no doubt that Viktor Prokopenko made any choice he made according to the call of his heart, without regretting anything later. He said this himself.

Upon learning of his death, without hesitation, I got into the car and drove to Odessa to pay tribute to the man who did so much for Ukrainian football. And he could do even more. Ukraine has lost a very strong specialist. At the funeral meeting, Raisa Bogatyreva said very touching words and asked Viktor Evgenievich for forgiveness for the fact that we were not entirely attentive to him...

P.S. A year and a half ago, in an interview, Viktor Prokopenko, who held the post of sports director, when asked if he was drawn to coaching again, answered in his characteristic spirit: “Who knows? I don’t understand some colleagues who pompously declare that they cannot live without football. What if tomorrow, God forbid, a war breaks out? What kind of football will we be talking about? Let's take machine guns and go dig trenches. You can’t go against fate...”

O. A. Butakova, Chief Physician of the Moscow Institute of Health Restoration, Head of the Health Academy at the International University of Peoples' Friendship named after. Patrice Lumumba, Academician of the International Academy of Informatization at the UN.

Themes:

1. What is blood?
2. Blood formation.
3. Causes of anemia.
4. Mechanism of blood restoration.
5. Causes of cardiovascular diseases.
6. Heart muscle strengthening program.
7. The main causes of hypertension.

What is blood?

For many years, official medical science has believed that blood is synthesized in the bone marrow...

For fifteen years I also thought that blood is synthesized in the bone marrow and the main thing is that there is more oxygen. And I thought: “My God, how many of these red blood cells can be synthesized there, if there are trillions of them.” In fact, I only realized about hemoglobin when a huge number of distributors appeared and started asking a lot of insanely stupid questions. Insanely stupid, as it seemed to me before. So one woman stands up at a Moscow school and says: “Olga Alekseevna, I understood everything from the film.” I say: “Great.” “Just tell me, please,” she says, “I don’t understand where the bone marrow is.” I say, “Bone marrow is in the elbows, knees, hips, sternum.” And then she asks a second, sacramental question: “What if you cut off the elbows, knees and pelvic bones, a person will not develop blood?” The brisket will remain, right? The weight of the sternum is 3 grams. Where will the blood form?

Until I told you ten times what blood is, until I was asked twenty times questions that I couldn’t answer, I myself didn’t understand what was what...

Blood formation

That's why 40% of the world's population suffers from anemia. At the same time, they eat liver, eat apples, inject iron intravenously, intramuscularly, orally, as you wish, and the anemia remains as it was. And the distributor asked me another question: “Tell me, Olga Alekseevna, do animals get anemia?” I say “Of course. What about it!” She says: “And if a cow develops anemia, how will she be treated?” Question! How will a cow be treated if she develops anemia? How are dogs treated? Grass! Not liver, not pomegranates. This means that there is another mechanism for maintaining blood! This is exactly what we will talk about now.

The hemoglobin molecule consists of 514 amino acids, of which 7 are never synthesized in the body, under any circumstances. They should only come with food. And each hemoglobin molecule contains only 4 iron atoms. There are many hemoglobin molecules in a red blood cell, but there are only 4 atoms of iron in each molecule.

Every day, up to 3 billion red blood cells die in the body. Each hemoglobin molecule contains 4 iron atoms. Where does all this go? Redistributed! Can it go through the ears? Can not! It is inside, in the body. This means we have enough iron. So something else is missing!

Iron remains in the body, passing through a whole chain of transformations, it passes into feces. It turns out a brown enzyme, which is why our stool is brown.

So, until we receive a molecule containing 514 amino acids arranged in a circle, and they do not form 4 places for the iron atom to sit, nothing will happen, because nothing is synthesized in the bone marrow. And it is almost impossible to find 514 amino acids in the body even for 1 red blood cell. Where do we get the 7 irreplaceable ones? 7 essential amino acids, we already know - this is raw meat, raw fish, this is raw cottage cheese, this is raw milk, this is avocado, these are unroasted seeds, these are raw nuts, this is soy, etc.

How then does blood formation occur, where do the raw materials come from? After all, trillions of blood molecules die every day. The answer came unexpectedly. Having opened the medical encyclopedia, I discovered that it turns out that the human hemoglobin molecule is an exact copy of the plant’s chlorophyll molecule. Only it contains 4 magnesium atoms instead of iron. Precise spatial structure, one to one. Not a single extra amino acid, nothing. Only 4 magnesium atoms. And it turns out that vitamin B12 (everyone has heard that vitamins B12 are needed for hematopoiesis) is an exact copy of the chlorophyll molecule, only instead of 4 molecules of magnesium-4 cobalt. And that's why they are called cyanocobalamin. And, most likely, assembly occurs in the bone marrow. That is, in the molecules of green chlorophyll in plants, passing through some bone marrow structures, in the presence of vitamin B12, 4 atoms of magnesium through cobalt are replaced by 4 atoms of iron, which is abundant in the body, and the result is a red blood cell. One condition is that in order for there to be blood, we must eat.

The cow was very lucky and you and I were very unlucky. Because all the chlorophyll in a plant is in the leaves. These are not fruits, these are leaves. And there are only 10 types of chlorophyll that we can use in our food chain. This is fundamentally important. And for some reason we don’t use these 10 types of chlorophyll. Or we use it in limited quantities. Let's put it this way: whoever knows, uses it. In order for us to get hemoglobin, we need to regularly eat: nettles, sorrel, salads, parsley, greens, spinach, green leeks, wheat greens, green seaweed, basil, wild garlic, cilantro. Now think about it - do your children eat this? Onions, cilantro, parsley, dill, celery? No! That's the whole answer. Where will humanity get its blood? I can tell you for sure, the Chinese and Japanese sit on the greenery, just sit on it. There are forty types of salad. There is very little greenery in our diet. Among medicinal herbs, nettle is a super chlorophyll. Add to borscht. If it’s cooked at 60 degrees, it’s okay, but if it’s cooked at 100 degrees, it’s no longer chlorophyll. An apple is not chlorophyll, and a pear is not chlorophyll. And pomegranate is not chlorophyll. Green apple, green broccoli are not leaves. Chlorophyll is leaves, lettuce, nettles, etc.

Anyone who does not eat chlorophyll does not have the raw materials for the production of hemoglobin. Moreover, chlorophyll must be raw, it should not be boiled, salted or canned. We won't get anything from salted wild garlic. You need to eat not just chlorophyll, but chlorophyll in its raw form. Algae are practically not digestible. The Czech professor received the Nobel Prize for proving that chlorophyll is a supersorbent and under no circumstances dissolves in our body. We don't have the enzyme to dissolve it, so we only get minerals from it, and all the fiber remains in the intestines. Sea kale is difficult to digest. Fucus is not digested at all.

This is the whole problem. And there are only five food plants that contain super chlorophyll.

Firstly, we digest it, absorb it perfectly, that’s why we ate it all. She was in two lakes, but now she is not there. It has to be cultivated. Second - . Third - the lightest algae - . Fourth - nettle. And here we can include, number five, green masses - barley sprouts, wheat sprouts, greens of any cereal plant. They contain chlorophyll, but they are not leaves yet. You can eat them. When they become leaves, they become indigestible to us. And this is why people cannot make normal blood for themselves or their children: we constantly do not receive enough green chlorophyll mass.

Causes of anemia

Chlorophyll is a substance that is synthesized by the plant itself using the energy of the sun and with the help of water. And, accordingly, now we can consider the causes of anemia. And the causes of anemia lie in the same vein.

The first cause of anemia is psychology. The person doesn't know what to eat. This is a serious psychological problem. He eats all the wrong things. It feeds on the corpses of animals, it feeds on various roots, etc. But this is not the same. He cooks them, fries them, steams them, pickles them, takes absolutely crazy products that our body does not need. For example, we absolutely do not need mushrooms. They protected themselves from us. 95% of mushrooms are poisonous, especially for us. And we say: “We soaked it for three days, then boiled it three times, then salted it for three months, then drained the water 10 times, then ate it.” What's the point? We don't have an enzyme that breaks down mushrooms.

The next reason is nutrition. We need to eat normally and not destroy our blood with colas and other sweet carbonated drinks, because the acids in them destroy our blood, they simply dissolve it.

The next reason is injuries. Of course, if these are bone marrow injuries. Ecology - affects 100%.

Heredity - if a mother whose hemoglobin is 60 gives birth to a child, then he will inherit exactly the same hemoglobin. And it will take a long time to bring it to a normal level. That is, all the same reasons that we talk about all the time - bioenergy, and time, because red blood cells do not live long - all this influences.

Mechanism of blood restoration

And now only one question arises - how to replenish and renew our blood? Knowing the reasons, we can cope with this task.

And then - cellular nutrition: (4-5 tablets per day), . prolongs the life of red blood cells. There are red blood cells that do not live to see 127 days, but die earlier, for example, after 30 days. If you take 2 tablets a day, red blood cells will live to their biological age. And plus, those who do not have enough iron (if there was continuous bleeding, or there was blood loss, or something else), they can take one iron tablet once a day. And after 2-3 months (the program can last a month; or maybe 2-3 months) there will not be a single old red blood cell. All the blood will be new because they live 127 days. And if you did everything correctly, if you figured out psychology, water, food, heredity, etc., then anemia should go away. Hundreds of people come up and say: “I had anemia for 30 years and it was cured. I started eating this, this, this, and the anemia went away.” Coral Club program “Blood restoration for anemia” 100% conceptual - to give the body raw materials for the formation of hemoglobin. This is an axiom. 3 tablets of spirulina, 3 tablets of alfalfa, 2 tablets of selenium, etc. I ask you to pay special attention to this program. Remember, like blood, like life. A child cannot develop normally if his hemoglobin is 70 or 90. You will not raise a healthy child. A healthy child can be raised provided it has good blood.

The cardiovascular system.

Initially it is a very reliable system. And when we say that a person has bad blood vessels, what could this mean? What could have happened to them? Vessels- these are wires with a hole inside through which blood runs. And it is very difficult to do anything with them. They can be corroded by corrosion, relatively speaking, by some properties of blood, or cut, torn, or pinched. Nothing else can theoretically happen to them. Therefore, we must clearly understand why blood vessels break in the human body. To do this, we must understand the mechanism of how blood moves through tissues.

The diameter of the vessel can be from large to very small. The diameter of a heart vessel, for example, is equal to the diameter of one red blood cell. It's a very, very small diameter.

Heart cells are found in intercellular water. It always seemed to me that the vessels reach the cells, as it seems to most people, both non-doctors and doctors, that each cell receives some kind of small thin vessel. And only later came the understanding that the vessel - this tube, has its own corridors, labyrinths, and these corridors are different, for each amino acid there is a separate corridor, i.e. a multi-layered wall of the vessel. And that the vessel, approaching directly to the organ, becomes a capillary, i.e. single-layer, with one cell in total. And between these capillaries there is an exchange of nutrients.

In simple terms, red blood cell- four molecules of iron (chair), which have one free bond. A connection is, relatively speaking, a free hand with which iron can attract something. And it attracts the oxygen that the red blood cell received in the lungs. That is, 4 oxygen atoms sit on four chairs and move through the circulatory system. They reached the heart and what happens? Through the wall of the vessel, oxygen seeps into the intercellular water and dissolves in it. And here there is already dissolved carbon dioxide, which seeps through the wall of the same vessel and takes the place of oxygen. There can be 4 atoms per erythrocyte molecule. And the red blood cell goes back to the lungs. It reaches the lungs, again carbon dioxide seeps into the tube and into the vial, and there is already oxygen there, which sits on this empty chair. And the blood started running again. Blood has no more serious functions. Blood has many functions, but this one is the most serious - oxygen transport.

Those who have seen blood on a dark-field microscope know: red blood cells glow, there is a kind of aura around them - this is oxygen attached to each iron molecule. This is the main function of blood.

The vessel begins nowhere and ends nowhere. The vessel begins at the heart and ends at the heart. He's reserved. But it is completely full of holes, especially at the level of the capillaries. What's in the blood? There we have red blood cells and white blood cells.

Leukocytes. This is a single-celled creature that performs its function. So the leukocyte is actually a conscious cell. If, for example, bacteria appear in the heart, then it will penetrate through the wall of the vessel into the tissue, water, swim along it to the bacteria and eat it. As a result, pus is formed, which we call rheumatic carditis, or myocarditis, or myocardial dystrophy, etc., etc. And then the leukocyte will think where to go. If its enzyme base is good, i.e. it can dissolve these bacteria, then it will go into the vessel in the opposite way. If it is not very good, it will go directly into the lymph, and will be released through the lymph nodes - into the nose, mouth, larynx, sweat glands, or through the genital tract.

What else is dissolved in the blood? Cellular nutrients are dissolved in the blood. And in the intestines there is a huge amount of proteins, dissolved and undissolved. Proteins are divided into 28 amino acids. The intestine has a corridor, and the vessel has a corridor. These corridors coincide. As soon as these amino acids are dissolved, they pass through this corridor one by one into the blood. So, 28 amino acids are dissolved in the blood. 15 minerals. Minerals simply cannot float, otherwise they simply form deposits of iron or copper; they are also combined with amino acids in conglomerates. 12 vitamins, these can be in free form. Fatty acids - three basic and several others, enzymes - 3 thousand. All this is dissolved in the blood. Blood is the nutrient medium from which the cell takes vital substances. Thus, the second function of blood is nutritional.

What happens: the blood came along with red blood cells and oxygen. Here it is called arterial. If it has already passed through the organ and picked up carbon dioxide, it is called venous. And the arterial capillary automatically turns into a venous capillary. Venous blood goes to the lungs and is replaced by arterial blood. And this is called the blood circulation in the body. Like the water cycle in nature. This is a basic diagram of how the cardiovascular system works.

The heart pushes the blood out and it moves on. But if on the way of blood there is a liver clogged with lamblia and opisthorchiasis, then the blood will not rise, but will accumulate below. As a consequence: varicose veins, thrombophlebitis, spider veins, hemorrhoids, etc. Blood should circulate freely.

The heart also needs nutrition. Imagine two halves of a heart. Half has shrunk - the blood has gone. Moreover, it decreased at once: the heart shrank, the second half expanded at that moment - the blood began to flow. The second half contracted - the blood left, the first half unclenched - the blood came out. That's it, nothing else happens. If the blood is good, clean, if it contains 99% water, and only 1 or 2 or 3% red blood cells, dry red blood cell mass, then so be it. If there are 28 amino acids, 15 minerals, 12 vitamins, 3 fatty acids and 7 enzymes (28-15-12-3-7) in the blood, then so be it. And if the blood clots, if the red blood cells stick to each other due to a disturbed acid-base balance, interruptions in the functioning of the entire system appear.

The red blood cell does not magnetize to anything on its own; it has its own aura. As soon as acid appears in the blood, the aura of the red blood cell is extinguished, they begin to stick together and formations similar to coin columns appear. Anyone who looked at their blood on a dark-field microscope could see them. This kind of blood cannot carry oxygen. This kind of blood contains fat. Cholesterol coagulates, just like in a barbecue with vinegar, and sticks to red blood cells. And this is called a thrombus. And from these blood clots, in fact, every fourth person on the planet dies. The statistics are the same everywhere. Only the Japanese have different statistics. Their people in some places, including our beloved island, do not die from disease, but stop living because their energy supply runs out. It turns out that this is possible too!

So, a heart can be ideal, kind, affectionate - it all depends on what kind of blood suits it. If there is good, clean, nutritious blood with a sufficient number of leukocytes, not sticky, slightly alkaline, then everything will be fine / The heart can beat almost forever, as Professor Dr. Alex Carrel proved with his famous experiment. You know that the heart remains automatic even when separated from the body. He took the heart of a chicken, put it in a cup, poured water with everything necessary (28, 3,12,15, 7), some water and changed it every day. The heart lived for 35 years. No chicken. It didn't know there was no chicken. The nutrients are appropriate - everything is fine, mom is in place. So she ate something good. The professor received the Nobel Prize because he proved that if a cell is kept under normal conditions, it can live for a very long time. In nature, not a single chicken lived to see its 35th birthday.

What is the viscosity of blood, what are the nutritional properties of blood, such is life. These are absolutely two interrelated things. If there is no essential element in the blood, the heart cells suffer. The heart cell suffers, suffers, suffers, and then dies. And the heart begins to beat irregularly, chaotically, too often or more slowly. We call this atrial fibrillation. It doesn't rest. It should rest for half a second and contract for half a second. If it is one third resting and three quarters contracting, or two thirds, it is exhausted. And we say: “Your heart is worn out.” And the pathologist sees that the heart is like a rag and says: “This man could no longer live.” He has wasted heart muscle. Waste is a lack of nutrients and oxygen. What do we need to care about in order to change the statistics of cardiovascular pathology? In principle, you need to take care of several things.

Causes of cardiovascular diseases

Next about the acid-base scale of blood. As we already know: 7 is neutral, 1 is acid and 14 is alkali. We are negatively charged: the intercellular fluid is charged -50, and the intracellular fluid is charged -40. There is a potential difference between them. Inside the cage -40, outside -50. This indicates that there is an electric current. If we perform a cardiogram, we will catch this electric current in the form of a curve at different points of the heart. So 7.43 is the blood pH constant. Blood is a weak alkaline electrolyte. If the blood pH drops to 7.1, it means death. From 7.43 to 7.1 is the border of our life. Electric potential can be extinguished with acid. Elementary. Three liters of Pepsi-Cola easily cope with this task. Or the person will be left without teeth, bones, nails, because all the calcium will be gone. There are several alkalizing minerals: calcium, magnesium, sodium, potassium. 90% of the foods we consume are sour: meat, fish, eggs, sugar, jam, processed cheese, any kind, drinks - tea, coffee, cocoa, compote, mineral water, I won’t even list further - everything is sour. And blood is alkaline. But there are not enough minerals. Calcium is absorbed by 5%, magnesium is basically minimal, we get sodium from fish.

I always give this example. A man comes home tired from work, takes out fresh frozen salmon, can you imagine? He sits down and eats. Introduced? How much fresh frozen fish can you eat without salt? And if you add salt, how much can you eat? How is salted salmon different from unsalted salmon? Sodium.

Anyone who has high acidity in the body experiences a strong need for sodium.
If there is a lack of calcium, teeth, bones, and hair suffer. Smart hair leaves a bad head. Law of nature. By the way, it is much more common in men. Maybe they have something with the acid-base balance.
If there is a lack of magnesium, the vessels become leaky like a sieve.
If there is a lack of potassium in the body, the heart muscle begins to fail.
In the town of Hunzakut in Pakistan, dried apricot porridge is the main dish with which people balance their microelements. There is one law. If a girl is taken to a place where there are no dried apricots, she has the right to refuse the groom. Because dried apricots are placed first in the hierarchy of products. This is a completely unique product. This is a powerful potassium pump.

Heart Strengthening Program

So, the heart needs calcium, magnesium, sodium, potassium. And energy plus all 28,15,12, 7,3. And therefore, the program for strengthening the heart muscle will accordingly consist of:

1 tablet 3 times;

Energy in an easily accessible form - 1 capsule 2 times. It is made from royal jelly. When the Japanese discovered this trace element, they said: “We have discovered the element of life, the elixir of life.” To prevent the cell from suffocating from free radicals, it needs this coenzyme, this coenzyme. It is also called ubiquinone. We have one of the best ubiquinones in the world. The capsule contains 30 mg of pure ubiquinone. There is such a chemical analogue, called a preduct, when a person is already very ill and does not have long to live, they are prescribed it.

May protect the heart cell wall. It is negatively charged and consists of three parts: one protein membrane and two lipid membranes. So, lipids are unsaturated fatty acids, unsaturated. They are not full and therefore they can take potassium, magnesium and transfer it into the cell. If there are a lot of free radicals: smoking, tanning, microwaves, and various other harmful substances (chlorine, toxins, medications), hydrogen free radicals are formed and the cell is extinguished. Remember yourself as a child, at 16 years old. Favorite dish is black bread with vegetable oil and salt. The greatest need was during puberty for fatty acids. But to get fatty acids from oil, you need to drink half a liter of it. On the other hand, to get the daily requirement, you need to drink only 2 capsules of Omega 3/60.

Those who have a heart condition need to drink this product, and the more, the better. Because it is simply fish oil of highly concentrated liver fractions. These are not pills. There will be an intravenous injection later, three liters of fluid will be given later, in the intensive care unit. Until that moment comes, you need to drink Omega. Every normal person over 50 should drink 2 Omega capsules, at least periodically, as much as you can afford. Once a year, twice a year, three times a year, after a heart attack for six months. But you don't have to wait for a heart attack to drink this. Plus, of course:

One and a half liters of coral water.

Do not leave the toilet until you have expressed one and a half liters. A person should allocate one and a half liters. If he secretes half a liter, then the intercellular substance is like a stagnant swamp. It should be like a mountain river - water there, water back, water there, water back. The water cycle in nature. This is where natural science begins - the water cycle in nature. The main mistake is that there is no person there. Everything is there except man. The water cycle in the human body is the life of the cardiovascular system. It is very important.

Main causes of hypertension

So, a program to strengthen the heart muscle. Let's consider the mechanisms of hypertension. It will be difficult for you to understand this thoroughly now, but I will name at least 6 causes of hypertension.

The first reason is viscous thick blood. The second reason is fatty blood. The third reason is blood with mucus, undissolved proteins. If there are no enzymes in the blood, proteins begin to stick to the red blood cells. And thrombosis occurs. But no longer cholesterol. A person does tests - his cholesterol is normal, but he has hypertension. So, viscous thick fatty blood without water.
The next reason is fourth - psychology. The man became nervous and adrenaline released. What is adrenaline? Hormone of fear. In nature, if adrenaline is released, the animal gets scared, its fur rises, it either bites or runs. If it bites, it secretes adrenaline through its saliva, if it runs, it either sweats or goes to the toilet on time in a small way. There is a release from adrenaline. Adrenaline is a terrible poison that is created to prevent the animal from bleeding out if it is bitten. It causes spasm of peripheral vessels. And blood is retained in vital organs - the liver, spleen. So if the adrenaline does not go away, the peripheral vessels do not relax. And adrenaline shock or stress occurs. And this is already a heart attack. That is, the vessels are compressed, oxygen does not reach the heart, brain, liver, kidneys, and the person ends up in intensive care.

There are three ways to get rid of adrenaline: sweat, go to the toilet, drink some water. The first thing we bring to a person when they are stressed is a glass of water. But we bring a glass of cold water. It is not right. I need a glass of hot water. He will immediately sweat, which means the adrenaline will go away. The ambulance mechanism is based on hot water. The ideal option is concentrated coral water. That is, the bag is not one and a half liters, as usual, but half a liter. Take small sips for 15-20 minutes. But this is not enough - half a liter of water. First aid for hypertension is water to rinse thrombosed vessels. At the same time, the blood will not immediately enter the vessels; thank God, it will be absorbed there for another half hour.

And your body inside and out will always be fine!

Contact us for more information

from our general representative - Natalya Evgenievna

• skype:talda120
• e-mail: [email protected]
• by phone +380509175463, +380975810562

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