How to recognize heart pain and when to see a cardiologist? Doctor’s advice

Recently, cardiovascular diseases in our country have “rejuvenated”. What is the reason?

In Russia, there is indeed a very high mortality rate from cardiovascular diseases. It is 4–5 times higher than that of residents of Europe and the United States. It is all due to the negative factors of our lifestyle: the high prevalence of arterial hypertension, hypercholesterolemia, smoking, alcohol abuse, overweight, depression, a sedentary lifestyle. This leads to an accelerated and complicated course of atherosclerosis and reduced the life expectancy of Russians by 20 years in comparison with the population of Europe. So far, men suffer from cardiovascular diseases more often than women, but ladies of Balzac’s age should also be on the alert, since it is with the approach of menopause that the risk of developing or exacerbating pathologies in the cardiovascular system increases. Menopause is a period of hormonal changes in the female body, when the production of female sex hormones – estrogens – stops, and it is they that protect a woman from coronary heart disease.

It often happens that patients start the disease, mistaking heart pain for thoracic osteochondrosis, and do nothing. What are the first bells to pay attention to?

If you experience pain in the chest during exertion, interruptions in the work of the heart, shortness of breath, you should contact a cardiologist to clarify the diagnosis. Do not guess on the coffee grounds – you have osteochondrosis or symptoms of ischemia. Knocked or burned in the sternum – get tested! It is fast and reliable. People suffering from high blood pressure and coronary heart disease often come to our medical center. For a full-fledged study, we have expert-class diagnostic equipment: an echocardiograph with color Doppler mapping and tissue myocardial Doppler, Holter monitoring equipment, ECG, a laboratory with modern equipment that performs the whole range of clinical, biochemical, immunological and hormonal studies. The medical center employs doctors of the first and the highest category. Annual programs of examination and treatment in cardiology and rheumatology have been developed.

What problems do you most often face at the reception?

Many patients do not want to depend on medication, believing that “we treat one thing, we cripple the other.” This is depressing. I believe that only with a trusting relationship between a doctor and a patient and a sufficiently systematic monitoring of treatment by a doctor, it is possible to achieve target blood pressure values.

I would like people suffering from hypertension to finally realize that medicines for their diagnosis must be taken constantly, just like brushing your teeth, that is, all your life. And the doctor’s task is to choose the optimal dose of the drug. Over the years, the sensitivity to one type of drug decreases, and every 4-5 years it must be changed to another. Then we will get the best effect. By the way, this approach applies not only to hypertension, but also to high blood cholesterol levels.

Echocardiography allows you to assess the structure of the heart, its contractile ability, the state of the valvular apparatus of the heart. Currently, coronary angiography is increasingly being performed, which allows you to obtain reliable information about the presence or absence of stenoses in the coronary vessels.

How does cholesterol level cause ischemia?

Arterial hypertension is inextricably linked with the development of coronary heart disease (CHD). At the heart of ischemic heart disease is the defeat of the coronary arteries by atherosclerotic plaques. The first plaques appear at a young age, they consist of cholesterol, and over time they are impregnated with protein substances and calcium salts. Gradually, plaques close the lumen of the arteries up to 70% or more, which leads to angina pectoris, myocardial infarction and death. Therefore, it is necessary to take lipid-lowering drugs. Recently I had a 25-year-old girl at a reception – thin and fragile. Her cholesterol levels are 8, while the norm is 5. Why? Because the liver code (cholesterol is produced by liver cells. – Approx. Wday) we inherit from our parents. The ability to produce high cholesterol is transmitted precisely at the genetic level. There is no cure, but drugs can make the cell produce less cholesterol. It is in our power to select the dose and observe the effect. As a rule, we go to decrease until we reach the lowest possible dose. The task of the doctor is to choose a dose that will curb cholesterol.

What are “bad” and “good” cholesterol?

When a patient claims to have “cleaned the vessels,” I do not take it seriously. Once formed in the vessels, the plaques will not go anywhere and will not dissolve them in any way. These plaques are formed from low-density cholesterol – “bad” cholesterol. A plaque is dangerous when it breaks. And as long as its surface is slippery and shiny, it is not dangerous. As soon as it is cracked, fibrin threads are wound on any rough surface and a blood clot forms.

Good cholesterol has a high density. We cannot exist without it. Such cholesterol is used for the synthesis of hormones, the construction of the cell membrane, without it, the cells will fall apart. It also prevents the deposition of “bad” cholesterol in plaques, so the higher the high-density cholesterol, the better. For a woman, its value must be greater than 1,2. This will help reduce plaque build-up and make it smoother so that it doesn’t tear.

How to stop the development of atherosclerosis?

Since atherosclerosis lies at the heart of coronary heart disease (IHD), it is necessary to study the lipid spectrum of blood not only in elderly patients, but also in middle-aged and young people, especially in the presence of heredity burdened by IHD. The increased content of cholesterol in the blood does not manifest itself for a long time, therefore atherosclerosis develops slowly. To delay the development of atherosclerosis, it is necessary to determine the lipid spectrum of the blood at least once a year. In the presence of clinical manifestations of atherosclerosis (angina pectoris, myocardial infarction, stroke), the lipid level should be monitored 2-3 times a year. People who correct blood lipids have 30-40% fewer serious heart complications and 20-30% fewer deaths from any cause. There is a large group of drugs (statins) to normalize blood lipids. The choice of the drug, the correction of its dosage is carried out by the cardiologist during the observation process.

To find out how many plaques, where and what they are, will help duplex scanning of the brachycephalic arteries, as well as the lower extremities (if there are complaints of pain in the muscles of the legs and a feeling of chilliness). A doctor’s gaze at a woman’s legs often saves her life. Because blood clots can form in the dilated veins in the legs, which lead to a heart attack of the brain or lungs. The presence of varicose veins is an important symptom for the doctor, which requires a duplex scan of the veins.

What else should girls and young women under 30 pay attention to?

At this age, vegetative-vascular dystonia is often found, which is manifested by fluctuations in pressure and pulse rate, pain in the heart. Such girls and boys in the future often become hypertensive. Dystonia should also be treated with drugs other than those used by hypertensive patients. It is necessary to treat in order to prevent the transition of vegetative-vascular dystonia to hypertension.

If the pressure jumps every time a person is worried, is this a normal reaction of the body to stress or is it necessary to get tested?

The low level of blood pressure control is one of the reasons for the high cardiovascular morbidity and mortality in our country. The target level is blood pressure less than 140/90 mm for healthy people and 130/80 mm for patients with diabetes mellitus and kidney failure. Even episodic surges in pressure may indicate that this is already a disease or its initial stage – vegetative-vascular dystonia. Only the equipment will help to identify an accurate diagnosis. For this, we offer a XNUMX-hour monitoring service to determine an accurate diagnosis. The question is fundamental here, because both diseases – hypertension and vascular neurosis, although they are similar in symptoms, are treated in completely different ways. We also offer monitoring of blood pressure to patients “with experience” in order to understand whether we have reached the target levels of blood pressure values.

In addition to Holter ECG monitoring in patients with arterial hypertension, fundus examination, which is carried out by a qualified ophthalmologist, is of great importance.

All these services are available at the Vash Doctor medical center at:

Omsk, st. 70 years of October, 16, building 4.

Opening hours: from 8 to 20, on Saturday – from 9 to 19, on Sunday – from 9 to 17.

Tel. (3812) 70-03-03

http://vashdoctor-omsk.ru

Take care and be healthy!

A specialist consultation is required.