Usually, with heart disease, patients come to the doctor with complaints of pain behind the sternum. If this symptom is aggravated by physical exertion, a specialist may suspect narrowing of the coronary arteries, as a result of which the blood supply of the heart is disturbed. In this case, the smaller the lumen of the vessel, the more often a person will experience discomfort in the chest and the more pronounced will be pain sensations.
The most unpleasant thing is that the appearance of the first signs of stenosis is not evidence of the onset of the disease, which for a long time could have been hidden. Discomfort during physical exertion occurs when the lumen of the vessel becomes significantly less than normal and the myocardium begins to experience oxygen starvation at a time when it requires active work.
Symptoms that are also worth paying attention to are shortness of breath and attacks of angina (symptomatic complex, which includes: rapid heartbeat, chest pain, hyperhidrosis, nausea, sensation of lack of oxygen, dizziness). All these signs may indicate coronary artery stenosis
It must be said that this pathology, regardless of the causes that cause it, does not have a very good prognosis. If we are talking about coronary artery atherosclerosis, then conservative treatment with statins that correct blood cholesterol level and drugs that reduce myocardial oxygen demand is prescribed only at the initial stages of the disease, when a person actually does not complain about anything. When there are symptoms of stenosis, traditional treatment can not produce results, and then doctors resort to surgical intervention.
A strong constriction of the vessels causes the onset of angina attacks, and the more the vessels are affected, the more obvious the disease is. Attacks of angina usually can be stopped with drugs, but if improvement does not occur, then there is no other way out, how to resort to coronary bypass or less traumatic stenting.
Coronary bypass surgery is the creation of a bypass for the flow of blood, if the blood vessel narrows so much that it can no longer cover the needs of the myocardium. To perform such an operation, a sternum opening is required and all manipulations are performed on the open heart, which is considered very dangerous.
At the same time, if a safer, less invasive operation called stenting, which does not require large incisions and a long recovery period. It is not surprising that the latter doctors have recently resorted much more often.
In this case, stenting can be successfully performed both with a single stenosis, and with narrowing of several arteries.
With a narrowing of the vessels by more than 70%, or a complete overlap of blood flow (occlusion), the risk of developing acute myocardial infarction is high. If the symptoms indicate a pre-infarcted condition, and a patient's examination indicates acute tissue hypoxia associated with a violation of blood flow in the coronary vessels, the doctor can refer the patient to an operation to restore the patency of the arteries, one of which is arterial stenting.
The operation of coronary stenting can also be performed during the treatment of a heart attack or in the post-infarction period, when an emergency is given to a person, and the activity of the heart is restored, i. The patient's condition can be called stable.
Stenting after a heart attack is prescribed in the first hours after the attack (maximum 6 hours), otherwise such an operation will not be of particular benefit. It is best, if no more than 2 hours pass from the appearance of the first symptoms of the infarction before the beginning of the operative intervention. Such treatment helps to prevent the attack itself and reduce the area of ischemic necrosis of the myocardial tissue, which will allow for early recovery and reduce the risk of recurrence of the disease.
Restoration of vascular patency within 2-6 hours after a heart attack will only prevent the recurrence. But this is also important, because every subsequent attack is more severe and at any time can put an end to the patient's life. In addition, aortocoronary stenting helps to restore normal breathing and nutrition of the heart muscle, which gives it the strength to recover more quickly after damage, since normal blood supply to tissues speeds up their regeneration.
The operation of stenting vessels in atherosclerosis can be performed both as prevention of heart failure and myocardial ischemia, and for therapeutic purposes. So, in chronic forms of IHD, when the vessels are half blocked by cholesterol deposits, stenting can help preserve healthy heart tissue and prolong the life of the patient.
Coronary stenting is prescribed in the case of frequent recurrences of angina at the slightest physical exertion, what to say about the violation of the patency of the coronary vessels. But you need to understand that severe cases of coronary heart disease (unstable or decompensated stress angina) can not be cured in this way. The operation only facilitates the patient's condition and improves the prognosis of the disease.
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