Moderate and diffuse changes in myocardium of metabolic type ventricles

The first and most important method of examining the work of the heart is an electrocardiogram. This simple at first glance survey provides complete information about the electrical conduction of the heart muscle, which in turn indicates the state of metabolism in its cells - cardiomyocytes. For us, the cardiogram is an ordinary broken line with a lot of peaks and depressions, which does not say anything particularly. And for specialists it is a whole opus about the state of health of our heart. And as soon as some segments of the broken line on the cardiogram begin to deviate from the isoline, with respect to which they are considered, the doctors endure the verdict - the metabolic changes of the myocardium. But how dangerous such a condition can be judged only by the presence of additional symptoms indicating a certain disease.

Dangerous and non-dangerous changes in the myocardium

Under the influence of negative factors, various changes constantly occur in our body, but since compensatory mechanisms are active in it, the depolarization of cells (change) under appropriate conditions is compensated by repolarization (restoration). But already failures in the work of compensatory mechanisms, caused by a metabolic disorder, a decrease in immunity, etc., lead to the development of a variety of pathologies of health and the chronicization of pathological processes.

Thus, metabolic changes in the myocardium can be either permanent or temporary. The latter does not pose a danger to humans and is not considered pathology. They are only the result of an excessive burden on the heart, for example, physical overstrain, alcohol abuse, or experienced stresses on the eve of an electrocardiogram.

Usually, the cardiogram shows moderate metabolic changes in the myocardium, which can be considered a borderline between health and illness. Find out how seriously everything can be done after a re-examination after some time, during which the patient is recommended physical rest, emotional rest, proper nutrition. In most cases this is enough to make the cardiogram come back to normal.

If this does not happen, then the changes occurring in the myocardium are associated with the development of some disease, which caused the ECG curve to change. That is, it's not about physical stress, stress or alcohol abuse, it's a systematic metabolic disorder in cardiomyocytes (depolarization without repolarization), which ultimately leads to malfunctioning of the heart.

If the cardiogram shows pronounced metabolic changes in the myocardium, it is no longer a question of a temporary state or the initial stage of the development of pathology, but rather the height of the disease. Moreover, in the myocardium, with the help of additional studies, even foci of necrotic tissue (dead cells) can be detected, the effect of the current on which does not lead to a contraction of the muscle. It is more about myocardial degeneration, a pathology that can occur in various forms (acute, subacute and chronic) and often lead to the development of decompensated heart failure and even the death of the patient due to sudden cardiac arrest.

Metabolic changes can be detected in different parts of the heart, but most often they are localized in the area of the left heart ventricle. This state of affairs is associated with the peculiarities of the structure of the heart, by virtue of which this part of the myocardium suffers from a deficiency of energetically valuable substances in the first place. Probably, therefore, left ventricular failure of the heart is considered one of the most common pathologies of the cardiovascular system.

Changes in cardiomyocytes can be focal (for example, with myocardial infarction or rheumatic fever, when a small area of the organ is severely affected with formation of foci with poor electrical conductivity, for example, scar tissue) and dismetabolic (regardless of the region they are associated with local or general damage a metabolic disorder).

Diffuse metabolic changes in the myocardium can be considered a sub-type of dismetabolic disorders. About such violations of the metabolism is the case if the heart muscle undergoes changes around the perimeter. The most common cause of diffuse changes are inflammatory diseases of the myocardium of the heart (myocarditis, myocardiosclerosis, etc.). Less voluminous changes on the cardiogram are observed as a result of physical exhaustion or long-term use of medications. If the diffuse changes are not paid due attention, then at some point the heart can simply stop, unable to obey the call of reason, i.e. Brain.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]

Causes of the metabolic changes in the myocardium

Doctors do not consider metabolic changes of the myocardium as a certain pathology. It is rather a symptom of more or less dangerous diseases of various systems and organs. For this reason, after discovering deviations of some segments on the cardiogram, the therapist or cardiologist first of all tries to find out the cause that caused this symptom.

It is clear that in the first place under suspicion are possible diseases of the cardiovascular system, such as angina, hypertension and some other vascular pathologies, heart defects, cardiosclerosis, rheumatic defeats of the heart muscle. More often metabolic changes of a myocardium are observed on a background of a cardiomyopathy - the pathology developing owing to disturbance of a food of cells of a myocardium. It is clear that the deficit of substances necessary for normal metabolism is immediately reflected in the form of changes on the electrocardiogram.

One can judge the rate of development of the process by comparing the characteristics of cardiograms conducted at a certain interval in time. But the magnitude of deviations from the isoline and the number of atypical segments will speak about the extent of the pathological process, ranging from mild or moderate abnormalities to myocardial dystrophy.

But let's return to our reasons. After all, heart diseases, it turns out, are not the only pathologies that can be accompanied by metabolic changes in the myocardium. Similar changes can be seen on the cardiogram of patients who have chronic inflammatory foci in the body (for example, with a recurring course of tonsillitis and even with the carious form started). The most common cause of inflammation are bacterial and viral infections (ARI, influenza, herpetic infection, bacterial or viral angina, etc.). But it can also be allergic reactions that occur in a chronic form.

Another pathological cause of metabolic changes in the myocardium can be endocrine pathologies associated with disruption of the pituitary, thyroid and parathyroid gland. In this case, there are hormonal and enzymatic changes that cause a violation of the total metabolism, which can not but negatively affect the metabolic processes occurring in the heart muscle. Metabolic changes on the cardiogram can be seen with diabetes, hyperthyroidism, during menopause and pregnancy.

Even acute inflammation of the gastrointestinal tract, for example, the pancreas or intestine, can adversely affect the metabolic processes in the body, which can subsequently affect the cardiogram. About the chronic course of such pathologies, it is probably not worth talking about, so much is their negative contribution to the metabolic processes that take place throughout the body, including the heart muscle.

In connection with this problem, it is necessary to mention the excretory system, whose diseases are considered a risk factor for the appearance of metabolic changes in cells. Violation of kidney function leads to the fact that the blood begins to enter harmful substances that can destroy energy-valuable substances. And if, in addition, such an important filter as the liver fails, the cardiac cells begin to receive harmful substances with blood, which not only can disrupt metabolism, but also destroy cardiomyocytes.

[12], [13], [14], [15], [16], [17]

Risk factors

The risk factors for the occurrence of metabolic disorders of the myocardium can be considered:

• Obesity, which was a consequence of metabolic disorders in the body,
• beriberi, most often associated with malnutrition, when the diet lacks vitamin-containing foods,
• Anemia associated with a deficiency of minerals, and in particular iron,
• chronic alcoholism,
• pathologies accompanied by fever, vomiting and diarrhea, which along with dehydration lead to a violation of the electrolyte balance.

Possible non-pathological causes that can cause temporary moderate changes in the myocardium include:

• enthusiasm for vegetarian food, as a result of which the body does not receive the required amount of animal protein,
• long episodes of starvation, when the body for a certain time did not receive the necessary nutrients for normal functioning,
• uncontrolled intake of medications without regard to the reaction to them from the body,
• close contact with toxic substances and household chemicals,
• work in chemical plants, in conditions of high radiation or vibration activity,
• the influence of high or low temperatures, leading to overheating or supercooling of the body, which slow down metabolic processes
• excessive physical activity.

As you can see, there are more causes of metabolic changes in the myocardium than could be expected. It will be difficult to disprove the assumption that every person on the cardiogram faces such violations at any time in life because of hormonal, physiological or pathological changes.

[18], [19], [20], [21], [22], [23], [24],

Pathogenesis

When you hear such an incomprehensible and blurred verdict of doctors, a lot of questions arise, which I would like to receive an answer in order to have concrete information about how stable our heart works. What is this diagnosis? Why do such changes occur? What are they related to? What is dangerous? How to live with metabolic changes in the myocardium? Are they being treated?

In fact, metabolic changes in the myocardium - this is not quite a diagnosis. This is a prerequisite for a more accurate verdict, because such changes can be in healthy people and in patients with various pathologies.

Despite such an important function performed by our heart, which is considered the motor of the whole organism, it is a hollow muscular organ, whose work is controlled by the brain and CNS. It is from there that electrical signals arrive, causing the heart to contract with a certain rhythm and pump blood throughout the body as a large strong pump.

Normally, the electrical conductivity throughout the heart muscle should be uniform (homogeneous), and then the heart works stably. Violation of electrical conductivity in a small area of muscle is associated with the appearance in it of certain seals, neoplasms, scar tissue, which inhibits the conductivity of nerve impulses, which affects the contractility of the myocardium and heart rate. In more serious cases, muscles are atrophied on large areas, which makes them less elastic and mobile.

The appearance of various "obstacles" in muscle fibers is associated with a violation of metabolic processes in it, because such formations have a different composition and structure than the total mass. Such areas can be found in the muscles of the heart, causing changes in nerve conduction, which adversely affects the work of the organ.

Myocardium, like any muscle in the human body, consists of individual cells - myocytes, which have a rich composition and are capable of contracting (contracting) under the action of electrical impulses. Those. Cells must have a certain amount of energy, which they receive as a result of biochemical reactions involving proteins, fats (lipoproteins), carbohydrates, various enzymes, amino acids, vitamins, electrolytes (salts of inorganic substances).

As a result of imbalance of nutrients in muscle fibers (cardiomyocytes and intercellular space), cells lose the energy that they need in order to maintain the contractile function of the myocardium. Plus, the accumulation of salts of inorganic substances can create obstacles in the muscles for the passage of nerve impulses. Thus, the fibers of the myocardium change, more accurately atrophy, and can no longer perform their function.

Metabolic changes are called because they are associated with a metabolic disorder in the cells of the heart muscle, and not with a violation of blood flow in the coronary vessels or trauma of the heart itself. Although in reality these events are interrelated, in fact oxygen and nutrients are obtained from the blood from the blood, so a violation of blood circulation in any case leads to a violation of cellular respiration and starvation of cells, which will be noticeable on the cardiogram.

How widespread metabolic changes in the myocardium can be judged by the statistics of diseases caused by these changes. And heart diseases are among the first in the list of the most common human pathologies. Yes, everything is not so simple, it's not limited to cardiac pathologies, and you can verify this by carefully studying the causes that can lead to a metabolic disorder in the heart muscle.

[25], [26], [27], [28], [29],

Symptoms of the metabolic changes in the myocardium

Since the metabolic changes in the myocardium, defined on the cardiogram, can be manifestations of various diseases, then they will be accompanied in each case by various symptoms characteristic of a particular pathology.

In many cases, metabolic changes in the myocardium are detected by chance, and the person did not even know about them. The cardiogram, which is part of a complex examination of the body, conducted at the initiative of the patient or organization that sent a person to the medical examination, can show the deviation of the curve from the isoline even against the background of apparent health.

With moderate metabolic changes in the myocardium, the symptoms can be so undefined that a person simply does not pay attention to them. Increased fatigue, shortness of breath after exercise or physical work and a slight discomfort in the chest may be the first signs of a developing pathology of metabolism in the myocardium, but few people consider them a reason to call a specialist.

Alertness causes only the emergence of more serious symptoms that significantly affect the quality of life of patients:

• the appearance of dyspnea not only after heavy physical exertion, but also in a state of rest or with little effort,
• feeling of lack of air,
• the extreme degree of increased fatigue, called the decline of strength,
• irregular heartbeat,
• an unnaturally pale skin tone,
• episodes of pain behind the sternum (tingling and discomfort).

These symptoms are not an indicator of a metabolic disorder in the heart muscle, but with pronounced changes in the myocardium they are more often than others. Nevertheless, even the transition of metabolic disturbances to myocardial dystrophy is far from always accompanied by the appearance of a clear clinical picture. Symptoms may be absent altogether, and sudden death with strong physical exertion will remain a mystery to many. In these cases, it is said that a person has never complained of a heart, and suddenly died from his stop.

To prevent this from happening to any of the readers, it is necessary to undergo regular ECG examinations even if the heart does not bother. Who knows what a doctor can see on a cardiogram? Perhaps during a preventive medical examination, he will see the danger that can cost a person's life.

Metabolic changes in the myocardium in different patient groups

Many believe that heart disease is the destiny of the elderly and do not rush to the doctor even when unpleasant sensations appear in the chest, and the whole appearance speaks of the person's unhealth. There is no temperature, severe diarrhea and vomiting, painful coughing or abdominal cuts, so there's no reason to go to the hospital. This is a common but erroneous view of all young people.

Yes, there is no dispute that with age, metabolic processes in the body are less and less active, which is noticeable even externally in skin condition, which loses its elasticity, wrinkles, becomes drier. Something similar happens to the heart muscle. So it is not surprising, considering a cardiogram of an elderly person, to see there significant deviations from normal indices.

And the beginning of these deviations can take even in middle age. For example, even on the whole, a healthy woman begins to celebrate unusual and unwanted changes in her appearance and well-being when menopause occurs. The same tides, characteristic of the pre-menopausal, menopausal and post-menopausal period, are associated with pressure fluctuations, which indicates the failure of the cardiovascular system. As a result of such failures, the power of cardiomyocytes, and hence the metabolic processes in them, proceeding with the participation of oxygen, enzymes and other necessary substances is disrupted.

And the cause of all the violation of the hormonal balance, because hormones directly affect the metabolism. No wonder that patients taking hormonal drugs often complain of weight gain and the appearance of other unpleasant symptoms indicating a change in metabolism.

With such a situation, doctors often encounter and in relation to pregnant women. Metabolic changes in the myocardium during pregnancy can be observed against a background of various pathologies peculiar to this period. We are talking about anemia, vitamin deficiency, general exhaustion of the body, which can develop against the background of early toxicosis of pregnant women or with an unbalanced diet (we must not forget that vitamins and trace elements should be enough for two).

This can also include endocrine disorders and digestive disorders, which is also not uncommon in expectant mothers, overwork, intoxication, etc. It is clear that organic lesions of the heart (congenital or acquired, for example, the same inflammation of the heart muscle, called myocarditis) can easily lead to myocardial dystrophy.

What makes us consider yourself indestructible, even if young children can suffer from heart disease, whether they are congenital malformations or acquired diseases. In general, moderate metabolic changes of the myocardium in an early child are not even considered a pathology by doctors, because the metabolism of babies is still in the formative stage, like many other body systems. Guards of doctors expressed changes on the cardiogram, which testify in favor of various pathologies, which requires a more detailed examination.

It is possible that metabolic changes were caused by stress (for example, constant quarrels, divorce or death of parents) or infectious-inflammatory pathology such as popular SARS and sore throats. But we should not exclude more serious pathologies related to the kidneys (for example, glomerulonephritis), the heart, digestive organs (the same food intoxication).

The causes of metabolic changes in the myocardium in adolescence and adulthood are even greater, beginning with hormonal failures and various pathologies and ending with chronic alcoholism. So no one is insured against such violations, and in time to identify them you can only regularly check the work of your heart with the help of an electrocardiogram.

Complications and consequences

As for the consequences of the malfunctions detected on the cardiogram, everything here depends on the duration, frequency and severity of the pathological changes. As we have already mentioned, in early childhood such changes are considered a variant of the norm and pass without a trace. The same can be said about short-term ECG changes in adults associated with drinking, physical stress, stressful situations. It is necessary to remove the irritant, normalize the mental and physical state, begin to eat fully and about heart disease, there will be no speech.

Another thing is if metabolic changes in the myocardium, even mild, are visible on the cardiogram on a regular basis or on an ongoing basis. This suggests that the heart can not work at full strength. And only a doctor can find out what hinders him and how to deal with it. Otherwise, disregard for your health will result in such deadly complications as decompensated heart failure and myocardial degeneration (dystrophy), which at any time can lead to death.

Thus, chronic and acute infectious pathologies, as well as failures in the endocrine system, can cause potassium dystrophy with violation of cell membranes. And stress, hormonal imbalance in menopause and pregnancy, decreased endocrine gland function (eg, hypothyroidism), pheochromocytoma may lead to an increase in calcium cardiomyocyte concentration, which reduces muscle tone (catecholamine degeneration). Increased activity of protease enzymes promotes destruction of cell mitochondria and weakens fibrillar connections, which leads to necrotic lesions in the myocardium, which reduce the overall contractility of the muscular organ (enzyme degeneration).

Yes, all these are necessary for the life of cells cells, but in excess they show the opposite effect. A metabolic disorder is always associated with the advantage of some important components over others.

[30], [31], [32], [33], [34], [35], [36], [37]

Diagnostics of the metabolic changes in the myocardium

Since metabolic changes in the myocardium in most cases do not manifest themselves in any way from the point of view of the patient's well-being, they can be detected only after carrying out the most popular study of the work of the heart - electrocardiography. When decoding the cardiogram the doctor should be alerted to such ECG moments that indicate metabolic changes in the myocardium, such as lengthening the ventricular systole (most often left), low voltage of the T wave or other teeth, low systolic and minute volume, etc.

Without delving into the details of the cardiogram study (this is a matter of specialists), let's say that moderate changes in it in the absence of other suspicious symptoms speak rather of their temporary nature. In this case, the doctor will give recommendations on how to behave and eat in the near future and appoint a control ECG after a few days.

Patients with moderate and severe metabolic changes are not assigned any special types of laboratory tests. Usually limited to clinical blood and urine tests. If degenerative processes in the tissues of the myocardium with areas of necrosis are detected, a morphological study can be prescribed.

Additional methods of instrumental diagnostics that allow to clarify the diagnosis include echocardiography (Echocardiography), which determines the boundaries of the heart and the size of the cavities within it, as well as ultrasound or cardiac radiography.

[38], [39], [40], [41], [42], [43], [44], [45]

Differential diagnosis

Differential diagnosis is carried out by examining the patient's history and complaints about unusual symptoms (dizziness, sudden changes in body weight in one direction or another, tremor of hands, stitching or aching pain in the heart, weakness and fatigue, etc.). This makes it possible to differentiate non-pathological changes from disorders caused by various diseases.

Studying the patient's medical card allows one to assume or exclude the infectious nature of pathologies that cause changes in metabolism. About the transferred or existing acute inflammatory diseases the doctor can ask and the patient.

A great help in establishing an accurate diagnosis and distinguishing metabolic and ischemic disorders in the myocardium is provided by a kind of ECG, such as cardiography with exercise. Those. First measure the conductivity of the myocardium at rest. Then re-examination during the load (torsion of pedals on a special apparatus, deep and frequent breathing, injection of a potassium-containing drug). A little time later, a third study is being conducted. If a strong deviation of the denticles of the cardiogram is observed only under load, and after a time returns to the initial results, it is a matter of metabolic changes.

Treatment of the metabolic changes in the myocardium

To begin with, the treatment of these is not always required. Do not prescribe medication for a person whose heart has given a temporary temporary failure and is able to come to normal with the stabilization of the mental and physical state. In this case, the best medicine will be rest and balanced nutrition, rich in essential vitamins, trace elements, amino acids and other substances responsible for the health of cardiomyocytes.

In more serious situations, the physician seeks first of all to identify the pathological cause of metabolic changes in the myocardium in order to prescribe the treatment of the underlying disease, and not just one of his symptoms. In this case, we must also take into account the fact that regardless of the cause of the metabolic processes, the heart suffers from them in the first place. So, there are general principles of treatment of metabolic changes in the myocardium.

Based on the situation and the causes of metabolic disturbances in the heart muscle, the doctor can prescribe medications that normalize the hormonal background (for example, with menopause), and sedatives, if the cause of the disturbances are frequent stressful situations. But the main emphasis will still be on those drugs that regulate energy metabolism in cells, i.e. Fill their need for energy.

The pronounced changes in the myocardium caused by metabolic disturbances in cardiomyocytes ultimately lead to heart failure, so you need to take measures that support cardiac activity, in parallel restoring the conduction of the heart muscle and the heart rhythm. The best assistants in this sense are the preparations of potassium salts (most of them contain magnesium, which participates in the conductivity of nerve impulses). These drugs include: "Panangin", "Asparkam", ATP, etc.

Regulation of nervous activity and muscle conduction is simply impossible without B vitamins (B1, B2, B6, B12) contained in Neurovitan, Neurobex, and others. It is recommended to take such medications in combination with lipoic and pantothenic acid preparations, as well as with antioxidants, which include the drug "Actovegin", vitamin E and nicotinic acid.

If there are problems with the assimilation of protein, steroid preparations from the anabolic group (for example, "Nerobol" or "Methandrostenolone") can be prescribed. To improve the nervous regulation of the heart, drugs from the discharge of nootropics, the most popular of which is considered to be "Piracetam", will be useful.

If there are coronary artery diseases, due to which the cells lack oxygen, the doctor can prescribe antispasmodics (for example, "No-shpa") and decongestants (in case of edemas caused by heart failure, Spironolactone has proven itself). In order for cardiomyocytes to function more easily in conditions of lack of oxygen in case of blood circulation disorders, the doctor can prescribe medicinal herbal tinctures (ginseng, eleuturococcus, rhodiola rosea, lemongrass).

If we are talking about diffuse changes in the myocardium caused by inflammatory pathologies, then anti-inflammatory drugs and antibiotics can be prescribed, since bacteria are considered the most common cause of internal inflammation.

But the most basic principle of treating metabolic changes in the myocardium is an individual approach to each patient, because there can be a great number of causes for disrupting the work of cardiac muscle cells, which means that there can be as many treatment schemes.

It is important to understand that drug therapy does not stop there. Patients, depending on the existing pathologies, may be prescribed physiotherapy and spa treatment, in which water procedures play a big role. In addition, the patient will have to revise his lifestyle and daily diet.

The doctor will definitely recommend to give up bad habits and great physical exertion. But daily walks on fresh air and high-grade rest (a night dream not less than 8-9 hours) will go only on advantage. If a person has an excitable nervous system and he reacts very violently to stressful situations and minor troubles, he will be recommended psychological sessions that will teach the patient to relax and calmly react to various stimuli.

If the patient has such a problem as a long-established caries, you will have to visit the dentist and correct the situation so as not to aggravate the situation with such a dangerous "trifle".

Particular attention will have to be given to the diet, pushing away the "delicacies" of fast food, semi-finished products, alcohol, sweet fizzy drinks that do not represent nutritional value, but saturate the body with carcinogens, toxic substances, poorly digested synthetic components. Preference should be given to products that contain easily digestible protein, vitamins, minerals.

If a person previously worked in harmful enterprises or was exposed to vibration, he will be offered to change a specialty or go to another job that will not have a negative impact on the heart. The same applies to those who work in shifts, because in these conditions it is very difficult to regulate the mode of work and rest.

Surgical treatment, if appointed, is not due to a metabolic disorder in the myocardium (surgery does not solve this problem), but about the underlying disease (heart disease, vascular pathology, etc.).

Medication

But let's go back to situations when we can not do without the help of medications, and we will give examples of drugs that are more likely to be prescribed by a doctor with expressed metabolic changes in the myocardium.

Panangin

The drug containing ions of potassium and magnesium, which is used mainly for cardiac pathologies (heart failure, heart rhythm disorders, as well as an imbalance of potassium and magnesium in the body).

Assign the drug in tablet form three times a day after meals. A single dose can fluctuate about 1 to 3 tablets.

The injection solution is used for slow intravenous infusions. For 1 dropper take the drug in the amount of 1-2 ampoules, which are diluted with a solution of glucose. Repeated IV set no earlier than 4 hours later.

As for the side effects of the drug, they are quite rare. There may be an increase in the frequency of bowel emptying, as well as redness of the skin (with IV infusions). In rare cases, the appearance of symptoms, indicating the excess in the body of potassium or magnesium.

The drug is not used in pediatrics because of insufficient knowledge of its effect on the child's body. Contraindications are also renal failure, Adesson's disease, cardiac arrest of grade 3, cardiogenic shock with a systolic pressure drop below 90 mm Hg.

The drug should be administered under ECG monitoring and electrolyte homeostasis. Caution should be observed, appointing "Panangin" as part of a comprehensive treatment with ACE inhibitors. Requires refusal from drinking alcohol.

ATP-LONG

A drug that affects metabolism in the heart muscle, which also prevents ischemic damage to the heart tissue and its rhythm disturbances. It refers to the category of energy-saving drugs, prevents damage to the cell membrane and the leakage of substances necessary for energy synthesis in cells. It improves blood circulation and contractile function of the myocardium, normalizes the levels of potassium and magnesium.

Tablets "ATP" can be taken as before meals, and during or after it. Eating does not affect the absorption of the medicine. The drug is produced in the form of sublingual tablets, which must be kept in the mouth until they are completely dissolved.

The drug in the form of tablets is prescribed in a single dosage from 10 to 40 mg (from 1 to 4 tablets). Multiplicity of medication is 3 or 4 times a day by a therapeutic course up to 1 month. In a fortnight, the course of treatment can be repeated.

The drug in solution is used for intramuscular injections and slow intravenous infusions through the system. In the first case, the adult dose is 1-2 ml, which is administered 1 or 2 times a day. In the second - the dosage can be increased to 5 ml. The therapeutic course is from 1.5 to 2 weeks.

Intravenous infusions are carried out only in a hospital. In this case, medical staff should monitor changes in blood pressure.

Side effects of the drug depend on the method of its administration. In / m injections can be accompanied by a headache, increased heart rate, frequent urination. For IV infusions are more typical: nausea, fever and redness of the face due to the flood of blood, dizziness, discomfort behind the sternum, more frequent defecation, bronchospasm, especially in case of an allergic predisposition.

The drug is not prescribed for obstruction of the airways, shock conditions, heart block, acute myocardial infarction, in severe cases of bronchial asthma.

It is undesirable to use the drug to treat patients with hypotension, children, pregnant women. Do not prescribe concurrently with cardiac glycosides.

Actovegin

A drug from the category of antioxidants, which activates the metabolism in cells due to stimulation of transport and the accumulation of oxygen and glucose, as participants in the synthesis of energy. Improves blood flow to tissues.

Patients with metabolic changes in the myocardium associated with various pathologies, the drug can be appointed as a dragee for oral administration and a solution used for intravenous, intraarterial and intramuscular administration.

In the form of a drug, the medicine is prescribed three times a day. Single dose - 1-2 dragees, which must be swallowed and washed down with water.

The initial dose of the solution for intravenous and intravenous injection is 10-20 ml. Further, it is reduced to 5 ml or transferred to the / m introduction of the same dose of the solution.

For infusion administration, the solution of the preparation is diluted with water for injection, glucose solution or sodium chloride. Depending on the patient's condition, 10 to 20 infusions may be required.

Among the side effects noted only allergic reactions, hot flashes, hyperhidrosis and hyperthermia.

Contraindications to the use of the drug are increased sensitivity to its components and lactation period. Caution should be observed when treating pregnant women.

Nerobol

The drug is from the category of anabolic steroids. When metabolic disturbances in cells stimulate the synthesis of DNA and proteins, improve tissue respiration and metabolism of ATP with release of energy.

The medicine is given in the form of tablets, which are prescribed at 5-10 mg per day (maximum 50 mg). The child's dose is calculated based on the weight of the child. Take pills before meals. The course of treatment is not more than 28 days with the possibility of repeating the course after 1.5-2 months.

The drug is not prescribed for hypersensitivity to it, oncology of the prostate, chest or mammary glands, excess calcium in the body, severe liver and kidney damage, pregnancy.

With caution apply the drug for the treatment of patients of advanced age, nursing mothers, children, patients with chronic heart failure, coronary artery atherosclerosis, diabetes, prostate hyperplasia.

The drug has many side effects, the occurrence of which is the reason for drug cancellation: edematous syndrome, the development of anemia, disruption of the liver, blood viscosity and bleeding, hypercalcemia, various disorders in children, etc.

During the treatment, the drug needs constant monitoring of blood calcium, cholesterol, sugar, phosphorus and other components in the blood. We need to monitor the liver.

As for homeopathy, in cases of metabolic disorders in cardiomyocytes, a multicomponent drug such as "Ubiquinone Compositum" can be administered as a solution for intramuscular injection.

Assign it to adult patients in a daily dosage equal to 1 ampoule. Multiplicity of administration - from 1 to 3 times a week with a course of treatment of at least 2 weeks.

Use of the drug may be accompanied by allergic reactions. Contraindications to it are hypersensitivity to at least one of the components (and there are more than 25), an age younger than 18 years, periods of pregnancy and lactation.

Can be used as part of complex therapy of cardiac and other diseases.

Alternative treatment

The main methods of both traditional and alternative treatment of moderate metabolic changes in the myocardium are a healthy lifestyle, peace and balanced nutrition. But in the case of severe metabolic disorders, leading to myocardial dystrophy and heart failure, this is not enough. We need funds that support the cardiac muscle, stimulate energy processes in its cells, improve the nutrition and respiration of cardiomyocytes.

To such means it is possible to carry apples, cucumbers, onions, potatoes, sea kale. The treatment with these delicious and useful natural "medicines" is based on a change in the diet. For example, a good effect in heart pathologies was seen in those patients who practiced apple, potato or cucumber unloading days once a week. This means that during the day you only need one kind of food (in this case, apples, potatoes or cucumbers) in quantities of 1 to 2 kg per day.

For those to whom such a diet is beyond the strength due to lack of variety of dishes, it can be improved. For example, on the day when only apples are allowed to be used, we reduce their quantity to one kilogram, but we add 300 grams of low-fat home-made cottage cheese to the ration. During the cucumber unloading day, you can drink about 1 liter of fresh yogurt or whey. With a potato diet, 1 kg of boiled potatoes without salt and 1 liter of curdled milk are allowed.

To eat at the same time it is recommended fractional: in small portions 5-6 times a day, thoroughly chewing food so that the beneficial substances from it are better absorbed.

Another not so pleasant medicine is a pulp of onions and fresh apples taken in equal proportions (you can grind it in a blender or in a meat grinder). Take the medicine for 1 tablespoon. 3 times a day.

Many people have heard about the benefits of sea kale for skin beauty, but not everyone knows that it improves the nutrition of cardiomyocytes. If there is a violation of metabolic processes in the myocardium, it is worth buying a powder of kelp in the pharmacy and taking it on a teaspoon three times a day.

Good hairs for the heart are also hips and hawthorn, which normalize metabolic processes and increase the resistance of cardiomyocytes to unfavorable conditions of oxygen starvation.

As for the treatment with herbs, it is customary to consider flowers of elderberry and arnica, corn root, rosemary, goricvet, valerian, motherwort, yarrow and some other medicinal plants useful in the heart, which are used in the form of medical dues.

[46], [47], [48], [49], [50], [51], [52], [53], [54]

Prevention

One of the most important conditions for the healthy functioning of the heart muscle for many years is considered correct energy metabolism in its cells. And here much depends on us, on our way of life, on how we monitor our health.

To metabolic changes in the myocardium observed on the cardiogram, only in exceptional cases, you need to take care of your health. This attitude includes:

• rejection of bad habits (smoking, alcoholism, drug addiction, overeating, etc.)
• normalization of the regimen of the day, so that the body can fully rest,
• transition to a balanced fractional food (products must represent nutritional value, and not just kill hunger and please our far from useful food preferences), which eliminates overeating and harmful foods,
• an active way of life without excessive physical exertion (you need to learn to distribute your forces rationally),
• training in psychological techniques to combat stress,
• if necessary, a change of place of work (after all, health is more expensive, sometimes to fix it no salary is not enough),
• regular examination of the cardiologist with existing problems with the heart, and if there are none, it is worth at least 1-2 times a year to do a cardiogram, especially for middle-aged and elderly people (the fact that the heart does not hurt does not mean that it is absolutely fine ),
• timely treatment of various infectious and inflammatory pathologies, endocrine diseases, health disorders associated with incorrect work of nervous and excretory systems, and, of course, caries, periodontitis, periodontitis and other dental problems.

Only with such an integrated approach to the preservation of one's health can one be sure that the heart will last long and without interruption, and life will not break off from an unexpected cardiac arrest caused by unnoticed metabolic changes in the myocardium in time.

[55], [56], [57], [58], [59], [60], [61], [62]

Forecast

The prognosis of metabolic changes in the myocardium depends on the severity of the metabolic processes observed on the electrocardiogram and the degree of damage to the heart muscle. With moderate changes, the prognosis is favorable, but the outcome of treatment of severe metabolic disturbances depends on the timeliness of seeking help and the accuracy of the doctor's prescriptions.

The worst prognosis is observed with diffuse changes in the tissues of the myocardium and the transition of the inflammatory process to a degenerative one. It should be understood that myocardial dystrophy even of a severe degree can proceed almost asymptomatically, without causing pain in the heart and other unpleasant sensations. Identify it can only simple diagnostic studies, which are ECG and ultrasound of the heart.

[63], [64], [65], [66], [67], [68],