Moderate and diffuse changes in ventricular myocardium of metabolic nature

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

Dangerous and harmless changes in the myocardium

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

Thus, metabolic changes in the myocardium can be both permanent and temporary. The latter are not dangerous for humans and are not considered a pathology. They are only a consequence of excessive load on the heart, such as physical overexertion, alcohol abuse, or stress experienced the day before the electrocardiogram.

Usually, the cardiogram shows moderate metabolic changes in the myocardium, which can be considered a borderline state between health and illness. It is possible to find out how serious it is only by conducting a repeat examination after some time, during which the patient is recommended physical rest, emotional peace, and proper nutrition. In most cases, this is enough for the cardiogram to return 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 change in the ECG curve. That is, the matter is not at all in physical exertion, stress or alcohol abuse, we are talking about a systematic disruption of metabolism in cardiomyocytes (depolarization without compensation by repolarization), which ultimately leads to failures in the heart.

If the cardiogram shows pronounced metabolic changes in the myocardium, we are no longer talking about a temporary condition or the initial stage of pathology development, but rather about the height of the disease. In this case, with the help of additional studies, even foci of necrotic tissue (dead cells) can be detected in the myocardium, the effect of current on which does not lead to muscle contraction. We are talking rather about myocardial dystrophy - a pathology that can occur in various forms (acute, subacute and chronic) and often lead to the development of decompensated heart failure and even 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 ventricle. This state of affairs is associated with the peculiarities of the structure of the heart, due to which it is this part of the myocardium that experiences a lack of energy-valuable substances first of all. This is probably why left ventricular heart failure is considered one of the most common pathologies of the cardiovascular system.

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

A subtype of dysmetabolic disorders can be considered diffuse metabolic changes in the myocardium. We are talking about such metabolic disorders if the heart muscle undergoes changes along its entire perimeter. The most common cause of diffuse changes are inflammatory diseases of the myocardium of the heart (myocarditis, myocardiosclerosis, etc.). Less often, volumetric changes on the cardiogram are observed as a result of physical exhaustion or long-term use of drugs. If diffuse changes are not given due attention, then at some point the heart may simply stop, unable to obey the call of reason, i.e. the brain.

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Causes metabolic changes in the myocardium

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

It is clear that the first to be suspected are possible cardiovascular diseases, such as angina pectoris, hypertension and some other vascular pathologies, heart defects, cardiosclerosis, rheumatic lesions of the heart muscle. Most often, metabolic changes in the myocardium are observed against the background of cardiomyopathy - a pathology that develops as a result of a disruption in the nutrition of myocardial cells. It is clear that the deficiency of substances necessary for normal metabolism is immediately reflected in the form of changes in the electrocardiogram.

The rate of development of the process can be judged by the comparative characteristics of cardiograms taken at a certain interval in time. But the magnitude of deviations from the isoline and the number of atypical segments will indicate the extent of the pathological process, ranging from mild or moderate deviations to myocardial dystrophy.

But let's get back to our reasons. After all, heart disease, it turns out, is not the only pathology that can be accompanied by metabolic changes in the myocardium. Similar changes can be seen on the cardiogram of patients with chronic inflammatory foci in the body (for example, with recurrent tonsillitis and even with advanced caries). Most often, the cause of inflammation is bacterial and viral infections (ARI, flu, herpes infection, bacterial or viral tonsillitis, etc.). But these can also be allergic reactions that occur in a chronic form.

Another pathological cause of metabolic changes in the myocardium may be endocrine pathologies associated with dysfunction of the pituitary gland, thyroid and parathyroid glands. In this case, hormonal and enzymatic changes are observed, causing a violation of the general metabolism, which cannot but have a negative effect on the metabolic processes occurring in the heart muscle. Metabolic changes on the cardiogram can be seen in diabetes mellitus, hyperthyroidism, during menopause and pregnancy.

Even acute inflammation of the gastrointestinal tract, such as the pancreas or intestines, can negatively affect metabolic processes in the body, which can subsequently be reflected in the cardiogram. It is probably not worth talking about the chronic course of such pathologies, so great is their negative contribution to metabolic processes occurring throughout the body, including the heart muscle.

In connection with this problem, it is necessary to mention the excretory system, diseases of which are considered a risk factor for the occurrence of metabolic changes in cells. Impaired kidney function leads to the fact that harmful substances begin to enter the blood, capable of destroying energy-valuable substances. And if such an important filter as the liver fails, then the heart cells begin to receive harmful substances with the blood, which are not only capable of disrupting metabolism, but also destroying cardiomyocytes.

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Risk factors

Risk factors for the development of metabolic disorders of the myocardium include:

• obesity resulting from metabolic disorders in the body,
• avitaminosis, most often associated with poor nutrition, when the diet lacks vitamin-containing foods,
• anemias associated with mineral deficiency, particularly iron,
• chronic alcoholism,
• pathologies accompanied by fever, vomiting and diarrhea, which, along with dehydration, lead to electrolyte imbalance.

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

• passion for vegetarian food, as a result of which the body does not receive the necessary amount of animal protein,
• prolonged episodes of starvation, when the body did not receive the nutrients necessary for normal functioning for a certain period of time,
• uncontrolled intake of medications without taking into account the body's reaction to them,
• close contact with toxic substances and household chemicals,
• work in chemical plants, in conditions of increased radiation or vibration activity,
• the effect of high or low temperatures, leading to overheating or hypothermia of the body, which slows down metabolic processes
• excessive physical exertion.

As we can see, there are more reasons for metabolic changes in the myocardium than one might expect. It will be difficult to refute the assumption that every person encounters such disturbances on the cardiogram at least once in their life due to hormonal, physiological or pathological changes.

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Pathogenesis

When you hear such an unclear and vague verdict from doctors, a lot of questions arise that you would like to get answers to in order to have specific information about how stable our heart is. What is this diagnosis? Why do such changes occur? What are they associated with? What are they dangerous for? How to live with metabolic changes in the myocardium? Are they treatable?

In fact, metabolic changes in the myocardium are not exactly a diagnosis. They are a prerequisite for making a more accurate verdict, because such changes can occur in healthy people and in patients with various pathologies.

Despite the important function that our heart performs, considered the motor of the entire body, it is a hollow muscular organ, the work of which is controlled by the brain and the central nervous system. It is from there that electrical signals come, forcing the heart to contract with a certain rhythm and pump blood throughout the body like a large, powerful pump.

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

The appearance of various "obstacles" in muscle fibers is associated with a disruption of metabolic processes in it, because such formations have a composition and structure different from the general mass. Such areas can also be found in the heart muscles, causing changes in nerve conduction, which negatively affects the functioning of the organ.

The myocardium, like any muscle in the human body, consists of individual cells - myocytes, which have a rich composition and are capable of contracting (shrinking) under the influence of electrical impulses. That is, the cells must have a certain reserve 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 the imbalance of useful substances in muscle fibers (cardiomyocytes and intercellular space), the cells lose the energy they need to maintain the contractile function of the myocardium. Plus, the accumulation of inorganic salts in the muscles can create obstacles for the passage of nerve impulses. Thus, the myocardial fibers change, or rather atrophy, and can no longer perform their function.

Metabolic changes are called so because they are associated with metabolic disorders in the cells of the heart muscle, and not with blood flow disorders in the coronary vessels or trauma to the heart itself. Although in fact these events are interconnected, because cardiomyocytes receive oxygen and nutrients from the blood, so blood circulation disorders in any case lead to cellular respiration disorders and cell starvation, which will be visible on the cardiogram.

How widespread are metabolic changes in the myocardium can be judged by the statistics of diseases caused by these changes. And heart diseases are among the first on the list of the most common human pathologies. But everything is not so simple, the matter is not limited to cardiac pathologies alone, and you can be convinced of this by carefully studying the causes that can lead to metabolic disorders in the heart muscle.

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Symptoms metabolic changes in the myocardium

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

In many cases, metabolic changes in the myocardium are discovered by chance, and the person did not even suspect them. A cardiogram, which is part of a comprehensive examination of the body, conducted at the initiative of the patient or the organization that sent the person for a medical examination, can show deviations of the curve from the isoline even against the background of apparent health.

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

Only the appearance of more serious symptoms that significantly affect the quality of life of patients raises concern:

• the appearance of shortness of breath not only after heavy physical exertion, but also at rest or with minor exertion,
• feeling of lack of air,
• an extreme degree of increased fatigue, called exhaustion,
• heart rhythm disturbances,
• unnaturally pale skin tone,
• episodes of chest pain (tingling and discomfort).

These symptoms are not an indicator of metabolic disorders in the heart muscle, but with pronounced changes in the myocardium they are present more often than others. However, even the transition of metabolic disorders to myocardial dystrophy is not always accompanied by the appearance of a clear clinical picture. Symptoms may be absent altogether, and sudden death during intense physical exertion will remain a mystery to many. In these cases, they say that the person never complained about his heart, and suddenly died from its arrest.

To prevent this from happening to any of the readers, it is necessary to undergo regular ECG examinations even if the heart is not bothering you. 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 his life.

Metabolic changes in the myocardium in different groups of patients

Many people believe that heart disease is the lot of older people and do not rush to see a doctor even when there is discomfort in the chest, and the whole appearance indicates that the person is unwell. There is no fever, severe diarrhea and vomiting, painful cough or abdominal pain, so there is no reason to go to the hospital. This is a common, but erroneous opinion of all young people.

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

Moreover, these deviations can begin in middle age. For example, even a generally healthy woman begins to notice unusual and unwanted changes in her appearance and well-being when menopause sets in. The same hot flashes, typical of the pre-menopausal, menopausal and post-menopausal periods, are associated with pressure fluctuations, which indicates problems with the cardiovascular system. As a result of such problems, the nutrition of cardiomyocytes is disrupted, and therefore the metabolic processes in them, which involve oxygen, enzymes and other necessary substances.

And the reason for all this is a hormonal imbalance, because hormones directly affect metabolism. It is not for nothing that patients taking hormonal drugs often complain of weight gain and the appearance of other unpleasant symptoms indicating a change in metabolism.

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

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

What makes us consider ourselves invincible if even small children can suffer from heart disease, be it congenital defects or acquired diseases. In general, doctors do not even consider moderate metabolic changes in the myocardium in a young child to be a pathology, because the metabolism of babies is still in the formation stage, like many other body systems. Doctors are alarmed by pronounced changes in the cardiogram, which indicate various pathologies, which requires a more detailed examination.

It is quite possible that metabolic changes were caused by stress (for example, constant quarrels, divorce or death of parents) or infectious and inflammatory pathology such as popular acute respiratory viral infections and tonsillitis. But more serious pathologies related to the kidneys (for example, glomerulonephritis), heart, digestive organs (the same food poisoning) should not be ruled out.

There are even more reasons for the appearance of metabolic changes in the myocardium in adolescence and adulthood, starting with hormonal imbalances and various pathologies and ending with chronic alcoholism. So no one is immune from such disorders, and they can be detected in time only by regularly checking the work of your heart using an electrocardiogram.

Complications and consequences

As for the consequences of the failures detected on the cardiogram, everything depends on the duration, frequency and severity of pathological changes. As we have already mentioned, in early childhood such changes are considered a normal variant and disappear without a trace with age. The same can be said about short-term changes in the ECG in adults associated with alcohol consumption, physical activity, stressful situations. It is worth removing the irritant, normalizing the mental and physical condition, starting to eat properly and there will be no talk of heart disease.

It is another matter if metabolic changes in the myocardium, even moderate ones, are visible on the cardiogram regularly or on a permanent basis. This indicates that the heart cannot work at full capacity. And only a doctor can find out what is hindering it and how to deal with it. Otherwise, a disregard for your health will result in such life-threatening complications as decompensated heart failure and degeneration (dystrophy) of the myocardium, which can lead to death at any time.

Thus, chronic and acute infectious pathologies, as well as failures in the endocrine system, can cause potassium dystrophy with disruption of cell membranes. And stress, hormonal imbalance during menopause and pregnancy, decreased function of the endocrine glands (for example, hypothyroidism), pheochromocytoma can lead to an increase in the concentration of calcium in cardiomyocytes, which reduces muscle tone (catecholamine degeneration). Increased activity of protease enzymes contributes to the destruction of cell mitochondria and weakens fibril bonds, which leads to the appearance of foci of necrosis in the myocardium, reducing the overall contractility of the muscular organ (enzymatic degeneration).

Yes, all of these are substances necessary for the vital activity of cells, but in excess they show the opposite effect. And metabolic disorders are always associated with the advantage of some important components over others.

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Diagnostics 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 only be detected by conducting the most popular study of the heart's work - electrocardiography. When decoding the cardiogram, the doctor should be alerted by such moments on the ECG indicating metabolic changes in the myocardium as lengthening of ventricular systole (most often the left), low voltage of the T wave or other waves, low systolic and minute volume, etc.

Without going into details of the cardiogram examination (this is a matter for specialists), we will say that moderate changes on it in the absence of other suspicious symptoms rather indicate their temporary nature. In this case, the doctor will give recommendations on how to behave and eat in the near future and will prescribe a control ECG in a few days.

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

Additional instrumental diagnostic methods that help clarify the diagnosis include echocardiography (EchoCG), which determines the boundaries of the heart and the size of the cavities inside it, as well as ultrasound or radiography of the heart.

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Differential diagnosis

Differential diagnostics is carried out by studying the patient's medical history and complaints about unusual symptoms (dizziness, sudden changes in body weight in one direction or another, hand tremors, stabbing or aching pain in the heart area, the appearance of weakness and fatigue, etc.). This allows us to differentiate non-pathological changes from disorders caused by various diseases.

Studying the patient's medical record allows one to assume or exclude the infectious nature of pathologies causing metabolic changes. The doctor may also ask the patient about past or existing acute inflammatory diseases.

A type of ECG called stress cardiography is of great help in establishing an accurate diagnosis and distinguishing between metabolic and ischemic disorders in the myocardium. That is, first, myocardial conductivity is measured at rest. Then, a repeat study is performed during stress (pedaling on a special device, deep and frequent breathing, injection of a potassium-containing drug). A third study is performed after a short time. If a strong deviation of the ECG teeth is observed only under stress, and after a while returns to the initial results, we are talking about metabolic changes.

Treatment metabolic changes in the myocardium

Let's start with the fact that treatment of such is not always required. You should not prescribe medication to a person whose heart has given a small temporary failure and is able to return to normal when the neuropsychic and physical condition stabilizes. In this case, the best medicine will be rest and a balanced diet rich in essential vitamins, microelements, amino acids and other substances responsible for the health of cardiomyocytes.

In more serious situations, the doctor first seeks to identify the pathological cause of metabolic changes in the myocardium in order to prescribe treatment for the underlying disease, not just one of its symptoms. It is also necessary to take into account the fact that regardless of the cause of metabolic disorders, the heart suffers from them first and foremost. This means that there are general principles for treating metabolic changes in the myocardium.

Based on the situation and the cause of metabolic disorders in the heart muscle, the doctor may prescribe drugs that normalize hormonal levels (for example, during menopause) and sedatives if the disorder is caused by frequent stressful situations. But the main emphasis will still be on those drugs that regulate energy metabolism in cells, i.e. replenish their need for energy.

Significant changes in the myocardium caused by metabolic disorders in cardiomyocytes eventually lead to heart failure, which means it is necessary to take measures to support cardiac activity, while simultaneously restoring the conductivity of the heart muscle and heart rhythm. The best helpers in this regard are considered to be potassium salt preparations (most of them also contain magnesium, which is involved in the conductivity of nerve impulses). Such preparations include: Panangin, Asparkam, ATP, etc.

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

If there are problems with protein absorption, steroid drugs from the anabolic group (for example, Nerobol or Methandrostenolone) may be prescribed. To improve the nervous regulation of heart activity, nootropic drugs will be useful, the most popular of which is Piracetam.

If there are coronary artery diseases, as a result of which the cells do not receive enough oxygen, the doctor may prescribe antispasmodics (for example, "No-shpa") and decongestants (in the case of edema caused by heart failure, "Spironolactone" has proven itself well). In order for cardiomyocytes to function more easily in conditions of oxygen deficiency due to circulatory disorders, the doctor may prescribe herbal tinctures (ginseng, eleutherococcus, rosea rhodiola, magnolia vine).

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 still considered the most common cause of internal inflammation.

But the most basic principle of treating metabolic changes in the myocardium is considered to be an individual approach to each patient, because there can be a great many reasons for the disruption of the functioning of the heart muscle cells, which means there can be just as many treatment regimens.

It is important to understand that drug therapy is not the only solution. Depending on the pathologies present, patients may be prescribed physiotherapy and spa treatment, in which water procedures play a major role. In addition, the patient will have to reconsider his lifestyle and daily diet.

The doctor will definitely recommend giving up bad habits and heavy physical activity. But daily walks in the fresh air and proper rest (at least 8-9 hours of sleep at night) will only be beneficial. If a person has an easily excitable nervous system and 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 irritants.

If a patient has a problem such as long-standing caries, he will have to visit a dentist and correct the situation so as not to aggravate the situation with such a dangerous “trifle”.

Particular attention will have to be paid to the diet, pushing away the "delicacies" of fast food, semi-finished products, alcohol, sweet carbonated drinks, which have no nutritional value, but saturate the body with carcinogens, toxic substances, poorly digestible synthetic components. Preference should be given to products that contain easily digestible protein, vitamins, minerals.

If a person has previously worked in hazardous industries or has been exposed to vibration, they will be offered to change their specialty or move to another job that will not have a negative impact on the heart. The same applies to those who work in shifts, because in such conditions it is very difficult to regulate the work and rest regime.

Surgical treatment, if prescribed, is not due to metabolic disorders in the myocardium (surgical intervention does not solve this problem), but due to the underlying disease (heart defects, vascular pathologies, etc.).

Drug treatment

But let us return to situations when medications are indispensable, and give examples of drugs that are likely to be prescribed by a doctor for severe metabolic changes in the myocardium.

Panangin

A drug containing potassium and magnesium ions, which is used primarily for cardiac pathologies (heart failure, heart rhythm disturbances, as well as potassium and magnesium imbalance in the body).

The medicine is prescribed in tablet form three times a day after meals. A single dose can range from 1 to 3 tablets.

The injection solution is used for slow intravenous infusions. For 1 dropper, take 1-2 ampoules of the drug, which are diluted with a glucose solution. The dropper is re-administered 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 movements, as well as reddening of the skin (with intravenous infusions). In rare cases, symptoms may appear that indicate an excess of potassium or magnesium in the body.

The drug is not used in pediatrics due to insufficient study of its effect on the child's body. Contraindications also include renal failure, Addison's disease, third-degree heart block, cardiogenic shock with a drop in systolic pressure below 90 mm Hg.

The drug should be taken under the control of ECG and electrolyte homeostasis. Caution should be exercised when prescribing Panangin as part of a complex treatment with ACE inhibitors. Alcohol abstinence is required.

ATP-LONG

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

ATP tablets can be taken before, during or after meals. Food intake does not affect the absorption of the drug. The drug is available only as sublingual tablets, which must be kept in the mouth until completely dissolved.

The drug in tablet form is prescribed in a single dosage of 10 to 40 mg (1 to 4 tablets). The frequency of taking the drug is 3 or 4 times a day for a therapeutic course of up to 1 month. After half a month, 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 dose for adults is 1-2 ml, which is administered 1 or 2 times a day. In the second case, the dosage can be increased to 5 ml. The therapeutic course is from 1.5 to 2 weeks.

Intravenous infusions are only administered in a hospital setting. In this case, medical personnel must monitor changes in blood pressure.

Side effects of the drug depend on the method of administration. Intramuscular injections may be accompanied by headache, increased heart rate, frequent urination. For intravenous infusions, the following are more typical: nausea, fever and redness of the skin of the face due to a rush of blood, dizziness, discomfort behind the breastbone, more frequent bowel movements, bronchospasm, especially in the case of an allergic predisposition.

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

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

Actovegin

A preparation from the category of antioxidants, which activates metabolism in cells by stimulating the transport and accumulation of oxygen and glucose, as participants in energy synthesis. Improves blood supply to tissues.

For patients with metabolic changes in the myocardium associated with various pathologies, the drug can be prescribed in the form of pills for oral administration and a solution used for intravenous, intra-arterial and intramuscular administration.

In the form of pills, the medicine is prescribed three times a day. A single dose is 1-2 pills, which should be swallowed with water.

The initial dose of the solution for intravenous and intraaesthetic injections is 10-20 ml. Then it is reduced to 5 ml or the same dose of the solution is administered intramuscularly.

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

The only side effects noted are allergic reactions, hot flashes, hyperhidrosis and hyperthermia.

Contraindications to the use of the drug include hypersensitivity to its components and lactation. Caution should be exercised when treating pregnant women.

Nerobol

A drug from the category of anabolic steroids. In case of metabolic disorders in cells, it stimulates DNA and protein synthesis, improves tissue respiration and ATP metabolism with energy release.

The medicine is available in tablet form, which are prescribed at 5-10 mg per day (maximum 50 mg). The pediatric dose is calculated based on the child's weight. The tablets are taken before meals. The course of treatment is no more than 28 days with the possibility of repeating the course after 1.5-2 months.

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

The drug should be used with caution in the treatment of elderly patients, nursing mothers, children, patients with chronic heart failure, coronary atherosclerosis, diabetes mellitus, and prostate hyperplasia.

The drug has many side effects, the occurrence of which is a reason for discontinuing the drug: edema syndrome, development of anemia, liver dysfunction, decreased blood viscosity and bleeding, hypercalcemia, various disorders in children, etc.

During treatment with the drug, constant monitoring of the blood levels of calcium, cholesterol, sugar, phosphorus and other components is required. The condition of the liver must also be monitored.

As for homeopathy, in case of metabolic disorders in cardiomyocytes, a multicomponent drug such as “Ubiquinone compositum” can be prescribed in the form of a solution for intramuscular administration.

It is prescribed to adult patients in a daily dosage of 1 ampoule. The frequency of administration is from 1 to 3 times a week with a course of treatment of at least 2 weeks.

The 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 of them), age under 18, periods of pregnancy and lactation.

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

Folk remedies

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

These include apples, cucumbers, onions, potatoes, and seaweed. Treatment with these tasty and healthy natural "medicines" is based on changing your diet. For example, a good effect in heart pathologies was noted in those patients who practiced apple, potato, or cucumber fasting days once a week. This means that during the day you need to eat only one type of food (in this case, apples, potatoes, or cucumbers) in an amount of 1 to 2 kg per day.

For those who cannot cope with such a diet due to the lack of variety of dishes, it can be improved. For example, on the day when only apples are allowed, we reduce their quantity to one kilogram, but introduce 300 g of low-fat homemade cottage cheese into the diet. During the cucumber fasting day, it is allowed to drink about 1 liter of fresh curdled milk or whey. With a potato diet, 1 kg of boiled potatoes without adding salt and 1 liter of curdled milk are allowed.

It is recommended to eat fractionally: in small portions 5-6 times a day, chewing food thoroughly so that the nutrients in it are better absorbed.

Another not so pleasant medicine is a gruel of onions and fresh apples, taken in equal proportions (can be chopped in a blender or meat grinder). Take the medicine 1 tbsp. 3 times a day.

Many have heard about the benefits of seaweed for beautiful skin, but not everyone knows that it improves the nutrition of cardiomyocytes. If metabolic processes in the myocardium are disturbed, it is worth buying kelp powder at the pharmacy and taking it one teaspoon three times a day.

Rose hips and hawthorn are also considered good helpers for the heart, as they normalize metabolic processes and increase the resistance of cardiomyocytes to unfavorable conditions of oxygen starvation.

As for herbal treatment, elderberry and arnica flowers, viburnum bark, rosemary, adonis, valerian, motherwort, yarrow and some other medicinal plants, which are used in the form of medicinal infusions, are considered beneficial for the heart.

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Prevention

One of the most important conditions for healthy functioning of the heart muscle over many years is considered to be the correct energy exchange in its cells. And here a lot depends on us, on our lifestyle, on how we monitor our health.

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

• giving up bad habits (smoking, alcoholism, drug addiction, overeating, etc.),
• normalization of the daily routine so that the body can fully rest,
• transition to a balanced fractional diet (products should have nutritional value, and not just kill hunger and please our far from healthy food preferences), which excludes overeating and unhealthy foods,
• an active lifestyle without excessive physical exertion (you need to learn to rationally distribute your energy),
• training in psychological methods of dealing with stress,
• if necessary, change jobs (after all, health is more important, sometimes no salary is enough to improve it),
• regular examination by a cardiologist if you have heart problems, and if you don’t have any, it’s worth doing an electrocardiogram at least 1-2 times a year, especially for middle-aged and elderly people (the fact that the heart doesn’t hurt doesn’t mean that it’s absolutely healthy),
• timely treatment of various infectious and inflammatory pathologies, endocrine diseases, health problems associated with improper functioning of the nervous and excretory systems, and, of course, caries, periodontosis, periodontitis and other dental problems.

Only with such a comprehensive approach to maintaining your health can you be sure that your heart will serve you for a long time and without interruptions, and your life will not end from unexpected cardiac arrest, the cause of which will be metabolic changes in the myocardium that were not noticed in time.

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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 disorders depends on the timeliness of seeking help and the accuracy of following the doctor's instructions.

The worst prognosis is observed with diffuse changes in myocardial tissue and the transition of the inflammatory process to a degenerative one. It is important to understand that myocardial dystrophy, even of a severe degree, can proceed almost asymptomatically, without causing pain in the heart or other unpleasant sensations. It can only be detected by simple diagnostic tests, such as ECG and ultrasound of the heart.

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