When, after eating, it hurts in the region of the heart at least once in a lifetime, but everyone felt it. Some immediately turn to a cardiologist, others ignore the problem, referring to overeating. But in one case or another, the heaviness in the sternum in the middle is caused by constant stress, alcohol abuse, smoking and environmental degradation.

Pressing pain in the middle of the sternum does not always occur when you overeat. Most often, this is a sign of pathological complications in the body, which indicate the manifestation of a disease of a cardiac, vascular, pulmonary, gastrointestinal, infectious and psychological nature.

Thanks to some tests, you will be able to identify the cause of the pain in the heart area, and you will be able to undergo treatment.

Cardiac pressing pain in the region of the heart

Causes of heart pain after eating

There are many factors that can cause unpleasant pressure and pain in the heart after eating.

Gastritis

Gastritis is an inflammatory process that covers the cavity of the gastric mucosa, leading to a malfunction.

One of the root causes of the manifestation of the disease is the formation of antibodies to the stomach's own cells. Sometimes pathology occurs against the background:

• not observing dietary food;
• alcohol abuse;
• smoking cigarettes;
• failure of the normal regulation of the human nervous system.

Gastritis

Chronic gastritis does not imply the presence of certain symptoms outside the period of exacerbation. And depending on what type of gastritis manifested itself, in the absence of a dietary menu, pains appear immediately or within half an hour after eating.

Can a stomach ulcer cause pain after eating?

Of course yes. After all, an ulcerative defect in the stomach cavity is considered a mandatory manifestation of this pathological disease.

And depending on the location of the ulcer, bouts of exacerbation may accompany:

• pain in the region of the heart after eating, half an hour or an hour after eating. There may be hunger pains that appear at night.
• dispersion phenomena;
• such attacks can exacerbate during certain seasons of the year, for example: in autumn or spring.

Pain syndrome does not disappear after:

• the use of antacids and antisecretory drugs;
• applying a hot heating pad to the site of pain localization.

Binge eating

Constant overeating leads to indigestion, which becomes an active provocateur of pain in the sternum. There is increased gas formation and a feeling of heaviness after eating. Although fatigue after eating can be a response (reaction) to foods, for example: to sweets or flour products. Discomfort can come from garlic. It all depends on the individual characteristics of the organism.

What should be done if the heart hurts after eating?

Those who have ever experienced chest pain after eating try to understand the causes of this phenomenon and what measures should be taken.

Given the fact that various factors can cause pain in the heart after eating, it is necessary to undergo an examination. Only highly specialized specialists will help to identify the cause of the discomfort. It is worth contacting a therapist, cardiologist, neurologist, gastroenterologist, surgeon, oncologist, and, if indicated, to a psychologist. But no one says that you should independently make an appointment with all doctors at the same time. Come to the therapist, he will examine you and give you a referral to narrow specialists.

Only after an appointment with a doctor and a series of tests will you be able to determine the cause of heart pain after eating.

It is necessary to conduct a number of laboratory and clinical studies that will determine:

• why there is pain in the region of the heart after eating;
• prescribe a correct and balanced diet in a particular case, a course of drug therapy.

Do not put off going to the doctor until later. After all, timely detection of pathologies at the initial stage of development will guarantee the effectiveness of treatment and complete recovery.

Yet:

Discomfort instead of satisfaction: why does extrasystole occur after eating? Why can the heart ache at night, and what is the danger of this symptom?

Could the contents of your plate be life-saving? Most of the studies show that the answer is yes. It turns out that almost 70% of cardiac problems could be avoided by choosing the right foods and avoiding heart-damaging foods. Do you want to know what a menu looks like that can save lives and prevent heart disease? Below you will find a universal recipe for how to maintain and strengthen your heart health with regular foods.

Eight rules for a heart-healthy diet

Control portion sizes

How much you eat is just as important as what you eat. Regular overeating is a direct path to obesity. Obesity is the shortest path to heart muscle dysfunction and vascular blockage. What consequences such a scenario is fraught with is perhaps not necessary to explain.

Eat more vegetables and fruits

Vegetables and fruits are good sources of vitamins and minerals. They also contain, as a rule, a minimum of calories and a maximum. In most herbal products, scientists find useful substances that prevent heart disease.

Prefer whole grains

Whole grains are a good source of fiber and other nutrients that play a significant role in maintaining healthy blood pressure.

Increasing your portions of your whole grain intake is easier than it might seem at first glance.

Limit unhealthy fats

Limiting saturated and trans fats is an important step in lowering blood levels and thus preventing ischemia.

High cholesterol leads to a build-up of lipid plaques in the blood, which can lead to atherosclerosis and increase the risk of heart attack or stroke.

The best way to reduce your intake of saturated and trans fats is to limit your intake of solid fats (butter, margarine). To do this, you can slightly reduce the portions of fat in sandwiches, cereals, soups, and also trim fat from meat as carefully as possible, give preference to lean varieties. Also, instead of fried potatoes, use baked cookies, instead of baked goods with creams - less high-calorie cookies.

In the process of cooking, it is better to give preference to such as olive oil, and which are found in some types of fish, nuts, seeds, avocados. Eating these fats instead of saturated fats helps regulate cholesterol levels.

Focus on fat-free proteins

Lean meats, fish, poultry, low-fat dairy products, and eggs are considered the best sources. Meanwhile, for people prone to cardiovascular disease, it is important to choose leaner options for these foods. For example, instead of whole, choose low-fat, and replace cutlets from fatty meats with boiled chicken breast.

Fish is also an excellent choice for the "heart diet" as it is an exceptional source of beneficial ones that lower blood triglyceride levels. The best choices in this regard are salmon, mackerel,. Plant-based sources of omega fats: flaxseeds, walnuts, soybeans.

Legumes such as beans, lentils, and peas are good sources of proteins that are low in lipids and free of cholesterol.

Minimize sodium intake

Eating large amounts of sodium can increase blood pressure, which increases the risk of heart disease. Limiting sodium intake is an important part of a healthy diet for your heart.

Doctors recommend that healthy adults consume no more than 2,300 mg of sodium per day, which is equal to 1 teaspoon of table salt. People over 50 years old, as well as people with high blood pressure, chronic kidney dysfunction, diabetes are advised not to exceed the norm of 1500 mg of sodium.

And it is important to remember that most of the excess salt does not come with freshly prepared food, but as part of canned food, instant food, and semi-finished products. It is also important to choose your seasonings carefully to reduce sodium intake.

Plan a menu

Now you know which foods are right for your heart and which ones are best to refuse. Use this knowledge to plan your menu. But it is important to introduce foods from different categories into the diet, focusing on foods from the allowed list. Make sure that the menu is varied and does not repeat from day to day. Consider the recommendations listed above.

Sometimes you can relax

Of course, it's better if your diet does not include foods from the list of harmful to the heart. But a chocolate bar or a few chips will not harm your heart if it appears in your diet from time to time. Give yourself a little indulgence when you feel like it. But remember, this is just a small indulgence, not a rejection of a healthy eating plan.

Take advantage of our advice, revise your menu. Let not only your stomach rejoice, but also the heart, which also has its favorite and hated dishes.

Benefits of different types of products

Product	What is useful	Remarks
	Rich source of Omega-3,; strengthens blood vessels and cardiac system	Eat baked
Sardines,	Rich in Omega-3 Acids, Lowers Cholesterol, Prevents Risk of Sudden Heart Attacks	Avoid canned food, which contains a lot of salt, if possible, give preference to "wild" fish, rather than raised in ponds
Liver	Contains fats useful for the heart, vascular system	Avoid excessively fatty
	A source of polyunsaturated fats, omega-3s, fiber, which support the functioning of the system	Avoid salty
Almond	Known for its rich omega-3 content	May serve as an alternative to walnuts
Oatmeal	Reduces cholesterol	Avoiding instant cereals with unhealthy additives
Blueberry	Contains resveratrol and which prevent coronary heart disease	Give preference to fresh fruits, can be combined with oatmeal, yogurt
Cherry	A source of components useful for the heart (,), which strengthen the walls of blood vessels, has the ability to lower blood pressure, and improves blood clotting
Strawberry	Reduces blood pressure, cleanses the walls of blood vessels from atherosclerotic plaques, regulates cholesterol; a diuretic, which is beneficial for lowering blood pressure
Cherries	Berry, rich in C, potassium and, which strengthen blood vessels
Red currant	Contains oxycoumarin, which promotes proper blood clotting, prevents myocardial infarction
Black currant	A treasure trove of useful components, strengthens blood vessels and heart, regulates the process of hematopoiesis
Red wine	Contains antioxidants (from grapes and other dark berries) that lower cholesterol and regulate blood pressure	Abuse Leads to the Opposite Effect
Green tea	The product is rich in antioxidants, flavonoids and catechins, which have many cardiovascular benefits, such as preventing blood clots	Consume at least once a day
Soy milk	A rich source of isoflavonoids that lower cholesterol and also contain beneficial for blood vessels
Black chocolate	Due to the presence of flavonoids, it stabilizes blood pressure, improves blood flow to the heart	The composition must contain at least 70% cocoa and not contain palm oil or other saturated fats
	Reduces blood pressure, high in potassium and immune-boosting antioxidants	A handful of raisins a day is enough
Broccoli	Rich source of powerful antioxidants and fiber	Better to boil, bake, steam without excess fat
Brussels sprouts	Contains many components useful for the heart, prevents inflammatory processes in the cardiovascular system, strengthens blood vessels
Cauliflower	The richest source of antioxidants, fiber, contains allicin, which prevents heart attacks and lowers cholesterol
Sweet potato	An excellent source of vitamin C, calcium and iron, which help stabilize blood pressure	Give preference to a vegetable with a skin - most of the heart-healthy substances are concentrated in it
Legumes (,)	Important sources of potassium, iron, fiber and flavonoids, which strengthen the heart and blood vessels, prevent system disturbances, and lower blood pressure	When eating a lot of fiber, remember to drink enough
	This and other yellow, orange and red vegetables are rich in beta-carotene, vitamin C and potassium, which are beneficial in preventing atherosclerosis, regulating water-salt balance, and lowering blood pressure.	Cook with a little vegetable oil (for better absorption of carotenoids)
Whole grain	Regulates cholesterol levels	Avoid Processed Grains
Apples	Extremely rich in antioxidants, in particular polyphenols, as well as pectin and fiber, which prevent high cholesterol, relieve swelling, stabilize blood pressure	The minimum daily allowance is 1 apple per day
	A rich source of pectin and flavonoids, which lower blood pressure, prevent inflammation in the arteries; contain hesperidin, which improves blood flow to the heart; contains large reserves of vitamin C, which is a powerful protector against stroke	Avoid for people with citrus allergies
Grapefruit	Good source of vitamin C, which reduces the risk of strokes, regulates cholesterol levels, and protects against heart attack and atherosclerosis	Avoiding grapefruit for breakfast for people taking heart medications
	Contains antioxidant substances, stabilizes blood pressure, prevents atherosclerosis	Drink at least a glass of juice a day
Avocado	A fruit rich in monounsaturated fats, vitamins B6, C and E, as well as good for the heart and iron; improves cholesterol levels in the bloodstream, prevents blood clots and hardening of the arteries, which are the cause of most heart disease	It is important to remember that this is a fairly high-calorie product.
Olive oil	A source of beneficial antioxidants that "unclog" arteries, considered the best oil for the heart	Must be natural, pure, free of impurities
Linseed oil	Exceptional source of Omega-3 fatty acids, prevents blood clots	It is important that it does not contain harmful impurities

Food as medicine

Disease	Healthy foods	Prohibited foods
Atherosclerosis, hypertension, ischemic disease	Fruits, vegetables, cereals, seafood, vegetable oils	Fatty dairy products, fatty meats and fish, processed meat, confectionery
Circulatory failure	Dried fruits, fruits, vegetables, nuts, dairy products, leafy greens	Salt, mushrooms, spices, spicy vegetables, fatty broths, chocolate
Angina pectoris, myocardial infarction	Chopped, boiled or baked vegetables and fruits, nuts, seafood, dairy products, fruit juices, broth, herbs, yesterday's bread	Fatty and processed meat, confectionery, warm bread, canned food, large amounts of salt and sugar, offal, grape juice, cocoa, legumes,

Also, our great-grandmothers used the healing power of herbs as preventive or medicinal preparations for cardiac ailments.

And with tachycardia, an infusion of motherwort. Our ancestors treated arrhythmias with hawthorn, lemon balm, valerian and yarrow. In case of heart rhythm disturbances, they also consumed black currant fruits, peaches and horsetail tea. Pain in the heart is relieved by cherries, infusion of asparagus or juniper fruits.

Meanwhile, it is important to consider: recipes for alternative medicine, especially when it comes to cardiac disorders, can be used only after consulting a cardiologist and only after his permission.

Do not self-medicate.

Food and herbs can be an excellent preventive measure, but not a substitute for treatment for serious pathologies in the heart or blood vessels.

After describing the diet for heart disease, recipes are presented with a description of the preparation recommended by nutritionists for heart disease.

The diet for heart disease depends on the patient's condition. If the heart disease is not accompanied by edema and shortness of breath, the diet should be close to that of a healthy person, that is, it should be rational. However, against the background of rational nutrition in the diet for heart disease in the stage of compensation, the following restrictions are necessary.

1. Meat and fish should be boiled.

2. Limit fats, carbohydrates should not exceed the norm.

3. Include fasting days (apple, milk, vegetable, berry). On fasting days, it is necessary to reduce physical activity, perhaps even lie in bed.

4. Limit the introduction of table salt to 5 g per day and liquid - to 1 liter per day.

5. To increase the introduction of vitamins, especially vitamin B1 - 3.5 mg and vitamin C - 100 mg.

6. To exclude substances that stimulate the nervous and cardiovascular systems (alcoholic beverages, strong coffee, tea, cocoa, spicy snacks, pickles).

7. Exclude cholesterol-rich foods from the diet for heart disease (liver, kidneys, brains, lungs, meat, fish broths, pork, beef, lamb fats).

8. Exclude from the diet foods that cause flatulence - legumes, grapes and grape juice, carbonated drinks.

7.Include in the diet for heart disease foods that promote bowel movement (vegetables, fruits, lactic acid products, juices)

8. Food must be taken 5 times a day, do not overeat. The last meal is 3-4 hours before bedtime, and a short rest is recommended before lunch.

All these requirements correspond to diet number 10, which is prescribed for heart disease in the stage of compensation.

The diet for heart disease accompanied by edema, that is, a state of decompensation or heart failure, depends on the degree of heart failure. Prescribe diet No. 10c, 10a, Karelian diet, Potassium diet.

Foods containing many lipotropic substances that prevent liver obesity (cottage cheese, buckwheat, oatmeal, lean meats and fish), potassium and magnesium salts are introduced into the diet for heart disease with heart failure. Food in the diet for heart disease with heart failure is prepared sparing, diet 6 times a day (diet No. 10a).

As the main diet for heart disease with grade I-IIa heart failure, diet No. 10c is prescribed, and diet No. 10a is prescribed in the form of fasting days 1 time in 7-10 days. If the patient is overweight, then apple, potato, milk, curd and milk fasting days are prescribed.

The diet for heart disease with heart failure of IIb degree is diet No. 10a, provided that the patient adheres to bed rest with fasting days - apple, rice-compote, from dried fruits, or prescribe the Karelian diet, or the Potassium diet. After improving the patient's condition, they are transferred to diet No. 10, or first, diet No. 10 is used for 1-2 days in the form of fasting days, and only with persistent improvement, they are transferred to diet No. 10.

The diet for heart disease with heart failure of the III degree begins with fasting days or with the Karelian diet, or with the Potassium diet, after improving the patient's condition, diet No. 10a is prescribed, observing fasting days 1 time in 7-10 days, then diet No. 10 is allowed the form of fasting days. With a persistent improvement in the patient's condition, he is transferred to diet No. 10, against which, if necessary, the Karelian diet is included for several days. The Karelian diet is a fluid-restricted, salt-free milk diet. She has 4 consecutive meals. I diet is prescribed for 1-2 days, II diet - for 3-4 days, III diet - for 2-4 days, IV - for 3-6 days. Karell's diet is described in detail in the section Therapeutic diets.

Diet for heart disease with heart failure should be expanded carefully, checking for swelling and shortness of breath.

Below are recipes for dietary meals for heart disease.

Diet for heart disease, recipes:

Diet for coronary heart disease

Principles of building a diet for coronary heart disease

At all stages of observation, in the process of prevention, treatment and rehabilitation patients with coronary heart disease diet therapy is built in accordance with the following principles

Correspondence of the caloric content of the diet to the energy needs of the body. The calorie content of the diet is calculated individually: depending on gender, age, level of physical activity and body weight. If the patient is overweight, a reduction in calorie content of no more than 40% (up to 1700-1400 kcal / day) is indicated. Fasting days no more than 1-2 times a week with calories up to 800-1000 kcal.

Control over the quantitative and qualitative composition of fat in the diet. Maintaining the correct ratio of saturated fatty acids (EFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA). Restriction of dietary cholesterol (the degree of restriction depends on the type of hyperlipidemia). It is important to meet the body's needs for phospholipids, plant sterols, lipotropic factors.

Correspondence of the total amount of carbohydrates in the diet to the energy needs of the body. The ratio of total / refined carbohydrates is not less than 7: 1. When indicated, insulinogenic refined carbohydrates are sharply limited up to their complete exclusion.

Meeting the needs for essential amino acids when the total protein content in the diet does not exceed 1.1 g / kg of ideal body weight, with the animal / vegetable protein ratio of 1: 1.

Pathogenetic balance of the diet in terms of vitamin composition, the content of micro- and macroelements, dietary fiber.

Compliance with the correct technological processing of products and medical dishes (removal of extractive substances, exclusion of fried, canned foods, hot spices, table salt for culinary purposes).

A fractional diet, including 4-6 meals. The last meal is 2-3 hours before bedtime.

Methodology for the differentiated use of dietary therapy for coronary heart disease

During the development of coronary heart disease, at different stages of its formation, metabolic disorders differ significantly, which necessitates the use of various methods of diet therapy.

With multifactorial primary and secondary prophylaxis, the use of a diet makes it possible to sufficiently effectively influence the disturbed metabolism and significantly reduce the significance of such risk factors for coronary heart disease as hyperlipidemia, overweight, low glucose tolerance, and arterial hypertension.

In the acute and subacute stages of the disease, adequate diet therapy, being the background for drug therapy, helps to restore the functional capacity of the myocardium, improve the course of reparative processes in the necrosis zone, reduce hemodynamic disturbances and hemocoagulation activity.

At the stage of rehabilitation of patients with ischemic heart disease, diet therapy helps to increase the body's resistance to stressful situations, corrects metabolic disorders.

In each case, it is necessary to individualize dietary recommendations, taking into account the characteristics of the course of the disease, its stage, and also taking into account the traditions in the patient's diet.

Literature

Oganov R.G. Ischemic heart disease (prevention, diagnosis, treatment). - M. 1998.

A. V. Pogozheva Fundamentals of rational diet therapy for cardiovascular diseases // Clinical dietetics. 2004.Vol. 1. No. 2.

A. V. Pogozheva Nutrition for ischemic heart disease // Medicine. The quality of life. 2007. No. 3.

Diet number 10, diet for atherosclerosis of the vessels of the heart and brain, hypertension - diet 10c

Indications: atherosclerosis of the vessels of the heart, brain, ischemic heart disease, hypertension against the background of atherosclerosis.

Cooking technology: meat, fish, poultry, vegetables, boil after chopping. Prepared without salt, food is salted with food.

Allowed:

Bread and flour products - wheat flour made of 1-2 grade flour, rye, doctor's, dry biscuit unsalted biscuits, baked goods without salt.

Soups - cabbage soup, borscht, beetroot soup, vegetarian soups with potatoes and cereals, fruit and dairy soups.

Meat, poultry, fish - various types of low-fat varieties, cut or chopped, after boiling, you can bake, seaweed, mussels.

Dairy products - low-fat milk and dairy products, low-fat cottage cheese and dishes made from it, low-fat, slightly salted cheese, sour cream - in dishes.

Eggs - protein omelets, soft-boiled 2-3 pcs. in Week.

Groats - buckwheat, oatmeal, millet in the form of crumbly and viscous cereals, casseroles. Limit rice, semolina, pasta.

Vegetables - cabbage of all kinds, carrots, zucchini, pumpkin, eggplant, potatoes, green peas in the form of mashed potatoes or finely chopped. Greens - in dishes.

Snacks - vinaigrette and salads with vegetable oil, including seaweed and other seafood, boiled jellied fish and meat, soaked herring, low-fat lightly salted cheese, low-fat boiled sausage, low-fat ham, sweet fruit salads.

Fruits, berries, sweets - raw ripe fruits and berries, dried fruits, compotes, jellies, semi-sweet mousses. Jam, sugar, honey is limited.

Drinks - weak tea with lemon, milk, weak natural coffee and coffee drink, vegetable, fruit and berry juices, broth of wild rose and wheat bran.

Fats - butter and vegetable oils for cooking and in dishes.

Excluded:

Pastry and puff pastry products, meat, fish and mushroom broths, legumes, fatty meats and fish, duck, goose, liver, kidneys, brains, smoked meats, all types of canned food, salted and fatty cheese, radish, radish, sorrel, spinach , mushrooms, chocolate, cream products, ice cream, peppers, mustard, strong tea and coffee, cocoa, animal and cooking fats, alcoholic beverages.

Tells cardiologist of the highest category, candidate of medical sciences Galina Znamenskaya.

10 kg per month ?!

It's great when a woman has a desire to take care of herself, to lose those extra pounds. As we get slimmer, we usually not only look younger and more attractive, but also feel healthier. But it is worth warning those who are determined to struggle too decisively with their own weight. The body is a delicate and complex system, everything is interconnected in it, so you need to act thoughtfully and gradually.

Let me give you an example. One of my patients came with complaints of pain in the heart. After talking with her, I learned that she set a goal for herself - to lose weight. To this goal she moved decisively: she went on a diet and began to disappear all day in the gym. As a result, 10 kg per month was gone. The woman was very pleased, if not for one "but": pains in the region of the heart began to disturb. By the way, according to the constitution, the lady was broad in bones and even in her youth she never looked like a fashion model, but here she decided to radically change - and in her almost 40 years she became slimmer than she was at 20. Fortunately, the examination did not reveal serious violations, interruptions in the heart were caused by excessive physical exertion and stopped after the patient began to visit the gym not five times a week, but two.

The flip side of the medal

According to the WHO recommendations, weight loss for those who are losing weight on their own, not in a clinic, should not exceed 3 kg per month. If you lose weight faster, this can cause a number of adverse changes: prolapse of internal organs, flabbiness of muscles and skin, metabolic disorders - including in the heart muscle. This means that the contractile ability of the heart deteriorates, it does not cope well even with the usual loads, not to mention the increased ones. In addition, rapid weight loss can be accompanied by a decrease in blood pressure - as a result, the heart suffers from a lack of oxygen, and this can lead to shortness of breath, tachycardia. All these processes begin slowly, with minor violations, which can then lead to more serious problems, especially if there is a hereditary predisposition.

The older a woman is, the more carefully she needs to try on herself various "weight-loss" techniques. Some are determined to go on a rigid diet after gaining weight from the onset of menopause. But if in youth, various experiments on oneself can still do without special consequences (and even then not always), then after 45 years, when age-related restructuring begins, such "trial and error" often lead to serious metabolic disorders.

No matter how much you dreamed of losing weight, remember: the daily diet should be at least 1200-1500 kcal! The body can safely withstand a diet limited to 600-700 kcal per day for no more than three days - then a protein deficiency occurs, the assimilation of vitamins and minerals is impaired.

The famous Dr. Christian Barnard, who was the first in the world to perform a heart transplant, wrote in his book "50 Ways to a Healthy Heart" that diets often lead to completely opposite results: "They make you fat, get depressed and get sick. Weight loss fanatics are 2 times more likely than other people to suffer from cardiovascular diseases and 5 times more often from diabetes. What you need is not a diet, but a nutritional plan that suits your lifestyle. You may be able to survive on a fruit and vegetable diet for a week, but what's the use? A meal plan can and should be adhered to throughout your life. At the same time, try to do without drastic changes and do not prohibit yourself. Love ice cream or chocolate - please, but not every day. "

If you don't have time to go to the gym, you can safely replace this activity with vigorous walking - 100-120 steps per minute - over long distances. This will both help you become slimmer and strengthen the cardiovascular system.

Always remember that optimal exercise should be pleasantly tired, not exhausted. The most productive work on yourself, on your figure is the one that gives you pleasure!

Elena Kobeleva, cardiologist, chief physician of the Seven Doctors clinic, tells everything that we are interested in knowing about the heart and the cardiovascular system.

Elena Kobeleva began her career in the regional cardiac dispensary, where she worked for 11 years, after that she worked as a medical director in a private cardioclinic on the basis of which the first private angiographic laboratory was opened, an angiograph was installed, where coronary angiography and angioplasty were performed. Then the work of the head of the cardiology department in the clinic "Medem", deputy chief physician for outpatient work. Now Elena works as the head physician of the clinic "7 Doctors" (St. Petersburg).

Heart disease is one of the leading causes of death

Diseases of the cardiovascular system are one of the most common causes of premature death in modern society. This problem is very urgent, and from year to year it becomes more and more acute. When I started work, men about 40 years old with heart attacks were very rare, we discussed each such case, examined at regional councils.

Today, unfortunately, a 40-year-old man with a heart attack has already become such an ordinary situation with which the doctor regularly meets in every cardiological hospital. Therefore, the problem is growing and the death rate is increasing.

Causes of a "young" heart attack

In my opinion, there are many reasons here and they work in combination, each contributes. First of all, these are the well-known risk factors for the development of cardiovascular diseases: arterial hypertension (persistent high blood pressure from 140/90 and above), smoking, high cholesterol levels, overweight. Heredity certainly also plays a role in risk factors.

Why high blood pressure is harmful

Due to the peculiarities of modern life, when tension and stress grows in our country, more and more people experience high blood pressure. At the same time, it is absolutely not necessary that a person clearly feels his increased pressure, he may not feel it at all, not control it and not reduce it in any way.

Increased pressure is the cause of microtraumatization of the vascular walls, the formation of atherosclerotic plaques, the formation of spontaneous blood clots that clog the vessels.

The effect of smoking on the cardiovascular system

Smoking is a very important risk factor. In fact, it is not in vain that attention is paid to the fight against smoking all over the world, but, unfortunately, despite the adopted legislative restrictions on smoking, the number of smokers in Russia is not decreasing so much.

In a simplified form, the mechanism of the harmful effects of smoking is as follows: toxic substances, resins, nicotine have a micro-damaging effect on the endothelium, which lines the vessels. This damage provokes regenerative processes in the vessel.

On the one hand, these processes are protective. On the other hand, there is a process of activation of cellular elements that begin to grow in order to patch the damage in the vessel, and all this leads to either a thickening of the membrane and the formation of an atherosclerotic plaque, or, if the damage is large, to the accumulation of platelets, adhesion, and ultimately to thrombosis. In fact, the body's protective actions against the effects of smoking provoke pathological processes in humans.

And arterial hypertension, and smoking, and overweight, and high cholesterol directly affect the walls of blood vessels, which ultimately leads to the progression of atherosclerosis.

Contribution of genetics to cardiovascular disease

The contribution of genetics is quite large, the doctor must always find out the hereditary predisposition to cardiovascular diseases.

It is believed that if the patient's mother had a heart attack earlier than at the age of 65, then this is early, the father is considered an early heart attack before the age of 55. In the same way, hypertension in many ways has a hereditary predisposition, and, as a rule, if the parents are hypertensive, then hypertension in children is quite likely. There are, of course, more subtle factors: you can do complex genetic tests in which hypercholesterolemia, coagulation factor, and a tendency to thrombosis are analyzed.

So yes, genetics are important. A person should be aware of his genetic predisposition, he should understand that if due to genetics he is at risk, then he needs to be more attentive to himself, to reduce the contribution of other negative factors (smoking, obesity, stress).

What can be determined with the help of research and how to determine the pre-infarction state

There is a standard cardiological examination: ECG, ultrasound of the heart, 24-hour monitoring, stress tests. On the ECG and with daily monitoring, we can detect rhythm disturbances and the so-called ischemic changes, that is, disturbances in the nutrition of the heart.

With echocardiography (ultrasound of the heart), the doctor looks at the size, contractility of the heart, and developmental defects. There is also such an important indicator as diastolic dysfunction - this is a violation of myocardial stiffness, when the heart does not relax well.

Violation of relaxation is a fairly early sign of problems in the work of the heart, very typical for hypertensive patients. Due to the high pressure, resistance in the vessels, the heart needs to work harder in order to eject blood, which means that the heart muscle begins to thicken - as any muscles increase under constant load. And it seems to be a compensatory mechanism, but the fact is that over time, this thickening is partially achieved not only due to muscle fibers, but also due to connective tissue.

Therefore, stiffness grows, the heart seems to be contracting still well, but it relaxes already slowly. And this, in turn, can lead to heart failure.

In cardiology, there is still such a method as an exercise stress test, which allows you to exclude some hidden problems of the cardiovascular system. We look at the state of the cardiovascular system at work (on an exercise bike or treadmill) during physical activity. The load level is calculated individually, depending on the age. It is believed that when such a pulse rate is reached, if there are any hidden problems with the vessels, then with a probability of 97% we will receive changes on the electrocardiogram or with a parallel ultrasound examination.

All these methods make it possible to determine the existing pathology and identify risk factors. At the same time, it is impossible to say absolutely definitely based on the results of an outpatient study whether or not there will be a heart attack.

How does a heart attack occur?

In addition to such chronic processes as vascular atherosclerosis, microdamage, there are spontaneous, acute processes. For example, a person has a lingering vasospasm - this can very quickly provoke the development of a blood clot, which clogs the vessel and gives a heart attack.

Or stress, pressure surge, microdamage, rapid blood clot formation and heart attack. Doctors are not able to predict the development of acute mechanisms, only to assess the risk factors.

How can you determine the state of the vessels

Without penetrating directly into the vessels, you can see what state they are in with the help of computed tomography (CT) of the heart.

Now CT of the heart has been actively developed with the determination of the calcification coefficient. This technique is called calcium scoring. The study shows the presence of calcium in the vessels at a fairly early stage. It has been shown that if the calcification coefficient is less than 100 points, then the probability that a person has a manifestation of coronary heart disease is very low, on the order of 1-2%.

This is what a CT scan of the heart looks like

If a person has heart pains, and exercise tests, 24-hour monitoring does not reveal any changes and a CT scan of the heart shows a calcification coefficient of less than 100, then the patient most likely has a heartache, but something else. It can be pain associated with radicular syndrome or stomach pathology.

But if a patient has atypical complaints, but we do a CT scan of the heart and get a calcification coefficient, for example, 350, this is an alarming result. In this case, you need to do coronary angiography, a study with direct contrasting of the coronary vessels. And, most likely, significant changes will be revealed there, which may require further, including surgical, treatment.

Is calcium harmful to the heart?

All of the above does not mean that calcium can be harmful to the body or that excessive consumption of vitamins with calcium can somehow damage the cardiovascular system. The fact is that calcium is a very interesting trace element, it is in our bones and connective tissue, it also exists intracellularly, it regulates the functioning of cell membranes. The use of calcium supplements for medical reasons will not lead to vascular calcification.

At the same time, there is a group of medicinal drugs called calcium antagonists, they block calcium at the level of cell membranes, regulate the cellular contractility of muscle fibers. These drugs do not flush calcium out of the body, as some patients think.

How to recognize a life-threatening acute situation and what to do

I would single out several acute conditions from the point of view of cardiology:

1. High pressure... It certainly needs to be reduced. A sudden surge in pressure can cause stroke, cerebral or vascular accidents. They reduce blood pressure with the most common drugs - as a rule, either Corinfar or Kapoten.

If the person is elderly, after 70 years, then the pressure should be reduced more smoothly. A sharp drop in pressure is a deterioration in cerebral blood flow. Ideally, in this case, the pressure should be reduced by 20% from the original. The pressure after taking the drugs will decrease in the next 15-20 minutes. You do not need to randomly take all the pills available.

There are also "folk", reflex methods that will also help: for example, a heating pad for the legs. Redistribution of blood, vasodilatation will lower the pressure and allow you to wait for the drugs to start working.

In any situation, with pain in the region of the heart or with high blood pressure, the usual mild sedatives will not be superfluous. If a person has, for example, valerian in his medicine cabinet, it is always better to take them.

2. Pain in the region of the heart... As for pain in the heart, this is a question that I would like to concretize.

Dangerous pains are associated precisely with ischemic heart disease, with vascular obstruction, the so-called angina pectoris - such pains have certain characteristics. As a rule, these are pains behind the sternum, of a compressive nature, not aching and stitching. These pains are very difficult to bear emotionally, causing an acute feeling of anxiety and fear.

As a rule, these dangerous pains are provoked by physical activity. ... What is meant: here, for example, a man walked quickly and was crushed in his chest. I stopped - and it seemed like it became easier. Pain is directly related to the load and occurs immediately during it.

But not so: he worked all day, came home in the evening, and something aches or hurts under the shoulder blade. These sensations are more often associated with increased pressure, muscle cramps, or some kind of radicular pain. Such delayed pain is unlikely to be cardiac pain.

It is important to dwell on this in detail, because the well-known remedy for chest pain - nitroglycerin, is actually not so harmless. Nitroglycerin taken under the tongue dramatically reduces blood pressure. An elderly person may take nitroglycerin under the tongue and faint because blood pressure has dropped.

If a person already knows his illness, knows that the attack is associated with coronary heart disease, then, of course, you need to take nitroglycerin, and if the pain is also very lingering, you need to additionally take aspirin to prevent thrombosis, and call an ambulance.

If a person did not initially have coronary heart disease, then, frankly, one must be careful with nitroglycerin. If the situation is not very well known, I would recommend better sedatives, pain relievers and, of course, see a doctor.

Can the heart ache from experience / stress

The human reaction to stress is typical throughout the body: the release of adrenaline and norepinephrine, components that can cause muscle contractions, vasospasm.

In principle, pain in the region of the heart can occur against the background of a stressful situation, and these pains can be associated with various reasons: a jump in pressure against the background of vasospasm (it can cause aching long-term discomfort in the region of the heart). Spasm of the coronary vessels can lead to the development of an attack of angina pectoris.

Small intervertebral muscles, intercostal muscles can spasm - this can provoke pain sensations associated with infringement of small nerve endings. These may be pains not of cardiac origin, but simply in the chest in the region of the heart.

It all depends on the nature of the pain. The clinical situation is very important, the doctor will find out the details: how it hurts, where it hurts, and in connection with what it hurts.

What to do if the vessels are heavily clogged

There are two options. For example, if, according to the results of research, a narrowing of a large cardiac vessel is found, it certainly needs to be expanded. This is done during a surgical operation using angioplasty and stenting: a heart balloon is inserted into the vessel, expanded, and then a small frame made of a thin mesh is placed there.

In an acute situation, this assistance is provided through the compulsory medical insurance system. It has been proven that such active tactics in a patient with acute coronary syndrome (or an already onset heart attack) significantly improves life prognosis and reduces mortality. Simply put, such an operation can save lives. This is what concerns an acute situation, a heart attack.

If the patient has chronically existing angina pectoris, pain associated with ischemic heart disease, or vasoconstriction is simply revealed, but there are no obvious manifestations and there is no heart attack, the patient can be managed conservatively, that is, he can be treated with pills, physically trained, and the influence of negative factors. And, in principle, in the long term we will get the same results as with the operation.

In this situation, several groups of medicines are used: antiplatelet agents, which thin the blood and improve the permeability of blood through small vessels (for example, aspirin), and the so-called statins, drugs that lower cholesterol levels. Statins not only lower cholesterol, they have pleiotropic effects: improving the state of the inner lining of endothelial vessels, its reactivity. Statins are the second main drug to be taken by a patient with manifestations of coronary heart disease and high cholesterol. Moreover, this technique should be constant, all life.

The risks of side effects with statins are no higher than with all other drugs. They have been widely accepted since the 1980s. For treatment, of course, other groups of drugs are also used, depending on the specific clinical situation.

Effects of anabolic steroids on the heart

First, indeed, because of steroids, the muscle mass of a person, including the mass of the heart, increases, hypertrophy occurs, which leads to the fact that the hypertrophied muscle of the heart begins to relax worse, which leads to the appearance of subsequent changes in the heart.

When resistance increases, the atrium, as a rule, does not hypertrophy, and there is no greater thickness there. And due to the growth of the overall size of the heart, it is forced to stretch. This stretching makes it more electrically unstable, and this in itself provokes a disturbance in the heart rhythm. Certain electrolyte changes can occur in athletes and in people taking steroids due to this overstretching of the atrium and hormonal imbalance, such people are more likely to develop heart rhythm disturbances.

Secondly, these patients often undergo hormonal changes, in particular, provoking hypertension.

Dangerous heart rhythm disturbances

In recent years, the number of people with atrial fibrillation, or atrial fibrillation, has increased significantly. There are two main dangers in these conditions: thromboembolic complications and heart failure.

The heart works like this: the atrium contracted, threw out blood, then the ventricle, and then the blood went into the body. When a rhythm disturbance occurs, the atrium stops contracting at once, and chaotic twitching occurs. And part of the ejection of blood does not occur, this reduces the stroke volume, a one-time ejection of blood by about a third, and this is a fairly significant volume.

It turns out that the heart pumps much less blood, it stagnates, and this can trigger the process of heart failure along a long mechanism. Heart failure leads to a decrease in exercise tolerance, rapid fatigue, shortness of breath, as an extreme option, the appearance of edema. As a result, a significant deterioration in the quality of life and, in the long term, a decrease in life expectancy.

With non-simultaneous contraction of the atrium, conditions are created for the formation of intracardiac thrombi. If a fragment of such a thrombus breaks off, it can enter the blood vessels of the brain with the blood stream and cause a stroke.

Impact of heart rate on life expectancy and health

Heart rate has been actively discussed by the world medical community for the past 10 years. To date, it has already been proven that an excessive heart rate (high resting heart rate) is a negative factor. The less often the heart beats, the better.

Now the norm is considered a resting heart rate in the range of 55-80 beats per minute. More than 80 is already a bit too much. By the way, before the upper limit of the norm was 90, now it is believed that it is better to have a pulse of up to 80 beats per minute.

Why is the heart beating / does the heart have a finite resource?

In the human heart, there are certain cells that spontaneously develop an action potential: an electrical process that leads to the so-called membrane repolarization - this produces an electrical impulse, which then spreads through the heart, from these cells, reaches the muscles and instructs them to contract.

The central nervous system and the brain can, due to certain of their influences, the production of active substances, for example, adrenaline, regulate the heart rate. We are worried: we have a rapid heartbeat, but initially the impulse to the heartbeat arises in the heart. This is called the automatism function.

There are several levels of automatism. The most active cells are in the sinus node: that's why we call normal heart rhythm sinus. When our sinus node is working normally, it discharges all the underlying parts of the heart. And if suddenly, for some reason, the sinus node does not work, a rhythm may occur in the lower parts, only it will be more rare.

Today there is such an opinion that the resource of the sinus node is limited by a certain number of impulses. Hence the hypothesis arose that the more often the heart beats, the faster the resource is consumed and the shorter the life.

Does exercise wear out the heart and shorten life?

No, this is not happening. Physical fitness, on the contrary, allows in everyday life situations to quickly restore the pulse to a calm one. For example: an untrained obese person, after 5 minutes of a brisk walk, can restore the pulse for 15-20 minutes or longer, and an athlete will take 1-2 minutes to do this.Imagine that this situation occurs every day several times a day.

Physical activity is useful and desirable for at least half an hour and daily: better for half an hour 5 times a week than once 3 hours.

What load on the body is useful, and what is excessive and harms the cardiovascular system

We usually say that the training load is somewhere around 75-80% of the submaximal (the calculation is as follows: the maximum heart rate is 220 minus age. The submaximal frequency is 85% of the maximum). And you can safely carry out the load that such a pulse gives you - it will train, strengthen, develop for you.

In principle, any workout is good, useful, it allows you to develop the cardiovascular system so that it can work in an economical mode. Training loads are not super-high and intense, but quite the opposite - monotonous and increasing in duration. For beginners, we recommend that you first walk along the path at a regular pace, for the first time 10 minutes, without bending. Then - 15 minutes at the same speed, in the future you need to load yourself for at least half an hour and monitor your pulse. Do not do "slides", increase the duration and monotony of the load - this will train the heart muscle.