Myocardial dystrophy (myocardial dystrophy): what it is, forms and stages, symptoms and treatment

Myocardial dystrophy is degeneration, thinning of the muscle layer of the heart. It develops as a result of a number of external and internal factors. The question of the influence of direct inflammatory moments on tissue conditions remains controversial.

It is not considered an independent unit, the ICD-10 code is I42, the pathology is classified as cardiomyopathy. The postfix indicates the origin of the deviation.

Recovery with a developed process no longer makes much sense: the heart in any case turns out to be incapable of full contractions and the release of blood in adequate volumes. Supportive therapy.

General information

In cardiology, the term myocardial dystrophy (myocardial dystrophy) combines a group of non-degenerative and non-inflammatory lesions of the myocardial cardiac muscle.
The code for myocardial dystrophy according to ICD-10 is I42.8 Other cardiomyopathies (dishormonal refers to I42.9 Cardiomyopathy, unspecified). The pathology is characterized by significant changes in metabolic processes and a pronounced decrease in the contractile function of the myocardium. Cardiac dystrophy is always a secondary process that combines electrolyte, dysmetabolic, neurohumoral, enzymatic and autonomic disorders. Dystrophy of the left ventricle of the heart is characterized by changes both in the myocytes themselves and in the structures of the conduction system of the heart, which leads to disturbances in the basic functions of the myocardium:

• excitability;
• conductivity;
• automatism;
• contractility.

Dystrophic degeneration of the myocardium, especially at the initial stage, is usually reversible, which greatly distinguishes it from the degeneration that occurs with cardiac amyloidosis and hemochromatosis .

Briefly about the structure of the myocardium

The myocardium is the middle (muscular) layer of the heart and consists of specific cells - cardiomyocytes. It also contains fibers of the conduction system that generate impulses for contraction of the organ. Among them:

• sinoatrial node (Kisa-Fleck);
• atrioventricular node (Aschoff-Tavara);
• right and left bundle branches;
• Purkinje fibers.

The myocardium of the ventricles and atria is separated from each other, due to which they are able to contract unsynchronously. The muscular layer of the ventricles is more developed and can reach 11 mm for the left and 5 mm for the right. This is due to the fact that they do more work. The thickness of the walls of the atria ranges from 2 to 3 mm.

Myocardial functions

• contractility, due to which blood is distributed throughout the body;
• excitability - the ability to contract in response to internal or external stimuli;
• conduction of an impulse through the fibers of the conductive system;
• automatism - the ability to relax and contract independently without external stimulation.

For muscle cells to contract, the following conditions are necessary:

• mitochondria must produce sufficient energy;
• cardiomyocytes, with a normally functioning conduction system, are required to capture the nerve impulse;
• Sufficient potassium levels must be maintained.

With myocardial dystrophy, the contraction process is noticeably disrupted, which leads to poor circulation, and all organs and tissues of the body do not receive the necessary nutrients and oxygen.

Pathogenesis

metabolites accumulate . As a result of changes in biochemical processes in the myocardium, the contractility of muscle fibers is disrupted, heart failure arrhythmias develop .

Myocytes are able to fully recover after eliminating the influence of negative factors. However, too long an exposure can lead to partial death of cardiomyocytes, which are subsequently replaced by connective tissue. cardiosclerosis is formed .

Dysmetabolic type

A separate type of myocardial dystrophy, which is not officially recognized by doctors, is dysmetabolic disease . Usually it is a consequence of an imbalance of carbohydrate and protein foods consumed by a person who consults a doctor. The name of the “unwritten” diagnosis directly indicates that the existing disorders are associated with metabolism, that is, metabolism, failures in which progress in the myocardium.

Such metabolic disorders are observed as a result of a lack of vitamins, proteins, iron (nutritional depletion), diabetes mellitus (often myocardial dystrophy that arises for this reason is called diabetic), amyloidosis (a disorder of protein metabolism with the deposition of the product of protein transformation - amyloid) in the tissues.

Signs of dysmetabolic dystrophy

With dysmetabolic myocardial dystrophy, it is extremely important to respond to symptoms, even if they are characteristic of the initial stage of the disease. The development of the disease is accompanied by:

• Shortness of breath, tachycardia;
• Cardiac pain syndrome;
• Increased fatigue;
• Infrequent pulse, decreased blood pressure;
• The presence of murmur over the pulmonary artery;

A subsequent sign of long-term and progressive myocardial dystrophy may be heart failure.

Classification

Pathological changes in the heart are classified according to the causes of their occurrence, which will be listed below in the appropriate section, by stages and by the speed of development.

By stages

• Compensation stage . At this stage, all changes are reversible. Gradually, foci of dystrophy form in the heart muscle, which are noticeable at the microscopic level. Symptoms are minimal or completely absent.
• Subcompensation stage . All changes in cardiomyocytes are still reversible. Confluent foci of dystrophy are formed. All changes are visible at the macroscopic level, the chambers of the heart begin to enlarge. Symptoms are increasing.
• Stage of decompensation . The changes become irreversible. necrosis occurs with their gradual replacement by connective tissue, which is unable to perform the normal functions of cardiomyocytes. The structure of the heart changes, symptoms increase sharply, and the patient’s condition worsens significantly.

Classification by speed of development

• Acute form . It occurs abruptly against the background of intense exposure to negative factors ( pulmonary embolism , severe physical overexertion, complicated hypertensive crisis ).
• Chronic form . It is formed under prolonged exposure to internal and external factors of moderate strength (frequent acute infections, chronic intoxication).

The mechanism of pathology development

Myocardial dystrophy is caused by a variety of reasons. Therefore, the process itself progresses or originates in different ways.

In any case, the basis of the disease is a violation of metabolic processes in the cardiac structures.

The approximate development scheme includes three stages:

• The emergence of a primary, provoking factor. This could be due to endocrine deviation, intoxication, or other issues.
• Impact on the muscle layer of the organ. The normal supply of oxygen and nutritional compounds is blocked. Trophy at the local level drops significantly.
• “Consolidation” of the result. There is a chronic deficiency of necessary substances and stabilization of dystrophic phenomena (thinning of the muscle layer of the myocardium).

The process can develop over a week, month or years. Depends on the aggressiveness of the pathology.

Destruction occurs gradually, not in one second. Typically, from the moment the first symptoms appear until a clear clinical picture emerges, it takes from 6 to 24 months. This gives hope for high-quality diagnosis and comprehensive treatment.

Causes

Myocardial dystrophy can develop under the influence of a variety of internal and external factors that disrupt the flow of metabolic and energy processes in the heart muscle.

Degenerative changes can form under the influence of acute and chronic exogenous intoxications (drug, industrial, alcohol), various physical agents (overheating, vibration, radiation).

The structure of the myocardium

Quite often, changes in the heart muscle are formed as a result of:

• metabolic and endocrine disorders (pathological menopause, Itsenko-Cushing syndrome , vitamin deficiency , obesity , diabetes mellitus , hyperparathyroidism , hypothyroidism , thyrotoxicosis );
• infections (chronic tonsillitis );
• systemic diseases (neuromuscular dystrophy, collagenosis);
• diseases of the digestive tract ( pancreatitis , cirrhotic liver disease , malabsorption syndrome ).

In newborns and young children, myocardial dystrophy can develop as a result of intrauterine infection , perinatal encephalopathy , and cardiovascular maladaptation syndrome due to hypoxia .

Pathological changes in the heart can also be observed in athletes, which is associated with excessive physical overload ( pathological athletic heart ).

Dishormonal myocardial dystrophy

It is diagnosed mainly in women aged 45-50 years. Occurs as a result of disturbances in the estrogenic functions of the ovaries. Dyshormonal cardiodystrophy occurs extremely rarely in men aged 50-55 years as a result of disturbances in the production of the hormone testosterone .

Main complaints:

• pain in the heart area during hot flashes;
• sensations of heat in the chest;
• increased sweating;
• feeling of rapid heartbeat.

If the patient has concomitant hypertension , heart failure may develop as a complication.

The dyshormonal form of myocardial dystrophy also includes changes in the heart muscle caused by disturbances in the functioning of the thyroid gland.

Cross-section of the heart with myocardial dystrophy

With thyrotoxicosis (hyperfunction of the thyroid gland), metabolism accelerates, which leads to weight loss, rhythm disturbances, insomnia , thirst, increased excitability of the nervous system and excessive nervousness.

With hypothyroidism, metabolism slows down. Patients complain of low blood pressure , swelling, a feeling of chilliness, and aching chest pain.

Fatty degeneration of the myocardium

With severe metabolic disorders, fats begin to be deposited in the heart muscle, completely replacing the cytoplasm of cardiomyocytes over time. Fatty degeneration of the myocardium leads to a significant decrease in the contractility of the heart.

Patients complain of severe shortness of breath and aching pain in the area where the heart is located. In more advanced cases, swelling of the lower extremities occurs. Such patients are primarily indicated for lifestyle correction in parallel with drug therapy.

Dysmetabolic myocardial dystrophy

What is dysmetabolic myocardial dystrophy and when does it develop?

This pathology is observed in patients suffering from diabetes. It occurs as a result of metabolic disorders, which leads to damage to the coronary arteries . Patients complain of chest pain, simulating angina . The pain is not relieved by Nitroglycerin and is less intense.

Myocardial dystrophy of mixed origin

Several factors contribute to the development of this pathology.

What is it and how does it manifest itself? Most often, mixed myocardial dystrophy is observed in children suffering from chronic anemia . In young patients, neuroendocrine myocardial dystrophy develops, and electrolyte metabolism changes. A similar disease can also occur in adults. The very first diagnostic signs on the ECG are dysfunction of contraction (especially in the left ventricle). In the absence of adequate timely therapy, the negative effect on the heart is aggravated, disturbances begin to be registered in relation to automaticity, excitability and conductivity of the heart. And as a complication, the patient develops an acute hemodynamically significant pathological disease.

Myocardial dystrophy of complex origin

This variant is characterized by a more severe course. The disease is provoked by a systematic disturbance in the metabolism of organs and tissues, which leads to systemic changes. The first symptoms of the disease are nonspecific, which makes early diagnosis difficult. In more advanced cases, patients complain of respiratory disorders, arrhythmias, and increases in blood pressure.

Alcoholic cardiac dystrophy

It is generally accepted that this form develops with systematic, daily consumption of alcohol for 10 years. However, with a hereditary deficiency of specific enzymes that are responsible for processing ethanol, the disease can develop within 3 years. Most often, males aged 25-55 years are affected.

Myocardial dystrophy with anemia

When hemoglobin decreases below the level of 90-80 g/l, hemic hypoxia , which is accompanied by an energy deficiency in the heart muscle. The disease develops against the background of chronic blood loss, hemolytic and iron deficiency anemia, and DIC syndrome .

General concept

Myocardial dystrophy: what is it?
Such a pathology is always a manifestation of another disease. The heart muscle undergoes pathological changes that are not inflammatory in nature. A similar anomaly is observed in people of different age categories: both infants and old people suffer from it. But myocardial damage is more often observed in elderly patients. Disturbances in the functioning of the heart muscle respond well to treatment, which allows a person at the initial stage of the disease to easily restore their previous standard of living. How does the myocardium react to developing dystrophy:

• Free radicals accumulate, destroying cardiomyocytes (heart cells).
• There is a significant decrease in cells capable of conducting electrical impulses and contracting.
• The need for oxygen is constantly growing, and heart cells lose the ability to absorb it.
• High levels of calcium reduce the tone of the heart fibers, and the tissues do not receive the necessary nutrition.
• The myocardium reacts sensitively to every surge of adrenaline, this weakens it.

The result of dystrophic disorders can be:

1. Dilation. The cavities of the heart chambers expand, their size becomes larger, but there is no tissue hypertrophy.
2. Hypertrophy. The walls of the myocardium become denser and their thickness increases.
3. Restriction. The parts of the heart begin to shrink and “shrink.”

The heart needs energy to contract. Most of it is produced in a state of cardiac rest (pause between contractions). For a biochemical reaction to occur, during which energy is released, the participation of hormones, glucose, various types of acids and enzymes, amino acids, ketone bodies, and oxygen is necessary. All these substances enter the heart through the blood. When there is nothing to draw energy from, myocardial cells use reserve glycogen. Obtaining kilocalories in this way can be carried out even in the absence of oxygen. But such food does not last long.

Myocardial dystrophy develops with complete energy deficiency. The advanced stage of the pathological condition leads to replacement processes, accompanied by the death of cardiomyocytes and their replacement with scar tissue.

Symptoms of myocardial dystrophy

The symptoms of myocardial dystrophy directly depend on its stage. In the early stages of development, cardiac complaints may be absent. Patients experience decreased performance, rapid fatigue, and poor tolerance to habitual physical activity.

Later, as the disease progresses, patients begin to complain of prolonged, aching pain in the heart area that is not associated with physical activity and does not stop after taking Nitroglycerin . But at the same time, emotional and physical stress can provoke chest pain in such patients, but after a certain time. Most often the pain is causeless.

Often there is a feeling of rapid heartbeat, a feeling of lack of air, and shortness of breath. At later stages, swelling appears in the lower extremities, arrhythmias , and shortness of breath appears at rest. During an objective examination, you can hear a weakening of the first sound above the apex of the heart, tachycardia and a short systolic murmur.

Clinical symptoms largely depend on the cause that led to changes in the heart. With menopausal pathology, patients complain of a feeling of heat, frequent “hot flashes”, excessive sweating, and a feeling of paresthesia in the extremities. With thyrotoxicosis , rhythm and conduction disturbances develop quite quickly, and with anemia , the symptoms of heart valve defects are simulated (a pathological systolic murmur appears, characteristic of insufficiency of one of the valves: aortic, tricuspid or mitral).

Stages of the pathological process

The second method of classification is by stage.

• The first stage is also neurohumonal. Minimal local symptoms are observed. The nature of metabolic disorders is not noticeable, but metabolic abnormalities are already present. Defects cannot be detected either on an ECG or using an ultrasound or tomographic method. The symptoms are nonspecific and have a vague character, which does not allow us to accurately determine the cause of the ailment.
• Second stage or organic phase. Objective features of the pathological process are already present. Most often, the diagnosis is made at this point. But this is not an axiom either. In some cases, the manifestations are so scanty that they are not able to motivate the patient to go to the doctor.
• The third stage is heart failure. The final stage of the condition. Accompanied by pronounced changes in well-being and clinical picture. Diagnostics is not a problem even for an inexperienced specialist.

Classifications are actively used in clinical practice for fixation and selection of therapy.

Tests and diagnostics

In the anamnesis, patients with myocardial dystrophy reveal various pathological conditions and diseases, which are manifested by disturbances in metabolic processes and tissue hypoxic syndrome. Objectively, when examining the heart, you can hear a weak systolic murmur, a weakening of the first sound at the apex of the heart, muffled heart sounds and irregular rhythm.

The electrocardiogram records nonspecific changes in the myocardium, disturbances in repolarization processes, arrhythmias, and signs of decreased myocardial contractile function.

Drug and stress tests give a negative result (coronary artery disease is excluded).

When performing phonocardiography , the ratio of the duration of electrical and mechanical systole changes.

Echocardiography confirms the expansion of the cavities of the heart, changes in the structures of the heart muscle are recorded. In this case, no organic pathology is observed.

If chest x-ray a myopathic configuration of the heart , then this indicates deep damage to the myocardium.

Using scintigraphy, you can assess the perfusion and metabolism of the heart muscle, detect diffuse/focal changes, which will indicate a decrease in the number of normally functioning cardiomyocytes.

In extremely doubtful cases, they resort to myocardial biopsy , when all non-invasive studies performed have not yielded any result. Differential diagnosis is carried out with such diseases as:

• myocarditis;
• IHD;
• cor pulmonale;
• cardiosclerosis;
• heart defects.

UAC indicators are usually normal.

What needs to be examined

Performed by a cardiologist, usually on an outpatient basis unless the patient is critically ill.

Since the origin of the process is extremely confusing, the involvement of a whole council of doctors is required, each ruling out their own group of pathologies.

List of main activities:

• Oral interview, history taking.
• Measurement of blood pressure, heart rate.
• Auscultation. Listening to sound.
• Daily monitoring using an automatic programmable tonometer. Records the same indicators for 24 hours. Multiple appointments are possible.
• Electrocardiography. Study of the functional characteristics of a muscular organ.
• Echocardiography. Ultrasound technique for tissue visualization.
• MRI (in controversial cases).
• Coronography. To assess the speed and nature of blood flow, and therefore the quality of heart nutrition.

Additionally prescribed: general blood test, biochemistry, hormonal techniques, assessment of neurological status, electroencephalography, ultrasound of the abdominal cavity and, as necessary, stress tests, scintigraphy (radioisotope study).

The list is adjusted taking into account the needs of rational diagnosis.

Treatment of myocardial dystrophy with folk remedies

Traditional methods of treatment can only be an addition to the main therapy, but not replace it.

Rosehip flower tincture

The prepared solution helps to normalize cardiac activity, even out heart rhythm during arrhythmia, and replenish the lack of vitamin C.

Pour two cups of boiling water over 2 tablespoons of rosehip flowers and let it brew for an hour. The prepared infusion should be taken before meals, 1 tablespoon.

Lemon harvest

Citrus collection will help normalize heart function and strengthen the heart muscle. To prepare a thick paste, you need to grind 150 grams of fresh figs and 250 grams of lemon in a meat grinder. Then add 50 grams of vodka and 100 grams of liquid bee honey to the resulting consistency. Lemon infusion should be taken three times a day, 1 teaspoon.

Honey-beet tincture

To improve blood circulation in the heart muscle and get rid of tachycardia, honey-beetroot tincture is recommended. Additionally, the solution has a sedative effect.

To prepare, stir 1 teaspoon of bee bread in 100 ml of a mixture of beetroot juice and honey (50/50). Let sit in the refrigerator for 3 hours. The resulting infusion should be taken three times a day, 3 tablespoons.

Folk remedy for shortness of breath

A frequent companion to myocardial dystrophy is shortness of breath . Breathing practices help combat it. Additionally, you can use proven traditional methods.

Squeeze the juice out of 10 whole heads of garlic and 10 lemons, and mix the resulting solution with 1 liter of bee honey. Place the finished mixture in a container, seal it tightly, and place it in a cool, dark place for 7 days. You need to take 4 teaspoons of the mixture daily for two months. The mixture should not be swallowed immediately; try to dissolve it slowly.

Vitamin cocktail

One of the primary tasks in the treatment of heart pathology is the general strengthening of the body and acceleration of metabolism. A healthy vitamin cocktail will solve these two problems at once.

Mix the juice of 1 grapefruit, 2 kiwis and 4 oranges. Pour a glass of rose hips into a liter of water and cook for 20 minutes. Let cool, then strain with cheesecloth and add to the berry mix. Additionally, grate the ginger root and add 1 teaspoon of honey to the resulting mixture.

Healing herbal tea

The presented recipe will allow you to prepare a collection that has a positive effect on the functioning of the cardiovascular and endocrine systems.

You'll need:

• 2 tbsp. spoons of oregano and valerian;
• 1.5 tbsp. spoons of adonis flowers and mint leaves;
• 1 tbsp. a spoonful of motherwort herb, juniper and dill fruits.

Pour boiling water over everything at the rate of 1 tbsp. spoon of herbal mixture per 1 liter of water. Bring the infusion to a boil and let it sit for 24 hours. You need to take the resulting solution before meals, 100 g.

Treatment of myocardial dystrophy

The treatment process includes medication, optimization of the daily routine and dietary nutrition. The patient can treat myocardial dystrophy at home, taking prescribed medications. Therapeutic influence is carried out in the following directions:

1. Elimination of the cause of the pathology, since the symptoms and treatment of dystrophy depend entirely on it.
2. Ensuring normal nutrition of the heart muscle.
3. Stabilization of metabolic reactions in myocardial tissues.

To improve the patient’s condition and prevent pathological changes, the following medications are prescribed for the treatment of myocardial dystrophy:

• A group of drugs with a high content of calcium and potassium (“Asparkam”). They help restore electrolyte balance and stabilize the functions of pathways.
• Magnesium is needed for normal electrolyte balance, restores damaged cells, and helps cells become saturated with oxygen.
• Drugs to improve metabolic reactions (“Mildronat”). Relieve pain in the heart, provide blood supply to damaged areas. Promote the removal of waste elements. Promote cellular respiration.
• “Riboxin” is needed to improve breathing and metabolism in tissues, helps the heart contract well and rest properly.
• “Dipyridamole” promotes good blood flow, eliminates pain, and dilates the walls of blood vessels.
• "Anaprilin" from the group of beta-blockers reduces the effect of the sympathetic nervous system on the myocardium. The load on the heart decreases, it contracts at a moderate pace.
• "Teonikol" (anticoagulant) is necessary for nutrition, respiration, cell restoration, and ATP synthesis. Stimulates the occurrence of redox processes.

An important role in the treatment of myocardial dystrophy is played by optimizing lifestyle. This is necessary to maintain the heart muscle and its rapid recovery:

1. Complete rest during the day and at night.
2. Adequate physical activity.
3. The use of contrast showers and therapeutic baths.
4. Massage treatments to improve blood flow.
5. Development of stress resistance. Relaxing activities.
6. Refusal of harmful addictions.
7. Normalization of nutrition: low calorie content, low salt, limited fluid intake, saturation with vitamins, ban on fatty and smoked foods.

Prevention

Lifestyle is of great importance in the prevention of myocardial dystrophy. Almost all preventive measures are aimed at correcting an existing lifestyle.

It is recommended to stop drinking alcoholic beverages and smoking. It is necessary to promptly treat all identified pathological changes in the heart muscle and various infectious diseases.

It is important to monitor the correct functioning of the endocrine system. obese people - dietary. Weight correction is important.

It is better to avoid excessive physical activity so as not to force the heart once again. When playing sports, you must take into account your physical fitness. Don't forget about warming up, which allows you to balance physical activity. Try to refuse to work in hazardous industries - health is more valuable than any money.

Main aspects of the prevention of myocardial dystrophy

• sanitation of foci of infection;
• complete, healthy, balanced diet;
• timely maintenance drug therapy (if cardiac pathology is detected, especially with dystrophic changes in the myocardium).

The basis of the disease is the nerves

It is worth mentioning such a type as neuroendocrine myocardial dystrophy. Frequent, strong neuroses and anxieties lead to its appearance. The tension of the nervous system, which is in a state of increased excitability for a long time, contributes to the excessive release of adrenaline into the blood. This disrupts the body's natural balance of its consumption, which increases the load on the heart muscle. As a result, myocardial dystrophy occurs.

It should be noted that modern life is quite conducive to the emergence of such diseases, since most people are subject to stress and stress on the nervous system. Therefore, examinations by a cardiologist and neurologist for preventive purposes are mandatory.

In children

In children, myocardial dystrophy can develop as a result of hypervitaminosis , rickets , chronic dietary disorders, bacterial and viral infections. Often this pathology is observed at an early age due to lack of physical activity, or, on the contrary, due to excessive force overload.

In pediatric practice, myocardial dystrophies that developed as a result of drug poisoning were observed.

Most often, the cause of the disease is vegetative, nervous and endocrine disorders.

The main symptoms in children consist of:

• asthenia;
• shortness of breath with minimal physical activity;
• weakening the sonority of heart sounds.

How is cardiodystrophy different from cardiomyopathy?

At first glance, it seems that both diseases reflect the same pathological condition of the heart and are synonymous. However, this is not at all true. The term “cardiomyopathy,” introduced in 1957, refers to a much broader range of various disorders of the heart, which is not directly related to diseases of the organ itself.

For example, secondary cardiomyopathies are distinguished - dysmetabolic, associated with metabolic disorders in pathologies such as diabetes mellitus, obesity; hypertensive - against the background of arterial hypertension; atherosclerotic - occurs with atherosclerosis (a disease in which plaques form in the walls of blood vessels due to impaired lipid metabolism). In addition, there are primary forms of cardiomyopathies, in which the heart suffers for unknown reasons, without damage to any other systems or organs.

Thus, we can conclude that the concept of “cardiomyopathy” consists of a very wide range of pathological conditions, in contrast to myocardial dystrophy. According to the latest recommendations of scientists, with the latest revision of the international classification of diseases (ICD-10), myocardial dystrophy corresponds to the only form of cardiomyopathies - with nutritional disorders and metabolic disorders.

During pregnancy

The most common myocardial disease in pregnant women is myocardial dystrophy.

Gynecologists quite often have to deal with this diagnosis in everyday practice, although it is not always justified. If we move away from all cases where myocardial dystrophy borders on other organic heart diseases ( valvular defects , myocarditis , etc.), then only those pathological changes that occur with anemia, vitamin deficiency, intoxication, overwork can be attributed to cardiac muscle dystrophy. pregnant women.

For pregnant women who suffer from myocardial dystrophy, according to the Institute of Obstetrics and Gynecology of the Academy of Medical Sciences, the following are typical: the addition of late toxicosis (35%), premature rupture of water (28%), weakness of labor (12%), perinatal mortality (6%).

Therapy for pregnant women with myocardial dystrophy consists of eliminating the underlying disease that caused this pathology, compensating for cardiac activity and eliminating pregnancy complications. Termination of pregnancy is not necessary in most cases.

Bad habits as a cause of illness

One of the consequences of frequent alcohol consumption is the development of alcoholic myocardial dystrophy , which is classified as toxic. Poisoning the body with ethanol (a component of alcoholic beverages) that is constantly present in it leads to myocardial disorders, in which cell membranes are destroyed, and the amount of fatty acids and potassium is sharply reduced. In the future, alcoholic dystrophy is manifested by arrhythmia, severe shortness of breath, lack of air and edema. The result is heart failure. In this case, there is usually no pain in the heart, although, in my opinion, if, along with alcoholic myocardial dystrophy, there are other underlying diseases (diabetes mellitus, stress), then there are quite pronounced pain sensations in the heart area.

ECG for alcoholic myocardial dystrophy:

Diet for myocardial dystrophy

Diet for heart failure

• Efficacy: therapeutic effect after 20 days
• Timing: constantly
• Cost of products: 1700-1800 rubles. in Week

Diet for vegetative-vascular dystonia (VSD)

• Efficacy: Healing effect
• Timing: constantly
• Cost of products: 1500-1600 rubles per week

Basic rules in nutrition:

• restriction in salt consumption (no more than 3 g per day);
• counting calories consumed;
• drinking enough liquid;
• weight control;
• eating foods rich in potassium, magnesium and fiber;
• consumption of multivitamins and fortified foods;
• avoidance of coffee and alcohol-containing products.

Illness and age

Myocardial dystrophy can be detected in children of any age, starting from newborns . The causes may include previous intrauterine inflammation, infections, rickets, perinatal encephalopathy (disorders of the nervous system of children under one year of age), hypervitaminosis, and chronic nutritional disorders.

If a child has been exposed to intense physical activity since childhood or, conversely, is inactive and not active enough, this can also be the cause of myocardial dystrophy subsequently.

Since young children are not able to clearly explain their state of health, and the symptoms of the disease are not too pronounced, parents should consult a cardiologist if there is any suspicion of heart disease: increased child fatigue, shortness of breath with minor exertion. An ultrasound of the heart, a thorough examination and an electrocardiogram can reveal abnormalities in the functioning of the heart.

As for the treatment of myocardial dystrophy during pregnancy, there is usually no reason to terminate the pregnancy . It is important to eliminate the cause and prevent complications affecting the development of the fetus. You should be careful and attentive to the prescribed vitamin complexes to avoid allergic reactions. In the presence of such a disease, the question of the natural process of childbirth is decided individually after passing all the tests.

Consequences and complications

Dangerous complications and consequences of an untreated disease:

• Chronic heart failure. Manifested by swelling, severe shortness of breath and general weakness. Initially, symptoms appear only during exercise, in more advanced cases - at rest and with minimal physical activity. Without adequate therapy, CHF progresses quite quickly and leads to death.
• Rhythm and conduction disorders . Changes concern the generation and conduction of nerve impulses through the heart muscle. It all can start with rare, seemingly harmless extrasystoles . Further, the disease progresses and affects conduction, provoking sinoatrial and atrioventricular blockades. Atrial fibrillation is often recorded . Patients complain of loss of consciousness, shortness of breath, and a feeling of arrhythmia. Treatment can be medication or emergency surgery (EC implantation).
• With severe hemodynamic disturbances, blood clots , which can travel through the bloodstream to the brain, kidneys, eyes, etc.

Conditional stages of the disease

It is customary to distinguish 3 main stages of myocardial dystrophy, the process of which is widespread or focal in nature:

1. Increased “wear and tear” of the heart muscle is its hyperfunction. The patient experiences prolonged heart pain and heavy breathing, even despite the lack of physical activity. Physical endurance decreases. Objective changes (for example, on an electrocardiogram) are not visible.
2. Myocardial compensation mechanisms are depleted. Myocardial dystrophy of the heart manifests itself in shortness of breath during physical exertion, cardiac arrhythmia, and slight swelling of the legs. The ECG shows atypical changes in which the deterioration of contractile function is in the initial stage.
3. A significant decrease in contraction function, a decrease in muscle tone, which leads to total heart failure. The patient experiences persistent pain in the heart, swelling of the legs, and shortness of breath during exercise does not go away even at rest. Atypical changes are clearly visible on the ECG.

Forecast

The prognosis is considered favorable for stages I and II. Heart functions can be fully restored after the cause-and-effect factor is eliminated. The duration of the recovery period is largely influenced by the general condition of the body (the fastest recovery is observed at a young age and in the absence of concomitant pathology), the time of initiation of therapy (the earlier competent treatment is prescribed, the faster the disease regresses). The duration can range from 1 year to several years.

At stage III, the prognosis directly depends on the presence of complications and the severity of already formed changes. When changes in the heart muscle are diagnosed, the emphasis is not on the patient’s well-being and restoration of normal heart parameters, but on reducing the rate of progression of chronic heart failure and restoring the rhythm. In the third stage, lifelong therapy is required. In the absence of adequate treatment, the life prognosis is extremely unfavorable.

Clinical forms

In addition, a number of clinical specialists distinguish forms of myocardial dystrophy depending on the clinical manifestations. Among them:

• cardialgic. Manifested by pain in the chest of an aching, pinching nature, not dependent on physical or emotional stress, taking nitroglycerin or other nitrates, not radiating (not radiating) to the area of ​​the shoulder blade or left arm, passing on its own; chilliness of the upper or lower extremities; rapid fatigue; general weakness; low physical endurance; dizziness;
• arrhythmic. Characteristic: attacks of pre-fainting or fainting, sensations of improper functioning of the heart, a feeling of lack of air, increased heart rate (patients feel them at a frequency of more than 90 per minute), pain in the chest;
• stagnant. It is formed in chronic heart failure and manifests itself in the form of swelling of the legs, feet, thighs, less often of the upper limbs and face, a non-productive cough due to stagnation of blood in the pulmonary circulation; increase in liver size; swelling of the neck veins; hydropericardium or hydrothorax - accumulation of fluid between the layers of the outer membrane of the heart or the pleural membrane of the lungs;
• combined. It occurs most often and is a combination of various forms of the disease.

Myocardial dystrophy has a long, slowly progressive course; decades can pass from the beginning of the first stage to the last.