Internal Disease

2. Content
1. Definition
2. Etiology
3. Classification
4. Pathogenesis
5. Clinical picture
6. Additional research methods
7. Treatment
8. Prevention

3. Atherosclerosis
This is an metabolic disease associated with
deposition on the inner lining of the arteries cholesterol
plaques

4. Risk factors
1. Age 40-50 years
2. Male gender
3. Presence of arterial
hypertension
4. Hypodynamia
5. Hereditary predisposition

5. Etiology
1. Disturbance of fat
metabolism: manifests
itself in the form of a
diet rich in fat and a
sedentary lifestyle
2. Smoking
3. Emotional overload

6. Clinical picture
Depending on the
localization of the
plaques:
1. With atherosclerosis of
the coronary arteries -
IHD
2. With atherosclerosis of
the kidneys -
malnutrition of the
kidneys, hypertension

7. Clinical picture
3. With atherosclerosis of
the lower extremities:
- Pain when walking
- Pain in the calf
muscles (symptom of
"intermittent claudication")
- Numbness in the legs,
chilliness in the lower
limbs
- Atrophic ulcers

8. Clinical picture
4. With atherosclerosis of the vessels of the brain:
- Headache
- Dizziness
- Decreased memory for upcoming events
- Noise
- Tinnitus

9. Additional examination
methods
1. General blood analysis
2. TANK: (cholesterol study)
- B-high density lipoproteins
- B-low density lipoproteins
4. EEG
5. ECG
6. Heart ultrasound
7. Rheovasography

10. Treatment
1. Hospitalization for high
cholesterol
2. Diet. Table number 10
3. Cholesterol-lowering drugs:
- Mevacor
- Misclairon
- Linetol
- Simvastatin

11. Treatment
4. Fight against hypodynamia
5. Eliminate stress
6. Vitamin therapy

12. Ischemic heart disease
This is a state of mismatch between needs myocardium in oxygen
and its deliveries
Diseases included in the IHD group:
1. Angina pectoris
2. Myocardial infarction
3. PEAKS
4. Arrhythmias
5. Heart failure
6. Sudden coronary death

13. Angina pectoris
This disease, which is
part of the ischemic heart
disease group, is
characterized by the
occurrence of attacks of the
retrosternal painassociated
with insufficient intake
oxygen to the myocardium

14. Etiology
1. Atherosclerosis
2. Spasm of the coronary
arteries
3. Psycho-emotional overstrain
4. Stress
5. Intense physical activity
6. Against the background of
an attack of tachycardia
7. Coronary

15. Pathogenesis
As a result of insufficient blood supply to the myocardium
under the influence of causes, the heart develops
ischemiafollowed by pain in the heart

16. Classification
1.Exertional angina
-First emerging
-Stable angina
Includes 4 functional classes
I. FC - seizures occur with significant physical activity
II. FC - limitation of physical activity (pain when walking or
quickly climbing stairs more than one floor with aggravating
factors: cold weather, wind, emotional stress. And when walking
on level ground for more than 500 meters)

17. Classification
III.FC - limitation of physical activity (pain when walking
from 500-100 meters and when climbing stairs one floor)
IV.FC - a pronounced limitation of physical activity
(inability to perform physical activity. Pain occurs at
minimum load when walking less than 100 meters)
-Progressive angina pectoris (occurs against the background
of previously existing seizures, seizures become more
frequent, are poorly stopped by nitroglycerin, the likelihood
of myocardial infarction increases.

18. Classification
Newly-onset and progressive angina pectoris can be summarized as
unstable angina(seizures can occur spontaneously and are characterized
by a high risk of developing myocardial infarction)
2. Spontaneous angina ( arises at rest)
3. Variant angina( Prince of Metal)
It occurs in young people. There are chest pains at night during
sleep at the same time. The duration of the pain is 20 minutes,
it is poorly controlled by nitroglycerin, the pain is associated
with the influence of the vagus nerve

19. Clinical picture
The main manifestation is pain behind the sternum of
a compressing, pressing, stabbing character, radiating to
the left shoulder, clavicle, scapula, arising from
physical activity or at rest, stopped with Nitroglycerin,
lasting up to 30 minutes

20. Additional examination
methods
1. ECG - wave depression S
2. Blood chemistry
- Cholesterol level
- Enzymes
- PTI level
3. Bicycle ergometry
4. Holter monitoring
5. Coronary angiography
6. Heart ultrasound

21. Angina pectoris treatment
1. Diet. Table number 10
2. Nitrates
- Nitrosorbitol
- Cardix
- Olikard
- Nitrong
- Trinitrolong
3. B-blockers
- Anaprilin
- Atenolol
- Metoprolol

22. Angina pectoris treatment
4.Ca channel blockers
-Verapamil
-Nifidipine
-Diltiazem
5.ACE inhibitors
-Kapoten
-Captopril
-Enalapril
-Lisinopril

23. Angina pectoris treatment
6.Disaggregants
- Aspirin
- Thromboass
7.Cardiomagnet
8.Curantil
9.One of the treatment methods for angina pectoris is
coronary artery bypass grafting.

24. Urgent care
1.Under the tongue 1 tablet of nitroglycerin
2.Call a doctor
3.Re nitroglycerine up to 3 tablets (if blood pressure is
lower to 90/60, then no longer give nitroglycerin)
4.Anesthesia
5.Unbutton embarrassing clothes
6.Chew an aspirin tablet
7.Antispasmodics
2% no-spa

25. Urgent care
8. Analgesics( 50% analgin + 1% diphenhydramine)
9. If there is no effect
- Trigan
- Revalgin
- Spazgan