Impact of diabetes on heart function

Diabetes mellitus is one of the causes of diseases of the cardiovascular system. In turn, heart failure aggravates the course of diabetes mellitus.

Heart lesions are frequent and unfavorable in terms of the prognosis of complications of diabetes mellitus. In such patients, coronary insufficiency comes to the fore. Let’s consider the main features of heart lesions in diabetes.

Impact of diabetes on the heart and blood vessels

Heart damage in diabetes mellitus is observed in many patients. About half of them develop a heart attack, and with diabetes this disease occurs in people of a relatively young age.

Disturbances in the work of the heart, pain are associated, first of all, with an increase in the damaging effect of high levels of glucose and cholesterol contained in the blood on the vessels. High sugar leads to the destruction of the inner lining of the arteries, low density lipoproteins (“bad” cholesterol) are easily incorporated into such a membrane, and the formation of cholesterol plaque begins. The vascular lumen gradually narrows – atherosclerosis develops.

Under the influence of atherosclerosis, the patient develops ischemic heart disease (IHD). Patients often suffer from heart pains. Against the background of diabetes, IHD is much more difficult. There is an increased risk of blood clots as the blood becomes thicker.

People with diabetes are much more likely to have high blood pressure. It causes complications after myocardial infarction, the most common of which is aortic aneurysm. With impaired healing of postinfarction scar in patients, the risk of sudden death increases significantly. The risk of repeated heart attacks also increases.

What is a “diabetic heart”

Diabetic cardiopathy is a condition of dysfunction of the heart muscle in patients with impaired diabetes compensation. Often the disease does not have pronounced symptoms, and the patient feels only aching pain.

There are cardiac arrhythmias (in particular tachycardia, bradycardia). The heart cannot pump blood normally, and its size gradually increases from increased exertion.

Symptoms of diabetic cardiopathy :

• exercise-related heart pain;
• an increase in edema and shortness of breath;
• patients are worried about pain behind the sternum, which does not have a clear localization.

In young people, diabetic cardiopathy is often asymptomatic .

Risk factors in people with diabetes

If a person has diabetes, then under the influence of a number of negative factors, the risk of developing cardiovascular diseases increases markedly.

Risk factors:

• the presence of a heart attack in any of the relatives of the diabetic;
• increased body weight;
• an increase in waist circumference (abdominal (central) obesity, resulting from an increase in blood cholesterol);
• an increase in the level of triglycerides in the blood;
• frequent increase in blood pressure;
• drinking a lot of alcohol;
• smoking.

Myocardial infarction in diabetes mellitus

Ischemic disease in diabetes mellitus threatens with many dangerous complications. The first of these is myocardial infarction (among diabetics, there is a high death rate).

The signs of myocardial infarction in people with diabetes are no different from those in people without diabetes. It’s just that a diabetic is more likely to experience them.

1. Pain in the region of the heart, radiating to the neck, shoulder, shoulder blade, jaw. She, unlike an attack of angina pectoris, is not stopped by taking nitroglycerin. In medical practice, there are also cases when pain is concentrated not in the region of the heart, but in the region of the stomach, which directs a person down the wrong path and he hesitates to see a doctor.
2. Nausea, sometimes vomiting. Such signs are often mistaken by people for food poisoning.
3. Heartbeat disorder.
4. In the region of the chest and heart, acute constricting pain appears, accompanied by the fear of death.

Against the background of myocardial infarction, pulmonary edema often develops.

In the presence of the above signs, you must immediately call an ambulance.

Angina pectoris in diabetes mellitus

With diabetes, the risk of angina pectoris doubles. This disease is manifested by shortness of breath, palpitations, weakness. In addition, the patient is worried about increased sweating. All these symptoms are relieved by nitroglycerin.

Angina pectoris in diabetes mellitus has its own characteristics.

1. The development of the disease depends not so much on the severity of diabetes as on its duration.
2. Angina pectoris occurs much earlier in diabetics than in people without diabetes.
3. Pain with angina pectoris is usually less severe. In some patients, it may not appear at all.
4. In many cases, patients experience cardiac arrhythmias that are often life-threatening.

Development of heart failure

Against the background of diabetes mellitus, patients may develop heart failure. It has many features of the course, therefore, for a doctor, the treatment of such patients is always fraught with certain difficulties.

Numerous studies show a high prevalence of heart failure in patients with diabetes, and it manifests itself at a much younger age. Diabetic women are more susceptible to illness than men.

Signs of illness:

• an increase in the size of the heart;
• development of edema;
• blue limbs;
• shortness of breath caused by fluid congestion in the lungs;
• dizziness;
• increased fatigue;
• cough;
• increased urination;
• weight gain caused by fluid retention in the body.

Conservative heart treatment for diabetes mellitus

For the treatment of heart diseases that have arisen against the background of diabetes mellitus, the following groups of drugs are used.

1. Antihypertensive drugs. The goal of treatment is to achieve blood pressure values ​​less than 130/90. However, if heart failure is complicated by renal impairment, an even lower blood pressure should be pursued.
2. ACE inhibitors. A significant improvement in the prognosis of the course of heart disease has been proven with regular intake of this group of drugs.
3. Angiotensin receptor blockers . They are able to inhibit the development of cardiac muscle hypertrophy. Appointed for all groups of patients with heart disorders.
4. Beta blockers – to reduce heart rate, lower blood pressure.
5. Nitrates – to stop a heart attack.
6. Cardiac glycosides – for the treatment of atrial fibrillation and severe edema. However, at present, the area of ​​their application is noticeably narrowing.
7. Anticoagulants – to reduce the viscosity of the blood.
8. Diuretics – to eliminate edema.

Operative treatment

Many patients are interested in whether bypass surgery is performed as a treatment for heart failure. Yes, it is carried out, and it gives a real chance to eliminate obstacles in the blood flow and normalize the work of the heart.

Indications for surgery:

• chest pain;
• arrhythmia attack;
• progressive angina pectoris;
• increased edema;
• suspicion of a heart attack;
• pronounced changes on the cardiogram.

Radical elimination of heart disease in diabetes mellitus is possible with the help of surgical treatment. The operation (including bypass surgery) is performed using modern methods of treatment.

Surgery for heart failure includes the following methods.

1. Balloon vasodilation . Eliminates the narrowing area of ​​the artery that feeds the heart. To do this, a catheter is inserted into the arterial lumen, through which a special balloon is supplied to the narrowed area of ​​the artery.
2. Coronary artery stenting . A special mesh construction is inserted into the lumen of the coronary artery. It prevents the formation of cholesterol plaques. Such an operation does not lead to significant trauma to the patient.
3. Coronary artery bypass grafting allows you to create an additional pathway for blood and significantly reduces the likelihood of recurrence.
4. Implantation of a pacemaker is used in diabetic kardiodistrofii . The device reacts to all changes in cardiac activity, corrects it. At the same time, the risk of arrhythmias is significantly reduced.

The goal of treating any violation of heart activity is to bring its indicators to the physiological norm as much as possible, which helps to prolong the patient’s life and reduce the risk of further complications.