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Heart pain treatment
Medical expert of the article
Last reviewed: 23.04.2024
The analysis of pathophysiological aspects and various clinical manifestations makes it possible to detect the multilevel and polysystemic nature of the various links in pathogenesis and symptom formation in the onset of pain in the region of the heart, rhythm disturbances and vascular tone, changes in the ECG.
One of the big problems that exist today in the treatment of these disorders is entrenched ideas that the basis of any suffering is necessarily morphological, anatomical changes, even in situations where the absence of the latter is proven. Such changes are related to the presence in the modern society of an "organism-centric" model of medicine, which, despite declarative slogans (not a disease, but a patient, etc.), is aimed at the body, organ, and not the person, the person.
In our opinion, the most realistic and effective approach to the treatment of vegetative disorders in the cardiovascular system is the one in which these disorders are considered as a systemic variant of the psychovegetative syndrome. In accordance with this approach, it is necessary to influence the mental, autonomic, somatic spheres.
Treatment of mental disorders
Clinical and psychological analysis allows us to identify the structure of existing disorders, conduct a correct syndromological assessment of affective disorders, identify the contribution of psychogenic, endogenous, somatogenic factors, the role of premorbid and others in the formation of a specific form of autonomic dysfunction.
Therapeutic measures are implemented in two, most often interrelated, programs.
- Psychotherapeutic correction. It consists in clarifying the structure of the internal picture of the disease and correcting it by convincing the patient that he does not have a dangerous somatic disease. This eliminates the iatrogenic effects that arose as a result of communication with doctors who suspected dangerous suffering and reading sick medical literature. In a number of cases, in the presence of hyperventilation disorders, hyperventilation provocation of vegetative phenomena is shown with their subsequent cupping. Rational psychotherapy, autogenic training, hypnosis, etc. Can also be applied.
- Psychotropic drugs. They are appointed depending on the structure of emotional disorders.
Effects on vegetative disorders
Effects are made in two ways: by random regulation of breathing and by the designation of vegetotrophic agents.
The impact on autonomic functions through the use of techniques of voluntary regulation of breathing is a new and promising chapter of modern vegetology. Respiratory gymnastics is shown in all cases of autonomic dysfunction, since the respiratory system is closely related to the cardiovascular and other body systems and its application results in a fairly effective stabilization of the psychovegetative status.
Among the preparations of the vegetative series, beta-blockers are the most widely used. The presence of arterial hypotension in the patient requires, in addition, the appointment of such drugs as saparal, magnolia vine, ginseng, zamanicha, pantocrine, calcium preparations (gluconate, calcium lactate), ascorbic acid. In a number of cases, the use of a regulton is shown to increase blood pressure.
[1], [2], [3], [4], [5], [6], [7]
Correction of somatic and other disorders
Correction of somatic and other disorders consists in influencing a number of phenomena that are important in maintaining vegetative perturbations. So, for example, in the overwhelming majority of patients, along with the presence of signs of hyperventilation, there are often signs of increased neuromuscular excitability (latent tetany). In such cases, prescribe drugs that reduce the level of neuromuscular excitability, - mineral correctors. The most commonly used drugs regulating calcium metabolism: ergocalciferol (vitamin D2), AT-10, tachystin, calcium gluconate, glycerophosphate, calcium chloride, as well as regulating the exchange of magnesium-magnesium lactate, aspartate, potassium and magnesium, magnesium-Vb.
As other symptomatic agents are shown drugs that reduce vestibular excitability in the presence of vestibular disorders. These preparations are stugerone, aeron, dedalon, torekan, betaserk, etc .; apply also vestibular gymnastics.
The presence of allergic manifestations requires the appointment of desensitizing agents - ascorbic acid, pifolen, suprastin, tavegil, dimedrol, claritin, etc.
Pain in the heart area shows the intake of valokurdin or tinctures of valerian, light self-massage in places of pain projection or the use of distracting local irritants (pepper plaster, mustard plasters). Pain in the heart that have features of anginal infections, serve as an indication for the appointment of calcium-blocking drugs such as isoptin (verapamil) to 0,04-0,08 g 3 times a day for 2-5 weeks.
From non-pharmacological methods of treatment, in addition to psychotherapy and respiratory gymnastics, are shown acupuncture, exercise therapy and massage, diet therapy, physiotherapy, balneotherapy, spa treatment.
In myofascial syndromes, in addition to the known principles of treatment of osteochondrosis, novocaine blockades and manual therapy are also shown.