Vascular insufficiency

Vascular insufficiency is observed in about 1-2% of the total population. This condition is always a consequence of a disease. In most cases, it leads to diseases of the cardiovascular system. These include cardiomyopathy, angina pectoris, myocardial infarction, heart defects.

The defeat of the heart muscle provokes a violation of the blood supply to the body, due to its weakening and unsatisfactory performance of its pumping function.

Vascular deficiency is characterized as a pathological condition, in which there is a decrease in the tone in the smooth muscles of the walls of the vessels. This provokes arterial hypotension, a violation in venous return and blood supply.

Vascular insufficiency is caused by heart lesions of a primary nature, accompanied by an organ failure and an unavoidable vascular response. This reaction is compensatory. In this case, acute cardiovascular failure is accompanied by a reaction manifested in the form of vasoconstriction in response to the influence of pressor mechanisms. This leads to an increase in vascular resistance for a certain period, a slight increase in blood pressure and the normalization of blood supply to organs important for life. In a chronic condition, vasoconstriction is replaced by hypertrophy of smooth muscle cells in the walls of the vessels.

When the compensatory mechanisms are exhausted, vascular insufficiency is added to heart failure. At the same time, the total peripheral resistance decreases, small veins, venules and capillaries widen sharply.

Almost every process in which the heart is forced to work intensively for a long time, or structural damage occurs in the myocardium, provokes cardiac and vascular insufficiency. As practice shows, most often the condition is marked against such diseases as IHD, heart defects (acquired and congenital), myocarditis, hypertensive states, cardiomyopathies. In addition, the disease can occur in diseases of the endocrine nature, metabolic lesions, with malnutrition.

The most common cause of death (more than 80% of cases) with cardiovascular insufficiency is ischemic heart disease.

Various causes can lead to the disease. Specialists distinguish three main groups of etiological factors.

The first group includes factors that have a direct damaging effect on the myocardium. This can be physical injuries, chemical effects (eg, drug overdose). In addition, biological factors (toxins, infectious agents, parasites) can also have a direct damaging effect.

The second group of factors includes factors that trigger a functional myocardial overload. These include an excessive increase in the volume of incoming blood to the heart ("overload volume"). This can occur with a failure of the heart valves, the presence of non-cardiac and intracardiac shunts, as well as hypervolemia. Overload of the myocardium causes and an increase in resistance when ejected from the heart cavity of the blood ("pressure overload"). In this case, cardiovascular insufficiency develops against the background of myocardial hypertrophy. It should be noted that hypertrophy occurs in that department of the body, which performs intensified work.

And the third group includes the factors, under the influence of which diastolic ventricular filling is disturbed. This condition is caused by a significant decrease in the volume of circulating blood (with severe blood loss or shock), as well as a violation in the diastolic relaxation of the heart when it is squeezed by the liquid that accumulates in the pericardium (blood, transudate, exudate).