Now a year she woke up with the feeling that she is extremely tired, she had no strength to get up, take a shower, drink coffee and somewhere to go. I wanted to fall face in the pillow and cry. Every day to do the usual steps for it was something of a feat. At work Svetlana suffered a headache, she often had fits of dizziness, stuffy office, she felt dizzy and was ready to faint. By evening, her condition continued to deteriorate. Often hurt the heart, hands and feet turning cold even in hot weather. And it seems to be nothing Svetlana was not sick, but since gone through a divorce, she ceased to live a normal life, felt the fear of possible death. Svetlana went to the doctor and underwent a complete examination, in which no pathology was identified. Excluding serious illness, the therapist diagnosed him with post-stress vegetative-vascular dystonia of hypotonic type.” Vegetative-vascular dystonia is one of the most frequent diagnoses in medicine. However, in modern medical references of the term “vegetative-vascular dystonia” you most likely will not find — it is out of date. However, almost all know what it means. Neurocirculatory dystonia, vegetative neurosis (vegetative neurosis, vagetoz), termometros, vegetative-vascular dystonia — all names of the same disease, which has a functional nature and which is characterized by disorders of the neuroendocrine regulation of the cardiovascular system. Given this fact, we will continue to call these disorders General term vegetative-vascular dystonia (abbreviated IRR). This disease brings together disorders of the circulatory system, which are caused by functional disturbances in the autonomic mechanisms by which the various organs and tissues are supplied with nervous elements (fibers, cells and so on).
In the nineteenth century the existence of the IRR called the Blues, in the XX century the disease was attributed to nervous diseases (neurasthenia). The nature of the disease seemed unclear, the complaint is uncertain. The malady began to speak, when a man stopped to enjoy life, become weak, apathetic or, conversely, fell into unreasonable anxiety.
In the first half of the nineteenth century, some lethargy, aristocratic pallor, frequent headaches, malaise for no apparent reason were essential attributes of female beauty. To ensure that the person has acquired a waxy color that was supposed to have a woman of noble birth, healthy and rosy-cheeked young ladies were forced to drink vinegar. And male fashion imposes the same requirements — think of Pushkin’s “Eugene Onegin.”
However, not all could afford to fainting and suffer a migraine for days. Illness prevented people normally live and work, so medicine had to understand this disease and defeat it. The people fought against it as best they could — treated from the evil eye and spoilage conspiracies and prayer. Physicians in the nineteenth century tried to find a connection between the tendency to the disease, and fragile physique. It was considered (as, indeed, today) that the disease is hereditary. Today the syndrome of a vegetative dystonia is defined as a disorder of the adaptive function of blood vessels in the form of its failure, redundancy or qualitative inadequacy. This disease is manifested by fatigue, decreased performance, frequent fainting conditions. For the VSD is characterized by a very rapid change in coloration of the skin, sweating, fluctuations in heart rate, blood pressure, headaches and disorders in the gastrointestinal tract, nausea, inclination to constantly elevated body temperature (37 °C), poor tolerance of physical and mental stress, the dependence of health on the weather. The syndrome of a vegetative dystonia may occur due to prolonged emotional stress, in some cases — trauma, closed brain injuries and many other reasons. In short, the manifestations and causes of autonomic neuropathy are diverse, and in order to understand the nature of this disease, let’s talk about how and why it occurs.
Part I. What you need to know about the disease
Chapter 1. How the vessels
So, what is vegetative-vascular dystonia? Speaking in plain language, it is a violation of the tone of blood vessels — arteries, veins, capillaries, — which occurred as a result of abnormalities in the autonomic nervous system. Cardiovascular system is a finely tuned mechanism, constantly in motion. Heart, by subtracting, shocks delivers the blood into the aorta — the largest blood vessel, and then into the arteries. Artery, in turn, is also Contracting and relaxing in a rhythmic, guiding a further blood throughout the body. This occurs because the walls of the arteries are muscular structure and thus compensate for the sharp beat of the heart so that more blood was flowing smoothly.
Artery as the distance from the heart branch out, their diameter becomes smaller, and they move in the so-called arterioles — the smallest blood vessels that are in front of the capillaries. They have a thick wall and narrow lumen, and this structure allows them to provide the total resistance to blood flow — that is why the arterioles called resistance vessels, or resistive vessels.
And finally, the last link in the delivery of gases, nutrients and minerals to the tissues is the capillaries that represent short tubes with very thin walls that shrink can’t. In the body of a huge number of them, and they are responsible for the exchange of substances between blood and interstitial fluid. Because the blood passing through the capillary, manages up to 40 times to share your content with the interstitial fluid. In the process, she gives the necessary body substance and “collects” the unneeded. The better proceeds this exchange, the more power get the organs and tissues. The capillaries are known as exchange vessels.
For proper nutrient delivery to the tissues is necessary to maintain a level of blood pressure. The magnitude of blood pressure depends on the force with which the blood presses against the walls of blood vessels or the blood flow from the centre to the periphery. In different vessels, the pressure value will be different. Thus, the pressure of blood in capillaries (capillary pressure) should be significantly lower than in larger arteries. The height of the arterial pressure depends on the force of heart contractions and blood volume that is ejected into the aorta, and the degree of contraction of small arteries and capillaries; it is also important how large elastic vessels.
The pressure drop in large and small blood vessels is very large (compare: 120-150 mm Hg. article for arteries and 10-15 mm Hg. article — for capillaries), despite the fact that all of them are directly connected among themselves — some move to other. This is because in the cardiovascular system is the mechanism whereby the walls of the arteries (blood vessels of the so-called muscle-type) is reduced. This mechanism prevents the movement of blood from the large vessels in the capillaries, and therefore the pressure in the two parts of a single bound and cardiovascular system so much different.
For understanding the mechanism of operation of the vessels we are interested mostly resistive vessels, or vessels resistance. They is only 3% of the total volume of our blood, but they are at the expense of their structure play a major role in the occurrence of pressure changes in the body. The walls of arterioles and capillaries are always in good shape, but they can change the diameter of the lumen under the influence of neurohumoral influences. How does it happen? What reasons cause the blood vessels to expand and contract?
First of all, the laws of hydrodynamics (or hemodynamic parameters, i.e. blood flow). Muscular fibre of the vessel reacts to the amount of blood that has entered the vessel. If its a lot, the vessel expands. But since the shell of resistive vessels badly stretched, the pressure of blood on the vessel wall increases.
Constriction or dilation of vessels is largely dependent on the intake of minerals — calcium, magnesium and potassium. For example, the lack of potassium leads to increased blood pressure; so a large content of free calcium in the blood may increase the resistance of the vessel walls and, as a result, a pressure increase.
Constriction and dilation of blood vessels depends on the influence of hormones. Some substances, such as epinephrine and norepinephrine produced by the medullary layer of the adrenal glands have the ability to influence vasoconstriction. The walls of resistance vessels expand and shrink the sympathetic nervous system. It regulates the emission of more or less of adrenaline and noradrenaline, which perform the transmission of nerve impulses in the receptors of the sympathetic nerves. Last sent a pulse to the tissues, including the walls of blood vessels resistance.
Significant role in the regulation of the heart and blood vessels play a special protein on the cell membrane receptors, which are abundant in the walls of blood vessels and heart muscle. Receptors respond to even minor changes in tissue metabolism, and if tissue is insufficiently nourished, receptors quickly transmit information to the cerebral cortex. Further, from the Central nervous system are sent impulses that cause vasodilatation, and provides enhanced functioning of the heart and increases the flow of nutrition to the organs and tissues.
So we see how difficult even in a healthy person is the regulation of the heart and blood vessels. And what is the picture, if there are functional abnormalities in the cortex of the brain and nervous system?