Angina pectoris FC 2 what is it

Angina pectoris is a chronic form of coronary heart disease (CHD), when the symptoms persist without significant deterioration for several months. Attacks with this option occur with threshold physical exertion (accurate values ​​are measured with bicycle ergometry) due to an increase in oxygen demand in the myocardium.

Modern physicians use the Canadian Classification of Functional Classes, supplemented by the Working Group of the European Society of Cardiology.

For the formulation of FC patients should be asked about the frequency of angina attacks, the severity of pain and the number of nitroglycerin tablets used during episodes. The main complaints of patients:

  • anxious discomfort in the chest (pressure, heaviness, burning or suffocation);
  • pain is localized mainly in the epigastrium, back, neck, jaw or shoulders;
  • pain caused by exertion, eating, exposure to cold, or emotional stress lasts about 1-5 minutes and is relieved by rest or Nitroglycerin;
  • the intensity does not change when breathing, coughing or changing position.

Rest angina pectoris is diagnosed within a week after the onset, when the symptoms are not associated with physical activity.

Unstable angina pectoris refers to acute coronary symptoms and requires urgent medical attention. In clinical practice, the condition is determined by the “transition” between a stable course and myocardial infarction. Unlike chronic forms of coronary heart disease, pathology is characterized by a high rate of development of irreversible changes and the risk of death.

Unstable angina pectoris is characterized by an increase and increase in the duration of anginal attacks. Additional signs of a worsening condition: severe shortness of breath, weakness, high heart rate, a feeling of interruption in the work of the heart. Pain in an unstable form can occur at rest. Moreover, the inefficiency of nitrates and other antianginal agents is often noted.

Working classification of unstable angina:

  • the first occurrence of the form (disease duration up to 4 weeks with certain changes in the electrocardiogram at rest);
  • progressive;
  • early post-infarction angina pectoris (from 3 to 28 days).

Etiological mechanism

Angina pectoris of tension 2 FC causes a sharp increase in the metabolic needs of the heart muscle as a result of changes in blood flow, impaired myocardial tone, cardiac functions. The following main endogenous causes can be distinguished: coronary arteriosclerosis (significantly reduces oxygen delivery);

In addition to internal factors, exogenous causes can also provoke angina pectoris. The following factors can be distinguished: excessive and prolonged physical activity; psychological stress, emotional outburst and nervous stress; sharp changes in temperature, atmospheric pressure and other climatic parameters; excessively plentiful food intake.

Causes of angina pectoris 2 FC

Angina pectoris of the second functional class (like other forms of coronary heart disease) is a multifactorial disease with a genetic predisposition. That is, it most often occurs in people whose relatives also suffered from coronary heart disease. There is no specific reason for the occurrence of the disease, but there are many factors that contribute to its development. It:

  • lack of physical activity
  • smoking and alcohol abuse
  • persistent increase in blood pressure,
  • obesity or being overweight,
  • private stress and psycho-emotional stress,
  • unhealthy diet and unhealthy lifestyle.

Angina pectoris of tension 2 FC very often develops in people with high blood pressure. However, regular use of antihypertensive drugs significantly reduces the risk of coronary heart disease. That is why doctors recommend hypertensive patients to control their pressure, avoid stress and eat right – a healthy lifestyle helps to maintain health and significantly extend a person’s life.

The development of the disease at a young age happens with a hereditary predisposition. In other cases, sclerosis occurs after 40. During this period, people become vulnerable to coronary disease. In people with genetic risks, the chance of getting angina pectoris increases.

IHD is a companion of metabolic diseases: obesity, diabetes. An increase in blood pressure is one of the signs of vascular atherosclerosis. Concomitant diseases increase the risk of heart attacks and strokes. Unhealthy lifestyles, lack of exercise, smoking – make a person a candidate for acute coronary insufficiency.

Most often, the provoking factor is atherosclerosis, which affects the coronary arteries. It was found that the mismatch between the oxygen demand of the myocardium and its transportation appears with atherosclerotic narrowing in the lumen of the coronary vessels by 50-75%. Clinical signs of this disorder are angina attacks.

Other potentially probable provoking factors include hypertrophic cardiomyopathy, severe arterial and primary pulmonary hypertension, stenosis at the mouth of the aorta, coronaritis, abnormalities in the coronary arteries of a congenital nature, aortic insufficiency. With the appearance of a partial or transient obstruction to blood flow, an attack can provoke acute coronary thrombosis.

But, as a rule, this condition is observed accompanied by a heart attack. Risk factors include smoking, age, family history, obesity and physical inactivity, diabetes and menopause. Hypoxia or severe anemia can aggravate the course of the pathology. Among the immediate causes of the attack, physical stress, emotional stress, temperature changes, overeating, a sharp change in climate and others are noted.

Classification

Pathology has four functional classes. They are determined in accordance with the tolerance of the loads. So, angina pectoris 1, 2 FC can be diagnosed. These forms are considered initial and in many cases can be adjusted. The first functional class is characterized by normal tolerance of a normal load.

Attacks appear only with physical stress. For example, it can be a long activity, climbing stairs, brisk walking. Angina of exertion FC 2, 3 is characterized by the patient’s ability to withstand loads. While in the second functional class, activity is moderately limited, then in the third it is essential.

In the latter case, signs of coronary heart disease become quite pronounced. Angina of exertion FC 2 may be accompanied by seizures if a person overcomes a distance of more than 500 meters without stopping. As in the third functional class, an aggravation of the state is likely during ascents by one flight.

Of particular clinical importance are emotional stress, windy or cold weather. Angina of exertion FC 2 differs from the latter form in the frequency of occurrence of seizures. So, the fourth functional class is characterized by aggravation even with minor loads, and in some cases at rest. In this case, the physical activity of the patient is significantly limited.

Coronary signs of angina pectoris: medical history

CHD is associated with shortness of breath and pain behind the sternum, which occurs during exercise of varying intensity. Symptoms of angina pectoris are due to insufficient oxygen supply to the myocardial tissue during increased stress. Blood flow is not adequate for myocardial needs.

Attacks of angina pectoris 2 fc pass after taking nitroglycerin for 5-10 minutes or alone at rest. Symptoms are associated with a lack of oxygen in the blood and may vary depending on the patient’s medical history.

Chest pain is typical or atypical. The first type – severe, aching pain disappears after taking nitroglycerin or during rest. The second type – occurs sharply, intensifies with pressure, may be in the back, abdominal cavity, on the right side or only in the fingers. This type of pain is associated not only with myocardial ischemia, but also with damage to the muscles and nervous system.

Other signs – fatigue and a heart attack, is a condition requiring emergency care. In most cases, a coronary symptom is the only sign of angina pectoris.

Angina II functional class has the following symptoms:

  • discomfort, tightness in the chest;
  • heartache;
  • dyspnea.

All these manifestations occur in the cold and in the wind, after a plentiful meal, as well as in the case of such loads as running, brisk walking, climbing uphill or stairs.

In people with angina pectoris 2 FC physical activity is limited. This is due to the occurrence of attacks when walking on flat terrain at an average pace at a distance of 500 meters or when climbing more than one floor. Some may feel signs of angina pectoris when rising above the 4th or 5th floor.

Attacks of angina pectoris 2FK occur during exertion

Attacks of angina pectoris 2 FC more often occur when walking fast, running, climbing uphill, in the wind and in the cold, with psycho-emotional arousal. That is, in order for an attack to occur, additional factors are necessary that cause an increased myocardial oxygen demand. But the main factor in the occurrence of an attack is physical activity, without it, only from cold or stress, it rarely happens.

Physical activity has a direct effect on the severity of the clinical picture of angina pectoris 2 functional class. For those who constantly exceed the permissible level of stress during the day, seizures can occur several times a day. Patients who build their day in such a way as to avoid stress can practically not experience angina attacks. From this we can conclude that the severity of the disease is more precisely determined by the frequency of attacks, and not by loads.

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There are several common symptoms for all classes of pathology. These, in particular, include:

  • Shortness of breath.
  • Heartache.
  • Feeling of tightness and discomfort in the chest.

These symptoms are observed in cold weather or in the wind, after eating a large amount of food. Angina FC 2 manifests itself under stress. In particular, when climbing stairs or uphill, running, fast walking. Angina FC 2 voltage is accompanied by limited activity. This is caused by poor portability of movements, even on a flat road at a distance of more than 500 meters or when climbing more than one span.

Overview of angina pectoris tension 2 FC: symptoms, treatment, prognosis for the disease

From this article you will learn: a description of angina pectoris of the second functional class, what kind of disease. Causes of its development, symptoms and treatment methods.

Angina pectoris of tension 2 FC is one of the forms of coronary heart disease (CHD), which is characterized by attacks of chest pain and shortness of breath (rapid breathing and a feeling of lack of air) after exercise. The people often call angina pectoris “angina pectoris.” Such a definition very accurately describes the nature of the pain during an attack: a person has a feeling that he is “crushing something” right inside the chest.

Doctors give out angina pectoris of rest and tension.

The first is characterized by the spontaneous occurrence of seizures in the absence of physical activity. Pain can appear even in a sedentary or a lying person. This type of disease is the final stage in the development of angina pectoris. It significantly limits the ability to work and reduces the quality of life of a sick person.

A feature of angina pectoris is the appearance of chest pain only after performing physical work. Depending on the severity of the load, which can provoke an attack, four functional classes (FC) of the disease are distinguished. This distribution helps doctors very accurately describe the severity of the disease in their documentation. Angina of exertion of 2 FC is characterized by the appearance of an attack after walking to a distance of 500 meters or rising by 1 flight of stairs.

Therapist or cardiologist is involved in the treatment of this pathology. The disease cannot be cured completely, but following all the recommendations of the attending physician, you can slow the progression of angina pectoris, improve the quality of life and avoid the development of complications.

This pathology has a number of characteristic symptoms:

  • sharp chest pain lasting 3-5 minutes;
  • irradiation (“backache”) of pain in the left shoulder or arm;
  • intense shortness of breath, feeling of lack of air;
  • sharp weakness and need for rest;
  • the appearance of cold sweat and intense fear.

Pain with angina pectoris can have a compressive, stitching, burning or cutting character. It can spread to other parts of the body, confusing people and doctors. Possible places of irradiation of angina pain: left shoulder blade, lower jaw, abdomen, spine, neck and even ear.

Sometimes the pain is how strong that provoke the appearance of nausea and even vomiting. If an attack of angina pectoris occurs for the first time, a person may be in terrible horror and begin to fear for his life. However, this form of coronary heart disease is not life threatening. With adequate treatment, it will not progress and is unlikely to lead to a heart attack.

Differential diagnostics

February 14, 2015

Angina pectoris is an episode of transient myocardial ischemia. There is a pathology due to emotional or physical overload, which provokes an increase in the oxygen demand of the heart muscle. Next, we take a closer look at how the exertional angina of 2 FC manifests itself, how it differs from other functional classes.

The main difference between pain in angina pectoris is that it is quickly eliminated after a patient has taken Nitroglycerin. Relief also occurs at rest.

February 14, 2015

IHD: treatment of angina pectoris 2fk

Of course, the treatment of angina pectoris should be carried out immediately after the detection of this ailment. Therapy involves a number of preventive measures and treatment with the use of medications. Also, this pathology is eliminated with the help of surgical treatment.

In the fight against coronary heart disease, many drugs are used that relate to:

  • nitrates;
  • statins;
  • calcium channel blockers;
  • adrenergic blockers;
  • anticoagulants;
  • antiaggregants.

The choice of drugs is based on the individual characteristics of the patient’s body and the pathological degree. Often, the disease is accompanied by atherosclerosis, ischemic crisis or hypertension.

Angina pectoris can be treated with surgery. To obtain permission for the operation, the patient should undergo a series of examinations. In addition, the patient should not have any contraindications to surgical operations.

In the treatment of the presented pathology, several types of operations are currently used:

  1. Balloon angioplasty.
  2. Coronary aortic bypass surgery.

Between themselves, these types of surgical intervention differ in their features and a list of contraindications.

If an attack occurs after exposure to provoking factors, it is necessary to take the following measures to stop it: termination of the provoking factor (load); ensuring a state of rest, better in a reclining position; fresh air intake; taking nitroglycerin.

Therapy between attacks is aimed at normalizing blood circulation and reducing the frequency of pain attacks. The following drugs are used as medications and only as prescribed by a doctor: aspirin (to reduce the risk of blood clots); beta-blockers and calcium antagonists (reduced myocardial oxygen demand); statins (lowering blood cholesterol); nitrates (elimination of spasms of blood vessels).

In addition to drug therapy, folk remedies are also successfully used. The following compounds can be recommended:

  1. Hawthorn tincture: fruits are used (3 tablespoons per 0,5 liters of boiling water), which are infused for at least 20 hours.
  2. A mixture of honey with horseradish in a ratio of 4: 1.
  3. Medicinal collection: field horsetail and valerian root (1 part each), hawthorn and lemon balm (2 parts). An infusion is prepared (1 tablespoon mixture per 200 ml of boiling water).

Angina pectoris of the second class does not apply to pathologies of increased danger, if timely measures are taken to prevent and treat it. When conducting professional treatment, it is quite possible to ensure a high quality of life.

Treatment of coronary heart disease should begin with the correction of lifestyle and nutrition. By eliminating the influence of provoking factors, you can significantly slow down the progression of the disease. Physical activity and proper diet are the key to successful treatment of most diseases of the cardiovascular system.

People with angina pectoris of the second functional class should avoid heavy physical exertion. If running or power loads will benefit a healthy person, then they can seriously harm a patient with this form of coronary heart disease. A heavy load can not only provoke a severe attack, but also lead to a heart attack or other serious complication.

With this disease, a person is shown:

  • light housework
  • breathing exercises,
  • unhurried walks
  • special exercises.

The elimination of stress factors that could provoke an attack or aggravate the course of the disease is very important. Therefore, a person should protect himself from people and things that annoy him. You may have to stop communicating with some people or quit hard onerous work.

Diet with angina pectoris 2 FC should exclude fatty, cholesterol-rich foods and salty foods. Salt retains fluid in the body, thus increasing pressure. This, like the formation of cholesterol plaques in the vessels, contributes to the development of IHD.

Products recommended for the disease:

  • marine fish rich in omega-3 fatty acid;
  • chicken, turkey meat, veal, game;
  • sunflower, olive, corn and other vegetable oils;
  • any fresh or frozen vegetables and fruits;
  • cereals, brown bread, wholemeal pasta.

In the presence of excess weight (which is very characteristic of angina pectoris), a person should lose weight. To do this, you should exclude from the diet fast carbohydrates (sweets, flour products from white flour) and limit the consumption of animal fats as much as possible. You need to eat 4-5 times a day, in small portions. It is better to forget about smoking, alcohol, carbonated drinks and coffee.

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Medicines

Drug groups Description
Antiplatelet

Examples: Acetylsalicylic acid, Aspirin Cardio, Clopidogrel, Dipyridamole, Ticlopidine.

All patients with angina pectoris 2 FC are prescribed antiplatelet agents. Drugs in this group reduce the risk of thromboembolic complications and thin the blood, making it easier for it to flow through the vessels. They must be taken under the control of blood coagulation. Statins

Examples: Roxer, Krestor, Torvakar, Atoris, Leskol Forte.

They are prescribed to reduce the level of cholesterol in the blood of a sick person. These drugs inhibit the synthesis of cholesterol in the liver. They should be taken strictly in the evenings. Fibrates have a similar effect. Fibrates

Examples: Fenofibrate, Exlip, Linapril, Tsiprofibrat, Trilipiks, Lipanor, Tricor.

They are used to reduce the level of “harmful” lipids in the blood: cholesterol, triglycerides, very low and low density lipoproteins. At the same time, fibrates increase the concentration of high-density lipoproteins that strengthen blood vessels and relieve inflammation of their inner shell. Nitrates

Examples: Nitroglycerin, Nitrolong, Pentacard, Isoket, Cardiket.

To stop attacks, short-acting nitrates are used. They expand the vessels of the heart and resume the flow of blood in the myocardium. Long-acting nitrates are used to prevent seizures. Beta blockers
(selective or non-selective)

Examples: Concor, Celiprolol, Bisoprolol, Nebicor, Talinolol.

Beta-blockers reduce heart rate and oxygen demand in the heart muscle. This has a positive effect on the heart and helps to avoid attacks. Calcium channel blockers

Examples: Verapamil, Amlodipine, Diltiazem, Nifedipine, Felodipine.

Drugs in this group block the flow of calcium into the smooth muscle fibers of blood vessels. This causes them to expand and relax. Thus, the blood supply to the myocardium is improved. ACE Inhibitors

Examples: Enalapril, Captopril, Prestarium, Fosinopril, Perindopril, Ramipril.

In many respects similar to the drugs of the previous group, however, they have an obvious advantage: they do not cause the appearance of cough. ACE inhibitors have a vasodilating and pressure-reducing effect.

Antiplatelet agents for the treatment of angina pectoris 2 FC

Medical care in the early stages consists of therapeutic methods, which include taking medication and physiotherapy. Medicines have a vasodilator, hypotensive and cholesterol-lowering effect. Later stages of angina pectoris are subject to cardiac surgery.

There is non-invasive and invasive intervention: angioplasty, as well as shunting with stenting.

Angioplasty is a mechanical extension of the narrowed arteries. It is used for emergency restoration of patency in acute conditions, as well as in a planned manner with angina and vasoconstriction of more than 50%.

Bypass surgery is a more complex procedure that restores blood flow by creating a bypass anastomosis. From the vessels of the limbs or chest take a piece of tissue to perform a shunt between healthy areas of the coronary vessels. The operation takes place both using cardiopulmonary bypass and on the open heart. Depending on the degree of stenosis of the coronary arteries, the number of shunts may be different for each patient.

In the treatment of mild forms of angina pectoris, therapeutic treatment is preferred. The following drugs are used:

  • Disaggregants (blood thinners);
  • Beta blockers;
  • ACE blockers;
  • Statins;
  • Nitrates.

The goal of therapy is to reduce the load on the heart, expand the coronary vessels, lower cholesterol and blood pressure. The complex effect on these mechanisms leads to the elimination of angina attacks 2 fc.

Treatment is aimed at reducing the number of seizures and improving the quality of life, as well as identifying and treating diseases that worsen the symptoms of angina and its course.

With angina pectoris of the second functional class, it is recommended to change the lifestyle, avoid physical exertion, leading to seizures, take medications prescribed by a doctor. In parallel, you can resort to traditional medicine.

Of the drugs for angina pectoris:

  • aspirin to prevent thrombosis;
  • beta-blockers and calcium antagonists to reduce the oxygen demand of the heart;
  • statins to lower cholesterol;
  • nitrates to eliminate coronary spasms.

Folk methods

Folk remedies are used for angina pectoris as an addition to the main drug treatment. For this, medicinal plants have long been used.

From its fruits prepare tincture. Berries of hawthorn (7 tablespoons with a slide) are laid out in a jar and pour seven glasses of boiling water into the jar. The jar is closed with a lid, wrapped in something warm and put in heat for a day. When the deadline is reached, the tincture is filtered and put in the refrigerator. Drink three times a day with meals in a glass.

February 14, 2015

Pathology therapy should be aimed at reducing the frequency of attacks and improving the quality of life of the patient. With angina 2 functional class, experts recommend first of all to review the lifestyle, reduce the number and severity of stress, provoking attacks. It is allowed to use folk remedies together with medicines prescribed by a doctor. However, they can only be an addition to the main therapy. Before use of any means consultation with the doctor is necessary.

Drug therapy

Before starting treatment, it is necessary to eliminate all provoking factors, if possible. The most effective way to stop the attack is the drug Nitroglycerin. It is taken sublingually (under the tongue). To prevent episodes of ischemia, nitrates of a long (prolonged) action are prescribed.

These include drugs such as isosorbide mononitrate and dinitrate, nitroglycerin ointment or patch. The doctor may also recommend taking beta-blockers – Atenolol, Metaprolol, Betaxolol, calcium channel blockers – Diltiazem, Verapamil, antiplatelet drugs – Aspirin.

The consequences of angina pectoris: disability

The development of pathology without therapeutic intervention leads to disability. The decision on disability is made by an expert commission. If the patient cannot go without pain above the first floor, more than 100 meters or the attack begins even at rest, he is sent for a medical and social examination to resolve the issue of disability.

Before the commission it is necessary to pass the necessary laboratory tests, instrumental functional studies:

  • Electrocardiogram;
  • Ultrasound of the heart;
  • Daily monitoring of the heart.

If the results of the study correspond to angina pectoris of 2 fc, then the patient has the right to disability group 3, which indicates a restriction of movement and self-care. The second group is given to patients with angina pectoris 3 fc. First gr. disability corresponds to 4 fc angina pectoris with the development of severe heart failure and the occurrence of seizures, even at rest.

Prevention of angina pectoris 2 fc

There are many methods for preventing CHD. The most ideal is an active lifestyle, proper and balanced nutrition, combined with physical activity. All measures started at an early age will be a good investment in health, since they will help to avoid severe coronary diseases at the age of 40.

Young age is the best period for the prevention of diseases. Avoid alcohol abuse and smoking. These two factors create favorable conditions for heart disease. Disease prevention is the most effective way to maintain optimal health.

Always adhere to a culture of nutrition, work and rest – this is the basis of well-being. No matter how hard it is to adhere to the correct mode of life, this is the only way to stop the progression of atherosclerosis of blood vessels.

Overview of angina pectoris tension 2 FC: symptoms, treatment, prognosis for the disease

Stable (non-progressive) angina pectoris of the second functional class has a relatively favorable prognosis. According to statistics, only 4,3% of people die from this disease within 5 years.

This form of coronary heart disease cannot be completely cured, since organic changes in the vessels are irreversible. But to eliminate the negative symptoms, stop the progression of the disease and live a normal full life – it is quite real. The normal blood supply to the heart can be fully restored only with the help of stenting, bypass surgery, angioplasty or other surgical interventions.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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