What does angina mean what needs to be done, what cannot be treated

In cardiological practice, doctors often encounter such a problem in patients as unstable angina pectoris. This is a type of coronary heart disease. This pathology is very common among the adult population. Often, it leads to necrosis of the heart muscle (myocardial infarction).

Unstable angina pectoris is a pathological condition that develops against the background of ischemia of the heart muscle.

The human heart, like any other organ, needs oxygen and nutrients. Blood supply to the heart is provided by the coronary arteries.

In the event that the lumen of these vessels decreases due to spasm or difficulty in blood flow due to thrombosis is observed, ischemia occurs.

This is a condition in which cardiomyocytes do not receive oxygen. In this situation, an attack of angina pectoris develops, which is manifested by pain behind the sternum. Do not confuse this condition with myocardial infarction.

In the latter case, the cells die and areas of necrosis appear. Unstable angina pectoris is a period of exacerbation of coronary heart disease (CHD).

The following signs are the basis for the division of angina into stable and unstable:

  • the duration of the attack;
  • pain intensity;
  • frequency of attacks;
  • the effectiveness of nitrates.

With an unstable form, the likelihood of developing a heart attack is much higher. With it, the pain syndrome is more pronounced and it is more intense. Every second person with coronary heart disease sooner or later develops angina pectoris. Men suffer from this disease more often than women. In common people, this pathology is called angina pectoris, since the main symptom is pressing pain behind the sternum.

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Varieties

The following types of unstable angina are distinguished:

  • first arising;
  • Prinzmetal;
  • post-infarction;
  • progressive.

The first option is different in that the attack occurs for the first time. It is manifested by pressing or compressing pain in the chest, which gives to the jaw, neck or left arm. The progressive form is characterized by the appearance of an attack with less load and an increase in its intensity (duration). Very often postinfarction angina pectoris develops.

The name speaks for itself. It develops up to 8 weeks after a heart muscle infarction. The unstable angina of Prinzmetal was separately highlighted. It develops at rest and is characterized by a prolonged pain attack. Often applied Braunwald classification. In this situation, 3 classes of this pathological condition are distinguished.

The higher the grade, the worse the prognosis for health and the higher the risk of complications. Grade 3 is placed if rest angina is observed during the last 2 days. At grade 2, an attack at rest worries for a month. Grade 1 is characterized by first-occurring angina pectoris.

The reasons for the development of unstable angina are various. The following factors are of greatest importance:

  • atherosclerosis of the coronary arteries;
  • vascular thrombosis;
  • decrease in blood flow through the coronary arteries due to hypotension;
  • decrease in cardiac output.

The most common cause is atherosclerosis of the heart vessels. With this disease, plaques form, which eventually become very hard and block the lumen of the vessels, thereby reducing blood flow. In case of increased oxygen demand (during physical work or stress) there is a lack of oxygen, which leads to an attack.

If the arteries of the heart overlap by 75%, then the attack develops with a slight load. Atherosclerosis is one of the most common cardiovascular diseases. It develops in violation of lipid metabolism, when the level of low density lipoproteins in the blood rises.

The attack itself can develop against the background of physical stress, hypothermia, stress, severe course of hypertension, and abuse of alcohol.

Angina pectoris often develops against a background of cardiac pathology (acquired heart defects, chronic heart failure, cardiomyopathy).

The following risk factors for the development of unstable angina are distinguished:

  • alcohol addiction;
  • smoking;
  • excess in the diet of animal fats;
  • obesity;
  • physical inactivity;
  • the presence of arterial hypertension;
  • the presence of somatic diseases (cholecystitis, ulcers);
  • local and general cooling of the body;
  • stress;
  • hyperventilation;
  • disruption of the autonomic nervous system.

In rare cases, this pathology is due to infection and an allergic reaction.

Evidence

Unstable angina pectoris has rather specific symptoms. It is manifested by the following symptoms:

  • pain in the heart;
  • heart rhythm disorder;
  • feeling of heartbeat;
  • shortness of breath;
  • feeling of lack of air;
  • heart palpitations.

Symptoms are few. The main one is pain. It has the following features:

  • strong
  • compressive or compressive;
  • accompanied by a feeling of lack of oxygen;
  • felt behind the sternum;
  • gives to the left hand, shoulder, neck or lower jaw;
  • subsides at rest or a couple of minutes after taking nitrates;
  • appears during physical exertion;
  • does not last long (with Prinzmetal’s angina, the attack is long).

A specific sign is the intensification of the pain syndrome with each subsequent time. During an attack, patients often experience fear. Unstable angina has its own clinical criteria.

Signs of unstable angina include an increase in symptoms, an increase in seizures, their elongation, the appearance of pain with less stress or at rest, and an increase in the need for nitrates (a decrease in the drug effect).

If the symptoms previously appeared with tension, then they occur at rest, as well as at night. Pain can bother a person for 10-15 minutes or more. In this situation, acute myocardial infarction should be excluded. In many patients, constant dyspnea appears over time. This may indicate the development of heart or respiratory failure.

Prinzmetal angina is quite rare. The frequency of this pathology is not more than 5%. Most often, it develops in middle-aged people (up to 50 years). This form of unstable angina is characterized by the following symptoms:

  • night and morning pains in the heart;
  • excessive sweating;
  • heart palpitations;
  • a drop or increase in blood pressure;
  • headache;
  • nausea;
  • pallor of the skin.

Some patients briefly lose consciousness. In the structure of coronary heart disease, unstable angina of Prinzmetal occupies an important position, as it often leads to complications and has a specific clinical picture. A pain attack with it lasts from 2 to 15 minutes. In rare cases, it drags on for half an hour.

Nitrates do not always help. The pain can subside only for a while, but then it reappears. Sometimes attacks occur sporadically. In the period between exacerbations, there are no complaints. In the absence of proper care, Prinzmetal angina can cause extensive myocardial infarction and aneurysm.

Often in such patients, the heart rhythm is disturbed. Atrial flutter or ventricular tachycardia is possible. Violation of the conduction of nerve impulses manifests itself in the form of blockade of the branches of the bundle of His. In severe cases, cardiac arrest may occur.

Diagnostics

When making a diagnosis, the doctor takes into account the following criteria:

  • medical history data;
  • clinical data;
  • results of instrumental research;
  • laboratory criteria.

Treatment is carried out only after a comprehensive examination. The following studies will be required:

  • electrocardiography;
  • Ultrasound of the heart;
  • coronary angiography;
  • physical examination;
  • Holter monitoring;
  • conducting load tests;
  • cold and ischemic test;
  • general blood and urine analysis;
  • blood chemistry;
  • scintigraphy.

ECG is of great value. It reveals signs of oxygen starvation of the heart. This is manifested by a change in the ST segment and T wave. In some patients, electrocardiography does not reveal changes. With the help of ultrasound, the state of the heart chambers and valves, blood volume, myocardial contractility are assessed. Coronary patency can be assessed during coronary angiography.

Laboratory tests may reveal the following changes:

  • leukocytosis;
  • increase in cholesterol;
  • increased troponin concentration.

In case of suspicion of Prinzmetal angina, provocative tests and stress tests (bicycle ergometry, treadmill test) are mandatory. They allow you to identify the relationship of pain with physical activity. At the same time, high resistance to physical activity is determined.

Treatment

8416dcf202525ebfda02d05918559cc5 - What does angina mean what needs to be done, what cannot be treated

Help with unstable angina involves calling an ambulance, calming the patient, giving him a comfortable posture, providing fresh, clean air, freeing himself from tight clothing, and using nitrates.

The main medicine for any type of angina pectoris is nitroglycerin.

In the absence of the effect of the drug, further treatment is carried out in a hospital.

Therapeutic activities include:

  • providing the patient with strict bed rest;
  • providing optimal nutrition;
  • intravenous administration of nitrates and heparin;
  • the use of beta blockers.

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With Prinzmetal angina without vascular lesions, atherosclerotic plaques beta-blockers can not be used. Antiplatelet agents (Aspirin) are prescribed to reduce the risk of blood clots. With developed congestive heart failure, pulmonary edema or cardiac asthma, diuretics are indicated (Lasix, Indapamide).

ACE inhibitors (Prestarium, Captopril, Perindopril) are often included in the treatment regimen. With severe pain, treatment involves neuroleptanalgesia. In this situation, Fentanyl and Droperidol are used. Instead of nitrates, calcium channel blockers can be prescribed to patients with angina pectoris. When atherosclerosis is detected, statins are prescribed.

In severe cases, surgery is performed (coronary artery bypass grafting, angioplasty, stenting). A similar treatment is organized if Prinzmetal angina is combined with severe atherosclerosis.

What should I do if an angina attack occurs?

You need to relax, and also take nitroglycerin in tablets or drops as quickly as possible under the tongue. Talk with your doctor about which nitroglycerin option is right for you. Some people cannot tolerate this medicine. For them, there are substitutes for nitroglycerin. Validol should not be used because it is a dummy tablet.

If the attack does not stop within a few minutes, taking 1-2 doses of nitroglycerin did not help – immediately call an ambulance. The patient may have unstable angina or myocardial infarction. Both of these diseases are life-threatening, require urgent hospitalization, examination and treatment in a hospital hospital.

You can not continue to be subjected to physical and emotional stress. The main thing is that you can’t drag out time! Some patients suffer pain, trying not to take nitroglycerin again. This is actually wrong. An attack of angina pectoris is harmful – it destroys the heart. Therefore, you need to quickly sit down to relax, and also take nitroglycerin. If rest and nitroglycerin do not help, urgently call an ambulance!

Probably, stable angina has become unstable, and this requires urgent hospitalization. In the worst case, a heart attack has already occurred. The above describes how to distinguish an attack of angina pectoris from myocardial infarction. A heart attack is the worst. But unstable angina pectoris is a significant threat to the life of the patient. Her in-patient treatment should be your # 1 priority.

Stenokardiya - What does angina mean what needs to be done, what cannot be treated

Syumakova Svetlana Aleksandrovna

Experience 24 years. Candidate of Medical Sciences

Experience 41 years.

Guryanova Violetta Anatolyevna

The term angina pectoris refers to a type of cardiac pathology, the main characteristic symptom of which is the presence of compressive periodic pains in the heart region, which are caused by a lack of incoming oxygen with the blood stream. The disease has long been called – angina pectoris.

The presence of angina pectoris in a patient indicates a possible atherosclerosis of the coronary vessels and a chronic manifestation of coronary artery disease. Often, discomfort in the chest region disappears as soon as the patient takes nitroglycerin, or after the elimination of provoking factors (rest after hard physical labor, rest and calm after experienced severe stress).

The disease is dangerous, since it entails not only unpleasant sensations, but also many problems with the general state of human health. It is worth studying in more detail what it is: symptoms of angina pectoris – what should be done and what cannot be done, the causes of the development of the disease, therapy and recommendations for the prevention of the disease.

Basically, possible therapeutic measures are aimed at preventing angina attacks in order to reduce their intensity and frequency of manifestation. Only in this way is it possible to normalize the living pace of an afflicted person. Also, most of the therapy is devoted to the prevention of myocardial infarction, which directly affects the patient’s life expectancy.

When a patient has symptoms of unstable angina, for example, when there is already familiar pain, which is present without visible irritants, hospitalization is required.

How is angina manifested:

  • the initial nature of pain of various kinds, which often manifest themselves as a result of mental, psychoemotional or physical overstrain;
  • pain is felt in the chest, in the heart region;
  • pain impulses can also radiate to the neck, lower jaw, left arm or shoulder blade;
  • pain can be described as a burning, compressive discomfort in the heart region;
  • it is also possible that there is a foreign object in the chest;
  • difficulty breathing, severe shortness of breath;
  • the patient may lose consciousness during an attack, vomiting and nausea are also possible;
  • the patient may experience a sense of panic attack, due to fear of possible cardiac arrest.

Causes of Angina Pectoris

The initial stage of development of atherosclerosis of the coronary arteries of the myocardium is considered the most common cause of angina pectoris and ischemic heart disease. Thanks to modern methods of diagnosing atherosclerosis, timely treatment can exclude the development of complications of the disease. The disease is often characteristic of people genetically predisposed to disorders and diseases of the cardiovascular system.

A severe family history is already becoming the reason for regular diagnosis in the field of cardiology. Such patients should immediately seek help from qualified specialists in case of the first acute symptoms of angina pectoris.

Factors that can provoke clinical manifestations of angina pectoris:

  • hypertension;
  • excessive physical activity;
  • chronic abuse of improper food, alcohol, smoking;
  • deviations from the norm of the endocrine system, the presence of diabetes;
  • overweight;
  • constant stress overload.

In view of such painful manifestations, life rhythm is difficult to call normal, so everyday life cannot proceed at the usual pace. Only by timely eliminating the causes of malaise of the cardiovascular system, it is possible to avoid the death of heart muscle cells, prevent myocardial infarction, and therefore, minimize the likelihood of death.

In the case of a sudden manifestation of heart pain, any load affecting the body should be immediately eliminated. It is recommended to take a comfortable position, dissolve the nitroglycerin tablet under the tongue.

A second medication is also possible if pain symptoms have not been eliminated.

In cases where the duration of the attack exceeds 20 minutes, emergency care specialists should be called because a heart attack can occur.

So, the list of what with angina cannot be attributed to:

  1. Smoking and close proximity to the smoker;
  2. Alcohol consumption should be strictly excluded;
  3. The use of unhealthy food is also excluded, it includes too fatty foods, foods with a high salt content, smoked meats, fried and fast food;
  4. It is not recommended to neglect light physical exertion;
  5. Excluded and interaction with factors that cause a nervous state, a sense of anxiety and excitement. Doctors also prohibit worrying about trifles;
  6. Neglect medication and the recommendations of your doctor;
  7. It is irresponsible to the symptoms of your own body, neglecting the recommendations for a physical examination.

Of course, the symptomatology is the same for everyone, but due to gender differences, different representatives have a number of certain features in the perception of manifestations of the disease. As with men, the first symptom of angina pectoris is the appearance of pain in the chest area.

Although due to the female physiology of the body, this symptom does not always indicate the development of angina pectoris. There is another difference, women often do not feel shortness of breath with such disorders of the cardiovascular system.

In addition, the very nature of the manifestation of pain in this area is different, most often from women suffering from an ailment; complaints are received not of compressive pain, of stitching and throbbing, men are characterized by a standard form of pain with such a disease.

Another characteristic difference is that women are often tormented by symptoms of nausea and vomiting, and complaints of pain in the abdomen are also often received, which is not characteristic of the strong half.

Often, such differences are associated with the fact that different sexes may have different sources of negative impact.

Women are more likely to suffer from pain caused by spasm of the coronars, and men – from narrowing of the lumen of the coronary vessels, plaques or blood clots.

Also, the symptom in women is affected by the age category to which the patient belongs. Rarely, such a disease manifests itself before the onset of menopause, so the risk of disease in women increases only after forty years. Men have no specific age criteria.

This is due to the presence of a large amount of estrogen in women, which often acts as a defense of the body from various ailments, and angina is also considered to be among them.

But since with the onset of menopause, the level of the hormone decreases sharply, the chances of men and women to develop angina are equalized.

As for male malaise from angina pectoris, excessive physical exertion, a greater number of experienced stresses, frequent overwork, as well as frequent stresses in a psychoemotional way are more likely to affect its development. The main factors influencing the development of the disease in men are also heredity and age.

Basically, the risk of developing the disease increases in men who have reached the age of fifty. This is justified by the presence of numerous processes occurring in the body, they also include age-related changes in the functionality of the endocrine system.

In addition, men are more susceptible to external influences on the body.

Yes, and the use of improper food, excessive amounts of alcohol and tobacco smoking are more characteristic of the male half, women behave more restrained in this regard. Also, male hypothermia include constant hypothermia.

Thanks to the experience of cardiologists, specialists currently apply such rational types of therapeutic measures: the use of drug treatment, angioplasty, stenting and coronary artery bypass grafting, treatment using autologous stem cells.The required number of medications are prescribed by a qualified cardiologist taking into account the individual factors of the patient himself.

What is the danger of unstable angina?

Varieties

Stable angina pectoris – means that during the previous month or longer, the patient’s attacks of chest pain were approximately the same intensity. The patient was able to determine the circumstances in which he has seizures, and learned to quickly relieve pain. He found out in practice what preventive and treatment measures help him.

Stable angina (tension), depending on severity, is usually divided into functional classes:

  • Functional class I – chest pain attacks are rare. Pain occurs with an unusually large, fast-loading load.
  • Functional class II – seizures develop when climbing stairs quickly, walking fast, especially in frosty weather, in a cold wind, sometimes after eating.
  • Functional class III – a pronounced limitation of physical activity, seizures appear during normal walking up to 100 meters, sometimes immediately when going outside in cold weather, when climbing to the first floor, they can be provoked by unrest.
  • VI functional class – there is a sharp restriction of physical activity, the patient becomes unable to perform any physical work without the manifestation of angina attacks; it is characteristic that seizures of angina pectoris can develop – without prior physical and emotional stress.

The allocation of functional classes allows the attending physician to choose the right medication and the amount of physical activity in each case.

Angina pectoris can last for months and even years stably. The patient gets used to her. If the situation worsens, then they say that stable angina has turned into unstable. It is possible that seizures began to occur at a lower load than usual, and for their removal, increased doses of nitrates are required. Also, unstable angina is when chest pain began to appear in a previously healthy person. Pain can be reflected from chest to arm, back, neck, and jaw. Attacks may be accompanied by shortness of breath or fainting.

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Unstable angina is much more dangerous than stable. It progresses rapidly and leads to myocardial infarction within 1 year in 10-20% of patients. There are such options:

  • primary angina pectoris – first appeared in the last 1-2 months;
  • acute rest angina pectoris – there was an attack of chest pain at rest for the past 48 hours;
  • subacute angina pectoris – an attack of chest pain at rest during the period of 48 hours – 1 month;
  • progressive angina pectoris – seizures intensify, they are similar to the III functional class of stable angina pectoris;
  • early post-infarction angina pectoris – 24 hours – 1 month after the development of myocardial infarction.

Angina pectoris – means that chest pain attacks occur during physical or emotional stress. This is better than if they occur in a patient at rest.

With stable angina pectoris in patients with coronary artery disease, pain occurs with a certain physical exertion and is well eliminated with the help of drugs.

Unstable angina is the first attack or condition when, against the background of a stable course of coronary heart disease, angina attacks become more frequent and lengthen.

If angina pectoris occurs with an unpredictable level of physical activity, it is necessary to limit the load to a minimum for several days and consult your doctor: more active treatment and, possibly, hospitalization will be required. An episode of unstable angina pectoris can result in myocardial infarction. When chest pain persists and diagnosis is difficult, the term “acute coronary syndrome” is used.

Angina pectoris symptoms what to do what cannot be done

An attack of angina pectoris is accompanied by characteristic pains – first there is discomfort in the chest or behind the sternum, then it develops into persistent pain. It can radiate to the left shoulder or to the left hand, in some cases – to the neck, lower jaw, or “spill” throughout the chest.

An attack of angina pectoris is always accompanied by anxiety and fear, but if the patient takes a lying position, then the pain will only intensify. It is noteworthy that it is for angina that there are features of the pain syndrome:

  • the pain is not paroxysmal, but constant and is aching in nature;
  • if the patient takes nitroglycerin, then the attack quickly ends;
  • the onset of pain, as a rule, is always associated with intense physical activity;
  • the duration of an attack of angina pectoris is a maximum of 20 minutes.

Please note: angina attack must be accurately and quickly diagnosed. The fact is that similar symptoms may indicate more serious heart pathologies.

The most important thing is to differentiate angina pectoris and myocardial infarction, so you need to remember the main differences between these two pathological conditions:

  • with angina pectoris, the pain disappears after 15-20 minutes, and with a heart attack, pain cannot be relieved even after the use of specific drugs;
  • if the patient develops myocardial infarction, then nausea and vomiting will bother him, with angina pectoris these symptoms never appear.

Angina pectoris, accompanied by frequent recurrence and protracted pain attacks, is an alarming signal – doctors know many cases when the disease in question develops into myocardial infarction.

Angina pectoris is one of the most insidious cardiac pathologies.

clinical picture

The main symptoms of angina pectoris are presented in the tablet.

SignDescription
Chest sensationSymptom may be combined with burning pain in the sternum. It radiates to the neck, left upper limb or under the shoulder blade on the left side. In rare cases, the pain gives to the right side.
It becomes difficult for a person to inhale and exhale air. Usually shortness of breath accompanies pain in the sternum.
The symptom is found in women, diabetics and the elderly.
The symptom is combined with nausea and increased sweating.

Note! Some people with coronary heart disease do not have any symptoms at all with myocardial ischemia.

This condition is called painless ischemia.

A climb can provoke an attack.

The duration of the attack varies from 2 to 14 minutes. Pain syndrome occurs against a background of physical activity, so a person is forced to periodically make stops. After several minutes of rest in complete peace, the pain disappears.

The provocateurs of angina pain should include:

  • brisk walking;
  • climbing stairs;
  • hearty meal.

Painful sensations can be combined with sharp, pronounced fatigue. This is due to a sharp deterioration in the supply of oxygen to the heart muscle.

First of all, you need to open a window or window

The emergency care algorithm for angina is as follows:

  1. Call an ambulance. It is important to accurately describe the clinical picture to the dispatcher.
  2. Place the patient in the most comfortable position. Movement should be kept to a minimum. It is desirable that the person takes a half-sitting position.
  3. Stop a panic attack. It is allowed to give a person a plant-based sedative.
  4. Provide people with access to fresh air. It is necessary to unfasten clothing on the chest, to open the window.
  5. Ask the patient to perform several even, deep breaths.
  6. Put 1 tablet of Nitroglycerin or Corinfar under the patient’s tongue. If after 10 minutes you feel unwell, you are allowed to give the medicine again. In total, you can take up to 3 tablets. The interval between doses is also 10 minutes.
  7. In order to improve blood circulation and blood thinning, give the patient a dissolve Aspirin tablet.

After stopping the symptoms, the patient should observe bed rest for 120 minutes. In order to prevent a recurrence of an attack, a person should adhere to a calm lifestyle for several days and avoid overwork.

Note! If an angina attack occurs on the street, you need to squat. Relief occurs in 3-5 minutes.

The duration of religious pain increases with:

  • spontaneous angina pectoris;
  • destabilization of the course of pathology;
  • progressive myocardial infarction.

In this case, emergency relief for angina involves the use of medical benefits.

To stop a pain attack, it is convenient to seat the patient. In order to reduce the venous return of blood to the heart, it is necessary to omit the limbs. The main task of first aid with signs of an anginal attack of angina pectoris is the rapid relief of pain.

The patient is prescribed 0,5 mg of Nitroglycerin. If necessary, the medicine is taken again. Nitroglycerin is available in various forms. See the diagram for more information.

The price of the drug varies from 19 to 147 rubles

The duration of a religious pain syndrome can be increased against a background of tachycardia or arterial hypertension. A drug correction of these conditions is required.

What symptom is eliminated?What medicine is used?What dosage?How is it introduced?
Diazepam5-10 mg.Into a muscle or vein.
Clonidine0,15 mgIntravenously.
DiltiazemIntravenously.
Mild pain in elderly patientsPromedol20 mg 5 g of droperidolIntravenously.
Morphine10 mgIntravenously.
Pronounced anti-angial activityPropranolol10-40 mgSublingual.

This type of angina pectoris is not common. The risk group includes people from 40 to 56 years old.

Severe atherosclerosis of the coronary vessels is not observed. Oxygen deficiency is caused by spasm of the coronary arteries. Ambulance medications for angina are presented on the tablet.

PreparationDescriptionCost
Class 3 selective calcium channel blocker, benzothiazepine derivative. It has antianginal, hypotensive and antiarrhythmic effects.71 rubles.
Calcium channel blocker. It has antiarrhythmic, antianginal, antiarrhythmic, antihypertensive effects. The drug reduces heart rate and helps reduce myocardial oxygen demand.32 ruble.
Selective slow calcium channel blocker. It has antianginal and antihypertensive effects.31 rubles.

Note! With this form of angina, beta-blockers are not prescribed. This is due to the fact that they contribute to the narrowing of the coronary vessels.

Emergency care for angina pectoris before the patient enters the clinic involves the use of drugs that reduce the heart’s oxygen demand. The doctor decides on the appointment of coronary-constricting drugs.

MedicineDescriptionCost
Non-selective beta-blocker with a strong hypotensive effect.24 ruble.
The medicine suppresses sinus tachycardia.13 rubles.

Additionally, beta-blockers can be prescribed that redistribute blood in favor of an ischemic myocardial site.

Forecast improvement

39390e128036351c7b25cf837abd8f75 - What does angina mean what needs to be done, what cannot be treated

The use of Aspirin will help improve the prognosis

What to do with frequent bouts of angina pectoris? The use of antiplatelet drugs is recommended.

The patient is prescribed Clopidogrel or Acetylsalicylic acid. These medicines stop the development of the pathological process at its earliest stage.

Note! Prolonged use of Aspirin is associated with a 32% reduction in myocardial infarction. This is especially true for people with a history of heart attack.

In the absence of proper treatment, there is a risk of developing angina pectoris. This is the most insidious and dangerous form of angina pectoris.

Medicines of this group have a blocking effect on the heart muscle. Reducing the myocardial oxygen demand, beta-blockers normalize the process of its delivery to the narrowed coronary arteries.

MedicineDescriptionCost
Cardioselective beta-adrenergic blocker. It has antiarrhythmic, antianginal, hypotensive effects.19 rubles.
The drug relieves the symptoms of myocardial ischemia, normalizes the disturbed rhythm of contractions of the heart muscle and helps lower blood pressure.37 rubles.

Use of statins

Medications in this group help lower total cholesterol. The use of statins helps reduce the risk of death and increase life expectancy.

MedicineDescriptionCost
The drug lowers the concentration of triglycerides, LDL and VLDL.40 rubles.
Hypocholesterolemic drug that reduces the amount of lipoproteins and cholesterol in plasma.67 rubles.

To stop the risk of developing heart failure, the patient is prescribed angiotensin-converting enzyme inhibitors.

PreparationDescriptionPrice
The medicine suppresses ACE.87 rubles.
The drug has a hypotensive, cardioprotective, vasodilating and natriuretic effect.26 rubles.

One of the most effective drugs in this group is enalapril. The cost of the medication is presented in the diagram.

The price of enalapril varies from 31 to 78 rubles

The patient’s life depends on how high-quality first aid is provided for an attack of angina pectoris. The risk of death often occurs against the background of perfect mistakes.

What should not do?Why is this dangerous?
Any excess movement contributes to the occurrence of myocardial infarction.
Cold contributes to spasm of the cardiac arteries. If an attack of angina pectoris caught a person in the store, it is recommended to stand for a while in the room and only then go out.
There is a risk of dehydration. This even against the background of a not very narrowed artery leads to a thrombus. Also, high temperature adversely affects blood pressure.
Travel by airIf symptoms appear, the trip should be rescheduled. To assist during an attack on an airplane is very problematic.
Tobacco products contribute to the appearance of atherosclerotic plaques in the vessels of the heart.
The relationship between alcohol-containing products and coronary heart disease is not proven. Alcohol has a detrimental effect on other organs sensitive to ethyl alcohol.
The drug does not have the proper effectiveness. Its use can help prolong the attack.
  1. Mark the start time of the attack.
  2. Measure blood pressure, heart rate, and heart rate.
  3. Sit down (preferably in a chair with armrests) or go to bed with a raised headboard.
  4. Provide fresh air (free the neck, open the window).
  5. Take acetylsalicylic acid (aspirin 0,25 g), chew the tablet and swallow.

Varieties

How to distinguish angina pectoris from myocardial infarction?

Pain in the center of the chest, in the middle third of the sternum, can spread to the left arm, scapula, lower jaw, upper abdomen.

Pain as with angina pectoris, but more often felt as more intense, intolerable, tearing and seizing the entire left half of the chest.

Discomfort is mild or moderate.

Severe discomfort, increased sweating, dizziness, nausea, growing sense of lack of air, fear of death.

An attack of angina pectoris is more often associated with previous physical activity or emotional arousal.

Myocardial infarction can occur at any time, including at rest.

The time of a pain attack takes about 3 to 15 minutes.

A pain attack with discomfort and suffocation lasts at least 15 to 30 minutes or more, there is a tendency to increase symptoms.

At rest, pain usually disappears.

In a state of physical rest, the pain does not go away completely, intensifies during conversation and deep breathing.

The use of nitroglycerin under the tongue or in the form of an aerosol from 1 to 3 doses interrupts the attack of angina pectoris.

Symptoms do not completely disappear after applying 3 doses of nitroglycerin.

Laboratory diagnosis of angina pectoris

Confirmation of a diagnosis in a clinical setting is a complex and lengthy process that requires several instrumental tests:

  • electrocardiogram at rest,
  • electrocardiogram under physical exertion,
  • daily monitoring of electrocardiography,
  • resting echocardiography,
  • scintigraphy under physical or pharmacological loads,
  • echocardiography under physical or pharmacological loads.

In parallel with this complex of instrumental studies, laboratory tests are carried out to identify pathologies that can provoke coronary heart disease.

Collection of complaints and medical history. It is important to pay attention to the factors provoking the appearance of pain, at what time of day they appear, what is their duration, intensity, localization, irradiation, and also what allows them to stop.

Laboratory methods. The patient’s blood is examined for the following indicators: total cholesterol, low and high density lipoproteins, triglycerides, ALT, AST, glucose, electrolytes, as well as blood coagulation indicators. It is also necessary to conduct a study on the presence of troponins in the blood – markers of myocardial damage. With their increase, we can talk about myocardial infarction.

  • ECG – at the time of the attack on the ECG, there is a decrease in the ST segment and a negative T wave in some leads. Myocardial conduction abnormalities may be recorded.
  • ECHO-KG – there may be violations of myocardial contractility and local myocardial ischemia.
  • Daily monitoring of the ECG is the removal of the ECG during the day. During this study, the patient records all his actions during the day, and he is also asked to have moderate physical activity during this time. An ECG shows how the heart responds to these loads, whether there are ischemic changes in the myocardium, rhythm disturbances. If there was an increased heart rate before the pain attack, then this suggests that most likely the patient has stable angina, if not, spontaneous.
  • Bicycle ergometry is a test during which the patient is engaged in an exercise bike, and ECG and pulse are recorded in parallel. The purpose of this test is to establish the maximum possible load for a given patient without the risk of ischemia.
  • Diagnostic coronarography is the most reliable diagnostic method that allows you to determine the degree of damage to the coronary arteries and determine which treatment method is needed. This method is not carried out for all patients, but for those who have angina pectoris III-IV FC, who have progressive angina pectoris, who have signs of myocardial ischemia, according to studies who have a history of an episode of sudden cardiac death. In these patients, as a rule, the question of surgical treatment of angina pectoris is open.

How to treat angina pectoris?

Treatment of angina pectoris can be conservative or surgical. Surgery is performed according to indications, and a person should carry out conservative treatment of angina pills throughout his life after identifying a pathology.

All methods of angina therapy are aimed at achieving the following goals:

  • Prevention of myocardial infarction and sudden cardiac death;
  • Prevention of disease progression;
  • Reducing the number, duration and intensity of seizures.

1) Drugs that improve the course of angina pectoris:

  • Drugs that prevent and reduce thrombus formation (Acetylsalicylic acid, Aspirin). For several decades, acetylsalicylic acid (ASA) has been used to prevent thrombosis and ischemic disease, but prolonged use of it can lead to problems in the gastrointestinal tract, such as heartburn, gastritis, nausea, stomach pain, etc. To reduce the risk of such undesirable consequences, it is necessary to take funds in a special enteric coating. For example, you can use the drug “Thrombo ACC®” *, each tablet of which is coated with an enteric film coating.
  • Beta-blockers (Metaprolol, Atenolol, Bisaprolol, Nebivolol, etc.) reduce the oxygen demand of the heart muscle. This eliminates the imbalance between the oxygen demand of the heart and the small amount of blood delivered through the narrowed vessels;
  • Statins (simvastatin, atorvastatin, etc.) reduce the concentration of cholesterol and its fractions in the blood. Due to this, the lumen of the coronary arteries is not clogged even more, and the blood supply to the myocardium does not worsen;
  • Inhibitors of the angiotensin-converting enzyme (ACE inhibitor) – Perindopril, Enalapril, Lisinopril, Noliprel, Sonoprel and others. Drugs prevent vascular spasm.

2) Antianginal drugs (anti-ischemic) aimed at reducing the number, duration and intensity of angina attacks:

  • Beta-blockers (Metaprolol, Atenolol, Bisaprolol, Nebivolol, etc.) reduce the heart rate, reduce blood pressure, thereby preventing angina attacks;
  • Calcium channel antagonists (Verapamil, Diltiazem, Verogalid, etc.) reduce the oxygen consumption of the heart muscle;
  • Nitrates (Nitroglycerin, Isosorbide dinitrate or mononitrate) dilate blood vessels, reducing the oxygen demand of the heart.

For complex therapy of angina pector, the doctor must select drugs from the group of antianginal drugs and improve the course of angina pectoris. Usually, 1-2 drugs are selected from each group. Drugs will have to be taken constantly, throughout life. If at some point the selected therapy is ineffective, then the doctor prescribes other drugs.

Currently, the inefficiency of vitamins, antioxidants, female sex hormones, Riboxin and Cocarboxylase for the treatment of angina pectoris has been proven.

Coronary (balloon) angioplasty is an invasive way to restore blood supply (revascularization) of the myocardium.

During coronary angioplasty, a special catheter under local anesthesia is inserted through the femoral artery and is conducted to the site of narrowing of the coronary artery. At the end of the catheter is a balloon, which (in a deflated state) is installed in the lumen of the vessel directly at the level of the atherosclerotic plaque.

With the subsequent expansion of the balloon, it crushes the plaque, thereby restoring impaired blood flow. The size of the spray can be selected in advance in accordance with the size of the affected vessel and the length of the narrowed area (according to previously performed coronary angiography). The restoration of blood flow is confirmed by control coronarography.

Coronary (balloon) angioplasty can be combined with other influences: installing a metal frame – an endoprosthesis (stent), burning a plaque with a laser, destroying a plaque with a rapidly rotating drill and cutting a plaque with a special catheter.

An indication for coronary angioplasty is high-grade angina pectoris, poorly responding to drug therapy, with significant damage to one or more coronary arteries.

The effectiveness of coronary angioplasty is obvious – angina attacks stop, the contractile function of the heart improves. However, relapses of the disease due to the development of repeated narrowing of the artery (restenosis) occur in approximately 30-40% of cases within 6 months after the intervention.

Aorto-coronary bypass surgery is an surgical intervention performed to restore the blood supply to the myocardium below the site of atherosclerotic narrowing of the vessel. This creates a different path for blood flow (shunt) to the area of ​​the heart muscle, the blood supply of which was impaired.

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The scope of the operation is determined by the number of affected arteries supplying a viable myocardium with blood. As a result of the operation, blood flow should be restored in all areas of the myocardium where blood circulation is impaired. In 20-25% of patients who underwent aorto-coronary bypass surgery, angina pectoris resumes within 8-10 years.

In these cases, the issue of reoperation is considered. Note. In patients with diabetes mellitus, prolonged occlusion (blockage) of the arteries, damage to the main trunk of the left coronary artery, and the presence of pronounced narrowing in all three main coronary arteries, aorto-coronary artery bypass grafting, rather than balloon angioplasty, is usually preferred.

Treatment of angina pectoris does not imply a complete elimination of the problem. The goal of therapy:

  • reduce the risk of seizures in myocardial infarction or in sudden death;
  • reduce the frequency of symptoms;
  • eliminate the manifestations of the disease.

The treatment can be divided into four groups:

  • symptom relief
  • drug therapy to reduce the risk of symptoms,
  • lifestyle change
  • surgical intervention.

The symptoms of the disease can be relieved by using short-acting nitrate drugs. The therapeutic effect of nitrates is based on the expansion of:

f4171226e1dea9a0da783595675c2aa6 - What does angina mean what needs to be done, what cannot be treated

This improves nutrition of ischemic sections of the myocardium, reduces peripheral resistance, improves coronary blood flow. Reduction of compressive pain in the chest area is achieved due to hemodynamic unloading of the myocardium and a decrease in the amount of stress on the heart. The latter fact reduces the heart’s oxygen demand.

That is, the supply of oxygen to the heart after taking nitrates does not increase. The need for them decreases. Among short-acting nitrates, the only drug is common: nitroglycerin. It is released in the form of tablets or a hyoid spray and costs at pharmacies from 66 rubles.

To relieve symptoms, a nitroglycerin tablet is placed under the tongue and held there until completely resorbed. To accelerate the effect of taking the medicine, a nitroglycerin tablet can be pre-bitten into several parts and also put under the tongue.

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To reduce the risk of angina pectoris, drugs of seven groups are prescribed in various combinations. Antiplatelet drugs inhibit platelet aggregation. This reduces the risk of blood clots.

Among antiplatelet drugs, aspirin is used, which is effective in both stable and unstable angina. Reducing the risk of coronary thrombosis reduces the risk of developing myocardial infarction.

Hypolipidemics – drugs to prevent the formation of lipids in the blood, which provoke atherosclerosis.

PreparationPriceDescription
Simvastatinfrom 54 rubles.In each tablet, depending on the dosage, 10 or 20 mg of simvastatin. In the package from ten to one hundred tablets.
Atorvastatinfrom 52 rubles.The drug is available in the form of tablets. Each contains 10, 20, or 40 mg of atorvastatin. A package may contain from ten to one hundred tablets.
Rosuvastatinfrom 154 rubles.Tablets with the active substance rosuvastatin. In each 5, 10, 20 or 40 mg of active substance. In a package of 30 or 60 tablets.

β-blockers – a group of drugs whose action is aimed at normalizing the heart rate and reducing the frequency of contractions of the heart muscle.

PreparationPriceDescription
Bisoprololfrom 79 rubles.The drug is in the form of tablets, each of which can contain 2,5, 5 or 10 mg of bisoprolol. Available in packs of 30, 50 or 60 tablets.
Nebivololfrom 187 rubles.Tablets with five milligrams of nebivolol hydrochloride in each. In the package, depending on the packaging, from 14 to 60 tablets.
Carvedilolfrom 69 rubles.Available in tablet form. Depending on the dosage, each may contain 6,25, 12,5 or 25 mg of carvedilol. In a package of 30 tablets.
PreparationPriceDescription
Nifedipinefrom 28 rubles.Available in the form of dragees and tablets. Regardless of the form of release, one unit of the drug contains 10 mg of the active substance nifedipine. In the package of 50 tablets or dragees.
Diltiazemfrom 95 rubles.Tablets containing 60 or 90 mg of diltiazem each, in a package of 30 pieces.
Verapamilfrom 17 rubles.Available in tablet form. The active substance of verapamil hydrochloride is contained, depending on the dosage, in a volume of 40, 80 or 240 mg per tablet. Available in packs of 50 tablets.
PreparationPriceDescription
Coraxanfrom 1100 rubles.Film-coated tablets containing 5,39 mg of ivabradine hydrochloride each. The package contains 56 tablets.
Bravadinfrom 392 rubles.Tablets with 5 or 7,5 mg of the active substance ivabradine. The package contains 28 or 56 tablets.
PreparationPriceDescription
Candesartanfrom 160 rubles.Tablets of 28 pieces in a package, each of which contains 8, 16 or 32 mg of candesartan cilexetil.
Perindoprilfrom 66 rubles.30 tablets per pack. Each, depending on the dosage, contains 4 or 8 mg of perindopril erbumin.
Ramiprilfrom 87 rubles.Available in the form of tablets of 5 or 10 mg of the active substance, 30 tablets per pack.
Valsartanfrom 309 rubles.Valsartan is available in tablet form, in packs of 28,30 or 84 pieces. Each film-coated tablet contains 80 or 160 mg of valsartan.

With stable angina pectoris, the patient’s diet should be adjusted. Experts recommend observing the following rules:

  • avoid overeating – this can lead to problems with the vessels;
  • regularly monitor blood cholesterol and stop eating chicken eggs, white sauces;
  • to introduce fish of fatty varieties on the menu more often – the beneficial substances contained in it make the vessels of the heart more elastic;
  • fresh onions and garlic must be present in the patient’s diet – they help stabilize blood pressure readings;
  • the menu should be fresh vegetables and fruits;
  • beef liver and rosehip broth will be useful;
  • you need to completely abandon coffee, strong black tea and alcoholic beverages.

Eating should be carried out often (at least 5 times a day), but in small portions. By the way, such a diet will help balance the metabolism, which will lead to weight loss in the patient – obesity is considered one of the causes of angina pectoris.

Physical exercise

Increased physical activity. The following physical exercises are recommended: brisk walking, jogging, swimming, cycling and skiing, tennis, volleyball, dancing with aerobic exercise.

Moreover, the heart rate should be no more than 60–70% of the maximum for a given age.

The duration of exercise should be 30-40 minutes:

  • 5-10 minutes warm up
  • 20-30 minutes aerobic phase
  • 5-10 minutes final phase.

The regularity of 4-5 p./Week. (with longer classes – 2-3 p./week);

With a body mass index of more than 25 kg/m2, a decrease in body weight through diet and regular exercise is necessary. This leads to a decrease in blood pressure, a decrease in the concentration of cholesterol in the blood.

Folk remedies

When treating angina pectoris with folk methods, two rules must be followed:

  • any prescription of traditional medicine must be approved by the attending physician;
  • folk methods are helpers of traditional drug methods.

There are many alternative methods of treatment. They are based on the main points of the traditional treatment of the disease: a healthy diet and a healthy lifestyle.

Clove of garlic

A common clove of garlic is an alternative to nitroglycerin during an attack of angina pectoris. After chewing a clove of garlic, pain in the chest area will pass after 20 minutes. This recipe is found in many old collections of traditional medicine recipes. In principle, if an attack occurs unexpectedly, such a recipe is a good way to deal with pain.

The most popular stenocardia prophylaxis is a mixture of garlic, lemon and honey. To prepare it, you need to put one liter of honey in a three-liter jar, juice squeezed out of ten lemons and five medium heads of garlic, peeled on cloves.

Mixing the resulting mixture is not easy, but the contents need to be well mixed. Then close the jar with a lid and put for a week in a dark place with a cool temperature. The prepared infusion should be taken in two tablespoons before breakfast, dissolving it in your mouth. The course of admission is until the entire prepared infusion is over.

Aloe infusion on honey

It strengthens the heart and the infusion of aloe on honey. This prescription of traditional medicine is especially effective at the first manifestations of the disease.

Five large aloe leaves and three large lemons are passed together through a meat grinder. The resulting slurry is mixed with a half liter of honey, heated in a water bath. Next, the mixture is put in the refrigerator for several days and taken on a tablespoon on an empty stomach. As in the previous recipe, the course of taking aloe vera infusion on honey is until the infusion is over.

Vegetable juice

This recipe is suitable for the prevention of many heart problems. It helps with both arrhythmia and coronary heart disease.

To prepare vegetable juice, you need to mix a liter of carrot juice, 600 grams of celery juice, 500 grams of spinach juice and 250 grams of parsley juice. Such a vegetable mix should be drunk in two glasses daily. There are no time limits on the course of admission. If possible, this juice should be made a permanent part of your daily diet.

Before using folk remedies for angina, be sure to consult your doctor!

  1. Garlic, lemon and honey. Put in a 3 liter jar 1 liter of honey, juice of 10 lemons and 5 heads of garlic (not cloves) squeezed through a garlic grinder, mix everything thoroughly, cover the jar with a lid and put in a dark, cool place for 7 days to insist. You need to take the drug for 2 tbsp. tablespoons in the morning, 1 time per day, on an empty stomach, slowly absorbing the product for a couple of minutes. The course of treatment is until the cooked remedy is over.
  2. Hawthorn. Pour in a thermos 4 tbsp. tablespoons of hawthorn and pour it with 1 liter of boiling water, put the product overnight for insisting. Drink the infusion throughout the day as tea.
  3. Mint and Valerian. 4 tbsp. tablespoons peppermint and 1 tbsp. add a spoonful of valerian to a thermos, fill the plants with 1 liter of boiling water and set aside for insisting for a couple of hours. Infusion should be drunk during the day. To increase the effectiveness of the remedy, you can also add a couple of teaspoons of rose hips, which will add to the drink a portion of vitamin C, directly counteracting the formation of atherosclerotic plaques.

Let’s get to know better this not-so-pretty “amphibian”. How to make sure that it doesn’t appear in the eye, and if it is destined to be not too pleasant “life partner”, then at least tame?

Angina pectoris is a process during which ischemia (acute oxygen starvation of the myocardium) of the heart muscle occurs. An attack of angina pectoris is a manifestation of cardiac ischemia. Therefore, when talking about angina pectoris, it is IHD, or coronary heart disease, that is meant.

At the time of the onset of an attack of angina pectoris, there is still no necrosis of the heart muscle, that is, a heart attack does not develop. But with a severe attack, a heart attack can be its outcome, and sometimes the cause, since post-infarction angina is known.

In angina pectoris, the mismatch between oxygen delivery to the myocardium and its need is especially acute.

Almost always, its causes are associated with processes developing in the coronary or coronary arteries that provide nutrition to the heart.

About risk factors

The entire “bouquet” of cardiovascular disease revolves around the same set of risk factors. Of course, there are those factors that are impossible to “get around or go around,” for example, being a male and over 50-60 years old.

But then you can largely avoid a heart attack (which is a possible outcome of an attack of angina pectoris), ischemic stroke and sudden cardiac death, if you deal with the following conditions:

  • Hyperlipidemia, dyslipidemia, increase in blood of atherogenic fractions (“bad” cholesterol);
  • Increased arterial vascular pressure (arterial hypertension);
  • Diabetes mellitus, or impaired glucose tolerance. In the event that you have diabetes, it is very important to keep your blood sugar levels as close to normal as possible;
  • Obesity. To reduce the risk of cardiovascular disease and angina, in addition to weight loss, it is necessary that for men, the waist circumference should not exceed 102 cm, and for women – 88 cm;
  • Smoking and alcohol abuse;
  • Lack of exercise. It is known that the absence of a regular load depletes the compensatory capacity of the myocardium, which can lead to the occurrence of myocardial ischemia even with a slight load.

First of all, angina pectoris is stable and unstable. It is difficult to find the official difference in textbooks, but this word can be replaced by another: “predicted.” And then everything will become clear.

Stable angina pectoris is a type in which the conditions for its occurrence, the nature of the course of the attack and, most importantly, the conditions for termination are known in advance. It is this type of angina that can be easily treated and prevented by a heart attack.

  • To put it simply, this is a type of angina pectoris, which for 2 months proceeded equally and did not “throw out surprises”.

This type of angina pectoris is called “stable angina pectoris”, and is divided into several functional classes.

FC 1: the usual load in everyday life does not cause an attack, only excessive or prolonged stress. That is why for diagnosis it takes a long time to “drive” the patient on a bicycle ergometer, and even with a heavy load. These patients only “enter” the diagnosis of angina pectoris, and they do not enter hospitals;

With FC 2, angina pectoris has to slightly limit the load. So, an attack can occur if you walk a kilometer at a fast pace, or climb non-stop to the 6-7th floor. In some cases, an additional provocation of attacks occurs, for example, when in freezing air or under stress;

With FC 3 it is no longer possible to walk more than 200 m. Or climb one flight of stairs without pain. Sometimes angina pectoris can occur not only stress, but also rest, and even lying down. You have to drastically limit yourself in everyday life, in your personal life, in sexual relationships;

FC 4 – the inability to perform any load. Getting up from the couch, brushing your teeth, cooking – causes painful discomfort. Often there are attacks at rest.

With unstable angina, the symptoms “fluctuate” – this occurs when the compensatory mechanisms fail and the angina transitions from the chronic to the acute phase, when seizures can occur in the most unforeseen and unexpected conditions.

These attacks are longer, more pronounced. They require often doubled doses of drugs when stopping an attack. With unstable forms, complications arise, for example, arrhythmias or heart failure appears.

You need to know that patients with unstable angina should be treated in a hospital, since this condition is life-threatening. During its development, a progressive narrowing of the coronary artery, tearing of the plaque, the formation of a thrombus, or arterial spasm usually occurs.

  • Typically, an attack of such unstable angina lasts no more than a week, but can result in a transformation into a heart attack.

There are several forms of unstable angina (briefly):

  • First occurring (in theory, any first-occurring angina pectoris is unstable for two months until doctors recognize its features);
  • Progressive angina pectoris, with the transition from class to class in a short time;
  • Arising after a heart attack or surgery;
  • Spontaneous angina pectoris (Prinzmetal).

This form of unstable angina is vasospastic, and severe atherosclerosis is not necessary for its appearance. It occurs during sleep, in the morning hours, against the background of tachycardia (REM sleep phase), turns in bed and nightmares.

As a result, dangerous rhythm disturbances can occur (in a dream), which can cause asystole and clinical death.

How does a typical attack of angina pectoris (angina pectoris) proceed, what are its symptoms and what should I pay attention to?

angina pectoris – a photo of symptoms of pain during an attack

A man clutching at a heart “brought to work” is a cinematic symptom of an angina attack. Medicine offers a slightly more detailed picture of the attack:

  • The first sign of an attack of angina pectoris is paroxysmal pain of a constricting nature behind the sternum;
  • In most cases, it appears at the height of any tension: both emotional and physical;
  • It provokes an attack, in addition to loading, an increase in blood pressure, an attack of tachycardia, cold, windy weather, plentiful and satisfying food intake (all blood rushes to the digestive system, robbing the heart), and even with a sharp transition to a lying position;
  • The nature of the pain is burning, pressing, heavy, compressing. In mild cases, simply chest discomfort;
  • The usual localization is the top and middle of the sternum;
  • Rare localization – in the projection of the heart itself, or in the epigastric region;
  • Gives pain (radiating) – to the left hand, jaw, left shoulder, hand, collarbone, scapula. But, in any case, there is pain behind the sternum. In the right half of the body, pain is very rare, but such cases are possible;
  • The duration of the attack is (in typical cases) from 1 to 15 minutes;
  • An important sign of angina pectoris is a quick and good response from taking nitroglycerin under the tongue. As a rule, with stable angina pectoris, in 1-2 minutes there is a complete relief of the pain syndrome.

The essence of pathology

Prevention

Primary prevention (for those who do not have angina pectoris):

  • Nutrition correction.
  • Moderate exercise.
  • Cholesterol and blood sugar control once a year.
  • In the presence of hypertension – the constant use of antihypertensive drugs with retention of blood pressure below 140/90 mm Hg.
  • To give up smoking.

Secondary prophylaxis (for those who have angina pectoris, reduces the frequency and duration of attacks, improves the prognosis):

  • Avoid severe stress and excessive physical exertion.
  • Before physical activity, you can take 1 dose of nitroglycerin.
  • Regularly take medications prescribed by your doctor that improve the prognosis of the disease.
  • Treatment of concomitant diseases.
  • Observation by a cardiologist.

Prevention of angina pectoris is important because the prognosis of the treatment of the disease is unfavorable. It is impossible to cure the disease with conservative methods. And the risk of it developing into myocardial infarction or sudden death is quite high.

Therefore, you need to start thinking about heart health when it is healthy. It is recommended that you make the few rules below a part of your lifestyle. Prevention of angina pectoris can fit into four simple truths:

  • constant physical activity
  • lack of emotional overstrain,
  • to give up smoking,
  • health monitoring.

Let us examine these truths in more detail.

The human heart is a muscle. Maintaining her tone requires regular exercise.

The loads can be different: walking, running, physical work, gym classes. And all of them will positively affect the state of the heart and strengthen it.

If you are not a professional athlete, do not exhaust the body with exhausting loads. But sitting all day in an office chair is not worth it. You need a middle ground. It is enough to walk a few kilometers daily or to run several circles around your block in the mornings. The main thing is constancy, and then the heart will be ready for exertion.

Stress is your enemy in preventing heart problems. Constant hassle and anxiety negatively affect the resource of the heart muscle. Everyone understands that you can’t put yourself in the sideboard and not worry about anything. But, thinking about your body, you need to properly prioritize.

Do not spray emotions on problems that do not deserve it. It has long been noted that non-conflict people are much less likely to encounter heart problems. This also applies to angina pectoris.

Therefore, we take it as a rule: to reduce the risk of developing angina pectoris, it is necessary to reduce the amount of stress in life.

To give up smoking

Smoking and prevention of angina pectoris are incompatible concepts. Oxygen, which must be delivered to the heart by blood vessels, is replaced by harmful compounds from tobacco smoke when smoked. Automatically, we get an aggravation of one of the factors in the development of the disease – a poor supply of oxygen to the heart.

This fact applies to the fight against the disease, and its prevention. With each cigarette, we worsen the nutrition of the heart and bring closer the moment when the first attack of chest pain occurs. Angina pectoris is much closer to those who smoke.

With regard to alcohol, there is an interesting opinion: alcohol perfectly breaks down fatty compounds that clog vessels and lead to atherosclerosis. Based on this fact, a number of experts believe that moderate-dose alcohol is useful as a prophylaxis for angina pectoris and other heart problems.

This statement is also supported by the fact that many old-timers regularly drank a glass of wine or a glass of cognac. But this fact cannot be taken as a guide to action.

If a person leads a healthy lifestyle, experiences regular physical exertion, avoids stress, then the best solution would be a complete rejection of alcohol.

It must be kept in mind that the likelihood of angina pectoris increases with concomitant diseases. Diseases of the lungs, liver, diabetes mellitus, problems with the gastrointestinal tract are all factors that increase the risk of developing angina pectoris.

Regular preventive examinations by a therapist will allow you to diagnose any health problems in the early stages. Early diagnosis is the easiest way to get rid of problems.

Remember that the heart is the motor of the body. But any problems with other organs increase the load on the heart and significantly reduce its resource.

Angina classification

In medicine, a stable and unstable form of the disease is shared.

Functional Class (FC) Angina PectorisCharacterization of the functional class of angina pectoris
IStable angina pectoris of the first FC occurs with intense and prolonged physical or emotional stress.
IIThe second FC of stable angina is diagnosed if the patient develops an attack in cases of walking at a distance of 500 meters or more, walking at an accelerated pace in frosty weather, climbing stairs two or more floors.
IIIThe third FC is given to a patient whose attack occurs after a hundred meters of walking in a calm rhythm. This functional class of stable angina pectoris leads to severe limitations in physical activity.
IVPain occurs even at rest or during sleep. Any physical activity leads to angina pectoris.

An unstable form of the disease is a more complex diagnosis. The complexity of the diagnosis is that there is no relationship between the loads and manifestations of the disease. In the medical hierarchy, the unstable form takes an intermediate place between the stable form and acute myocardial infarction.

The unstable form requires constant monitoring by a doctor. The danger of an unstable form of angina pectoris is that seizures occur without obvious prerequisites and there is a risk of myocardial infarction or sudden death.

There are three classifications of unstable angina pectoris.

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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