Angina form of myocardial infarction – learn how to recognize and help

The first attack of pathology can be short-lived. It is called unstable angina. In fact, this is a pre-infarction condition. In this case, with timely measures taken, a heart attack can be avoided. The main symptom of a heart attack itself is acute pain. The following features are characteristic of it:

  • compressive character resembling an attack of angina pectoris;
  • spread throughout the chest;
  • associated symptoms in the form of fainting, cold, sticky sweat, dizziness.

Pain with an anginal form of pathology can radiate to different parts of the body. This is the upper part of the abdominal wall, the area between the shoulder blades, the left little finger, upper limbs, lower jaw. The pain symptom can manifest itself with different intensities. For young people, a subsequent reflex pain shock is characteristic.

In this case, weakness builds up, the skin turns pale, blood pressure drops sharply, and cold perspiration appears. Elderly people may not have characteristic pains. In case of myocardial infarction, including its anginal form, the patient needs immediate hospitalization. Treatment should be supervised by specialists.

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First a >

With signs of myocardial infarction, an ambulance must be urgently called. Prior to her arrival, first aid can be provided to the victim:

  • it is convenient to place a person so that he is lying;
  • relieve the victim of tight clothes, a belt, a tie;
  • provide fresh air;
  • give nitroglycerin and a sedative.

The remaining measures will be taken by the arriving ambulance crew.

Further treatment

In a hospital, complex measures are used. They are designed to solve several goals:

  • restore blood flow in the affected area;
  • stop the pain;
  • reduce the risk of irreversible changes;
  • normalize blood pressure.

Be sure to comply with bed rest. Medication includes taking the following groups of drugs:

  • anticoagulants;
  • thrombolytics;
  • nitroglycerin;
  • antiplatelet agents;
  • analgesics;
  • ? -adrenergic blockers.

Nitroglycerin relieves vascular spasm and reduces the load on the left ventricle. With angina infarction, pain is sometimes very difficult to stop. Narcotic substances like Morphine, Fentanyl, Promedol can be used. In this case, tranquilizers are additionally used, often resorting to Sibazon. Oxygen inhalations are also used for the analgesic effect if the blood saturation is below 95%.

As an antishock agent, heparin can be used. It also prevents blood clots. Its introduction may be required when using some thrombolytics, which are appropriate in the first hours of a heart attack. They dissolve the blood clot, reducing pain. In a severe case, the patient requires surgical treatment.

Its goal is to eliminate vascular spasm or thrombus. The anginal form of myocardial infarction can be recognized by characteristic signs. The patient must be hospitalized immediately, otherwise his condition can be fatal. The treatment is carried out mainly with medication, but especially severe cases require surgical intervention.

The main feature are acute pain. The emerging pain syndrome has the following symptoms:

  • constricting chest pain, as with an attack of angina pectoris;
  • the spread of pain not only to the region of the heart, but also to the entire chest, in some cases to the abdomen and lower jaw;
  • pain can be given to the left, less often to the right shoulder joint, sometimes a pain attack affects the patient’s neck;
  • concomitant symptoms: cold, sticky sweat, fainting, dizziness, in rare cases, vomiting and diarrhea.

The anginal form of a heart attack can be accompanied by such severe pain that cardiogenic shock is possible. This condition is characterized by the following symptoms:

  • growing weakness;
  • adynamia;
  • pallor of the skin;
  • a sharp decrease in blood pressure;
  • cold sweat.

Another feature indicating the onset of the anginal status of the disease is the inability to stop pain with nitroglycerin.

infarkt miokarda anginoznyj 1 - Angina form of myocardial infarction - learn how to recognize and help

Angina myocardial infarction is the most common type of disease that occurs in 90 percent of patients. Pain in the region of the heart can be single, in some cases a series of wave-like pain attacks can occur, increasing on an increasing basis. It is noted that elderly patients often do not have pain (anginal pain), while young people necessarily show severe (often unusual) pain onset of an attack.

  • The person is sick.
  • Arrhythmia is detected.
  • General, rapidly progressing weakness.
  • Pallor of the skin.
  • Sticky, cold sweat.
  • Drop in blood pressure.

    Pain can torment a person for several hours. Another type of myocardial disease is the gastralgic form. The disease can suddenly begin with a sharp, sharp pain in the epigastric region. Then the pain goes to the localization of the heart muscle, or begin to disturb the patient in the area between the shoulder blades.

    Atypical forms can be combined with each other, as well as with an anginal form of heart attack.

    The first attack of pathology can be short-lived. It is called unstable angina. In fact, this is a pre-infarction condition. In this case, with timely measures taken, a heart attack can be avoided.

    Pain with an anginal form of pathology can radiate to different parts of the body. This is the upper portion of the abdominal wall, the area between the shoulder blades, the left little finger, upper limbs, lower jaw.

    A pain symptom can occur with varying intensity. For young people, a subsequent reflex pain shock is characteristic. In this case, weakness increases, the skin turns pale, blood pressure drops sharply, and cold perspiration appears. In older people, characteristic pain may not be.

    With myocardial infarction, including its anginal form, the patient needs immediate hospitalization. Treatment should be supervised by specialists.

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    Further treatment

    543caceb9ac6091ad23549a64b21c332 - Angina form of myocardial infarction - learn how to recognize and help

    In a hospital, complex measures are used. They are designed to solve several goals:

    • anticoagulants;
    • thrombolytics;
    • nitroglycerin;
    • antiplatelet agents;
    • analgesics;
    • β-blockers.

    Nitroglycerin relieves vascular spasm and reduces the load on the left ventricle.

    With angina infarction, the pain is sometimes very difficult to stop. Narcotic substances like Morphine, Fentanyl, Promedol can be used. In this case, tranquilizers are additionally used, often resorting to Sibazon.

    Oxygen inhalations are also used for the analgesic effect if blood saturation is below 95%.

    As an antishock agent, heparin can be used. It also prevents blood clots. Its introduction may be required when using some thrombolytics, which are appropriate in the first hours of a heart attack. They dissolve a blood clot, reducing pain.

    In a severe case, the patient requires surgical treatment. Its purpose is to eliminate vascular spasm or thrombus.

    The anginal form of myocardial infarction can be recognized by characteristic signs. The patient must be hospitalized immediately, otherwise his condition can be fatal. The treatment is carried out mainly with medication, but especially severe cases require surgical intervention.

    Angina myocardial infarction

    Pain (anginous) form refers to typical forms of heart attack. She appears after not only during emotional or physical exertion, but also at night, in a dream. The intensity of the pain determines the severity of the course and the development of complications. An anginal attack can be stopped by the introduction of narcotic drugs, and then arise with renewed vigor. The pain, which is accompanied by more than an hour, passes into a state that is characterized as anginal status.

    • Left little finger;
    • Lower jaw;
    • Interscapular region;
    • Upper limbs;
    • The upper abdominal wall.
    • An anginal attack, in contrast to angina pectoris.

    The intensity of the pain symptom is different. In young patients, it is intense, accompanied by the development of reflex pain shock – the main symptom in the anginal form. Often the first attack is short-term and goes away on its own, this is a state of pre-infarction, which, if you do not take action, will go into a heart attack.

    In the clinic, this diagnosis is called “unstable angina. There are wave-like pain attacks. They are characterized by alternating strong intensities with weak ones. In patients under 60 years old, when the nerve endings are preserved, they describe the pain “as a dagger strike”. The height of the pain symptom causes panic and fear of death. Patients are restless, rushing about in bed, finding no place for themselves.

    Pain (anginous) form refers to typical forms of heart attack. She appears after not only during emotional or physical exertion, but also at night, in a dream. The intensity of the pain determines the severity of the course and the development of complications. An anginal attack can be stopped by the introduction of narcotic drugs, and then arise with renewed vigor. The pain, which is accompanied by more than an hour, passes into a state that is characterized as anginal status.

    The intensity of the pain symptom is different. In young patients, it is intense, accompanied by the development of reflex pain shock – the main symptom in the anginal form. Often the first attack is short-term and goes away on its own, this is a state of pre-infarction, which, if you do not take action, will go into a heart attack. In the clinic, this diagnosis is called “unstable angina.

    There are wave-like pain attacks. They are characterized by alternating strong intensities with weak ones. In patients under 60 years old, when the nerve endings are preserved, they describe the pain “as a dagger strike”. The height of the pain symptom causes panic and fear of death. Patients are restless, rushing about in bed, finding no place for themselves.

    Diagnosis of the disease

    Echocardiography combines a classic ECG with ultrasound of the heart and the use of the Doppler effect to visualize the movement of blood flows inside the heart. This mode allows you to see the hemodynamics necessary for assessing the consequences of a heart attack, valve failure, regurgitation of blood masses. Echocardiography also allows you to determine the exact localization of the focus of necrosis.

    A biochemical blood test serves as the final confirmation of the diagnosis. After the destruction of myocardial cells, proteins and enzymes (troponin, KFK-MV, etc.) are secreted. They indicate a high specificity of necrosis, i.e., the location of the focus in the myocardium.

    All of these classifications help to accurately determine the type of myocardial infarction, to develop principles for approaching each of them, to assess the required volume of treatment and subsequent rehabilitation, and sometimes with a high degree of certainty to give a forecast.

    Arbitration methods for diagnosis are ECG (electrocardiography), echocardiography (ultrasound examination of the heart), as well as the determination of specific markers of inflammation in the blood. Based on the anatomical location and size of the focal point of necrosis, a large-focal myocardial infarction is identified, it is also transmural, also called Q-infarct .

    The name is due to specific ECG signs of this type of myocardial infarction – a Q wave is preserved with it. According to the ECG, one can determine the degree of myocardial necrosis, its type and the approximate depth of the defect formed, evaluate preserved conductivity, excitability and other properties of the heart muscle. Echocardiography combines classical ECG with ultrasound of the heart and the use of the Doppler effect to visualize the movement of blood flows inside the heart.

    This mode allows you to see the hemodynamics necessary for assessing the consequences of a heart attack, valve failure, regurgitation of blood masses. Echocardiography also allows you to determine the exact location of the focus of necrosis. A biochemical blood test serves as the final confirmation of the diagnosis. After the destruction of myocardial cells, proteins and enzymes (troponin, KFK-MV, etc.) are secreted.

    They testify to the high specificity of necrosis, i.e., the location of the focus in the myocardium. All of these classifications help to accurately determine the type of myocardial infarction, develop principles for approaching each of them, evaluate the required amount of treatment and subsequent rehabilitation, and sometimes with a high degree of certainty give a forecast. We offer to watch a video on the topic of the article.

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    The basis for the diagnosis of a pathological condition (especially in the first hours of an attack) is a detailed analysis of the nature of the pain, while the specialist should take into account the patient’s history, indicating the presence of coronary artery disease and other negative factors. Further, constant monitoring of the dynamics of changes in ECG indicators and monitoring of increased activity of enzymes in the blood of the patient is carried out. Modern diagnostics includes instrumental methods:

    • electrocardiogram;
    • magnetic resonance imaging;
    • echocardiography.

    The following laboratory methods are used to diagnose the disease:

    • assessment of enzyme activity in the patient’s blood;
    • measuring the amount of cardiospecific protein in the patient’s blood;
    • assessment of the amount of myoglobin in the patient’s urine.

    For greater informativeness, laboratory tests are carried out several times (after a certain time) in order to monitor the patient’s condition in dynamics.

    The emergency diagnostic technique for the timely detection of pathological changes in the myocardium deserves a separate description. An immunological test that determines the amount and content of a specific protein “troponin-T” in the patient’s blood makes it possible to quickly and timely detect myocardial infarction. In the presence of pathology, the concentration of a specific protein increases sharply.

    • the patient’s blood is applied to the test strip;
    • after 20 minutes, study the results;
    • in the presence of two dashes on the control strip, myocardial infarction is diagnosed;
    • one trait means a negative result.

    In the early stages of the development of pathology, testing is carried out repeatedly.

    Treatment of angina status

    The first remedy that relieves spasm of coronary vessels and reduces the load on the left ventricle is nitroglycerin. Start taking with one tablet. Method of use – under the tongue. If the attack does not stop, after 10 minutes you can re-take the drug.

    Morphine significantly alleviates the condition, providing analgesic as well as sedative effects. Enough drug management, relieve symptoms of pain shock.

  • In the case of severe resistant pain symptom, nitrous oxide is used. The tool comes with air in the form of a 50% mixture.
  • Heparin also has an anti-shock effect, which is used to prevent thrombosis. In order to prevent vascular coagulation, fraxiparin is used.
  • Thrombolytic drugs in the first hours dissolve a blood clot and relieve pain. Altepalza is used according to strict indications: absence of bleeding, peptic ulcer, stroke. Thrombolytics are also contraindicated in the postoperative period and in acute stroke.
  • According to the testimony, antiarrhythmic drugs are administered, the introduction of isoket and diuretics.
  • Oxygen has an analgesic effect, therefore, oxygen inhalation is enough to relieve an anginal attack in the acute form of myocardial infarction. Oxygen is used to reduce blood oxygen saturation below 95%.

    In the specialized department in the first hours it is already possible to use surgical intervention of angioplasty, shunting with stenting. Intensive therapy is continued until the termination of anginal status under the control of electrocardiographic monitoring.

    With the first symptoms of anginal status, you should begin to help the patient at home:

    • lay the patient, relax clothes, provide an influx of fresh air;
    • give a sedative and nitroglycerin, create a positive mood for the patient;
    • urgently call the ambulance team to place the patient in a hospital.

    In the hospital, the following methods of treatment of pathology are used:

    • restoration of blood flow in affected areas with the help of medications;
    • relief of pain by the use of potent analgesics;
    • reduction of irreversible changes in the affected area with the help of anticoagulants;
    • normalization of blood pressure by ACE inhibitors.

    In especially severe cases, the patient is shown surgery, his goal is to eliminate spasm of the vessel or thrombus. Using special techniques, the patient manages to completely restore impaired blood flow.

    It is possible to alleviate the suffering of the patient by using narcotic drugs with the complex introduction of other drugs:

    1. The first remedy that relieves spasm of coronary vessels and reduces the load on the left ventricle is nitroglycerin. Start taking with one tablet. Method of use – under the tongue. If the attack does not stop, after 10 minutes you can re-take the drug.
    2. The angina form in myocardial infarction does not always stop even after the administration of drugs (morphine, promedol, fentanyl). Often, an additional administration of tranquilizers (sibazon) is required to relieve the attack.
    3. Morphine significantly alleviates the condition, providing analgesic as well as sedative effects. Enough drug management, relieve symptoms of pain shock.
    4. In the case of severe resistant pain symptom, nitrous oxide is used. The tool comes with air in the form of a 50% mixture.
    5. Heparin also has an anti-shock effect, which is used to prevent thrombosis. In order to prevent vascular coagulation, fraxiparin is used.
    6. Thrombolytic drugs in the first hours dissolve a blood clot and relieve pain. Altepalza is used according to strict indications: absence of bleeding, peptic ulcer, stroke. Thrombolytics are also contraindicated in the postoperative period and in acute stroke.
    7. According to the testimony, antiarrhythmic drugs are administered, the introduction of isoket and diuretics.
    8. Oxygen has an analgesic effect, therefore, oxygen inhalation is enough to relieve an anginal attack in the acute form of myocardial infarction. Oxygen is used to reduce blood oxygen saturation below 95%.

    In the specialized department in the first hours it is already possible to use surgical intervention of angioplasty, shunting with stenting. Intensive therapy is continued until the termination of anginal status under the control of electrocardiographic monitoring.

  • Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

    For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

    He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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