Angina: what is it, symptoms, classification, treatment
Most people with any heart pain is called angina. However, this statement is not only wrong, but can lead to disastrous consequences. It is against the background stenokardicheskie seizures most often occurs myocardial infarction. What is angina, what is dangerous, how to treat it and be cured if the disease is in the answers to these questions everyone should know for their own health and the lives of loved ones.
Angina: what is it?
Angina is a form of ischemic heart disease, manifested by paroxysmal pain in the chest. The painful symptoms result from impaired blood flow in the coronary arteries when reduces the amount delivered to the myocardium of oxygen.
While oxygen deprivation is temporary – it appears under the influence of a provoking factor (stress, exercise) and removed after some time. The current long-term or significant reduction in the number of admissions to the heart muscle of oxygen leads to local necrosis of the myocardium. That is why in any case should not suffer the heartache, so as stenokardicheskie attack did not lead to irreversible consequences and a heart attack.
Angina is diagnosed in one out of every four women and nearly every second men up to 50 years. Such a significant difference due to hormonal background: female hormones prevent the development of damaging blood vessels pathologies (e.g., atherosclerosis). However, in old age women suffer from angina pectoris also often hormonal changes during menopause adversely affects the vasculature and the coronary arteries. Often diagnosed angina and adolescents. This is due to their emotional instability and hormonal changes in puberty.
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The etiology of angina pectoris
Causes of disease lie in the conditions in which there is damage to the vascular wall and narrowing of the arteries, in this case, coronary. Such pathologies include:
- diabetes mellitus;
- high blood clotting.
Increased need of cardiac muscle in oxygen, and, consequently, the risk of stenokardicheskie attack provoke the following problems of the patient with heart:
- hypertrophy of the left ventricle;
- hypertrophic/dilated cardiomyopathy;
- stenosis of the aortic valve;
- regurgitate reverse blood flow through the heart chambers due to a defect of the aortic valve;
- a heart attack (early postinfarction angina) — myocardial necrosis disrupts coronary blood flow that can be manifested stenokardicheskie attacks, scarring necrosis symptoms disappear.
Patients with these heart conditions ischemic attack (hemodynamic failure) is triggered by the following factors:
- adrenaline rush (in stressful situations, during intercourse);
- overeating, particularly with high gas formation;
- the increased heart rate at high temperature, agitation, and physical activity;
- a decrease in blood sugar;
Even without the identification of serious pathologies, the threat of pain is not excluded. Risk group includes people:
- over the age of 50 – 55 years old — age-related changes start in the first place from the blood vessels;
- Smoking — nicotine provokes vascular spasms; carbon monoxide that is produced during Smoking, reduces the oxygen level of sufficiency;
- abusing alcohol — although alcohol initially have a vasodilator effect, angina and alcohol are incompatible: subsequent vasospasm and alcohol intoxication can trigger even heart attack;
- fragile to stress (the so-called psychogenic angina) — severe emotional distress and chronic stress increase the load on the myocardium, disrupt the delivery to it of vitamins and minerals;
- with a sedentary lifestyle, adynamic — easy work, and physical inactivity increase the risk of CHD in 5 times;
- obese — overeating and high-calorie diet leads to the accumulation of extra pounds, damage to the vessel and additional load on the heart;
- after a serious infection and allergic reactions that provoke the violation of the metabolism and lack of nutrition of the myocardium;
- poorly fed (diet, monotonous food) — lack of vitamins and minerals, especially magnesium and potassium, also leads to a metabolic shift.
Signs of angina
Angina is characteristic symptoms:
- The beginning is sudden.
- Pain is the main symptom. Location: behind the sternum, radiating to left arm, neck, jaw, under the shoulder blade. Character of pain: burning, pressing. Duration of pain: up to 15 minutes.
- Other symptoms — shortness of breath, palpitations (often arrhythmia), rapid pulse, pale skin, perspiration on forehead, cold hands (sometimes numbness hands).
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Types of angina
Cardiologists there are 3 main types of angina:
- onset — before any symptoms of pain were noted;
- stable (exertional angina) — depending on who provoked the attack load is divided into 4 classes;
- unstable — the connection between heart pain and physical activity is not fixed.
Functional classes of stable angina:
- I — rare attacks occur after a large load;
- II — chest pain provokes climbing stairs, brisk walking, heavy lunch;
- III — marked limitation of physical abilities — stenokardicheskie pain occurs when relaxed walking 100 m, climbing 1 floor, inhalation of cold air, with a little unrest.
- IV — a sharp decline in physical activity — the minimum load causes painful symptoms, it is possible to attack at rest (angina at rest).
Unstable angina: types
The reason for provoking the attack (paroxysm), consider the following groups of unstable angina:
- primary — no external causes;
- secondary — external factor enhances ischemia;
- early post-infarction is recorded in the first 2 weeks after suffering necrosis of the myocardium;
- variant (spontaneous), including prinzmetals angina (spasm caused by a sudden vascular spasm).
Classification by Braunwald:
- I primary/secondary/post-infarction — onset with progressive course (angina at rest is not fixed);
- II primary/secondary/post-infarction — fixing of angina at rest for 1 month (no characteristic symptoms in the next 2 days after challenge);
- III primary/secondary/post-myocardial infarction — angina at rest in the first 2 days.
Complications of angina pectoris
The consequences of stenokardicheskie attacks severe enough. This:
- myocardial infarction;
- arrhythmias, including ventricular fibrillation;
- cardiogenic shock;
- epistemologically pericarditis;
- pulmonary edema, pulmonary embolism;
- bleeding (if not properly treated with thrombolytic drugs).
Specific complaints of the patient will suggest angina. To confirm the diagnosis and determine the cause of the disease held by:
- Laboratory tests blood General, biochemistry, sugar, cholesterol.
- ECG at rest (detection of coronary disorders), stress (treadmill, Bicycle ergometry), during attack (ST elevation 2 mm and above, sometimes merging with the T wave, negative T wave, increased amplitude of the R wave, long QT), Holter monitoring (daily ECG angina will help to identify and commit the changes within a day). Characteristic ECG changes appear only during an attack.
- Scintigraphy, Echo-CG, angiography.
First aid is as follows:
- The elimination of physical load.
- The patient should be in a half upright position.
- Indoors to open window.
- Nitroglycerin under the tongue. In case of stable a single pill, while unstable — to 3 tablets every 2 – 3 min.
- Aspirin 500 mg to chew.
How to treat angina?
Treatment of angina involves a range of activities.
Correction of the image
What not to do:
- to drink alcohol, to smoke;
- eat fatty, salty food;
- neglected adequate physical activity (exercise, Hiking, physical therapy, massage, respiratory gymnastics exercises in the Buteyko system);
- excessively to test their physical capabilities;
- saunas, steam rooms;
- to gain weight.
Drug therapy includes the following drugs for the treatment of angina:
- nitrates (Isosorbide, Nitroglycerin) — antispasmodic;
- thrombolytics (Aspirin, Thrombotic ass, Cardiomagnyl) — prevent blood clots and reduce the risk of heart attack;
- beta-blockers (Atenolol, etc.) — reduces the need of myocardium in oxygen;
- statins (Simvastatin) — cholesterol normalize indicators;
- ACE inhibitors (enalapril, Perindopril), reduce pressure, prevent the development of heart failure;
- calcium antagonists (Verapamil) — reduce the oxygen need of the myocardium; in the malfunction of the sinus node should be used with caution.
Proven medication ATP/kokarboksilaza, vitamin complexes and Riboxin not have a therapeutic effect for angina. Particularly noteworthy are the tablets with magnesium: deficiency of this trace element provokes to one-third of heart attacks.
The cure for angina, the dose and duration of use determined by your doctor taking into account diagnostic data of the General condition of the body and forms of angina. Only a qualified cardiologist knows how to treat angina to prevent its progression and increase the frequency of the paroxysms. Most often therapy is conducted in the home, hospitalization of the patient is appropriate only in serious condition and suspected myocardial infarction.
Traditional methods of treatment
Folk remedies are used only in consultation with your doctor. It is worth to remember that herbs have side effects. Reliance solely on treatment of folk remedies is fraught with deterioration of the patient. Homemade recipes are only suitable to enhance the effect of medicines.
The most effective recipe: 6 lemons, head of garlic and 1 liter of honey. The crushed products and honey infused 2 weeks. Regimen: 1 teaspoon on an empty stomach in the morning and before bed.
Surgical intervention is appropriate in rapidly progressive angina and in the absence of therapeutic effect of conservative measures.
- Coronary artery bypass surgery – suturing of the vessel to create a detour circulation.
- Stenting — introduction into the vessel of the mesh, widening the narrowed heart vessel.
- Plastic balloon — expansion of the narrowed area samorastekayushchikhsya tank.
All methods of surgical intervention often carried out endoscopically (through miniraise). Angioplasty and stenting are often combined. If the clinic has special equipment possible crestatura (endovascular) delivery of therapeutic instruments to a site of pathological narrowing of the vessel.
Is there a cure for angina?
Angina in most cases, eliminated under the following rules:
- the elimination of cause of heart disease;
- correction of living habits;
- the corresponding condition treatment program;
- clear patient compliance with medical recommendations.
Should understand all about angina only knows the cardiologist. Only a doctor can make a correct therapeutic scheme that will ensure maximum chances of recovery.
To prevent the development of angina and heart attack:
- To monitor their weight.
- To abandon bad habits (cigarettes and alcohol).
- To keep your vitality physical exertion.
- When the genetic predisposition to take preventive checkups.
- To treat the disease, provoking stenokardicheskie seizures.