Angina pectoris: causes, symptoms and treatment
What is it - one of the forms of chronic heart disease, manifested by severe pain in the chest - coronary disease( angina).
The disease is caused by a complication of cardiac arterial atherosclerosis - a narrowing of the arterial lumen, which causes cardiac circulatory disorders and, as a consequence, a lack of oxygen entering the myocardium.
The disease originates from the ancient Greek times of Hippocrates, and for the first time it was comprehensively examined in the eighteenth century by the English scientist W. Herberden and named it "angina pectoris"
The main factor in the development of the disease is the deposition on the walls of the bloodvessels carrying myocardium nutrients and oxygen, cholesterol plaques. Gradually accumulating, "scum" on the vascular walls narrows their cavity and creates difficulties for normal blood supply.
Also read: increased cholesterol in the blood, what should I do?
Pathological processes in the coronary vessels that cause blood flow disturbance create prerequisites for the formation of IHD( cardiac ischemia) and angina attacks. Manifestations of seizures are caused by organic and functional disorders, as a result of which the imbalance between the opportunity and the need for nutrients and the amount of oxygen delivered to the myocardium is sharply manifested.
Organometric disorders include atherosclerosis of cardiac coronary arteries. This circumstance causes a narrowing of the blood vessels, which, with increased workloads, causes increased heart function and, as a consequence, an attack of coronary insufficiency. Functional disorders are caused by coronarospasm, as a result of disturbances in the mechanisms of humoral and nervous regulation of the contractile activity of the walls of blood vessels.
The development of angina pectoris causes:
The risk of developing pathology depends on many factors. One can influence and prevent the development of the disease, they are called - modifiable or eliminated, other factors are those that can not be modified, that is, unavoidable.
To unavoidable factors is the human factor, which we can not change, is:
By eliminating smoking, you can get rid of the high blood pressure caused by spasm of the arteries when smoking. Exclusion from the diet of fatty foods helps to reduce the formation of excessive cholesterol in the blood, weight loss, and the same arterial pressure that provokes attacks of angina pectoris.
Reducing risk factors are facilitated by timely measures to prevent:
The main symptoms of angina pectoris in women and men are expressed in varying degrees of chest and chest pain. When there is insufficient delivery of nutrients and oxygen, to any part of the heart, the myocardium uses a less efficient type of "fuel" to restore its functions.
A by-product of this fuel in the form of lactic acid, accumulates in the muscles, causing pain. It can be acute, pressing or burning. In most cases, pain can be radiated into the cervical region, expressed as acute toothache in the lower jaw, pain in the hands, legs, and lower back.
Pain symptoms with angina appear clearly under certain actions and circumstances that cause oxygen starvation of the myocardium. Basically, this is a physical or emotional strain.
Reflected on the state of health:
Clinical classification defines several types of manifestations of angina attacks. Pathological changes, the basis of which is narrowing of the vessels of the main arteries, leading to subendocardial ischemic disease, is referred to stable forms of angina pectoris - angina pectoris. It is characterized by increased sensitivity of the myocardium to any kinds of functional load.
Provoke increased blood flow and oxygen consumption by the myocardium:
Coronary insufficiency, caused by a sharp and sudden narrowing of the coronary arteries( spasm), even with the optional presence of atherosclerosis, was called stenocardia of rest or Prinzmetal. Develops in a state of hypobiosis, during rest or during sleep. The consequence of such stenocardia is transmural ischemia of the heart muscle. The attack can last up to half an hour.
Increasing, frequent attacks, in any condition manifests an unstable form of angina. The basis of this type is a violation of the structural integrity of cholesterol deposits( plaques) in the main vessels, although the manifestation of spasms in small vessels, with acute occlusion of vessels( embolism) is possible. The destruction of fibrotic plaques leads to the formation of many small blood clots in the vessels. This is facilitated not only by spasm, but also:
From the correct diagnosis depends on the further treatment of the patient, aimed at preventing the development of angina and reducing the risk of further degeneration of the myocardium.
For this use:
The prognosis for coronary insufficiency is uncertain, as everything depends on background diseases that promote the development of angina pectoris, the degree of its severity, the effectiveness of treatment and the lifestyle of the patient. You can live more than twenty years or die from a heart attack due to coronary insufficiency.
The method of prevention is observance of simple rules:
The disease is caused by a complication of cardiac arterial atherosclerosis - a narrowing of the arterial lumen, which causes cardiac circulatory disorders and, as a consequence, a lack of oxygen entering the myocardium.
The disease originates from the ancient Greek times of Hippocrates, and for the first time it was comprehensively examined in the eighteenth century by the English scientist W. Herberden and named it "angina pectoris"
Causes of angina
The main factor in the development of the disease is the deposition on the walls of the bloodvessels carrying myocardium nutrients and oxygen, cholesterol plaques. Gradually accumulating, "scum" on the vascular walls narrows their cavity and creates difficulties for normal blood supply.
Also read: increased cholesterol in the blood, what should I do?
Pathological processes in the coronary vessels that cause blood flow disturbance create prerequisites for the formation of IHD( cardiac ischemia) and angina attacks. Manifestations of seizures are caused by organic and functional disorders, as a result of which the imbalance between the opportunity and the need for nutrients and the amount of oxygen delivered to the myocardium is sharply manifested.
Organometric disorders include atherosclerosis of cardiac coronary arteries. This circumstance causes a narrowing of the blood vessels, which, with increased workloads, causes increased heart function and, as a consequence, an attack of coronary insufficiency. Functional disorders are caused by coronarospasm, as a result of disturbances in the mechanisms of humoral and nervous regulation of the contractile activity of the walls of blood vessels.
The development of angina pectoris causes:
- attacks of excitement and excitement;
- cold and addiction to smoking
- reflex effects on cholelithiasis;
- for gastric diseases and parasophageal hernia;
- inflammatory changes in the coronary arteries;
- syphilitic mesoarthritis and panarrititis;
- obliterating endarteritis and nodular periarteritis;
- rheumatism and hypertension
Risk Factors
The risk of developing pathology depends on many factors. One can influence and prevent the development of the disease, they are called - modifiable or eliminated, other factors are those that can not be modified, that is, unavoidable.
To unavoidable factors is the human factor, which we can not change, is:
- age factor;
- sexual and racial affiliation;
- is a genetic factor.
By eliminating smoking, you can get rid of the high blood pressure caused by spasm of the arteries when smoking. Exclusion from the diet of fatty foods helps to reduce the formation of excessive cholesterol in the blood, weight loss, and the same arterial pressure that provokes attacks of angina pectoris.
Reducing risk factors are facilitated by timely measures to prevent:
- development of diabetes mellitus and hypertension;
- in time begun treatment for the normalization of blood viscosity, to exclude thrombus formation;
- recovery of normal cholesterol metabolism functions;
- reduced the increased burden on the heart, protecting it from emotional stress.
Symptoms of angina
The main symptoms of angina pectoris in women and men are expressed in varying degrees of chest and chest pain. When there is insufficient delivery of nutrients and oxygen, to any part of the heart, the myocardium uses a less efficient type of "fuel" to restore its functions.
A by-product of this fuel in the form of lactic acid, accumulates in the muscles, causing pain. It can be acute, pressing or burning. In most cases, pain can be radiated into the cervical region, expressed as acute toothache in the lower jaw, pain in the hands, legs, and lower back.
Pain symptoms with angina appear clearly under certain actions and circumstances that cause oxygen starvation of the myocardium. Basically, this is a physical or emotional strain.
Reflected on the state of health:
- by sudden changes in blood pressure in the arteries of
- by cardiac rhythm disturbances;
- is characterized by chronic fatigue syndrome;
- signs of hyperhidrosis, intoxication and dizziness;
- skin pale, pronounced "nasolabial" triangle.
Classification of the disease
Clinical classification defines several types of manifestations of angina attacks. Pathological changes, the basis of which is narrowing of the vessels of the main arteries, leading to subendocardial ischemic disease, is referred to stable forms of angina pectoris - angina pectoris. It is characterized by increased sensitivity of the myocardium to any kinds of functional load.
Provoke increased blood flow and oxygen consumption by the myocardium:
- load during labor activity;
- periods of emotional state( relaxation);
- state of cold and overheating.
Coronary insufficiency, caused by a sharp and sudden narrowing of the coronary arteries( spasm), even with the optional presence of atherosclerosis, was called stenocardia of rest or Prinzmetal. Develops in a state of hypobiosis, during rest or during sleep. The consequence of such stenocardia is transmural ischemia of the heart muscle. The attack can last up to half an hour.
Increasing, frequent attacks, in any condition manifests an unstable form of angina. The basis of this type is a violation of the structural integrity of cholesterol deposits( plaques) in the main vessels, although the manifestation of spasms in small vessels, with acute occlusion of vessels( embolism) is possible. The destruction of fibrotic plaques leads to the formation of many small blood clots in the vessels. This is facilitated not only by spasm, but also:
- prolonged heart rhythm disorders;
- hemorrhage in the cholesterol deposits;
- hypercholesterolemia.
Treatment of angina
From the correct diagnosis depends on the further treatment of the patient, aimed at preventing the development of angina and reducing the risk of further degeneration of the myocardium.
For this use:
- 1) Clinical and biological analysis data, which determine the severity of the disease and the presence of background diseases.
- 2) A glucose tolerance test measures the level of glucose in the blood plasma that determines the presence of diabetes.
- 3) Detection of narrowed coronary arteries, changes in heart size, possible formation of an aneurysm of the cardiac ventricle, reveals chest X-ray.
- 4) Valuable information is given by the ECG and ultrasound data, carried out with the load, in the hypobiosis stage, with increasing loads, starting with minimal loads.
- 5) The method of scintigraphy using contrast preparations, allows to determine the place of abnormal narrowing of the vessel.
- 6) The most reliable method of diagnosing coronary disease is coronary angiography. The contrast substance introduced into the vessels, with the help of gamma radiation, allows us to see with a high accuracy the complete picture of the problematic sections of the vessels on the screen.
- 1) In order to reduce oxygen starvation, inhalations are prescribed with humidified oxygen.
- 2) Analgesics of narcotic and non-narcotic orientation are prescribed for relief of pain symptoms.
- 3) The administration of nitrates reduces the oxygen demand of the heart muscle and increases its susceptibility to stress.
- 4) Antiaggregant therapy and anticoagulant drugs strengthen vascular walls, promote blood thinning to prevent the formation of blood clots.
- 5) The use of beta-blockers and inhibitors provides an economical regimen to the heart, reducing heart rate and normalizing blood pressure.
- 6) Diuretics control the accumulation of salts in the blood plasma and in combination with other medications provide an antihypertensive effect.
- 7) The purpose of taking statins is to block the formation of cholesterol.
- 8) Protection of the myocardium from ischemia ensures reception of metabolic drugs that improve metabolic processes.
Prognosis and prophylaxis of angina
The prognosis for coronary insufficiency is uncertain, as everything depends on background diseases that promote the development of angina pectoris, the degree of its severity, the effectiveness of treatment and the lifestyle of the patient. You can live more than twenty years or die from a heart attack due to coronary insufficiency.
The method of prevention is observance of simple rules:
- healthy, rational mode;
- regular, balanced nutrition;
- control of blood lipids and blood pressure;
- timely treatment.