Angina pectoris - Causes, symptoms and treatment. MF.

Angina is a condition that occurs with coronary heart disease as a consequence of blockage of arteries that feed blood to the heart muscle with atherosclerotic plaques and is manifested by attacks of pain in the heart. The frequency of the onset of pain attacks depends on the degree of narrowing of the coronary artery - the narrower the lumen, the less frequent the attacks and vice versa, for example, with a pronounced degree of constriction( more than 75%), the pain is disturbed several times a day. Attacks of angina develop more often after 45 years in men and 50 years in women, but sometimes they can occur in younger people.

Symptoms of an attack of angina pectoris

The main manifestation of angina pectoris are the pains in the heart that occur during physical activity, for example, when climbing stairs, running, walking, or training in the gym. Also, an attack can be triggered by a sharp load after a tight dinner, going out from a warm room to a cold, with a strong emotional experience. In patients with high functional class( IV FK), pain occurs several times a day, when doing ordinary household activities( when brushing teeth, cooking, tying shoelaces) or at rest.

As a rule, the pains are characterized by burning, pressing, compressing, located behind the breastbone, in the chest, can be felt in the left shoulder blade, hand, jaw, neck, may be girdled or given only to the epigastrium( solar plexus zone).Usually the attack lasts about two minutes or longer, but not more than 15 minutes. The pain passes independently in a state of rest or reception of nitroglycerin under language.

In addition to pain, an attack can be accompanied by fear of death, sweating, general weakness, dizziness, dyspnea, with increased blood pressure - headache in the occipital region, nausea.

Sometimes in young men, severe, pressing pains in the heart occur suddenly in a dream, at night or in early pre-morning hours. They are caused by a spasm of the heart-feeding vessels, and are not necessarily associated with atherosclerosis. This type of angina is called vasospastic, or stenocardia of Prinzmetall.

If the above complaints concern the patient for more than 15 minutes, and pain is not stopped by taking nitroglycerin, and even more so if accompanied by a general severe condition, this may indicate the development of an acute myocardial infarction.

The patient can sometimes take for pain in the heart the discomfort caused by diseases of other organs. For example, in diseases of the esophagus, stomach, pancreas, the burning sensation behind the sternum and pain in the left hypochondrium are disturbed, but these symptoms are most likely to be associated with eating, not physical exertion. With intercostal neuralgia caused by the osteochondrosis of the spine, the pain is of a piercing, shooting character, the patient can not take a deep breath because of the pain in the intercostal muscles, which does not occur with angina pectoris. In diseases of the pleura( the membrane covering the lungs), the pains are more associated with respiratory movements than with the load. But in any case, only the doctor will be able to correctly assess the nature of the pains, suggesting which disease they are caused, to assign the necessary methods of examination. The patient, in turn, should tell the doctor in detail about the conditions of the pain( the connection with stress, load, food intake, etc.).

. First aid with an attack of angina.

. When pain occurs in the heart, the following actions should be taken:

- openwindow, unbutton the collar of the shirt, ensuring the influx of fresh air
- to measure blood pressure, to calculate the pulse
- if necessary call an ambulance by calling "03" or from the mobile "112"
-lucid with lowered legs to reduce blood flow to the heart and load on the heart muscle
- under reduced pressure to assume the prone position
- take a nitroglycerin pill or one dose of nitromite, nitrospray, if within three minutes of relief does not come, take the drug twice more at an intervalin three minutes
- in the absence of the effect of nitroglycerin, the development of myocardial infarction is possible, so you need to chew a pill of aspirin or another antiagregant prescribed by a doctor earlier( aspicor, aspirin Cardio, cariomagnil, thrombotic Ass) to prevent further clot formation in the coronary artery
- for patients with angina Printsmetalla receiving sublingual tablets corinfar or amlodipine is often more effective than nitroglycerin

When you need to call an ambulance?

If, at the time of an attack of angina, the patient or his loved ones have at least the slightest doubt about the general condition of the patient, you need to call an ambulance as soon as possible. Moreover, urgent medical consultation is necessary in case the attack of pain in the heart appeared for the first time in life and / or is accompanied by the following symptoms:

- severe pain in the heart area that does not pass when taking nitroglycerin for 15 minutes or more
- pain accompanied by nausea, vomiting
- there is a strong sweating, a general pronounced weakness
- there was severe pallor or cyanosis of the skin( cyanosis)
- observed increased or decreased blood pressure, loss of consciousness
-The drug developed within eight weeks after myocardial infarction
- angina episodes during the last month are characterized by more severe course and less effective nitroglycerin

. In case the patient suffers from ischemic heart disease long ago, and the attack of angina proceeds as usual( without pronounced weakness sharply reducedblood pressure, taking nitroglycerin is effective), the need to call an ambulance and in urgent hospitalization does not arise, enough routine visit to the attending physicianin the clinic.

Doctor therapist Sazykina O.Yu.