Causes and treatment of angina pectoris
Sudden sharp pain behind the breastbone in most cases is a sign of chronic angina (other names, angina pectoris, acute coronary insufficiency, angina pectoris).
That is paroxysmal character of the pain allows you to accurately diagnose the disease. Angina is considered to be a form of cardiac ischemia. The most serious complication of the disease — myocardial infarction.
The basis of angina lies a pathological narrowing of the major blood vascular supplying the myocardium (stenos in Greek — narrow). The reason for the decrease in the diameter of arteries is atherosclerosis — the fouling of the inner walls of blood vascular cholesterol plaques.
Fat deposits gradually reduce the lumen of the coronary arteries, leading to myocardial ischemia (insufficient blood supply to the muscle layer of the heart wall).
In a state of relative calm, the person may not feel discomfort, especially in the early stages of development of angina pectoris. Pain syndrome usually develops during physical or mental stress, when the heart needs increased amounts of oxygen.
This can be running, weight lifting, leaving the house in the cold and the wind stress. There is a sharp mismatch between the demand of the heart muscle and real blood flow, which leads to acute coronary insufficiency.
Classification of angina pectoris
There are two main types of the disease — stable and unstable angina.
Stable form, depending on the load threshold, which is developing a pain syndrome is divided into 4 functional classes (FC):
- FC-1 — the attacks are rare, occur at excessive load;
- FC-2 — sharp pain occurs when fast walking and severe nervous tension;
- FC-3 — the attack develops at a calm and slow walk climbing stairs;
- FC-4 — the pain catches up with the rest.
Unstable angina is a more dangerous condition. Attacks occur frequently, continue longer, the pain is particularly intense. People can Wake up in the morning from severe pain. The taking nitroglycerin ineffective, brings only brief relief.
The causes of pathology
In addition to atherosclerosis, the formation of the disease contribute to other factors:
- Genetic predisposition;
- Heart disease;
- Inflammatory changes of the coronary arteries, rheumatism, occlusive endarteritis, syphilitic Mesaoria;
- Compression of the mouths of the arteriesneoplasms (tumors, Gumm);
- Shunts between the coronary arteries and cardiac (pulmonary) veins;
- Lipid disorders (dyslipidemia, hypercholesterolemia);
- Increased blood clotting;
- Endocrine diseases;
- Lack of exercise;
- The abuse of alcohol;
- The carbon monoxide poisoning.
Provoking factors is the physical and nervous overstrain. The pain may begin during climbing stairs, walking against a strong cold wind, after a heavy meal.
In men pathology is manifested more often than in women. According to statistics, the attacks each year happen at 180 thousand people per million population and 120 thousand of them — men.
The clinical picture
The main symptom of pathology is a sharp intermittent pain behind the breastbone. Disease angina pectoris has expressed symptoms:
- Heaviness, squeezing, burning in the chest;
- The spread of pain to the shoulder, arm, clavicle, upper part of the stomach, in the jaw, under the left shoulder blade;
- Instability of heart rate;
- Interruptions in the heart (arrhythmia);
- A sharp jump in blood pressure;
- Pale skin, perspiration;
- Shortness of breath, feeling of panic;
- Dizziness, headache, vomiting.
Sometimes the obvious no pain, but in the chest there is a feeling of discomfort, strong of heaviness, squeezing or fullness. All this is accompanied by severe shortness of breath. The symptoms of angina pectoris appear to be behavioral responses — he stops, stops, presses a hand to his chest, takes a forced position of the body to ease suffering.
The attack lasts from 3 to 15 minutes, sometimes up to an hour. It is important to immediately stop the physical activity, to calm down. Pain can pass spontaneously or under the action of nitroglycerin.
Although the diagnosis can be made, based on the pronounced signs of angina pectoris, the cardiologist will prescribe medical research:
- A blood test for lipids, glucose, creatinine, hematocrite number.
- Urinalysis for white blood cells, protein, sugar, ketone bodies.
- Chest x-ray. Detects abnormalities in the left ventricle, the degree of damage of coronary vascular, increase the heart.
- Electrocardiography, including daily.
- Stress electrocardiography (ECG before and after tests on a cycle Ergometer or treadmill).
- Coronagraphy. Detects atherosclerosis and obstructive lesions in the coronary arteries, evaluate the contractile function of the ventricles.
First aid during a seizure
The patient, experiencing severe pain and fear of death, often in a helpless position. Therefore the surrounding should provide people with all possible assistance. The first thing you need to stop (interrupt) the pain. Patient seated, unbuttoning it tight clothing, open Windows. Of the drugs usually used nitroglycerin under the tongue.
If the attack fails, you can give 2-3 tablets with a break of 2 minutes.
Most often the victim is a drug that helps him. It can be validol, molsidomine, nitromint. If the nitro is expressed headache at the same time taking any analgesic: baralgin, tsitramon, analginum.
In the case of ineffectiveness of the measures taken, call an ambulance. We can not allow the patient to independently get to medical facilities. In the path of possible complications, up to myocardial infarction.
Arrived at the doctors off the attack, using a number of drugs:
- Vasodilators — Promedol, Omnopon or Morphine;
- Nitrates, removes spasm of smooth muscles (trinitrolong, isosorbide dinitrate, isosorbide-5-Mononitrate);
- Beta-blockers — Konkor, Nebilet, Betalok. Lower blood pressure and heart rate (HR), remove hand tremors and a feeling of fear;
- Calcium blockers — Verapamil, Cinnarizine, Fenigidin. Reducing a tonus of the coronary arteries, improving blood flow to the myocardium.
Further treatment of angina pectoris conducted by the specialist cardiologist.
Patient prescribers for the treatment of diseases:
- Cordrol, Reglan, Amiodarone, to prevent the development of angina pectoris;
- First sign of a cold, Corvalment, Barboval drops, relieves pain and feeling of compression in the chest;
- Aspecard, Aspirin Cardiomagnyl. Means reduce blood viscosity, prevent blood clots;
- Traducta, Kordaron, Trasicor. This B-blockers that reduce the risk of a new attack;
For correction of blood pressure prescribe diuretics and antihypertensive medications.
If drugs are ineffective, consider the possibility of surgery. To eliminate the causes of disease and to restore blood flow to the heart angioplasty helps. The essence of the intervention that narrowed the inside spread vessel and implanted stent in him.
The lumen of the artery increases, allowing normal blood flow.
If damaged or clogged by plaque, large sections of the vessel showncoronary artery bypass grafting. Using the shunt creates a new path for blood flow. To do this, take surface vascular great saphenous vein of the leg, thoracic or radial artery. One end of the shunt is sutured to the aorta, the other to the Central artery. The blood supply to the myocardium is restored.
Traditional medicine for angina
Angina pectoris treat medication and folk remedies. Well help patients, including preventive, the following recipes:
- A mixture of equal parts dried apricots, prunes, honey, lemon, walnuts, raisins;
- A decoction of birch buds, chamomile flowers, Hypericum and Helichrysum;
- Tea from viola tricolor;
- A mixture of 10 heads of garlic, 10 lemons and 1 kg of honey;
- Water extract of the Golden mustache;
- "Cocktail CFS — pills, alcohol tinctures of Valerian, motherwort and hawthorn mixed in equal parts;
- Balls of Lily of the valley with sugar.
Treatment with traditional medicine is only effective with prolonged use. One-time techniques of herbs and potions useless.
In conclusion. Angina pectoris manifests itself when blood vascular are clogged with cholesterol by 60-70%. The disease also has a highly individual character. It is therefore important to pass a designated examination, to carry out doctor's instructions, to conduct a correct way of life. This significantly improves the prognosis of angina pectoris.