Treatment and diagnosis of prinzmetals angina

• variant;
• spontaneous;
• vasospastic.

All these concepts are synonymous. It is not only rare, but also quite dangerous when abused, a problem, because you need to know what it can bring and what you can do with it, if it still appeared.

What is it?

This angina occurs when the blood vascular that feed the heart, experiencing a spasm. If to speak more precisely - a clinical form of angina at rest. It triggers coronary spasm, which occurs due to the fact that the metabolic needs of the heart muscle before the onset of the attack does not increase.

This is a very rare variant of the disease, the number of patients in whom it occurs, does not exceed five percent of the total number of people who suffer from some form of CHD.

The name of the disease has received from M. Prinzmetala, the famous American cardiologist, who first described it in 1959. Usually suffer from this problem faces middle age, from thirty to fifty years, but, if to compare with other types of angina, patients of this kind will be somewhat younger.

Usually Prinzmetal allocated in a separate form, as its characteristics and treatment approaches vary from other variations of the disease. It can occur in isolation or coupled with angina.

Reasons

There are different causes of this disease, but key among them is atherosclerosis. Moreover, it is not necessary that he was in advanced stage, even in the early stages it can lead to similar strokes. 75% of people suffering from it are atherosclerotic plaques that lead to persistent stenosis and that causes the angina of this kind.

Also continuing for a long time stable angina can also cause appear, in addition to her more and variant angina.

One of the factors influencing the problem directly, but creates the conditions for its formation, is active Smoking.

Symptoms

There are a number of characteristic symptoms which can determine that the person manifested the disease.

Here are the basic symptoms:

• a sharp, very severe pain in the early morning during sleep or when a person is at rest,mainly in the chest region;
• the manifestation of hypotension and tachycardia;
• in the electrocardiogram, the ST segment is lifted or depressed, the picture is similar approximately similar to that of myocardial infarction;
• accompanied by pain then they begin to be unbearable;
• duration of pain - from five to fifteen minutes, the intervals between them can vary from two to fifteen minutes, although sometimes the attacks are single;
• vegetative disorders;
• headache, nausea, pale skin, fainting, and changes in blood pressure before heart attack.

If these symptoms are present in humans, it is necessary to conduct further diagnostics, which will identify, does he have this pathology, or the reason in something else. You can not to defer the diagnosis, or the probability of worsening the situation could increase considerably.

The consequences

Although this pathology can lead to heart attack, the probability is small enough, because the spasms long enough for this kind of impact.

Sometimes such strokes can disrupt the electrical function of the heart, which is very dangerous. This can lead to cardiac arrhythmias, some of which, for example, ventricular tachycardia can lead to death if not captured beforehand.

The probability of an adverse outcome is extremely small in the absence of obstructive lesions in coronary arteries. If angina prinzmetals name is long, the attacks frequent and severe, the probability of death may increase to twenty-five percent.

Diagnosis

The main method of diagnosis of the disease is an ECG during an attack. If the ST segment on the electrocardiogram is raised, it is usually diagnosed with this disease. The main difference from myocardial infarction is that the heart attack the specified segment is in the raised position for approximately one month, and such angina, as a rule, not more than twenty minutes.

There are other diagnostic methods, if there is a suspicion that it is a rare disease manifested itself and the symptoms show it - but the ECG is not sufficient. Implemented various provocation test with hyperventilation, administration of acetylcholine or ergometrine, as well ascold test and coronary test.

There are a load of studies that demonstrate relatively high tolerance to different kinds of physical activity. Also performed coronary angiography, which in most cases confirms the absence of large-scale stenosis in coronary arteries. After that it is usually diagnosed with variant angina this type.

Treatment

As soon as there is suspicion of a pectoris, the first thing that needs to be done - patient must be hospitalized. Leaving the problem could aggravate the situation and hamper the treatment of angina prinzmetals.

To start the treatment is done with the help of medications. For example, nitroglycerin is taken for the relief of painful attacks occurring in the course of the disease. In the future, it is gradually replaced by the nitrates of prolonged action. Also taken antagonists potassium that extend collateral and coronary arteries.

If patients manifest obstructive disease of the coronary arteries, then you can also start taking beta-blockers. But there is an alternative view that beta-blockers only increase the attacks similar to angina, often because they did not appoint. Alpha-blockers can have a positive effect.

Note that this treatment should be strictly according to the program. If we suddenly stop it, it is possible negative effects. In particular, the number of attacks, instead of diminishing, may increase one and a half times the symptoms will only get worse - and the risk of acute myocardial infarction, so it is necessary to take medicines exactly according to the schedule prescribed by your doctor.

Often this may be enough, but if the desired effect there, particularly in situations when a person has severe coronary atherosclerosis, valid surgery. There are several different surgical approaches to this problem, for example, coronary arteries stenting, angioplasty, coronary artery bypass grafting and so on.

Prognosis and prevention

As a rule, long-term forecast is positive. There may be spontaneous remission, which lasts for years. Of the negative consequences - in patients who for a long time there is this disease, can occur myocardial infarction. Since this pathology is unstable, every person that is suffering from it, must be at the dispensary at the cardiologist to monitor the situation and avoid further deterioration.

In addition to the situation is not repeated, you need to stop Smoking, to normalize the tonus of VNS and get rid of hyperlipidemia, if present. For the prevention of myocardial infarction in the presence of this problem, it is recommended to take on an ongoing basis acetylsalicylic acid.

More information about preventive procedures you can learn from your doctor.

If you have any such problem, if you notice its symptoms - generally you should not resort to any treatment at home. First and foremost, consult with your doctor, then the situation in most cases will be able to align, achieving the reduction of the impact of this disease on your life.

Material has been prepared by: Alex Burmistrov practitioner cardiologist.