Angina pectoris

Angina pectoris

Description angina

Angina pectoris (AP) is one of acute forms of ischemic heart disease.

This disease is defined by burning pain behind the breastbone,which is caused by lack of oxygen in the heart muscle. Their causes and symptoms is similar to acute myocardial infarction with the difference that angina no necrosis (ischemia), cardiac tissue, and the treatment is an effective drug nitroglycerin(spray or tablet).

The entire process of this pain is described as little oxygenated blood flowing to the heart, which needs a higher oxygen concentration. This leads to erroneous loading of the heart muscle, the heart ceases to perform its function as a pump and thus the whole body does not receive enough oxygen-rich blood and back again to the heart.

Angina pectoris is pain that occurs with increased oxygen demand – brisk walking, running, stress etc., when a diseased vessel predominantly atherosclerosis (= hardening = narrowing vessel storage of fat, most often due to the high cholesterol levels) can not sufficiently supply the body or heart blood with oxygen.

This process can be imagined as cramps in your muscles while running. You know the tingling in the thighs or abdomen when they expose the movement to which you’re accustomed. We call it the oxygen debt. Similarly, in angina pectoris, but his heart was not draining lactic acid, which causes pain in oxygen debt. This pain is localized to the surface again as in acute myocardial infarction is associated with burning,pinching to stabbing, pressure in the chest or a feeling that they can not breathe.

Angina pectoris has two basic distinction between stable and unstable angina. Since angina pectoris is a condition with which the patient may live for years, then may cure or the disease worsens or switches to other cardiac disease, it is important to this division.

Stable angina is a sign for always follow the seizure of chest pain. For example, the patient indicates the pain when climbing stairs, after eating, while another effort like. Patients with this disease usually receive a first aid medicine nitroglycerin (spray or tablets), which applied at the first sign under the tongue.

Unstable angina is the same chest pain or worse, but where the patient is unusual. For example, the patient knows that the pain manifests itself when it comes out four flights of stairs, but it was enough time must be from one room to another, or have never had symptoms after a meal, but ate and pain resulted.

Any patient who has angina should be informed about the medication dosage options for its subsequent physical activity. It is important to remember that this pain is very similar to other cardiac disease, so far does not impress dose of nitroglycerin may be an acute myocardial infarction, and therefore it is necessary to seek medical attention or call the best ambulance.


Risk factors for angina pectoris

Risk factors include, as in acute myocardial infarction – the age and family history.

Among influenced mainly include obesity, smoking, high cholesterol (hypercholesterlémie),decreased physical activity.

Other are ongoing diseases such as hypertension (high blood pressure) and atherosclerosis(vasoconstriction deposition of fat on the vessel wall).

All these factors are closely related. If the human body maintains the shape, not only a possibility to reduce weight, but also the overall support of the vascular system including the heart.

Few may know that smoking is not only harmful to the lungs. Nicotine contained in cigarettes has clotting effects and promotes more fat deposition and other substances on the wall of blood vessels (atherosclerosis) and provides for the formation trombům (clot of blood components) and embolům (other elements that do not pass through the narrowed wall as air, fat colonies cells, etc.).

High blood pressure is spent on the entire circulatory system and high demands in damaged blood vessels may be rapid blood flow release precipitate is reached, to close blood vessels and are formed ischemia (tissue necrosis lack of nutrients, mainly oxygen).


Prevention of angina

As mentioned above, it is important to try to reduce the possibility of influencing disease risk factors. That means quitting smoking, avoiding fatty foods and salt to keep fit (for heart disease in the elderly often recommended cycling).

There are also preventive visits to the doctor, detecting blood pressure – if it is high, it is an effort to reduce – and compliance with their guidelines.


Signs and symptoms of angina pectoris

Custom symptoms of angina can be very colorful. Patients frequently describe it as a stabbing or squeezing pain, pressure without pain or feel they can not breathe.

Most often, these symptoms localize flat for middle or upper third of the sternum. Pain may move to the left or right shoulder, the arm (a typical symptom is tingling left little finger) in the neck, jaw, stomach area (epigastrium), between the shoulder blades and even the neck.

Angina symptoms lasting several tens of seconds to a few minutes. If the pain longer than ten minutes, we have to think about the possibility of unstable angina, acute myocardial infarction or other diseases.

Very important in determining this disease is a moment that chest pain (angina) raises. The characteristic pain of angina comes on exertion, excitement, stress situation, after meals (typical of the effort after eating food), inhalation of cold air (walking against the wind, ice) or during the early morning journey from home. Typical for this pain caused difficulty is that it forces you to interrupt work to be performed.

A patient who already knows this pain, they may determine their course and usually already has tested how much effort can tolerate and what you can afford. If the pain gets in an unusual situation, so it is a manifestation of unstable angina and need medical attention.

For the practical need for a classification of the pain due to monitoring the progress of the disease and treatment effect. This classification divides angina according to severity into four stages.

  1. chest pain (angina pectoris) caused only “exceptional” effort (eg .: a man not accustomed to sporting activity, but will run and the pain is triggered)
  2. angina pectoris caused by larger, but the usual exertion (eg .: emerge with more flights of stairs) or normal activities in the wind and freezing temperatures or stress situations
  3. stenocardia has thrown normal activities for mental compensation (eg .: walk on the flat or up the stairs to the first floor)
  4. angina pectoris and at least demanding activity or at rest (eg .: get out of bed, get dressed, eat, etc.).

Other accompanying symptoms indicate the possibility of anxiety, fear for their lives, the lack of oxygen, shortness of breath, pallor, high blood pressure (hypertension), but these symptoms appear and other diseases, so it can not be described as accurate for the determination of angina.

For the correct identification of this disease usually suffices typical chest pain resolves after effects of nitrates (Nitroglycerin is used most often). In unusual cases, the diagnosis of disease accompanied by ECG (electrocardiography) or stress echocardiography.

These methods are to specify the movement of the problem of disease, whether the angina pectris induced atherosclerosis (narrowing of the arteries) or whether necrosis of cardiac tissue (myocardial ischemia) were induced illness (eg .: hypertension, functional disorder, generalized disease of the vascular system and the like. ).

If these examinations have not confirmed angina or other cardiac disease, then it is necessary to search for another possible cause (back pain, lung disease, upper gastrointestinal tract, etc.).


Treatment of angina pectoris

The first symptoms of the disease angina are captured in a doctor’s office or rescue salary after the call.

After basic tests (especially symptoms, medical history, EKG) followed by pharmacologicaltreatment of nitrates (substances that relax the blood vessels in the heart downloaded – BC .:Nitroglycerin) and the treatment of other symptoms. Following is already in healthcare facilities reduce the risk factors.

Angina thus involves two levels. On the one hand, emphasis on improving the quality of life. That means quitting smoking, weight loss, reduced intake of fat and salt, and improving physical fitness according to the patient’s condition.

On the other hand, it is already rather pharmacological which includes mainly nitrate – usually known nitroglycerin, which has the effect of stretching of blood vessels, thereby restoring blood flow to the heart. Further drugs are used to control high blood pressure, anti-clotting and other diseases which are related with angina.

In most patients, usually after years of stable state, some patients may even lose difficulties or conversely may have worsening of the disease. For properly treated patient already after possibly reduces mortality (mortality) by 4% and the ability to transfer disease in myocardial infarction by 2-4%.


How can I help myself

If you feel that this disease occurs at you, the best advice is to be a doctor and to be examinedand then follow the instructions. You should bear in mind that with heart or respiratory problems not to be trifled – you can never know for example that it is not a heart attack or pulmonary embolism.

In the event that you have to provide first aid to someone with signs of angina pectoris, call an ambulance, throughout monitor the status of persons with disabilities (pulse and respiration), leave it in its natural position (preferably in a semi-sitting position) and watch it that does not fall into shock state. Upon arrival, the doctor will try to add as accurately as possible the sequence of events, if not ill.

If you suffer for angina, you need to follow doctor’s orders and avoid risk factors (described above). Most individuals suffering from this disease have already knows what they attack causes pain and tries to avoid this therefore, and typically wears a nitroglycerin spray, which, when induced seizure chest pain splashed by sublingual dosage.


Complications angina

Major complications include transition from angina pectoris to myocardial infarction and other cardiac diseases. For all heart disease is a high probability of transition to sudden cardiac arrest.

Other names: angina pectoris, AP, stable angina, unstable angina pectoris, coronary heart disease, CHD

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