Painful angina

Proven content

Angina is a result of ischemic heart disease, manifested by shortness of breath and pain around the sternum. Angina occurs as a result of disturbances in the blood supply to the heart muscle caused, for example, by atherosclerosis. Treatment of angina is based on drug therapy.

Angina pectoris – what is it?

Angina is a condition caused by problems with myocardial ischemia. Angina is characterized by chest pain or a feeling of pressure and heaviness. Angina, as a rule, quickly disappears after taking preparations or rest. This condition is most common in men over 40 and women over 50. Sometimes angina does not present any warning symptoms, which is a risk for the patient because diagnosis and treatment are very late.

The causes of angina

The heart is responsible for blood circulation and the functioning of the body. The coronary flow impairment, which is the direct cause of angina, is most often caused atherosclerotic complaints – as a result, blood flow to the heart is disturbed, and thus the supply of oxygen and nutrients is disturbed.

Other causes of angina pectoris that compromise the circulation of the coronary include:

1. nervous tension,
2. mental stress,
3. excessive consumption of alcohol and nicotine,
4. obesity,
5. physical effort,
6. anemia,
7. traffic injuries, for example as a result of a beating,
8. aortic dissection,
9. a heart condition that impairs the function of the left ventricle,
10. inflammation of the coronary arteries,
11. coronary artery embolism,
12. the use of drugs that affect the spasm of the coronary arteries,
13. poor structure of the coronary arteries,
14. hypercoagulability in the form of: polycythemia, thrombocythemia or antiphospholipid syndrome,
15. metabolic problems, e.g. homocystinuria

Angina pectoris – symptoms

The symptom of angina, as the name suggests, is shortness of breath combined with crushing pain radiating to the left shoulder or the entire left upper limb, sometimes the pain radiates in the area of ​​the left jaw. The pain may last several minutes and may be accompanied by:

1. palpitations,
2. breathlessness
3. anxiety.

In such a situation, the patient should be reassured and a place with free access to oxygen should be provided. The basic condition for accelerating improvement during a pain attack is to maintain mental and physical peace. A typical symptom of angina is pain relief after oral ingestion of nitrates.

Diagnosis of angina

The diagnosis of angina is based on the characteristic symptoms and physical examination. In diagnostics, doctors recommend additional tests to determine:

1. anemia,
2. high blood pressure
3. whether the patient has lipid disorders,
4. whether the patient has an underactive thyroid gland.

Among the other tests used in the diagnosis of angina, we can mention:

1. electrocardiogram – this is a test performed to determine the characteristics of myocardial ischemia. During the examination, the patient must be at rest, and the method itself is performed as an electrocardiographic exercise test. If the first result is correct, then testing with physical exertion (e.g. treadmill) allows to determine if there are any abnormalities;
2. holter – is a method that monitors the work of the heart for 24 hours. The patient is fitted with a special device with electrodes, which records the ECG XNUMX hours a day;
3. heart echo – this is another auxiliary examination;
4. heart scintigraphy;
5. computed tomography;
6. magnetic resonance imaging.

On the occasion of diagnostics, one should not forget about coronarography. The purpose of this study is not to make a diagnosis, but to confirm it and assess the extent to which the coronary arteries are damaged. During the examination, the doctor places a catheter in the patient’s femoral artery and gives a contrast. Then, X-ray pictures are taken in various sections, thanks to which the specialist has a detailed view of the coronary arteries and possible narrowing. Based on the coronary angiography, the doctor decides whether the patient qualifies for the procedure.

Treatment of angina

In a patient with angina, treatment consists in stopping the changes in the area of ​​the coronary vessels and preventing the situation of myocardial ischemia. For the treatment of angina, doctors may recommend pharmaceuticals (mainly nitroglycerin), which cause the coronary vessels to relax and the symptoms of angina ease within a few minutes and finally disappear.

It is also important for patients to take preparations that inhibit the clotting process, such as thienopyridine derivatives, acetylsalicylic acid, drugs that lower blood pressure and those that inhibit defective changes in the area of ​​the vascular wall (angiotensin converting enzyme inhibitors). In addition, in patients with angina pectoris, preparations of beta-blockers or calcium channel blockers are administered, which improve the tolerance of exercise and regulate the contractions of the heart muscle and reduce its oxygen demand.

People in whom drug treatment is ineffective, doctors are considering surgery. The most popular of them are:

1. coronary angioplasty – during the procedure, the doctor places a catheter within the patient’s peripheral artery. Subsequently, it introduces it into the heart and coronary vessels, when it gets into the stenosis, it mechanically widens the lumen of the vessel with a balloon or laser. Sometimes a stent is inserted into the narrowed arteries, which is a kind of scaffolding of the vessel walls to prevent further narrowing;
2. «By-passes» – is nothing more than the transplant of a part of the vessel taken from the patient, in a way that allows the blood flowing to the heart to bypass the stenosis.

In extreme cases, when none of the methods works (even operative), it is necessary to perform a transplant.

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