Acute angina pectoris: what you need to know about pathology in order to avoid its consequences

Acute angina pectoris: what you need to know about pathology in order to avoid its consequences

Acute angina is a severe painful attack in the region of the heart, which occurs due to a lack of oxygen entering the heart tissue. It develops unexpectedly, patients describe painful sensations with adjectives – strong, pressing, squeezing. Pain can radiate to the left side of the body – neck, lower jaw, arm, shoulder. The duration of the onset of symptoms can vary – from a few minutes to half an hour.

If an acute attack of angina pectoris occurs, then the life of a person depends on the correctness of the actions of others and doctors. The patient and his relatives need to know about the causes of acute angina pectoris, symptoms of an attack, the provision of first aid, treatment and prevention of a dangerous condition.

Types of angina pectoris

Angina pectoris has several types. Doctors classify pathology depending on the cause of its occurrence, highlighting angina pectoris of rest and excitement, the nature of manifestations – stable and unstable. Each of them has certain characteristics and characteristics.

Rest angina occurs in situations where a person is in a calm state – during a night’s sleep, after waking up. It can be caused by:

any movement;
nervous tension;
change in blood pressure.

The diagnosis of stable angina pectoris is typical for situations where attacks occur after certain exertion, are repeated for a month or more. Pain manifestations with angina pectoris of this type are removed after taking nitroglycerin. Stable angina pectoris can be 1, 2, 3, 4 functional class (FC). 1 FC – an attack occurs with extremely strong physical exertion experienced by the patient, 4 FC is characterized by the appearance of signs after a person performs simple physical actions.

The clinical picture with unstable angina is the occurrence of attacks of varying intensity and duration, character, they can begin at different times of the day, regardless of the patient’s activity, even during treatment.

Types of angina pectoris

Unstable angina has several types, which determine:

the nature and severity of manifestations (initial, subacute, acute);
conditions of occurrence (primary, secondary, postinfarction).

Reasons for the development of angina pectoris

In most people, acute angina pectoris develops as a consequence of pathologies:

atherosclerosis ;
arterial hypertension ;
coronary heart disease.

They are the main reasons for the insufficient supply of blood and oxygen to the heart myocardium. Dangerous processes take place in the heart – tissues accumulate metabolic products, toxins, which gradually destroy the muscles of the organ, contribute to a decrease in its functions. Acute coronary angina occurs when there are factors:

confirmation of diagnoses – cardiomyopathy, left ventricular hypertrophy, aortic valve stenosis, regurgitation;
persistently high blood cholesterol levels;
increased blood clotting, blood clots;
low values of hemoglobin in the blood, the development of anemia;
eating a lot of animal fats and carbohydrates;
tendency to be overweight, obesity, lipid metabolism disorders;
unstable psychological climate, the impact of stress;
insufficient physical activity;
age over 45 years for men, 55 years for women;
genetic predisposition.
Help to understand that a person has an acute attack of angina pectoris, symptoms. Chief among them is the sudden onset of pain. It can occur in various life situations – at rest or during physical stress, in a stuffy room or outdoors. Painful sensations may not last long, in most cases the duration of an attack does not exceed 5-15 minutes. Pain (pressing, squeezing) in the retrosternal region is accompanied by additional manifestations:

burning sensation, the presence of a foreign body in the chest;
the presence of “echoes” of pain in the left side of the body;
increased blood pressure;
instability in the pulse rate – at first it becomes more frequent, then it becomes rare;
the skin turns pale, the patient may have cold sweat;
hands become cold;
a person is short of air;
the patient freezes during an attack, presses his hand to the heart region;
facial expressions change, signs of physical suffering appear on it.
Acute angina pectoris, the symptoms of which are quite pronounced, require immediate action from the surrounding people – it is necessary to help the patient to take a comfortable position, unbutton his clothes, provide fresh air into the room, call an ambulance.


An attack of acute angina pectoris that has occurred is a good reason to contact a medical institution for additional diagnostics. At the initial visit of the patient, the doctor conducts his clinical examination, asks him about the peculiarities of the state of health. The survey technique allows you to identify the patient’s complaints, determine the frequency of occurrence of angina attacks, their intensity, and attribute them to one of the types of pathology. At the reception, the doctor assesses the patient’s health indicators:

body mass index;
heart rate;
arterial pressure;
auscultation of the heart.
The patient receives referrals for clinical trials: for general analysis of blood and urine, biochemistry.

arterial hypertension

To confirm acute angina pectoris, the doctor prescribes instrumental diagnostic methods:

electrocardiography, including Holter monitoring;
stress tests;
angiography of the coronary vessels;
computed tomography of the heart and blood vessels (multispiral);
endovascular echocardiography;
chest x-ray.


In acute angina pectoris, treatment is prescribed only after confirmation of the diagnosis. During seizures, doctors recommend taking nitroglycerin. It is important to remember that it is forbidden to use this medicine on your own, before the examination, as it can negatively affect the patient’s body.

When pain occurs, the patient should put 1 tablet of nitroglycerin under the tongue, sometimes the doctor reduces a single dose of the drug to half a tablet. Some patients prefer to use a 1% nitroglycerin solution, which is contained in ampoules. 1-2 drops of liquid medicine are dripped onto a piece of sugar, which is then slowly absorbed. In most cases, the pain stops within 5 minutes. If the symptom persists, it is required to take nitroglycerin again. If the person’s condition has not improved, they call an ambulance.

Acute angina pectoris, symptoms of which recur without treatment, requires drug adjustment. For therapy, drugs are prescribed that belong to several pharmacological groups:

antianginal drugs – they can reduce the frequency of attacks, the intensity of pain;
ACE inhibitors – to prevent the development of heart failure;
antiplatelet agents – prevent myocardial infarction, acute coronary syndrome, unstable angina pectoris, prevent the process of thrombus formation in the vessels;
-blockers – are used to expand the coronary vessels of the heart, normalize the rhythmic work of the heart, regulate oxygen exchange in the cardiac myocardium;
nitrates – indicated for relieving spasms of peripheral cardiac vessels, reducing venous blood flow to the heart, stress on the heart muscles;
statins – are prescribed to normalize blood cholesterol levels, they are able to dissolve cholesterol deposits inside blood vessels, reduce the size of plaques, which is an opposition to the development of myocardial infarction ;
calcium channel blockers – to lower blood pressure.
If the patient has angina pectoris due to poor patency of the coronary arteries, he may be prescribed surgical intervention – coronary stenting or coronary artery bypass grafting. The choice of the method is determined by the characteristics of the state of health.

Forecast and prevention

Acute angina pectoris is one of the manifestations of coronary heart disease – a harbinger of myocardial infarction. These cardiovascular pathologies have a high mortality rate, many complications, and lead to disability.

Prevention of angina pectoris can be carried out with the development of one of 3 life scenarios:

if signs of the disease have never been observed in a person;
in cases of occurrence or recurrence of an attack, to prevent deterioration of health;
after surgical treatment.
The main preventive measures against the development of angina pectoris are:

transition to the correct diet;

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