Anginaーclinical form of ischemic heart disease. The people called this condition “angina pectoris”. This characterizes the main symptoms: a feeling of tightness in the chest, pain, lack of airーas if “a toad is strangling”. A prolonged attack of angina pectoris can cause heart failure and myocardial infarction , which poses a direct threat to the patient’s life due to possible cardiac arrest. It cannot be cured, but it can be controlled with medication to keep it from getting worse.
Overview of Angina
An attack of angina pectoris develops when there is insufficient oxygen supply to the cells of the heart muscle. This occurs with narrowing of the coronary vessels and an increase in myocardial oxygen demand. An attack can be triggered by physical activity, emotional stress, going out into the cold. The pain goes away after a few minutes at rest or after taking nitroglycerin.
Under conditions of oxygen starvation, cells cannot efficiently convert glucose into energy. Metabolic by-products build up and acidify tissues, causing severe pain. If blood flow is not restored in time, the myocardium diesーa heart attack develops .
Classification of angina pectoris
Depending on the connection of seizures with physical activity, angina pectoris of tension and rest are distinguished. The latter can occur without the influence of provoking factors, therefore it is more difficult to control it.
Angina pectoris can be divided into two types: stable and progressive. In the first case, the frequency and severity of attacks depends on the amount of physical activity; they are easily eliminated with the help of drug therapy. Progressive angina pectoris is practically not amenable to correction with pharmaceutical drugs, the frequency of attacks increases over time.
There are such functional classes of stable angina pectoris:
Pain appears only with intense or prolonged physical activity.
The onset of an attack when walking more than 200 m or climbing more than one flight of stairs at a normal pace. With severe emotional stress.
Pain when walking less than 200 meters or climbing one flight of stairs at a calm pace.
Attacks appear with minor physical exertion or at rest.
There is Prinzmetal’s angina or spontaneous (special, vasospastic) angina – caused by sudden spasm of the coronary arteries. Attacks develop only at rest, at night or early in the morning.
Risk factors for angina pectoris
The following factors lead to narrowing of the coronary vessels and insufficient blood supply to the myocardium:
atherosclerosisーdeposition of cholesterol plaques in the walls of blood vessels;
hypotensionーlow blood pressure;
thrombosis of the coronary arteries;
age-related changes in blood vessels.
In the vast majority of cases, angina pectoris is caused by atherosclerotic lesions of the coronary arteries. It develops due to a violation of the metabolism of cholesterol and other lipids: an excess of animal fats in the diet, a lack of plant foods. Therefore, proper nutritionーbasis for successful prevention of angina.
Nicotine also constricts blood vessels, so angina pectoris develops more often in smokers.
The risk group for the development of angina pectoris is:
people over 55;
people who abuse alcohol, drugs;
people with pathologies of the cardiovascular system (heart defects, heart failure );
with pathologies of the respiratory system (bronchial asthma , chronic obstructive diseases);
All of these factors increase the risk of developing atherosclerosis , cardiac ischemia, and angina pectoris. Most of them can be eliminated through lifestyle adjustments.
An attack of angina pectoris is characterized by the following manifestations:
sudden pain behind the sternum of a pressing, burning character;
occurs during physical stress, stress, going out into the cold;
pain radiates to the left half of the face, scapula, arm, abdomen;
duration from a few seconds to 20 minutes;
passes after the termination of physical activity and taking nitroglycerin.
Diagnosis of angina pectoris
Angina pectoris has a fairly typical clinical picture, so it will not be difficult for a therapist and cardiologist with experience to recognize it. To find out the cause of the seizures and determine the possible treatment tactics, the specialists of the Paracelsus Medical Center recommend to undergo the following examination:
general and biochemical blood test (cholesterol and other lipids);
ECG at rest and during exercise;
echocardiography (Echo-KG) ;
coronary angiographyーstudy of cardiac vessels using a contrast agent;
Holter monitoringーrecord electrical impulses of the heart for 24 hours (the patient at the same time sticking to his usual routine).
Forecast and prevention of angina pectoris
Basis angina preventionーproper nutrition and sports. The diet should be dominated by proteins, vegetable fats, complex carbohydrates. Alcohol and trans fats (fast food) should be avoided. Give preference to white meat, fish and seafood.
Regular physical activity should be present in every person’s life, it can be swimming, playing sports, fitness, running or just walking. Its intensity is determined by the state of human health, if there are chronic diseases, you should consult your doctor about the types of physical activity that are acceptable for you.
When all the doctor’s recommendations are followed, angina pectoris can be controlled, but, unfortunately, most patients ignore lifestyle prescriptions, which is fraught with a deterioration in the condition.