Causes and symptoms of angina pectoris. Diagnosis, treatment and prevention

Causes and symptoms of angina pectoris. Treatment and prevention

Angina is an unpleasant painful sensation in the projection of the heart or behind the sternum. Why such a pathology appears, what to do and what not to do during an angina attack, what help is available - you should know about this.

Classification.

WHO experts have proposed to distinguish between angina pectoris and angina pectoris at rest.

Angina pectoris is divided into stable and progressive. Progressive angina in women and men is the subject of a separate article.

Clinicians usually distinguish 4 functional classes of stable angina:

Class I - the patient tolerates standard physical activity well and poorly - intensified;
Class II - angina pectoris begins to disturb when walking on flat ground for a distance of up to 500 m, climbing stairs above 1 floor;
Class III - angina pectoris appears with the same walking at a distance of 100 to 200 m, climbing the stairs to the 1st floor;
Class IV - angina develops when walking at a distance of up to 100 m, at rest and even in a dream.

There is another classification of angina by functional classes - depending on the severity of unstable angina:

Class I - severe. Exacerbation episodes are manifested up to 2 months;
Class II - subacute, with regular pain attacks for 1 month;
Class III - acute, with attacks within the last 48 hours.

Unstable angina depending on the conditions of occurrence:

class A (secondary unstable) - observed against the background of anemia, fever, infection, etc;
class B (primary unstable) - occurs on its own, without any stated factors;
class C (early post-infarction) - manifested in the first 2 weeks after a myocardial infarction.

In addition, it is customary to distinguish types of unstable angina depending on whether it was treated:

without or with minimal treatment;
against the background of full-fledged prescriptions;
during treatment with all groups of medications used for the pathology.

Symptoms of angina pectoris can also include heartburn and abdominal pain.

Causes of angina pectoris

The most important, “basic” cause of angina episodes is deterioration of coronary circulation. Because of this, a chain of successive disorders develops:

myocardial ischemia (lack of oxygen)
“breakdown” of oxidative processes in the heart muscle;
deposition of underoxidized metabolic products in the heart.

The typical causes of such circulatory failure are

atherosclerosis of the coronary vessels (mainly);
infectious compromise of the coronary vessels (much less common).

The causes should be known in order to understand how to treat angina.

The provocateurs of angina attacks are psycho-emotional and physical stress.

Symptoms of angina pectoris

The main symptom of angina is pain:

by the place of origin - in the heart area or behind the sternum;
by radiation - “shoots” to the left shoulder and arm, to the back between the shoulder blades, sometimes to the upper abdomen, to the left to the lower jaw and teeth, less often to the right half of the chest;
by nature - in the form of pressing, squeezing, burning sensation;
intensity - from tolerable to severe;
by its occurrence - during exercise or at rest, significant overeating, being in low or high temperatures;
by duration - from 1 to 15 minutes.

Signs of stable angina, angina pectoris, and angina pectoris at rest are the same, but appear under different circumstances.

It is characteristic that during a conversation with a doctor, patients put their fist or palm to their chest to illustrate the sensations.

If you have any of the above symptoms, you should consult a doctor without delay.

Diagnosis

The diagnosis is based on typical complaints of patients and the results of additional diagnostic methods.

Instrumental methods involved:

Electrocardiography (ECG) at rest;
ECG with exercise;
Holter monitoring (with recording of bioelectrical impulses of the heart for 24 hours)
echocardiography (ultrasound of the heart);
scintigraphy (using special radioisotopes);
coronary angiography (with a contrast agent). It allows to diagnose vasospastic angina.

Laboratory methods:

complete blood count;
biochemical blood test (it is especially important to know the level of cholesterol, lipoproteins, triglycerides);
determination of biochemical compounds that signal damage to the heart muscle.

How to treat angina pectoris

The main postulates of angina treatment:

Avoidance of excessive exercise;
immediate rejection of all bad habits;
physical activity as much as possible;
drug therapy.

Drug therapy is based on the following prescriptions:

lipid-lowering drugs
antiplatelet agents;
symptomatic treatment.

For the symptomatic treatment of unstable angina, angina pectoris and its other varieties, drugs are used to eliminate pain and discomfort in the heart. These are:

nitrates. The most recognizable of these is nitroglycerin, known as a “first aid” for angina;
β-blockers;
calcium channel blockers.

All medications must be prescribed by a doctor; self-medication is prohibited, even if the diagnosis is known.

If the results of conservative treatment are not satisfactory, surgical treatment is used. Its strategic goal is to improve existing or create new ways of blood flow to the myocardium. Effective methods are:

coronary artery stenting;
coronary artery bypass grafting;
plastic restoration of coronary vessels.

Prevention and diet

A healthy lifestyle, avoidance of physical exertion and stress, positive thinking, and, if necessary, a change of environment can help to avoid the development of angina.

Nutrition for angina is aimed at:

body weight regulation;
reducing the amount of lipids in the blood.

To do this, the patient should limit the intake of easily digestible carbohydrates and fats.

On our website Dobrobut.com you will find more information about the pathology - whether its consequences are critical, how the diagnosis of angina pectoris is carried out, and so on.