home Diseases How does an angina attack go? Angina pectoris: stress and rest, stable and unstable - signs, treatment. Angina: what is it?

How does an angina attack go? Angina pectoris: stress and rest, stable and unstable - signs, treatment. Angina: what is it?

From this article you will learn: what an angina attack is, what causes it, its characteristic symptoms and how it differs from other pathologies. How to relieve an attack and prevent its occurrence in the future.

Article publication date: 12/19/2016

Article updated date: 05/25/2019

During an attack of angina, a pathological narrowing of the coronary arteries occurs by 50% or more. This condition leads to a lack of oxygen in the heart, which is characterized by certain symptoms (pain, burning, pressure behind the sternum) and threatens with a complication - myocardial infarction.

An attack of angina can lead to myocardial infarction

The attack can be completely relieved by taking nitroglycerin, but this will not affect the cause of the problem - it is only a temporary solution. After eliminating the symptoms, you should definitely contact a specialist - a cardiologist - for further treatment.

Causes of angina attack

An angina attack can occur for three reasons:

as a result of atherosclerosis - narrowing of the lumen of blood vessels due to deposits of atherosclerotic plaques);
thromboembolism – acute blockage of a blood vessel by a thrombus;
spasm - a sudden repeated narrowing of the lumen of blood vessels.

Provoking factors can be any condition in which the work of the heart increases:

stress tension;

hypothermia;

overheat;

drinking alcohol;

rich and spicy food.

Predisposing factors:

excess weight;
age (more common in older people);
smoking;
increased blood clotting;
lack of physical activity;
high blood pressure;
diabetes;
high cholesterol;
congenital anomalies of the heart and blood vessels;
heredity.

Diseases of the lungs and stomach can also cause pathology due to a deterioration in the supply of oxygen to the heart.

Symptoms of an angina attack

Main features:

pain behind the sternum, in the stomach, in the shoulder blade, left arm, shoulder, lower jaw;
burning sensation;
the appearance of shortness of breath - rapid and difficult breathing, a feeling of lack of air;
dizziness;
increased sweating;
weakness;
feeling of panic and anxiety.

Some people may not have any symptoms during an attack: women, people with diabetes, and older people. In men, such an attack of angina pectoris is much more likely to pass with pain.

Pain syndrome (complex of symptoms) can have different localization, duration and intensity:

Nature of pain	There may be a feeling of squeezing or squeezing, boring or pulling.
Pain intensity	From insignificant sensations to very strong, unbearable
Duration	From 2–5 minutes to 20; if longer, then this indicates the development of a heart attack
Localization of pain syndrome	In the area of the sternum, in its upper region; radiates to the lower part, to the abdominal area (in this case, the attack can easily be confused with an exacerbation of a peptic ulcer or gastritis); shoulder; shoulder blade; hand; collarbone on the left side of the body; sometimes (rarely) the pain radiates to the lower jaw or earlobe; The syndrome may also manifest itself on the right side.

Locations and main signs of an angina attack

Features of the attack depending on the type of angina

For different types of angina, the signs of the problem will differ:

With, the severity of which is divided into 4 classes, attacks also have their own characteristics.

Differential diagnosis (difference from other pathologies)

Since an attack of angina is similar in pain to some diseases, in order to provide competent assistance, it is necessary to carry out a differential diagnosis.

Comparison of an attack of angina with other pathologies:

First aid (relieving an attack) and treatment

If an attack happens to you, then you need to be able to provide yourself with first aid.

You need to sit down, stop any activity, call an ambulance.
Unbutton your clothes, if possible, or remove your outerwear. It is advisable to unfasten your belt, bra, and untie your tie.
Place nitroglycerin (1 tablet) under your tongue.
If after 5-8 minutes the symptoms still continue, then you can put another one.
Pay attention to your pulse and blood pressure: if it rises, you need to take the appropriate medication.

If a problem occurs to someone close to you, you should provide him with the same emergency assistance.

Most often, nitroglycerin completely relieves symptoms and the person can move independently, but this does not mean that the problem will not recur.

There is no treatment for an attack as such - it is simply removed. And since an attack of angina is not an independent disease, but a syndrome (complex of symptoms) of other pathologies, after the attack is relieved with nitroglycerin, further treatment of the underlying problematic pathology is necessary.

Prevention

To prevent the occurrence of angina attacks, you should exclude those factors that lead to them, especially if you have a predisposition to diseases of the cardiovascular system. Of course, it is impossible to prevent the influence of factors such as age or gender, but we can help ourselves and protect ourselves from problems in the future. To do this you need:

get rid of bad habits;
Healthy food;
fight excess weight;
be physically active;
undergo preventive examinations in a timely manner, measure cholesterol and blood sugar levels.

Lifestyle recommendations to prevent angina attacks

Health forecast

It is impossible to make an unambiguous prognosis for health after an attack of angina for all patients. The course of the disease is individual and depends on the person’s conditions and lifestyle. Therefore, in one case, if preventive measures are followed, someone will not have attacks at all, but in another, a complication or tragic outcome may arise.

At the moment, angina pectoris has become significantly younger. Signs of angina occur in people under 45–50 years of age (and even in teenagers). It is important to explain to your child in time the dangerous consequences of bad habits and the importance of sports, healthy eating and an optimistic outlook on life situations. After all, a healthy attitude to life is the best prevention of heart disease.

At the initial stage, angina pectoris is practically asymptomatic; once pain appears, prevention is no longer enough; treatment and qualified examination are needed.

Pain with angina appears in different directions. The pain is localized in the area of the heart, neck, under the shoulder blade. It can be pressing, squeezing, as if in a vice, drilling or pulling. There is profuse sweating, weakness, lethargy, nausea, pale skin, rapid or weak pulse.

Why does pain occur?

The cause of the malaise is the lack of oxygen to the heart, which comes to it with the blood. Constriction of blood vessels leads to disturbances in blood circulation, due to which the heart begins to experience a lack of oxygen and a lack of nutrients. This process from the inside looks like the formation of plaques on the walls of the arteries. They narrow the lumen and inhibit the movement of blood through the vessels. The blood vessels also narrow as a result of spasms, and pain occurs with angina pectoris.

An unbalanced diet and lack of the required amount of oxygen leads to the accumulation of lactic acid, which is the source of pain. And if the ducts narrow until blood flow into the heart stops, a very dangerous disease will develop - myocardial infarction.

Painful sensations due to cardiac pathology are quite vivid

Leading experts note many causes of heart pain not associated with angina:

It is very important to recognize the first signs in time to avoid serious complications.

Nature of pain in angina pectoris

The attack begins progressively, at first there is mild discomfort, then the condition worsens. Nature of pain with angina pectoris:

heaviness, burning, numbness of the limbs occurs;
further the sensations intensify:
the pain becomes duller, heaviness appears in the chest area;
symptoms intensify;
sweating increases (“cold sweat”).

The pain is localized in the upper left part of the chest, forcing the person to fix the body in one comfortable position. An attack can occur after a dense and heavy meal, during heavy physical exertion, as a result of high blood pressure, or in a stuffy room, while the duration of angina pain lasts from 10 to 45 minutes.

Pain may occur without previous action - angina at rest

Pain intensity

From the moment the attack begins and until the end, the intensity of pain varies, it all depends on the degree of angina, from mild sensations to severe pain that cannot be tolerated until loss of consciousness.

It must be remembered that a typical attack of angina pectoris is characterized by manifestations of pain that increase, gradually, and, having reached a climax, stop. You need to have time to do something, and not let it take its course.

The intensity and duration of a painful attack during angina pectoris will depend on:

on the type of disease;
other diseases of the heart, blood vessels, arteries;
from age.

There are two types of angina, stable - the pain is easy to predict, it is predictable, occurs after exercise, and unstable - it is unpredictable and very dangerous, it is spontaneous and can lead to death.

A person at the time of an angina attack has a feeling of a foreign object in the sternum; he does not feel the area where the blood path is blocked by blockage of the artery

Localization

The pain is usually localized in the chest area, in its upper part or in the middle. Very rarely, the pain goes down and is felt in the left side of the chest within the second or third rib. Very rarely - to the right of the heart.

Irradiation

A very common occurrence is the displacement or irradiation of pain symptoms to the shoulder, shoulder blade, or hand, but these will not always be signs of angina, but pain in the neck or lower jaw signals danger.

In the rarest cases, patients complain of abdominal or back pain.

When irradiating, the pain sensation varies slightly, they can be confused with an inflamed nerve in the tooth or in the neck.

There are angina pectoris, sudden pain during exercise (walking, eating, climbing stairs) and stable angina, which depends on the degree of exertion.

Features of pain during an angina attack

Only a specialist can assess the severity of pain and the level, since many factors, symptoms and the age of the patient are taken into account.

Typical localization has one general appearance - pain during angina pectoris appears in the upper or middle part of the sternum with a shift to the left towards the heart

A study of the duration of pain in angina pectoris showed the following:

the younger generation (20–45) during an attack complain of increasing pain in the shoulder, under the shoulder blade, in the neck, the pain goes away quickly;
the older generation (50–80) in a state of spasm feel mild pain, but quite long lasting from 20 minutes to an hour.

Angina pectoris can contribute to the occurrence of psychoneurological disorders, because the sensations are terrible: severe anxiety, panic, a feeling of imminent death. In terms of autonomic reactions, they include: dry mouth, dizziness, thirst appears, the color of the skin changes and blood pressure jumps.

How to relieve pain from angina pectoris? You need to take “Validol” under the tongue or “Nitroglycerin”, if it doesn’t get better, then call an ambulance.

How to get rid of angina pain

Not everyone is able to recognize an upcoming attack, and if it occurs, then you want to quickly get rid of severe discomfort in the chest.

take a sitting position, relax;
put a Nitroglycerin tablet under the tongue (Validol), it will dilate blood vessels and normalize blood flow, relieve spasms;
drink drops to calm Corvalol.

If the symptoms do not go away, but intensify, you need to call a doctor, as only qualified help will help.

Prevention

It is necessary to undergo a high-quality medical examination to determine the extent of the disease. For preventative purposes, treat blood vessels, breathe fresh air, and do not overheat in the sun. Avoid heavy emotional and physical stress by all means possible.

Twice a year, take vitamins, medications for blood vessels and to improve heart function, naturally, after consultation and prescription.

Angina pectoris is a pain syndrome in the heart area caused by insufficient blood supply to the heart muscle. In other words, angina is not an independent disease, but a collection of symptoms related to pain. Angina syndrome is a manifestation of coronary heart disease (CHD).

What kind of disease this is, why it occurs in people, as well as what main signs and treatment methods are effective for angina pectoris, we will consider further in the article.

Angina: what is it?

Angina is a clinical syndrome characterized by discomfort or severe pain in the chest, the main cause of which is a violation of the coronary blood supply to the heart muscle.

The name is associated with the signs of the disease, which manifest themselves in sensations pressure or compression(narrow - stenos from Greek), burning sensations in the heart area (cardia), behind the sternum, turning into pain.

As a manifestation of coronary artery disease, angina pectoris occurs in almost 50% of patients, being the most common form of ischemic heart disease. The prevalence is higher among men - 5-20% (versus 1-15% among women), and its frequency increases sharply with age. Angina pectoris, due to its specific symptoms, is also known as “angina pectoris” or coronary heart disease.

Symptoms of angina appear due to atherosclerosis of the coronary arteries, a disease in which cholesterol is deposited on their walls and forms. Over time, the lumen narrows, and complete blockage often occurs.

Classification

Currently, based on the characteristics of the clinical course, three main types of angina are distinguished:

Stable angina

Stable angina means that the patient has had attacks of chest pain of approximately the same intensity over the previous month or longer. Stable angina is also called exertional angina, since the development of attacks is associated with overly intense work of the heart muscle, forced to pump blood through vessels whose lumen is narrowed by 50–75%.

Angina is divided into 4 functional classes (FC):

Attacks of chest pain are rare, only under maximum physical and emotional overload. ECG changes are rarely detected. The lumen of the coronary arteries can be narrowed by 50%. Perhaps only one of them is affected by atherosclerosis.
Second functional class causes attacks and pain when climbing stairs, walking at a brisk pace, after a heavy meal. The provoking factors here are often frosty weather and wind.
In FC 3, severe limitation of physical activity is diagnosed. Angina makes itself felt when moving calmly on a flat road at a distance of one hundred to two hundred meters, or when climbing to the first floor. Attacks become more frequent if the patient smokes. Such patients have angina at rest in the supine position after a nervous shock.
. Often in the history of a person with this type of angina, one can find a heart attack or heart failure in the chronic stage. Often, angiosis syndrome occurs at complete rest or even at night.

Unstable angina of the heart

What it is? Unstable angina is characterized by painful attacks of varying intensity, duration, and unpredictable occurrence, for example, at rest. Pain syndrome is more difficult to relieve when taking nitrates (nitroglycerin). The risk of developing myocardial infarction is higher, in contrast to the stable form of this pathology.

Unstable angina is divided into:

New-onset angina - the first attack occurred no later than 30 days.
Progressive – the severity, duration or frequency of pain attacks increases.
Spontaneous (Prinzmetal or vasostastic) - occurs as a result of spasm of the coronary arteries.
Early post-infarction angina - in the period up to 14 days after a heart attack.

There is also the so-called variant angina, which most often manifests itself at night or in the early morning. Attacks occur when the patient is at rest. They last on average about 3-5 minutes. They are provoked by a sudden spasm of the coronary arteries. In this case, the walls of the vessels can be loaded with plaques, but sometimes they are absolutely clean.

To distinguish between stable and unstable angina, the following factors must be assessed:

What level of physical activity provokes an angina attack;
Duration;
Efficacy of Nitroglycerin.

With stable angina, the attack is provoked by the same level of physical or emotional stress. In an unstable form, the attack is provoked by less physical activity or even occurs at rest.

With stable angina, the duration is no longer than 5–10 minutes, and with unstable angina it can last up to 15 minutes.

Causes

Risk factors include heredity, age and gender. Men aged 50-55 years are more susceptible to developing the disease than women. If we talk about percentages, then at the age of 45 to 54 years, angina attacks affect 2-5% of people, while among 65-74 year olds, it increases to 10-20%.

The leading cause of angina, as well as coronary heart disease, is the narrowing of the coronary vessels caused by atherosclerosis. Symptoms develop when the lumen of the coronary arteries narrows by 50-70%. The more pronounced the atherosclerotic stenosis, the more severe the angina.

Factors that contribute to the occurrence of angina attacks are:

Strong emotional experience, stress;

Tachycardia;

Exit from a warm room into cold, cold and windy weather.

Those most prone to angina are:

Males;
Overweight, obese persons;
Addicted to smoking, alcohol, drugs;
Fast food lovers;
People with a sedentary lifestyle;
People often exposed to stress;
Persons with diseases such as, (hypertension).

The first signs in men and women

The most significant symptom of angina is pain. Duration: from 1-15 minutes (2-5 minutes).

Nature of the pain syndrome: paroxysmal discomfort or pressing, squeezing, deep dull pain; an attack can be described as tightness, heaviness, lack of air.

Localization and irradiation:

The most typical location is behind the sternum or along the left edge of the sternum.
irradiation to the neck, lower jaw, teeth, interscapular space, less often to the elbow or wrist joints, mastoid processes.

In addition to pain, symptoms may also include so-called angina equivalents. These include:

shortness of breath - a feeling of difficulty breathing both when inhaling and exhaling. Shortness of breath occurs due to impaired relaxation of the heart
severe and sudden fatigue during exercise is a consequence of insufficient oxygen supply to the muscles due to reduced contractility of the heart.

Signs

Among women

Signs of cardiac angina in women

Pain in the heart area.
Pain in the forearm, neck or back along with chest pain.
Dyspnea.
Increased sweating.
Dizziness.
Anxiety, fear of death.
Feeling weak and tired.

Women may also experience the following symptoms:

Cough is a common occurrence with angina. It most often occurs at night when lying down. This is due to stagnation of blood in the pulmonary circulation.
Feeling of numbness in fingertips.
Presence of shallow breathing.

In men

A typical angina attack is often accompanied by the following characteristic symptoms:

feeling of lack of air;
feeling of fear and anxiety;
the patient groans and presses his hand to his chest due to pain;
pallor;
coldness or numbness of the hands;
rapid pulse;
feeling of heartbeat;
increased blood pressure.

Symptoms of angina

Characteristic symptoms in adults with angina pectoris:

Painful sensations are usually localized in the upper or lower part of the sternum (much less often in the lower), on either side of it or behind it.
In extremely rare cases, angina pectoris manifests itself with pain in the epigastric region - it can be mistaken for manifestations of an exacerbation of an ulcer or symptoms of a disease of the duodenum.
The pain radiates mainly to the left side of the body - arm, neck, shoulder, back, shoulder blade, lower jaw, earlobe.
Pain with angina pectoris often occurs during walking, climbing stairs, exertion, stress, and can occur at night. An attack of pain lasts from 1 to 15-20 minutes. Factors that alleviate the condition are taking nitroglycerin, standing or sitting.

If it hurts too much, and the pain comes in waves, and nitroglycerin hardly helps, it is necessary to urgently call an ambulance, since this is one of the signs of myocardial infarction.

The following symptoms of angina pectoris are less common:

An increase in blood pressure, which in turn provokes headaches, dizziness, and weakness.
Shortness of breath is a common symptom of myocardial oxygen starvation. A person begins to sweat for no apparent reason.
Also, angina pectoris is often accompanied by interruptions in the functioning of the heart; a person clearly feels the uneven and chaotic pulsation.
There may be nausea and vomiting.
A person experiences fear and motor activity increases.

As for the frequency of attacks, everything is individual - the intervals between them are sometimes long months, and sometimes they are repeated 60 or even 100 times a day.

Angina pectoris may be disguised as:

Heart attack;
Diseases of the gastrointestinal tract (peptic ulcer, diseases of the esophagus);
Diseases of the chest and spine (osteochondrosis of the thoracic spine, herpes zoster);
Lung diseases (,).

Remember that only a doctor can determine the cause of chest pain.

Angina attack: symptoms and first aid

The main symptom of an angina attack is sudden pain in the chest, and people describe this condition in different ways. Some complain of a burning sensation and aching pain radiating to the left arm. Others feel bursting pain radiating under the shoulder blade or in the stomach, neck, and throat.

The attack most often lasts no more than 15 minutes and goes away on its own or after taking nitroglycerin. If this condition does not go away, it may mean that an acute heart attack has occurred.

There are many cases when the symptoms of an angina attack appear only in the form of discomfort in the stomach or headaches. In this case, diagnosing the disease causes certain difficulties.

It is also necessary to distinguish painful attacks of angina from myocardial symptoms. They are short-term and can be easily relieved by taking nitroglycerin or nidefilin. While pain during a heart attack is not relieved by this drug.

In addition, with angina pectoris there is no congestion in the lungs and shortness of breath, body temperature remains normal, and the patient does not experience agitation during an attack.

Providing emergency care for angina pectoris

Direct first aid provided for angina pectoris before the ambulance arrives consists of the following points:

the patient sits comfortably with his legs lowered; he should also be reassured, avoiding sudden movements and standing up;
Half a large aspirin tablet or 1 tablet is given under the tongue;
To alleviate the condition, nitroglycerin is also subsequently given - 1 tablet under the tongue;
instead of nitroglycerin, isoket aerosol (single dose, not inhaled) or nitrolingual can be used;
the use of nitroglycerin can be carried out at an interval of three minutes, while the use of aerosol medications is carried out at an interval of one minute;
reuse of drugs is possible only up to three times, otherwise it can provoke a sharp drop in blood pressure.

After providing the necessary first aid, the patient must see a doctor, who will clarify the diagnosis and select the optimal treatment. For this purpose, a diagnostic examination is carried out

Diagnostics

When making a diagnosis, an important role is given to clarifying the patient’s complaints and pathological history. Clinical symptoms are assessed, instrumental and laboratory tests are performed in order to accurately determine the severity of the disease.

The minimum list of biochemical indicators for suspected coronary heart disease and angina pectoris includes determination of the content in the blood:

Instrumental diagnostics:

Holter monitoring. A portable recorder is attached to the patient for 24 hours, recording an ECG and transmitting the obtained information to the clinic computer.
Testing. Heart reactions are tested under various loads - a bicycle ergometer has been created for this (it can be replaced with a treadmill).
Computed multislice tomography. Required to differentiate angina from other ailments.
Coronary angiography. The doctor uses this technique to decide on the choice of treatment (surgical or conservative).
EchoCG. Determines the degree of damage affecting the heart vessels.

Treatment of cardiac angina in adults

How to treat angina? Treatment of angina pectoris is aimed at relieving pain, preventing the development of a heart attack, as well as stopping the development of atherosclerosis and cleansing blood vessels of atherosclerotic plaques.

All methods of angina therapy are aimed at achieving the following goals:

Prevention of myocardial infarction and sudden cardiac death;
Preventing progression of the disease;
Reducing the number, duration and intensity of attacks.

Drug therapy involves the use of the following medications:

ACE inhibitors. Keep blood pressure normal and reduce heart rate.
Omega-3 polyunsaturated acids, statins, fibrates. Stabilize and slow down the occurrence of sclerotic plaques.
Antiplatelet agents. Prevents the formation of blood clots in the coronary vessels.
Calcium antagonists. With vasospastic angina, the formation of coronary spasms is reduced. Nitrates (nitroglycerin and others). They stop attacks.
Prescribed for prevention before prolonged physical activity or before an outburst of emotions.

Surgery

This type of surgical treatment of the disease involves creating a bypass for blood flow to the individual affected area of the heart. A so-called shunt is placed below the damage; this procedure is called coronary artery bypass grafting.

This intervention is indicated for patients who have a severe form of angina pectoris with reduced lumen of the heart vessels (70% or more).

Surgical intervention is often used in cases of previous myocardial infarction. The result of the operation is the restoration of impaired blood flow in the arteries that supply the heart muscle with oxygen.

Diet and proper nutrition

The diet for angina pectoris is aimed at slowing the progression of atherosclerosis. It is aimed at eliminating lipid metabolism disorders, weight loss and improving blood circulation.

General principles of nutrition:

Reducing animal fats and carbohydrates (easily digestible). When cooking, you need to trim off the fat, remove the fat rendered during cooking and remove the skin from the bird. The degree of restriction of fats and carbohydrates depends on the patient’s weight.
Normal protein content.
The content of linoleic acid, lipotropic substances, dietary fiber, potassium and magnesium has been increased due to an increase in vegetable oils, seafood, vegetables, fruits and cottage cheese in the diet.
Increasing the proportion of products containing iodine (seaweed, mussels, sea fish, squid, shrimp).

A person needs potassium, the daily requirement of which is about 300-3000 mg. This microelement normalizes heart rhythms, improves the functioning of the endocrine system and heart muscle. The following foods contain potassium:

Products that you need to avoid or reduce your intake:

Fats of animal origin, since they contain a lot of cholesterol, and it contributes to the appearance of cholesterol plaques in blood vessels and, as a result, causes atherosclerosis. This includes fatty meats, such as pork, and poultry (duck, goose).
Flour and confectionery products, as they are rich in carbohydrates, which cause obesity.
It is necessary to limit salt intake, as it slows down the process of removing fluid from the body. You can replace salt with greens, which, moreover, contain many vitamins (A, B, C, PP) and minerals (folic acid, phosphorus, potassium, calcium, iron).
Drinks containing caffeine (coffee, strong tea), as they have a diuretic effect and remove a lot of fluid from the body.

Folk remedies

Before using traditional methods for angina pectoris, be sure to consult a cardiologist.

Take fresh juice of motherwort herb 40 drops for 2 s. l. before meals for a month. For winter storage, mix the juice with the same amount of vodka. Take 1 tsp. 3 times a day.
Mix valerian roots, licorice rhizomes, dill fruits, string grass, woolly panceria, marigold inflorescences (1: 2: 1: 2: 2: 2). Brew a tablespoon of the mixture in a glass of boiling water, leave in a warm place for at least an hour, filter and drink a third of a glass three times a day.
In the traditional treatment of angina, a mixture of garlic and honey is used. Grind 5 lemons through a meat grinder, peeled if possible, and squeeze out the juice. Add 5 chopped garlic heads and 0.5 liters of honey to it, mix. Store in a cool place for a week. Take 2 tbsp. every day for two weeks.
Hawthorn tea- brings relief from heart pain after just a short time of daily use. Method of preparation: take 3-4 tablespoons of dried hawthorn for 1 liter of boiling water. To preserve the properties of the medicinal plant, it is brewed in thermoses.

Prevention

Primary prevention (for those who do not have angina):

Nutrition correction.
Moderate physical activity.
Check cholesterol and blood sugar once a year.
In the presence of hypertension, constant use of antihypertensive drugs to keep blood pressure below 140/90 mmHg.
To give up smoking.

Secondary prevention (for those who have angina, reduces the frequency and duration of attacks, improves the prognosis):

Avoid extreme stress and excessive physical activity.
Before physical activity, you can take 1 dose of nitroglycerin.
Regularly take medications prescribed by your doctor to improve the prognosis of the disease.
Treatment of concomitant diseases.
Observation by a cardiologist.

Angina pectoris is pain in the area of the heart, manifested by attacks that are provoked by a lack of blood circulation in the myocardium.

It is not a separate disease, but is included in the group of symptoms manifested in cardiac ischemia.

The disease can lead to chronic heart failure, as well as death of heart muscle tissue. In many cases, angina is noted as a symptom of damage to the coronary arteries of the heart.

There is also another name for angina, in simple words it is called “angina pectoris”. It received this name due to the fact that pain is localized in the chest, near the heart.

The pain inherent in angina is described as severe, pressing, burning, squeezing pain, radiating to the back, throat, shoulder blades, upper limbs, and cervical spine.

Classification

Classification in the case of angina pectoris occurs in several groups, for a more correct and accurate assessment of the type of disease.

Among the types are:

Spontaneous (sudden, variant). This type is quite rare and is provoked by spasm of the coronary arteries, which leads to a decrease in blood flow to the heart muscle.

This type of angina is characterized by severe pain in the chest area and heart rhythm disturbances.

An unexpected spasm does not lead to myocardial infarction and is eliminated quickly, but it provokes a prolonged lack of oxygen in the myocardium.

It is an unfavorable form, and in most cases.

Progressive (unstable). The patient may suddenly feel a deterioration in his condition, without obvious reasons. The progression of this type of angina is attributed to the formation of a crack in the wall of a heart vessel, localized near cholesterol deposits.

This leads to increased formation of blood clots located inside the vessels of the heart, which interfere with normal blood circulation.

Accompanied by prolonged pain at night, lack of air, and heart rhythm disturbances.

Stable (angina pectoris). The manifestation of symptoms is due to squeezing, burning pain in the chest. In most cases it radiates to the left shoulder. The pain disappears suddenly after finishing physical activity, or as a result of using Nitroglycerin.

The division also occurs according to the development of the disease with various symptoms:

1st period. Functional deviations occur that cause narrowing of the vessel. Attacks of pain begin after serious unrest, in people who do not have symptoms of atherosclerosis. Initially, the symptoms of angina pectoris are associated with menopausal neurosis (a condition in which mental disorders associated with changes in the hypothalamus occur) in women, as well as smoking in men;
2nd period. Prolonged contraction of heart vessels leads to the progression of atherosclerotic narrowing. Painful attacks are unstable in their manifestations;
3rd period. Obvious changes of an atherosclerotic nature appear, painful attacks are aggravated by arrhythmia and heart failure. Subsequent repeated attacks lead to the progression of small areas of development of cardiosclerosis.

Depending on the severity of the disease, angina pectoris is divided into functional classes.

Among them:

1st class. There is a rare manifestation of symptoms of short painful attacks. The appearance of symptoms of angina pectoris occurs with unusual or rapid physical activity (sudden lifting of weights);

2nd grade. The manifestation of symptoms of angina pectoris occurs when walking, running, or quickly climbing stairs. Auxiliary factors that provoke an attack may be dense food, cold frosty weather, as well as strong gusts of cold wind;

3rd grade. Symptoms appear when walking at a slow pace over distances of more than a hundred meters, or when climbing stairs to a low floor.

Sharp pain may occur when going out in cold weather or frosty wind. Symptoms also appear after nervous experiences.

At this stage, the person’s daily life is greatly limited in order to avoid recurrence of attacks;

4th grade. Symptoms occur with any type of physical activity. The person cannot perform any type of physical activity, even such as sweeping the floor, or walking a distance of up to fifty meters. At this stage, painful attacks are possible even in the absence of physical and emotional stress.

In most cases, when diagnosing, the functional class (FC) is indicated. This happens using the abbreviation FC, as well as a number corresponding to the class number. It is important for the doctor to determine the FC of angina pectoris.

This provides the basis for prescribing medications and coordinating maximum physical activity on the body.

Symptoms

In case of progression of angina pectoris, the main symptom is compressive pain in the chest area and under the ribs in their central area. The pain manifests itself in the form of attacks, which last on average for five minutes.

If a painful attack does not stop within twenty minutes, this may indicate an acute myocardial infarction. The frequency of attacks varies and can range from several times a year to a hundred times a day.

The main typical symptoms that indicate progression of angina are:

Paroxysmal pain in the chest area;
Characteristics of attacks are squeezing, burning, heaviness in the chest;
The intensity of pain increases gradually until it becomes very strong;
Heavy breathing, feeling of chest tightness;
The pain will radiate to the left upper limb and left shoulder blade, and can sometimes also spread to the jaw and cervical region;
The person freezes to prevent the pain from increasing;
Feeling of impending disaster, fear of death;
Duration of pain from five to forty minutes;
Quick fatigue.

Less common are the atypical, but still inherent, symptoms of angina:

Symptoms of angina pectoris other than pain are also common. These include:

The appearance of pain after physical activity. The occurrence of an attack when walking stops, and resumption after walking begins;
Shortness of breath and heavy breathing are rarely bothered. This is associated with acute heart failure. At the time of a painful attack, pulmonary edema may progress, which will lead to death;
Fluctuations in heart rate in both directions. There is both a decrease and an increase in the frequency of contractions;
In most cases, blood pressure increases;
Pallor of the skin of the face, as well as a frightened look;
Feeling depressed and afraid.

If you notice any of the symptoms, seek medical attention from a qualified physician. Do not self-medicate.

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What to do if there is an attack?

If an attack occurs outside the hospital, then you need to know the algorithm of actions to calm the pain.

Such actions include:

The main task of first aid is to dilate the coronary vessels with the help of medications.

Treatment

Before prescribing treatment, the doctor sends the patient for the following examinations:

Clinical blood test,
Blood chemistry,
Blood for cholesterol, hemoglobin, and sugar levels, indicators of blood lipid concentrations,
Ultrasound examination (ultrasound) of blood vessels,
Bicycle ergometry,
Coronary angiography,
Daily monitoring of ECG (electrocardiography).

The most accurate study for determining the form of angina pectoris and the extent of spasm of the heart vessels is coronary angiography. It helps to accurately determine the length of the lesion and how large the narrowing has occurred.

Also, when examining using this method, it is possible to determine thrombosis and tearing of the arteries. This type of research has no side effects or contraindications. Therefore, it is used for all patients, regardless of the severity.

To treat a pathological condition such as angina, both medications and surgical interventions are used. Moreover, the medications should be taken throughout life, after registering angina in a person.

The main goals of treatment are to prevent heart attack and unexpected death, prevent progression of the disease, and eliminate the large number of attacks and their severity.

The following drugs are most often prescribed for drug treatment:

Group of drugs	Effect on the body
Medicines aimed against the formation of blood clots (Aspirin).	It is aimed at preventing the formation of blood clots, which can subsequently clog an already narrowed vessel, leading to early death. Long-term use of these drugs may lead to stomach upsets. So it is advised to use Thrombo ACC, which dissolves in the stomach without causing irritation. The effect of the drug begins approximately 15 minutes after administration and lasts several hours;
Beta blockers (Bisoprolol, Metoprolol, Atenolol, etc.).	These drugs reduce the myocardium's need for oxygen. This normalizes the imbalance formed by the low blood flow caused by the narrowing. They help lower blood pressure and slow the heart rate, which is the prevention of angina pectoris. The effect of the drugs begins approximately 2 hours after administration and continues throughout the day;

Statins (Atorvastatin, Simvastatin, etc.).	Such medications reduce the saturation of cholesterol in the blood. The drugs prevent more cholesterol from settling in the coronary vessels, thereby preventing their narrowing. The maximum effect of the drug Atorvastatin begins 1-2 hours after consumption and lasts throughout the day. In the case of Simvastatin, the effect lasts only 12 hours;

ACE inhibitors (Perindopril, Lisinopril, Noliprel, etc.)	This group of drugs is aimed against vascular spasms. Perindopril has maximum effect 3-5 hours after administration. The effect of Lisinopril occurs after 4-6 hours, and lasts throughout the day, like the effect of Noliprel;

Nitrates (Nitroglycerin, etc.).	Helps to expand the lumen of the vessel, allowing more blood to flow into the heart. The effect is visible after 5 minutes, the effect lasts up to 45 minutes;

Calcium channel antagonists (Verapamil, Verogalid, etc.).	This group of drugs reduces the myocardium's need for oxygen. The action of Verapamil begins immediately after administration (up to 5 minutes), the maximum effect is recorded 3-5 minutes after intravenous administration and lasts 10-20 minutes. - hemodynamic effect and 2 hours - antiarrhythmic.

Among the surgical interventions used are the following:. In this operation, a catheter is inserted through the femoral artery and reaches the area where the blood vessels are narrowing.

After this, the balloon expands, releasing the narrowing, which leads to restoration of blood flow.

In most cases, the operation is performed with the installation of a stent.

In the place where the balloon inflates the vessel, a special stent is installed, which maintains the lumen of the vessel.

The operation does not provide a complete guarantee of recovery; relapses are recorded in up to 40 percent of all cases.

That is why after surgery, constant maintenance of the body with medications is required.

The operating method is prescribed exclusively by the attending physician, based on all test results and assessment of the patient’s condition.

How to prevent angina?

To effectively prevent angina pectoris, it is necessary to exclude factors that can provoke the pathological condition:

Get rid of excess weight (if any);
Quit smoking, drinking alcohol, drugs;
Contact the hospital in advance if you have symptoms of concomitant diseases;
In the case of a hereditary predisposition, it is necessary to carefully monitor the appearance of symptoms, as well as apply all preventive measures;
Healthy lifestyle;
Proper nutrition. It is necessary to reduce foods high in cholesterol.

Expert forecast

If the patient follows a healthy lifestyle and eliminates factors that provoke angina pectoris. With early treatment at the hospital, diagnosis and effective therapy, the outcome is favorable.

If attacks last more than twenty minutes, this leads to acute myocardial infarction, which can be fatal. The patient requires urgent hospitalization and surgical intervention.

If you notice symptoms, go to the hospital immediately. Do not self-medicate and be healthy!

There are many causes of angina pectoris. The main symptom of “angina pectoris” is considered to be a compressive pain spreading throughout the chest. In this case, the following is observed - the heart provides fresh blood to all tissues and cells of the body, while it itself does not work well due to lack of oxygen.

Many patients feel pain on the left side, radiating under the shoulder blade or into the arm, shoulder, and sometimes even into the jaw. But in addition to pain, the symptoms of this disease can appear due to the vegetative-vascular reaction of the body.

The most characteristic symptoms of angina pectoris

Symptoms of an attack of angina pectoris include darkening of the eyes, shortness of breath and cardiac arrhythmia. An incomprehensible weakness against the general background of active physical health or a sudden fear of death - all this indicates angina pectoris.

Sometimes people suffering from angina complain of unexpected sweating, which is not related to the temperature of the surrounding area. For no reason at all, a person may break into a sweat, although he is dressed very lightly. There are attacks of shortness of breath, accompanied by a sharp lack of oxygen.

During attacks of “angina pectoris”, the symptoms of the disease are sharp and do not cause any controversy. The patient begins to grab the left side of his chest, trying to calm his heart. The sufferer's face may turn pale from lack of air and the release of a portion of adrenaline.

Individual signs of the onset of an angina attack

Sometimes the only symptom of this disease is considered to be ordinary heartburn or a disorder of the entire digestive system, manifested by loose stools. By the way, this condition most often occurs in the elderly. That is why it is important to do an electrocardiogram for disorders of the digestive tract and the symptoms described above.

In addition, there are more characteristic signs of the presence of this disease, which make it possible to suspect such a pathology when the pain is characterized by paroxysmal character, often occurs during physical activity and decreases after taking a nitroglycerin tablet.

In addition, there are the following manifestations, for example, an attack is accompanied by some changes in blood pressure, a feeling of interruptions in the heart and pallor. A person who feels at least some of the listed symptoms should not delay visiting a doctor.