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Angina pectoris


Angina pectoris

Angina pectoris

Angina is a pathology that develops as a result of a lack of oxygen by the heart muscle. This is the most common form of manifestation of coronary heart disease is for the body a kind of signal about problems with the cardiac circulation, which should not be ignored. Men suffer from angina attacks 3-4 times more often than women. Usually the disease affects people older than 40-50 years. Recently, however, patients have visibly looked younger, which can not but alarm the doctors.

Angina Pectoris: Causes

The main cause of angina is impaired blood circulation in the coronary arteries, which supply the heart with oxygen and essential nutrients. Often the blame for atherosclerotic plaques lining the walls of blood vessels is similar to how gradually scum forms on the walls of a teapot. An attack occurs when the lumen of the artery narrows by more than 70%. In addition, sudden long-term contraction of the heart vessels (spasm) can also cause pathology.

As a rule, stenocardia manifests itself during physical activity (playing sports, hard work) or during a stressful situation.

There are a number of factors that significantly increase the risk of developing angina:

  • overweight and obesity;
  • nicotine and alcohol abuse;
  • a lifestyle characterized by lack of physical activity;
  • hypertension;
  • high cholesterol;
  • diabetes;
  • genetic predisposition;
  • elderly age.

Congenital defects and defects of the heart and blood vessels are also the cause of the development of angina pectoris. In addition, there are a number of diseases that do not directly affect the cardiovascular system, but worsen the blood supply to the heart - these are broncho-pulmonary diseases, exacerbations of diseases of the stomach and intestines.

Symptoms of angina pectoris

Angina is manifested by pain, which is impossible not to notice. Its character can be different - pressing, piercing, compressing, pulling, drilling. Intensity also varies in each specific case - from minor sensations to harsh, unbearable pain, which makes you want to moan and scream. Sometimes a symptom of angina is a burning sensation and pressure in the chest.

The painful sensations are usually located in the upper or lower part of the sternum (much less often in the lower part), on either side of it or behind it. In extremely rare cases, angina pectoris manifests itself as pain in the epigastric region — it can be mistaken for manifestations of an acute ulcer or symptoms of duodenal ulcer. The pain gives mainly to the left side of the body - arm, neck, shoulder, back, scapula, lower jaw, earlobe.

The pain rolls attacks, which last an average of not more than 5 minutes. If the duration of the attack exceeds 20 minutes - this may already indicate a transition of an angina attack to acute myocardial infarction.

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

Permanent companions of angina attacks are also a sense of impending catastrophe, panic and the fear of death.

In addition to the above symptoms, angina pectoris may indicate signs of dyspnea and fatigue even under slight exertion.

Similar symptoms: do not confuse!

Chest pain, similar to that accompanying strokes, may have very different reasons. These symptoms do not always signal problems with the cardiovascular system - there are many diseases that are masked as angina.

The most common cause of similar pain is osteochondrosis in the region of the thoracic or cervical spine. The intensity of the discomfort changes when the head turns, changing the position of the body. Unlike signs of angina, the symptoms of osteochondrosis do not manifest themselves during physical exertion, but after it.

Diseases of the gastrointestinal tract, such as hernia of the esophagus or esophagitis, can also manifest themselves through sensations resembling the symptoms of angina pectoris. In this case, a person suffers from long heartburn, and chest pains appear, as a rule, after eating.

Cholecystitis , pancreatitis and cholelithiasis are accompanied by painful sensations, which often return to the heart.

The cause of excruciating chest pain can also be various diseases of the muscles, pinching of the nerves. For example, intercostal neuralgia is often confused with an attack of angina.

Vegetative-vascular dystonia, although it has a second name — cardiac neurosis — has no significant effect on the functioning of the heart. However, her constant companions are panic attacks, simulating an attack of angina. A person's heart rate quickens, chest pain appears, sweating increases, and there is a lack of air. But the treatment of this disease should be dealt with not by a cardiologist, but by a neuropathologist.

Types of angina pectoris

There are several varieties of angina.

Stable angina occurs when the vessel lumen narrows by 50-70% due to the growth of atherosclerotic plaques on their walls. In the absence of appropriate treatment, the pathology progresses, the plaques are damaged, blood clots form on them, the lumen of the arteries is becoming narrower. As a result, angina attacks become more frequent, they occur already with minimal exertion or even at rest. There are four functional classes of stable angina (or, as it is also called, stress angina), which are characterized by varying degrees of severity.

The first functional class is distinguished by a rather rare occurrence of attacks of chest pains. As a rule, they bother a person in the process of performing feasible physical exertion at a fast pace.

The second functional class causes seizures and pain when climbing steps, walking in quick steps, after a hearty meal. Frosty weather and wind often act as provoking factors.

The third functional class is already associated with a significant limitation of physical activity. Attacks significantly affect the quality of life - a person suffers from pain already during normal walking for short distances. Sometimes the pathology is aggravated by just going outside in cold weather, climbing the stairs even to the first floor, the slightest excitement.

The fourth functional class is characterized by the complete inability of the patient to any kind of stress. Attacks develop in a state of rest without prior emotional upheavals and stressful situations.

The next type - unstable angina - is an indisputable indication for urgent hospitalization. This kind of pathology is distinguished by unpredictable and changeable behavior, hence its name. Often, doctors equate unstable angina with a preincarnated condition.

So, in which cases, angina is classified as unstable:

  • if the seizures occurred for the first time and declared themselves less than a month ago;
  • if there is a rapid progression of the disease, in which the number of attacks increases and their intensity increases;
  • if the seizures start to bother the person, even when he is at rest;
  • if angina occurs within two weeks after a person has had a heart attack.

There is also the so-called variant angina , which most often declares 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 blood vessels can be loaded with plaques, but sometimes they are completely clean.

Angina: what to do?

So, what to do if you understand that an attack of angina begins? First of all, you must immediately stop any physical activity. If you go - you have to stop, but rather sit down. In some cases, this is already enough to normalize the situation.

The next step is taking nitroglycerin in the manner and dosage prescribed by the doctor. It is worth remembering that this drug can cause a sharp decrease in blood pressure. The result of these sudden changes in the body are dizziness and even fainting. Therefore, be sure to sit down.

If after 5 minutes the attack is not cropped, you need to repeat the procedure. If nitroglycerin has no effect, and the pain has been bothering you for more than 15 minutes, call an ambulance immediately. A prolonged attack of angina pectoris can have serious consequences, even death.

Angina pectoris and its complications

The most serious complication of a prolonged attack of angina is myocardial infarction. This extremely dangerous condition often has irreversible effects and is a fairly common cause of high mortality in people over the age of 45-50 years old (especially for men). Chronic heart failure and cardiosclerosis, which significantly reduce the patient’s quality of life, can be called the long-term effects of angina pectoris.

Treatment of angina pectoris

So, angina pectoris is an organism's cry for help, it is a signal indicating serious problems of the cardiovascular system. Pathology needs medical supervision and qualified treatment, the objectives of which are:

  • relief of seizures;
  • detection and treatment of diseases contributing to the development of angina pectoris;
  • prevention of the development of complications (primarily myocardial infarction);
  • improving the quality of life of the patient by reducing the frequency and intensity of attacks.

The doctor, on the basis of a thorough examination of the patient, will select a competent drug treatment. As a rule, it is not complete without taking antianginal drugs that reduce the oxygen demand of the heart muscle. Often in the scheme of drug treatment, the presence of anti-sclerotic drugs is also advisable. The doctor will also explain to the patient the rules for the use of first aid when the symptoms of an angina attack - nitroglycerin occur.

In severe cases, when you can not arrest the risk of myocardial infarction, the attending physician decides on the need for surgery. As a rule, the patient requires coronary artery bypass surgery or balloon angioplasty.

Prevention of angina pectoris

For the health of the entire cardiovascular system, it is necessary to eliminate the influence of as many factors as possible, which increase the risk of developing angina and related complications.

Changes in some conditions that threaten angina pectoris are outside the range of our capabilities — first of all, we are talking about age and sex. Still, each of us is able to do much to protect ourselves from serious health problems.

  • Eat right. So you will avoid problems with excess weight, normalize the level of cholesterol in the blood and provide the body with essential vitamins and microelements.
  • Give up bad habits. Alcohol and cigarette abuse has a devastating effect on the entire body. The cardiovascular system takes a significant impact on itself.
  • Active lifestyle. People leading a sedentary lifestyle, sooner or later, will engender problems with blood circulation. An active lifestyle involves regular and moderate exercise. If the problems with the heart and blood vessels have already declared themselves, you should seek help from an exercise therapy specialist, who will select the optimal load for you.
  • Do not run health. High blood pressure, diabetes, diseases of the lungs and bronchi ... In the absence of timely, competent treatment, all this can cause the development of angina pectoris.

It is best to start angina prevention from an early age. Tell the children more often about how dangerous smoking is, do not overfeed the kids, attach them to the sport.

All these preventive measures must be observed in the process of treatment of already developed angina. They are part of the therapeutic care of the patient. It is hardly possible to talk about rainbow predictions if the patient does not reconsider his lifestyle.


The course of angina is very individual in each case. Someone has been doing for years without worsening the clinical picture, for others the rapid development of the disease is characteristic, leading to myocardial infarction and even death. There are many factors that allow the doctor to draw conclusions about the prognosis and the chances of a particular patient. This is the degree of damage to the coronary arteries, and exercise tolerance, and especially myocardial contractility. Significantly improves the prognosis for adequate treatment of the patient’s condition and the fulfillment of all prescriptions.

Angina is a fairly common disease in our time. If earlier heart problems mainly occurred in people who overstepped the 50-year-old frontier, now patients are rapidly getting younger. Angina attacks are recorded even in children (especially in adolescents). This is a dangerous condition that does not allow a person to fully enjoy life, limits his physical activity and in severe cases can lead to disability or cause death. That is why today everyone should be aware of the symptoms of angina, as well as its prevention.

| 20 December 2014 | | 9 741 | Uncategorized