The Angina pectoris: symptoms and treatment of angina pectoris
medicine online

Angina pectoris


Angina pectoris

Angina pectoris

Angina pectoris is a pathology that develops as a result of a lack of oxygen in the heart muscle. This most common form of manifestation of coronary heart disease is for the body a kind of signal about problems with cardiac circulation, which should not be left without attention. Men suffer from angina attacks 3-4 times more often than women. People usually are more than 40-50 years old. However, recently the patients have become noticeably younger, which can not but cause concern among doctors.

Angina pectoris: causes

The main cause of angina is a violation of blood circulation in the coronary arteries, which supply the heart with oxygen and necessary nutrients. Often blame for everything are atherosclerotic plaques, lining the walls of blood vessels, just as gradually the scale forms on the walls of the kettle. An attack occurs when the lumen artery narrows more than 70%. In addition, a sudden long-term contraction of the blood vessels (spasm) can cause pathology.

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

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

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

Congenital malformations and defects of the heart and 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 supply of the heart with blood - these are broncho-pulmonary diseases, exacerbations of diseases of the stomach and intestines.

Symptoms of stenocardia

Angina is manifested by pain, which can not be noticed. Its nature can be different - pressing, stitching, compressing, pulling, drilling. The intensity also varies in each case - from minor sensations to severe unbearable pain, from which you want to moan and scream. Sometimes a symptom of angina is a burning sensation and pressure behind the sternum.

Painful sensations usually localize in the upper or lower part of the sternum (much less often in the lower part), on either side of or behind it. In extremely rare cases, angina pierces itself in the epigastric region - it can be taken as a manifestation of an acute ulcer or symptoms of duodenal disease. The pain extends mainly to the left side of the body - arm, neck, shoulder, back, shoulder blade, lower jaw, earlobe.

The pain rolls by attacks, which last on average no more than 5 minutes. If the duration of the attack exceeds 20 minutes - this can already indicate the transition of an attack of angina in an acute myocardial infarction.

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

The constant companions of attacks of angina are also the feeling of an impending catastrophe, panic and the fear of death.

In addition to the above symptoms on angina may indicate signs such as shortness of breath and rapid fatigue, even with minor loads.

Similar symptoms: do not confuse!

Pain in the chest, similar to the one that accompanies angina attacks, can have very different reasons. Not always these symptoms signal problems with the cardiovascular system - there are many diseases that masquerade as angina pectoris.

The most common cause of similar pain is osteochondrosis in the thoracic or cervical spine. The intensity of uncomfortable sensations changes when the head rotates, the position of the body changes. Unlike signs of angina pectoris, the symptoms of osteochondrosis do not manifest themselves during exercise, but after it.

Such diseases of the gastrointestinal tract, as a hernia of the esophagus or esophagitis, can also manifest themselves through sensations resembling the symptoms of angina pectoris. In this case, a person is tormented by a long heartburn, and chest pains appear, usually after a meal.

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

The cause of painful pain in the chest can be and various diseases of the muscles, infringement of nerves. For example, with an attack of angina pectoris, intercostal neuralgia is often confused.

Vegeto-vascular dystonia, although it has a second name - cardiac neurosis - does not significantly affect the work of the heart. However, her constant companions are panic attacks, simulating an attack of angina pectoris. A person's heart rate increases, there is pain in the chest, sweating increases, there is a shortage of air. But the treatment of this disease should not be dealt with by a cardiologist, but by a neuropathologist.

Types of angina pectoris

There are several varieties of angina pectoris.

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

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

The second functional class causes seizures and pain when climbing the steps, walking fast, after a plentiful meal. The provoking factors are often frosty weather and wind.

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 at close range. Sometimes pathology is aggravated by simply going out into the street in cold weather, climbing the stairs even to the first floor, the slightest excitement.

The fourth functional class is characterized by a complete inability of the patient to any kind of stress. Attacks develop and at rest without previous emotional shocks and stressful situations.

The next type - unstable angina - is an indisputable indication for urgent hospitalization. This kind of pathology is characterized by unpredictable and volatile behavior, hence its name. Often, doctors equate unstable angina to the pre-infarction state.

So, in what cases is angina 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, which increases the number of attacks and increases their intensity;
  • if attacks start to bother a person, even when he is at rest;
  • if angina occurs within two weeks after a person has had a heart attack.

There is also a so-called variant angina , which often manifests itself at night or early in the morning. Attacks occur when the patient is at rest. They last an average of 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.

Angina pectoris: 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 - it is necessary to stop, and it is better to sit down. In some cases, this is enough to normalize the situation.

The next step is taking nitroglycerin in this way and in the dosage prescribed by the doctor. It is worth remembering that this drug can cause a sharp drop in blood pressure. The result of such sudden changes in the body are dizziness and even fainting. Therefore, you must sit down.

If after 5 minutes the attack is not stopped, you need to repeat the procedure. In the event that nitroglycerin does not have any effect, and the pain bothers you for more than 15 minutes, immediately call an ambulance. A prolonged attack of angina threatens with serious consequences right up to a lethal outcome.

Angina pectoris and its complications

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

Treatment of angina pectoris

So, stenocardia is a cry of the body for help, it is a signal that indicates serious problems of the cardiovascular system. Pathology needs medical supervision and qualified treatment, the goals of which are:

  • relief of seizures;
  • the detection and treatment of diseases that promote the development of angina pectoris;
  • prevention of complications (in the first place, myocardial infarction);
  • improving the quality of life of the patient by reducing the frequency and intensity of seizures.

The doctor will select competent medical treatment based on a thorough examination of the patient. As a rule, it can not do without taking antianginal drugs, which reduce the need for oxygen in the heart muscle. Often in the scheme of drug treatment, the presence of antisclerotic agents is also advisable. The doctor will also explain to the patient the rules for using the first aid in case of symptoms of an attack of angina pectoris - nitroglycerin.

In especially severe cases, when the risk of developing a myocardial infarction can not be reduced, the attending physician decides on the need for surgical intervention. As a rule, the patient requires aortocoronary bypass or balloon angioplasty.

Prophylaxis of angina pectoris

For the health of the entire cardiovascular system, it is necessary to exclude the influence of as many factors as possible, which increase the risk of angina pectoris and the complications that accompany it.

Changing some of the conditions that threaten angina is beyond the scope of our possibilities - above all, we are talking about age and sex. But still, each of us is able to do a lot to protect ourselves from serious health problems.

  • Eat right. So you avoid problems with excess weight, normalize the level of cholesterol in the blood and provide the body with the necessary vitamins and microelements.
  • Refuse bad habits. Abuse of alcohol and cigarettes has a harmful effect on the whole body. A significant blow to yourself, including, takes the cardiovascular system.
  • Active lifestyle. People who lead a sedentary lifestyle sooner or later will get themselves problems with blood circulation. Active lifestyle means regular and moderate physical activity. If problems with the heart and blood vessels have already manifested themselves, it is worthwhile to seek help from a specialist of exercise therapy, who will choose the optimal load for you.
  • Do not run out of health. High blood pressure, diabetes, lung and bronchial diseases ... In the absence of timely competent treatment, all this can lead to the development of angina pectoris.

It is best to start the prevention of angina from a very young age. More often tell the children about the dangerous smoking, do not overfeed the kids, add them to the sport.

All these preventive measures must be followed and in the treatment of already developed angina pectoris. They are part of therapeutic care for the patient. It is hardly possible to talk about bright forecasts if the patient does not reconsider his way of life.


The course of angina pectoris is very individual in each case. For some years, someone does without deteriorating the clinical picture, others are characterized by a rapid development of the disease, leading to myocardial infarction and even death. There are many factors that allow a doctor to draw conclusions about the prognosis and chances of a particular patient. This is the degree of damage to the coronary arteries, and the tolerability of physical activity, and the peculiarities of myocardial contractility. Significantly improves the prognosis adequate for the patient's condition treatment and compliance with all the prescriptions.

Angina pectoris is a common disease in our time. If earlier heart problems mostly arose among people who have crossed the 50-year threshold, now patients are rapidly becoming younger. Attacks of angina are recorded even in children (especially in adolescents). This is a dangerous condition that does not allow a person to fully enjoy life, restricts his physical activity and in severe cases can lead to disability or cause a fatal outcome. That's why today everyone should know about the symptoms of angina pectoris, and also about its prevention.

| 20 December 2014 | | 9 741 | Uncategorized