Monday , June 14 2021

Everything you need to know about angina. Why should patients be considered PUBLICATION .MD

Angina pectoris. What are the forms of angina, how do we recognize the pain associated with angina, how much does it maintain and what should be done if it occurs?

Angina pectoris. Professor Florin Mitu, head of the cardiology section in emergency cardiology at Iasi Recovery Hospital: "One of the most common questions is whether angina means that the patient has a myocardial infarction.An angina pectoris does not necessarily mean myocardial infarction, but it means a risk of heart attack Episode of angina expresses higher oxygen demand for myocardial part, higher oxygen demand is temporary, i.e. Short-term (eg During exercise, when the heart needs more oxygen) Myocardial infarction usually occurs when the blood flow from one side of the muscle If the blood clot does not dissolve (by emergency treatment or, rarely, by itself), the part of the myocardium irrigated by the blocked vessel dies. Thus, the occurrence of angina pectoris is terminated abruptly and definitively, usually by the appearance of a blood clot inside the vessel. there is a signal alarm.

There are two main types of breast chest: stable and unstable.

* Stable angina pectoris: means a situation that does not change for a long time. There are episodes of angina pectoris, with forms that remain constant – appear on the same level of physical activity, give up at rest or sublingually, nitroglycerin, have a certain frequency over time – which depends on the effort of the patient. A patient with stable angina may have different degrees of physical pain at which pain occurs – both during the day and every day. For example, angina can occur with less effort in the morning than stress, which causes a crisis during the day. There may be differences from day to day. For example, when it is cold, angina can occur with less effort than usual. It can also happen after heavy meals or stress.

* Unstable angina: is a type of angina with a higher severity, so the patient should be urgently present.

It can manifest in several ways, among which the most common are:

* increase the frequency and intensity of angina attacks in a patient who has stable angina (angina begins to appear more often than before, at lower rates, crises may be more intense);

* the onset of angina at rest (no stress factors such as physical stress, stress, hearty meals);

* 20-minute resting attacks of angina, no longer undergoing sublingual nitroglycerin;

* angina pectoris occurring at night (waking up a patient from sleep).

In all these cases, there is a high risk of acute myocardial infarction, severe arrhythmias or even sudden death All these conditions should be immediately announced to the doctor.

What should I do after the diagnosis of angina?

In addition to the medications prescribed by the doctor, all risk factors that can be changed should be removed. Quitting smoking, non-fat diet, weight loss – are a very important part of treatment and depend on the patient himself.

How do we recognize pain in angina?

The location of pain usually occurs behind the sternum, lower, middle or upper, and rarely before the heart. Irradiation of pain occurs in the left arm and forearm, along its inner part, in the small and annular finger. Sometimes pain is perceived as a feeling of pressure (oppression), crushing, burning, pain. Anxiety, fear, anxiety are symptoms that almost always accompany attacks of angina. The pain occurs in the following conditions: in physical effort, during it and it may disappear when it is interrupted; exposure to cold, after lunch, during sexual intercourse, stress. Patients may not show symptoms between crises, writes

Angina pectoris. How much pain does the angina crisis occur?

A typical angina episode lasts from 2 to 10 minutes.

Very short, very acute pains – usually not angina but muscle pain, "functional" pain – occurring without organic disease. In case of chest pain lasting over 30 minutes, sometimes hours in a row, uninterrupted for periods of silence, you should immediately contact your doctor.

What goes through pain?

Typically, chest pain in regular angina disappears after physical exercise. Resting – standing or sitting – calms the pain and makes it disappear within a minute to 5 minutes. Administration of nitroglycerin tablets or sublingual aerosol also calms angina pain within 1 to 5 minutes. The reaction to nitroglycerine is not specific for angina. The pain in some oesophageal disorders also goes into sublingual nitroglycerin.

How to use nitroglycerin?

Patients with angina should always have a nitroglycerin or nitroglycerin tablet at hand to be able to act quickly in angina. Do not hesitate to use them. They do not cause addiction and have a quick effect, the nitroglycerin tablet is placed under the tongue and, in order to act quickly, it should not be swallowed. The effect begins to appear in two minutes. If the pain subsides within 5 minutes, you can take another tablet. If the episode of angina does not subside after 3 sublingual nitroglycerin tablets taken within 5 minutes, urgently call for salvation and go to the hospital.

In which other diseases can chest pain occur?

* Esophageal pain – The esophagus, the muscular duct joining the mouth with the stomach, is very close to the heart and large vessels. Often, pains in the esophagus are very similar to typical angina pectoris. However, the pain may be below the sternum (n. R. – chest bone of the ribs and clavicle); In addition, the pain often burns, can occur after a meal, when the patient is sitting in bed to get a siesta, may accompany the regurgitation of acid and improves the antacids, writes grains.

The pain that occurs in esophageal spasm may give way to sublingual nitroglycerin, as does chest pain in angina. Chest pain may also occur in other gastroenterological conditions, such as acute pancreatitis, gastric or duodenal ulcers. Sometimes the pains that appear in the esophagus and stomach imitate angina and some tests, such as digestive endoscopy, are needed to make the correct diagnosis.

* Aortic dissection – The aorta is the largest vessel in the body and carries blood from the heart throughout the body. Aortic dissection is a ruptured vessel wall and is a serious cardiovascular risk. In this case, chest pain is suddenly installed, it is very intense, lasting, and often irradiated between the shoulder blades and the back.

Pleuritis / pleuritis – lung leaf inflammation – often causes chest pain, sharper than in angina, and changes in position and breathing. In this condition, there is a tendency to breathe superficially, because each deep breath causes accentuation of pain.

* Pericarditis – leaf inflammation wrapping the heart – pain is felt more on the left side of the chest, 'in the area of ​​the heart', it can reach the neck, shoulders and back, sometimes even the left arm. It has a longer duration, changes in position and is enhanced in deep breathing.

* "Functional" pain – without cause – is a special type of sore throat, which usually occurs under stress, fatigue, not related to physical exertion. It does not express the organ's suffering, but the state of fear. Frequent placement is in the precordium region on the "tip" of the heart. The duration is longer than in angina – it lasts several hours, is a deafening pain, crippled by short, sharp ears, for a few seconds. It is often associated with numbness of the hands and feet, tingling, dizziness, panic attacks, sometimes fainting. This type of chest pain is more common in women under 40 years of age with symptoms of emotional instability and depression.

There are usually angina pains:

* pains located in a shallow area that accentuate or subside after a chest buckling;

* pain on a small area – less than 3 cm;

* short steps for a few seconds;

* A sore throat that changes with the breath and which accentuates the mobilization of the chest, neck or arms.

Why should you consider patients with angina

* Resting after eating is very important.

* Ending any activity when there is a crisis of angina, relaxation and administration of the drug used in such situations.

* The contraceptive pill should be discontinued if there is angina. The estrogen contained in it increases the risk of blood clotting.

* If the angina crisis occurs at night, it is necessary to correct the position of the body by keeping the head or chest higher. In this way, the heart will be less effort, pumping blood through the veins to the heart.

* The risk of myocardial infarction and unstable angina is significantly reduced when aspirin is given as prescribed by a doctor.

* Smoking cessation. The presence of nicotine attacks has a negative effect on the occurrence of angina attacks.

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