Manifestation of angina pectoris symptoms. Stable exertional angina. Angina pectoris - doctor

There are many causes for angina pectoris. The main sign of the manifestation of "angina pectoris" is considered to be compressive pain that spreads through the chest. At the same time, the following is observed - the heart ensures the supply of fresh blood to all tissues and cells of the body, while it itself does not work well due to a lack of oxygen.

Many patients feel pain in the left side, radiating under the shoulder blade or into the arm, shoulder, sometimes even into the jaw. But in addition to the pain syndrome, the symptoms of this disease can manifest themselves due to the vegetovascular 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. Incomprehensible weakness against the general background of active physical health or a sudden fear of death are all indications of angina pectoris.

Sometimes people suffering from angina pectoris complain of sudden sweating, which is not related to the temperature of the surrounding space. A person for no reason can be thrown into a sweat, although he is dressed very lightly. There are attacks of shortness of breath, accompanied by a sharp lack of oxygen.

During the period of attacks of "angina pectoris", the symptoms of the disease are sharp, not causing any controversy. The patient begins to grasp left side chest trying to calm my heart. The face of the sufferer 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 the manifestation of this disease is the usual heartburn or a disorder of the entire digestive system, manifested liquid stool. By the way, this condition is most common in the elderly. That's why it's important to do with disorders digestive tract and the symptoms described above, an electrocardiogram.

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 nature, 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 has experienced at least some of these symptoms should not delay visiting a doctor.

Sudden attacks of chest pain are called angina pectoris. The disease is common in older and middle-aged people, and partial obstruction of the arteries is considered the main cause of its development. Because of this, angina pectoris is sometimes called coronary heart disease or angina pectoris.

Unstable angina

According to the classification, the disease has a stable and unstable form. The type of pathology is determined by the duration and frequency of attacks, the effectiveness of pain relief with nitroglycerin. When does it escalate coronary disease heart (CHD), the intensity and duration of heart pain increases - this is manifested by unstable angina pectoris. It includes the following subtypes of the disease:

post-infarction disease;
progressive angina;
Prinzmetal pathology;
first time disease.

stable

If, in response to a certain level of load, a retrosternal paroxysmal pain of a pressing or shrinking character appears, then this manifests itself as a stable form of coronary disease. Angina pectoris of this kind occurs with strong emotional stress. Pain subsides when taking nitroglycerin or after relieving stress. Angina pectoris of any severity can begin due to stress, windy cold weather, plentiful food. The variant form of stable ischemia can develop at rest, and the microvascular form can develop with increased physical activity.

Vasospastic

A clear sign of coronary heart disease is a vasospastic type of disease, or, as it is also called, princemetal angina. The difference between this pathology is that a large spasm occurs in the artery, in which the blood flow to the myocardium decreases sharply. The main cause of the condition is atherosclerosis, which contributes to the development of such attacks. Angina pectoris of the vasospastic type often develops in people of middle age from 30 to 50 years, although the form of the disease itself is observed in only 5% of patients. It is extremely rare for a child to develop the disease.

Causes of angina pectoris

Unfortunately, angina - what it is know firsthand, millions of people around the world. Risk factors include heredity, age and gender. Men aged 50-55 are more susceptible to the onset of the disease than women. Often coronary disease are diagnosed in direct relatives. The main cause of angina pectoris is an unbalanced diet and excess weight.

A person can influence many risk factors by excluding them from life. Preventable causes of angina include:

Hyperlipidemia. In 96% of patients with angina pectoris, there is an increase in cholesterol and other lipid fractions. This enhances thrombus formation in the vessels.
Physical inactivity. Lack of physical activity gradually leads to obesity and impaired lipid metabolism. The presence of two factors increases the risk of ischemia progression.
Smoking. The combination of hemoglobin with carbon monoxide leads to oxygen starvation of cells. This condition provokes spasm of the arteries, increased pressure, increases the risk of developing myocardial infarction.
Hypertension. When blood pressure rises, a person's myocardial tension increases and the need for oxygen increases.
Intoxication and anemia. It is accompanied by a decrease in oxygen delivery to the heart muscle, which provokes ischemic attacks.
Psycho-emotional stress. The heart works under high load, blood pressure rises, the myocardium does not receive enough nutrients and oxygen. Stress provokes arrhythmia, shortness of breath, acute attacks ischemia, hypertensive crisis, sudden coronary death.

signs

Symptoms of the disease are few, but characteristic. They are easy to distinguish from signs of other diseases. Heart pain in angina pectoris manifests itself as intense heaviness in the chest, a feeling of discomfort and burning behind the sternum, especially at night. Pain may differ: transmitted to the left arm or shoulder blade, throat or lower jaw. The duration of the attack is from 1 to 15 minutes. It always starts suddenly, abruptly, sharply. Symptoms often go away on their own within 2-3 minutes after taking valocordin or other heart pills.

Diagnosis of angina pectoris

When making a diagnosis, an important role is given to clarifying the patient's complaints, anamnesis of the pathology. Assessed clinical symptoms, instrumental and laboratory research in order to accurately determine the severity of the course of the disease. After the specialist has decided on the diagnosis, this is angina pectoris and myocardial infarction, the following examinations are prescribed:

coronary angiography;
Echo-KG;
scintigraphy;
bicycle ergometry;
Holter monitoring;

Treatment of angina pectoris

Conservative methods and surgical intervention are used to eliminate angina attacks. Drug therapy involves the use of the following drugs:

ACE inhibitors. Keep blood pressure normal, lower 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). Buy seizures. They are prescribed for prophylaxis before prolonged physical exertion or before a surge of emotions.

What is the treatment for angina pectoris? Non-drug treatment is a diet aimed at lowering cholesterol in the blood. It is necessary to normalize body weight, eliminate bad habits. Surgical therapy depends on the severity of the disease. It includes operations:

coronary angioplasty;
rotation;
atherectomy;
coronary artery bypass grafting.

An attack of angina pectoris

Not all people may know what angina pectoris is, especially if an ischemic attack has overtaken for the first time. Chest pain may be accompanied by tachycardia, dizziness, loss of consciousness. Nitroglycerin tablets give only a short-term effect. The patient becomes pale, his pulse is barely palpable, the pressure drops. Relief of an attack of angina pectoris can only be done by an emergency doctor medical care.

All patients with suspected heart attack are immediately sent to the hospital, where they are carefully examined. First aid for angina pectoris is to provide the patient with mental and physical rest, supply with fresh air, and give the body a comfortable position. You should give a nitroglycerin tablet under the tongue (if not available, the drug in drops of Corvalol or Valocordin 25 k), unfasten tight clothing and wait for the doctor.

Diet

An important part of the treatment of IHD is the right diet. Heart disease develops against the background of insufficient blood supply to the heart muscle, so nutrition for angina pectoris excludes all types of foods that contribute to coronary spasm:

lard, fatty meats;
dairy products with high content fats;
sausages, smoked meats;
offal.

Useful for ischemia are fish and seafood, all types of leafy vegetables, unpolished cereals, black bread, legumes and soy dishes. It is allowed to use low-fat varieties of poultry, meat, low-fat dairy products, unsweetened fruits. Cereals are very useful: oatmeal, rice, buckwheat, cells, millet. Reduce blood cholesterol and replenish the body with vitamins vegetable oils: olive, linseed, corn.

Alternative treatment

Since ancient times, heart disease has been successfully treated with herbs. Effective remedies treatment for angina is herbal decoctions and tinctures. Hawthorn with wild rose is considered the best remedy for the treatment of ischemia. You can prepare it like this:

place in a jar 7 tablespoons (tablespoons) of chopped hawthorn berries and 7 cups of boiling water;
close the container, wrap it up, put it in a warm place for two days;
strain the medicine, add 2 tablespoons (table) of rose hips;
place the infusion in the refrigerator, take 1 glass with meals.

Complications of angina pectoris

Attacks of ischemia are fraught not only with serious complications, but also with a fatal outcome. Why is angina pectoris dangerous? Often, patients develop cardiosclerosis, after which myocardial infarction progresses - the most dangerous consequence of the disease. A symptom of such a pathology is considered to be a prolonged coronary attack - up to half an hour. Long-term complications of angina pectoris are the development of arrhythmia and chronic heart failure.

Prevention

For decades, aspirin (acetylsalicylic acid) has been used to prevent thrombosis and coronary disease, but long-term use of it can lead to problems with gastrointestinal tract such as heartburn, gastritis, nausea, stomach pain, etc.
To reduce the risk of such undesirable consequences, it is necessary to take funds in a special enteric coating. For example, you can use the drug "Trombo ACC®" *, each tablet of which is coated with an enteric film coating that is resistant to of hydrochloric acid stomach and dissolves only in the intestines. This avoids direct contact with the gastric mucosa and reduces the risk of heartburn, ulcers, gastritis, bleeding, etc.

In order to avoid an attack, it is necessary to follow some recommendations: quit smoking, alcohol, consumption of fatty foods, monitor body weight. Even second hand smoke may lead to the development of coronary heart disease. Causes angina pectoris and hypodynamia. Most people spend their lives sitting in front of computers and TV. Moderate exercise will reduce the risk of developing heart disease. People with diabetes and hypertension are at risk - they should especially monitor their weight and nutrition.

Video

* There are contraindications, before use it is necessary to consult a specialist

Sudden attacks of pain behind the chest, burning between the shoulder blades can be signs of angina pectoris. The disease is common in patients old age and those who suffer from partial obstruction of the coronary arteries. It is important to know what other symptoms are present with heart disease in order to see a doctor in time and start treatment.

What is angina

A heart attack that occurs during physical and psycho-emotional stress is called angina pectoris. This disease is accompanied by discomfort in the chest (pain, burning, heaviness), which is why in the past it was called angina pectoris. According to medical statistics, people with angina pectoris are at several times the risk of developing coronary heart disease. All in all medical directory diseases (ICD-10) cardiac pathology passes under codes I20-24.

Symptoms

characteristic feature An angina attack is a sharp, pressing or burning pain. Often discomfort localized behind the sternum, in the region of the heart or in the center of the chest. Somewhat less often, patients complain of pain in the neck, jaw, legs, arms, or burning between the shoulder blades. Heart attacks are short-term in nature - from 3 to 15 minutes. They disappear at rest or after taking Nitroglycerin tablets under the tongue.

Other symptoms include:

difficulty breathing, feeling short of breath;
increased blood pressure;
tachycardia - rapid heart rate up to 90 beats per minute or more;
bouts of nausea, vomiting;
feeling of fear, anxiety, panic attacks;
sweating;
loss of sensation in the fingers;
pallor skin;
dyspnea.

The reasons

Attacks occur due to insufficient supply of the heart muscle (myocardium) with blood, nutrients and oxygen. This happens as a result of the development of atherosclerosis, when cholesterol plaques narrow or completely clog the lumen of the coronary vessels leading to the heart. During physical or emotional stress, when the myocardium needs additional blood flow, but narrow vessels cannot deliver the required amount, sharp pain. The formation of atherosclerotic plaques contribute to:

the use of fatty foods, smoked meats, fast food;
smoking, alcohol abuse;
taking some medicines;
hormonal disorders, including menopause;
violation metabolic processes in the body;
increased blood clotting.

Often, angina attacks happen when a person is under a lot of stress or excitement, climbing stairs, or playing hard sports. Somewhat less often, acute pain occurs when leaving a warm room for cold, infection or allergic reactions. Other reasons include:

spasms of the coronary arteries and coronary vessels;
ischemic heart disease;
damage to blood vessels by viruses and bacteria (herpes virus, chlamydia, cytomegalovirus);
thrombosis or thromboembolism;
left ventricular hypertrophy;
cardiomyopathy;
tachycardia;
abnormal development of arteries or myocardium.

According to medical statistics, men are more prone to seizures than women. Doctors attribute this to the ability female body produce hormones that inhibit the development of atherosclerosis. In addition to men, the risk group includes:

people who are overweight, obese;
street food lovers;
hypertension;
patients with diabetes;
people who are addicted to smoking drugs;
elderly patients;
those who lead a sedentary lifestyle.

Classification

For the convenience of diagnosing the severity of the course of the disease, doctors usually divide angina pectoris into three main groups:

stable - the course does not worsen over time;
unstable - characterized by atypical symptoms and causes;
painless (silent) - the development of the disease proceeds without any obvious external signs.

The stable variant is also called exertional angina, since the occurrence of attacks is directly related to physical exertion, stress, and strong emotions. Depending on the severity of the pathology, it is divided into several functional classes (FC):

FC 1 - characterized by a rare occurrence of short-term seizures. The pain appears when doing physical exercises at a too fast pace, due to wearing uncomfortable heavy objects, during an emotional outburst.
FC 2 - acute pain behind the sternum appears when walking fast, while climbing stairs, after eating too fatty or high-calorie foods.
FC 3 - discomfort in the chest occurs even with minor physical exertion, immediately after going out into the cold, minor emotions.
FC 4 - attacks appear with any physical activity. A person becomes unable to perform even the slightest self-care actions.

Unstable angina is characterized by the manifestation of atypical symptoms, when the attack lasts longer or, conversely, shorter than usual, provoked by unexpected factors. In addition, the unstable type also includes a disease that changes the nature of the course over time. Currently, there are such types of angina pectoris:

Primary - the disease occurred for the first time and did not last longer than a month.
Progressive - characterized by a sharp increase in the intensity, number, duration of angina attacks.
Postinfarction - pain appears 10-14 days after myocardial infarction.
Variant or Prinzmetal's angina - sudden pain can overtake the patient during sleep, rest during the day, when the body is in a relaxed state. The causes of the development of such an ailment are not atherosclerotic plaques, but spasms of the coronary vessels.

The most dangerous type is painless or silent angina. The patient does not feel any discomfort during exercise, and the disease is detected during a routine examination. This type of pathology is divided into 3 groups:

Type 1 is diagnosed in patients with severe coronary artery obstruction. These people often have a distorted perception of pain.
Type 2 is detected in patients who have recently had a myocardial infarction or have several risk factors for coronary heart disease.
Type 3 is diagnosed in patients with ischemic heart disease and arterial hypertension, diabetes mellitus or obstructive pulmonary disease.

Complications

It is important to understand that angina is not just a fleeting pain syndrome, but the most important signal that the heart needs help. The part of the organ cut off from the blood circulation eventually experiences oxygen starvation, lacks the necessary nutrients and loses the rhythm of work. All this can lead to very sad consequences:

myocardial infarction;
cardiac arrest;
thrombosis in the vessels of the brain and stroke;
lethal outcome.

Diagnostics

The doctor will first draw up a medical history, based on the patient's complaints, determine the intensity of the course of the disease and the root cause. To clarify the diagnosis, instrumental and laboratory methods diagnostics. These include:

General and biochemical analysis blood - is necessary to determine the level of cholesterol in the blood and the presence of prerequisites for the development of atherosclerosis.
Holter monitoring. For the procedure, the patient must wear a special device during the day, which fixes the work of the heart and leads the control of blood pressure. Thanks to the data received, doctors determine at what time the violation occurs. heart rate.
ECG (electrocardiography) physical activity – additional research, is prescribed for inaccurate results of a previous analysis in a hospital using an exercise bike or treadmill.
Computed multispiral tomography is necessary if patients complain of pain uncharacteristic of angina pectoris.
Scintigraphy is an analysis that helps to identify abnormalities and damaged areas of the myocardium by introducing radioactive isotopes into the body.
Coronary angiography is a method for examining the coronary arteries based on the use x-rays. Coronary angiography helps doctors to determine the condition of the vessels leading to the heart, to diagnose their narrowing or blockage.
EchoCG (endovascular echocardiography) - modern method ultrasound examination of the coronary vessels. Diagnostics helps doctors determine the size of an atherosclerotic plaque, determine the likelihood of a blood clot.

Treatment of angina pectoris

To treat angina pectoris, doctors may resort to conservative or surgical treatments. Surgical intervention carried out only in severe cases and strictly according to indications. conservative methods treatment a person must adhere to throughout life. Their action is aimed at achieving the following results:

prevention of stroke and myocardial infarction;
prevention of disease progression;
improving the patient's quality of life;
reduction in the frequency, intensity and duration of seizures;
stopping the development of atherosclerosis, cleansing blood vessels from atherosclerotic plaques;
relief of pain syndrome.

At the time of treatment, the patient needs to minimize physical activity, avoid stress and a strong surge of emotions. At the stage of rehabilitation, the patient is prescribed physiotherapy exercises. An integral part conservative therapy is a diet with a significant restriction of fats and salt. Proper nutrition helps to reduce levels bad cholesterol in the blood and relieve symptoms.

Food calories should be reduced by 10-15% of your daily diet, and in patients with severe obesity by 20%. The menu should be built so that you eat no more than 80 g of fat, 400 g of carbohydrates and 8 grams of salt per day. The amount of protein should be calculated based on your body weight: 1.5 grams per 1 kg of weight. With angina pectoris, the following products are strictly prohibited:

ham;
sausages;
sausages;
potato;
soy sauce;
snacks like crackers or chips;
mayonnaise, ketchup;
fatty dairy products;
fatty meats - pork, lamb, duck, lard;
vegetable and milk fats - butter, margarine, lard, sunflower oil, cream;
sweet carbonated drinks;
pickles;
smoked meats;
muffin, fresh bread, sweets.

You need to eat often, but in small portions. The preferred culinary processing of dishes is boiling, stewing, steaming, baking. The menu must be built on the basis of such heart-healthy products:

cereals - oatmeal, buckwheat porridge, couscous, millet;
predominantly green vegetables - cucumbers, zucchini, spinach, asparagus, cabbage;
fresh fruits and berries - watermelon, all citrus fruits, bananas, kiwi, avocados, blueberries;
legumes;
seafood and sea fish - salmon, mackerel, sardines, trout;
nuts;
rye or bran bread;
mineral water, herbal teas, juices.

First aid

If you notice that close person suddenly turned pale, put his hand on his heart, and drops of sweat appeared on his forehead, in this case it is required urgent care during an attack of angina pectoris. Your actions should be as follows:

Try to seat or lay the victim, open his neck by unbuttoning the collar.
If the incident occurs indoors, open windows to allow air to flow. fresh air.
Look in the first aid kit or in the victim's pockets for Nitroglycerin, Nitrolingval, Valocordin, Validol, or half an Aspirin tablet and put it under his tongue.
Record the time. If after 2-3 minutes the patient does not feel better, immediately call an ambulance.

Today, some medicines for emergency withdrawal heart attack(nitrates) are released as liquid aerosols. They act faster and much more effectively than their counterparts in tablets. Before spraying, the spray bottle with the product must be thoroughly shaken 2-3 times and inject one dose of the aerosol under the tongue. Liquid nitrates include preparations under trade name:

Isoket;
Nitrospray;
Nitro Mac;
Nitrosprint;
Nitromint.

Prevention of seizures and improvement of the course of pathology

Drug therapy helps to reduce the intensity, duration and frequency of seizures, prevents the development of complications. To improve the patient's condition, the following groups of drugs are used:

Beta-adrenergic blockers - Atenolol, Bisaprolol, Nebivolol. They reduce myocardial oxygen demand, eliminate the imbalance of nutrients necessary for the work of the heart.
Angiotensin-converting enzyme inhibitors (ACE inhibitors) - Lisinopril, Sonoprel, Noliprel. Medicines are prescribed to prevent and treat spasm of the coronary arteries.

Anti-sclerotic therapy

For complex therapy the doctor also selects other drugs from the group of antianginal drugs. They improve the course of the disease, help purify the blood, prevent the formation cholesterol plaques on the walls of blood vessels. These include:

Statins - Atorvastatin, Simvastatin. These drugs inhibit the release of tropic pituitary hormones, reduce the concentration of harmful cholesterol in the blood.
Means that prevent the formation of blood clots and thin the blood - Acetylsalicylic acid, Aspirin, Dipyridamole.
Fibrates - Lopid, Bezalip, Lipantil. Drugs from this group increase the amount of lipoproteins high density, which are actually cholesterol solvents. Regular use of fibrates reduces the risk lethal outcome from ischemic heart disease.

Surgical intervention

The operation is prescribed only in particularly severe cases, when non-invasive methods of therapy have not yielded results or an atherosclerotic plaque has almost completely blocked the lumen of the coronary artery. Among the methods of surgical treatment are used:

Coronary artery bypass grafting is an operation to restore the function of hematopoiesis in the heart by bypassing the site of vasoconstriction using shunts (special vascular prostheses). Contraindications for the procedure are serious illnesses lungs or liver.
Balloon angioplasty is a method of arterial stenting based on the introduction of a special balloon into the blood vessel, which, with the help of pumped air, expands the narrowing site. After artificial expansion of the vessels, a stent (metal frame) is installed in place of the formed lumen.

Drugs for angina pectoris

Like any other disease of cardio-vascular system, angina attacks are treated with a combination of several groups of drugs that, interacting with each other, provide the maximum therapeutic effect and prevent the development of complications. These medicines must be taken regularly, strictly following the dosage and prescriptions of the doctor.

Nitrates

Pharmacological agents based on nitrates are still one of the most reliable means for stopping heart attacks. They reduce myocardial oxygen demand, quickly relieve painful spasm blood vessels that help drain blood from the heart. Such funds are produced in the form of tablets and liquid aerosols for spraying into the mouth. This pharmacological group includes dozens of different tools. The most popular include:

Nitroglycerine;
Nitrong;
Trinitrolong;
Erinite;
Isolong;
Dilasid.

Quickly relieves pain attack Nitroglycerin. The drug is available in the form of small white tablets, a solution in oil and microgranules. The action of the active component (nitroglycerin) is aimed at expanding peripheral veins, reducing blood flow to the right atrium and reducing vascular resistance. The medicine is taken at the time of the attack, under the tongue. During the use of the product, slight dizziness, dry mouth, tachycardia may occur. Nitroglycerin is categorically contraindicated in the presence of the following diagnoses:

craniocerebral hypertension;
uncontrolled hypovolemia;
mitral stenosis;
collapse;
hemorrhagic stroke;
toxic edema lung;
closed form glaucoma;
violation cerebral circulation;
pregnancy;
arterial hypertension.

For those who do not like to take pills, drug manufacturers have developed special transdermal stickers with a slow release of nitroglycerin. The Nitroderm patch has proven itself well. When applied to the skin, it provides a continuous supply of nitroglycerin to the blood for 24 hours. The patch is glued on the anterolateral surface of the chest (left) or on the left forearm. Nitroderm is contraindicated in stroke, hypotension, glaucoma. With prolonged use of the patch, the following side effects are possible:

allergic shock;
collapse;
pulmonary edema;
promotion intraocular pressure;
acute disorder cerebral blood supply.

Beta blockers

Drugs from this pharmacological group reduce the number of heart contractions, thereby reducing myocardial oxygen demand. The action of drugs begins with increased physical activity and automatically slows down when the patient is at rest. Popular beta-blockers include:

Atenolol is a drug with a selective principle of action. It does not affect the entire body, but only the heart and the coronary vessels that feed it. The drug relieves or prevents the occurrence of angina attacks, helps the myocardium to cope with the increased load. By following the instructions adverse reactions occur extremely rarely. Main contraindications: bradycardia, period breastfeeding, heart failure.
Betaxolol - tablets of prolonged action. It is necessary to take the drug only 1 time per day at a dosage of 10 mg. Betaxolol is prescribed with caution to patients with diabetes mellitus, kidney failure, pregnant. In case of accidental overdose, convulsions, headaches, bronchospasm are possible.

calcium channel antagonists

These drugs for the treatment of angina pectoris block the formation of complex proteins, due to which spasm of blood vessels is excluded, the frequency of contractions of the heart muscle decreases, and blood flows from the myocardium. Among the antagonists calcium channels more commonly prescribed are:

Diltiazem. The drug has a vasodilating effect, antiarrhythmic action, reduces the flow of calcium ions to the myocardium, reduces the tone of smooth muscles. For the prevention of seizures, tablets are taken orally before meals according to an individual dosage. Diltiazem has an impressive list of contraindications and side effects.
Gallopamil. An anti-ischemic drug reduces myocardial oxygen demand, reduces heart rate, and dilates blood vessels. The dosage of the drug is prescribed based on the severity of the underlying disease - from 50 to 100 mg twice a day. Like its predecessor (Diltiazem), Gallopamil has wide list side effects. Main contraindications: pregnancy, hypotension, kidney disease, congenital diseases hearts.

Anticoagulants and antiplatelet agents

This group of drugs is designed to thin the blood. Anticoagulants and antiplatelet agents suppress the production of platelets, reduce the risk of thrombosis of veins and arteries. Popular medications include:

Warfarin. The anticoagulant inhibits the hepatic synthesis of vitamin K, which affects blood clotting, and prevents the formation of new blood clots. The dose is selected individually for each patient. It is prescribed with caution in diseases of the liver or kidneys, diabetes mellitus, alcoholism, arterial hypertension. An overdose of Warfarin can cause uncontrolled internal bleeding.
Dipyridamole. Antiplatelet expands blood vessels, increases the oxygen content in venous blood. The drug is categorically contraindicated in myocardial infarction, hypotension, peptic ulcer. During treatment with dipyridamole, tachycardia, nausea, and allergic reactions may occur.

Sedatives

With attacks of angina pectoris caused by excessive nervous excitement, sedative drugs are indicated. In complex therapy cardiovascular diseases they are used as sedatives. The doctor may prescribe:

Persen is a herbal medicine based on valerian, peppermint. Phytopreparation has a sedative effect, helps relieve spasm of the coronary vessels, eliminate the symptoms of nervous excitability. Persen rarely causes negative effects, among which are more common allergic reactions. The agent is contraindicated in case of individual intolerance to the composition, deficiency of lactase, sucrose, hypotension.
Tenoten - lozenges based on antibodies to a brain-specific protein. The drug improves the tolerance of psycho-emotional stress, normalizes the work of the cardiovascular system. There are no side effects when used as directed. With caution, Tenoten is prescribed to children and pregnant women.

Diuretics

Diuretics help to get rid of excess liquid from the body and thereby relax the heart muscle. Diuretics are prescribed only in conjunction with calcium antagonists and adrenoceptor blockers. Doctors often recommend such remedies:

Chlortalidone. The drug has low toxicity, quickly reduces arterial pressure relieves swelling. For therapeutic purposes, it is taken once a day. Chlortalidone has multiple side effects and should be used with caution in bronchial asthma, diabetes mellitus, systemic lupus erythematosus.
Lasix is a drug based on furosemide. The drug is prescribed only in cases where weaker diuretics have not brought the desired effect. Lasix quickly reduces pressure, promotes the active removal of fluid from the body. Categorical contraindications are: anuria, lactation period, hepatic coma.

Statins

If the patient has an increased risk of developing myocardial infarction, statins are added to therapy. This pharmacological group reduces the level of bad cholesterol in the blood, prevents the formation of atherosclerotic plaques. Commonly used medications include:

Simvastatin is a lipid-lowering drug based on ascorbic acid. The drug prevents the early stage of cholesterol synthesis, reduces blood clotting. While taking the pills, the doctor additionally prescribes a hypocholesterol diet. The dosage of the drug is selected individually. Simvastatin has multiple contraindications and side effects.
Atorvastatin is a tablet from the group of statins, developed on the basis of calcium dihydrate. The drug reduces the synthesis of cholesterol in the liver, helps cleanse blood vessels from atherosclerotic plaque. Atorvastatin is not prescribed during pregnancy, liver failure, during lactation. Tablets can provoke insomnia, chest pain, ringing in the ears, dizziness.

vitamins

As aids, besides sedatives, appoint a reception of special vitamin complexes. Strengthen the walls of blood vessels, prevent the deposition of harmful cholesterol, normalize the work of the heart vitamins of the following groups: C, E, PP, B6 and 11. Mineral supplements with magnesium, potassium, phosphorus will also benefit. Popular and effective vitamin-mineral complexes for cores include:

Askorutin;
Vitrum Cardio;
Cardio Forte;
Cardiohealth;
Hawthorn Forte.

ethnoscience

Some help with angina pectoris herbal remedies, often used in traditional medicine. If you are often attacked by pain behind the sternum, burning between the shoulder blades, prepare medicines according to the following recipes:

Pour 1 liter of honey, juice from 10 lemons, 5 crushed garlic heads into a three-liter jar. Mix the ingredients thoroughly, put in a dark place for a week to infuse. Take medicine for 2 tbsp. l. every morning on an empty stomach, slowly dissolving in the mouth. The course of treatment is 2-3 months.
In a thermos, pour 4 tbsp. l. hawthorn. Pour raw materials with 1 liter of boiling water. Insist under a towel for 12 hours. Take infusion instead of tea all day long. You can use the drink to prevent angina pectoris all the time.
Brew in a thermos 4 tbsp. l. mint, 1 tbsp. l. valerian, bay raw materials 1 liter of boiling water. Infuse the drink for 4-5 hours, then filter. The entire volume must be drunk throughout the day. The course of treatment is indefinite.

Prevention

Measures to prevent the development of angina pectoris include the following rules and recommendations:

complete cessation of alcohol and smoking;
switching to healthy foods rich in heart-healthy vitamins and minerals;
refusal of fatty, fried, salty;
maintaining normal weight;
active lifestyle - swimming, light gymnastics;
regular preventive examination by a cardiologist.

Video

Heart diseases are always accompanied by unpleasant symptoms, but usually they give the patient a "break" during sleep or rest. But there are pathologies that are ready to hit a person at any moment. These include and, the attacks of which often occur at rest, during the fast phase of sleep. In more detail, we will tell you about what rest angina is, what are its symptoms and treatment.

Features of the disease

Resting angina is one of the clinical forms ischemic disease. AT medical practice it is referred to as unstable forms of angina pectoris, and also assigned to it the IV functional class.

The peculiarity of the pathology is in attacks of pain of an angiosity nature, which occur in the absence of any factors predisposing to this, that is, when the patient is at rest. In this case, the condition is accompanied by severe suffocation and fear of death.

Statistics show that men over the age of 50 get sick more often than women by about 1.5 times. The condition can develop in any age group.

Classification and forms

There is no clear classification of pathology, however, in medical practice, there are two forms:

, which develops against a background of spasm of the coronary arteries;
, which appears 2 weeks after;

There is a division of the joint venture downstream into acute and subacute forms.

The first case is diagnosed if the patient has experienced seizures in the last 48 hours.
In the subacute form, the patient had seizures in the last month.

Causes

The main cause of rest angina is atherosclerosis. coronary arteries clogged with atherosclerotic plaques, which affects blood circulation and the delivery of nutrients to the heart muscle. In addition, the cause of the joint venture can be:

hypertension;
coronaritis;
increased tone of the vagus nerve;

There is also a group of factors that can influence the development of rest angina. These include:

fever
anemia
addiction to bad habits;
infectious diseases in history;
diabetes;
thyrotoxicosis;
tachyarrhythmia;

Hereditary predisposition has a great influence on the appearance of the disease. Often, angina of motion can flow into a form of rest angina.

For more information on how to identify rest angina, the following video will tell:

Symptoms

Characteristic for any form of angina pectoris, angio pain occurs in a patient even during the absence of physical activity. activity. Most often the pain occurs in the early morning or sleep. In the latter case, the patient may dream that he is lifting weights or running: this is the effect of the pain that affects a person during the REM phase, since it excites the autonomic nervous system and generates the release of catecholamines. The pain is characterized by patients as pressing and strong, spreading to some parts of the body, such as the jaw or shoulder blade.

An angina pectoris attack is accompanied by such sensations and signs:

anxiety;
anxiety;
fatigue;
nausea;
increased sweating;
dizziness;
pallor or flushing of the skin;
elevated blood pressure;

Diagnostics

Diagnosis of angina pectoris must be carried out in a hospital, since a routine examination will not allow an accurate diagnosis. Before identifying the patient in the hospital, the doctor must conduct a physical examination and auscultation, which reveals noise in the listening area.

Already by definition of the patient, such diagnostic studies, how:

General blood and urine tests to identify concomitant pathologies and diseases.
Blood chemistry to assess levels of cholesterol, glucose, triglycerides, and other compounds that help determine the cause of angina.
ECG. Detects the rise or fall of the ST segment, and muscle conduction.
Stress tests, for example, bicycle ergometry or a treadmill test, which are rarely prescribed due to low information content.
Daily ECG monitoring that detects signs of ischemia.
echocardiography to determine concomitant diseases, myocardial contractility.
Coronary angiography to evaluate the condition of the coronary arteries.
PET to determine the location of ischemia.

In the early stages, differential diagnosis, which is designed to distinguish angina pectoris from pleurisy, ulcers and. About how to treat angina pectoris of IHD, read on.

Treatment

Treatment of angina at rest is a combination of therapeutic and medical methods. The main treatment can be carried out outside the hospital, provided that the patient's condition is constantly monitored.

Therapeutic way

The foundation therapeutic method- change your lifestyle. It is important to direct it in a healthy direction: give up bad habits, teach yourself to eat right and observe moderate physical activity. activity.

For the duration of drug treatment, it is better to follow the following diet:

Animal fats - no more than 30% of the calorie content of food.
Saturated fats - no more than 30% of the total number of fats.
Cholesterol - less than 300 mg / day.
Focus on fruits, grains and vegetables.
Limit your salt intake.

If the patient is obese, it is necessary to attend to weight loss. It is better not to use shock diets: sufficient healthy eating and sports.

medication

basis drug therapy is nitroglycerin. It is this drug that can stop an attack of angina pectoris. Nitroglycerin is prescribed in a dosage of up to 0.5 mg under the tongue, and it begins to act within 5 minutes. from the moment of acceptance. Nitroglycerin analogs may also be prescribed, for example:

Sustaq. Begins to act after about 10 minutes. after acceptance.
Trinitrolong. Domestic drug with the best price.

Note! If the attack lasts more than 10 minutes, it is necessary to resort to analgesics, as this can become a symptom of an incipient myocardial infarction.

Also, with rest angina, drugs such as:

Antihypertensive if the patient has sustained high blood pressure.
Beta-blockers, which reduce myocardial oxygen demand and slow down the heart.
ACE inhibitors if the patient has symptoms.
Anticoagulants if the risk of thromboembolism is high.

Other drugs may also be prescribed, for example, diuretics, immune support, and others.

Surgical

Operations for rest angina pectoris are performed only in case of severe heart damage. Usually prescribed:

Coronary angioplasty, in which a metal stent is installed in the affected vessel, thereby improving blood flow.
Coronary artery bypass grafting. Using biological material, surgeons create a bypass for blood to enter the heart muscle.

Against the background of angina pectoris can develop severe conditions that damage the heart so much that something can't work properly. In this case, the patient needs a heart transplant.

Disease prevention

Preventing angina pectoris is easier than getting rid of it. If a person is at risk, it is important for his health to reconsider his outlook on life, moreover, in all plans and adhere to simple preventive rules:

Diversify a sedentary lifestyle physical. activity.
Pay more attention to cardio exercises.
Monitor your cholesterol levels.
Switch to a diet that is as close to healthy as possible.
Avoid stressful situations.
and reduce the amount of alcohol.

It is also important to visit preventive examinations cardiologist and take only those medicines that the doctor prescribes.

The following video will tell you how to treat and how to eat right for angina pectoris:

First aid for rest angina

An attack of angina pectoris can take the patient by surprise, so he and his relatives need to set themselves up for the fact that first aid will have to be provided at any time. To ease the attack, you must:

Give the patient a sitting and comfortable position.
Put 1 table under the tongue. glycerin or a piece of sugar with 1-2 drops. one; solution of nitroglycerin.
If after 5 min. the drug had no effect, then the previous paragraph must be repeated. At one time, you can take no more than 3 tablets. with breaks of 5 min.
To eliminate the headache, give the patient Validol or Citramon.
If the patient has tachycardia or cardiac arrhythmia, it is necessary to give him an adrenergic blocker, for example, Anaprilin or Metaprolol.

If the repeated intake of nitroglycerin did not relieve the pain within 15 minutes, and the patient complains of weakness and increased pain symptoms, it is urgent to call an ambulance, since there is a high risk of developing myocardial infarction.

Complications

Most often, rest angina is complicated by the fact that it goes into. In this case, without treatment, the patient may need surgery. Also, the joint venture can develop into:

myocardial infarction;