Angina pectoris
Summary/Definition
Angina pectoris is a pathological condition in which there is a lack of blood supply to the myocardium due to atherosclerosis-induced stenosis of the coronary artery responsible for supplying blood to the heart. This condition is characterized by a feeling of heaviness and pressure in the heart. Angina pectoris is classified as stable angina, unstable angina, and spontaneous angina (resting angina). The most common cause of Angina pectoris is the development of atherosclerosis of the coronary arteries, which causes these arteries to narrow due to cholesterol build-up and fatty deposits on their walls. The risk factors for Angina pectoris are smoking, hyperlipidemia, diabetes mellitus, high blood pressure, etc. Besides the above factors, risk factors also include obesity, low levels of physical activity, stress, etc.
Symptoms
The most common manifestations of Angina pectoris are pain and discomfort in the chest area, often spreading to the chin, shoulders, back, and arms. These pains are accompanied by a feeling of heaviness under the sternum, usually in the solar plexus area, as well as a sensation of pressure, compression, and squeezing. They may occur slowly over 2-5 minutes and then gradually diminish. When the body is in a stable state (during regression, at rest), the pain may be absent but may occur with excitement, exposure to cold, physical exertion or deficiency of important micro- and macro-nutrients for the myocardium, especially during physical activity.
Diagnostics
For diagnosis, the primary focus is on clinical symptoms, which are obtained by questioning the patient, including the nature and duration of chest pain, general symptoms, the patient’s history of previous illnesses, current medication, etc. Various investigative techniques may be used to confirm the diagnosis, such as electrocardiography (ECG), echocardiography, radionuclide tests, coronary arteriography, etc.
Treatment and course of the disease
For mild forms of the disease, treatment with medication is possible, as well as interventional procedures or surgery to prevent recurrences and relieve symptoms in the early stages. Suppose therapeutic recommendations for the treatment of angina pectoris are not followed. In that case, there may be an increased risk of myocardial infarction, so comprehensive preventive measures are important to stabilize the body and prevent myocardial infarction. When symptoms of myocardial infarction develop, heart attacks and heart failure may occur, which can lead to worsening heart function. The symptoms of unstable angina or myocardial infarction to look out for include short-term or worsening pain. Comprehensive drug treatment including nitrates, beta-blockers, calcium channel blockers, evolocumab, angiotensin-converting enzyme inhibitors, hypolipidemic drugs, and other agents are used to stabilize symptoms and prevent myocardial infarction. In addition, invasive treatment methods are used, such as percutaneous coronary angioplasty, aortocoronary bypass, etc.
