Angina pectoris (angina pectoris) is a disease characterized by bouts of severe pain and a feeling of compression behind the sternum or in the heart. The immediate cause of an attack of angina pectoris is a decrease in the supply of blood to the heart muscle.
Clinical symptoms of angina pectoris.
Angina pectoris is characterized by sensations of compression, heaviness, bursting, burning behind the sternum that occur during physical exertion. Pain can spread to the left arm, under the left shoulder blade, to the neck. Less commonly, pain is given to the lower jaw, the right half of the chest, the right arm, and to the upper abdomen.
The duration of an attack of angina pectoris is usually several minutes. Since pain in the heart often occurs during movement, a person is forced to stop, after a few minutes of rest, the pain usually goes away.
A pain attack with angina pectoris lasts more than one, but less than 15 minutes. The onset of pain is sudden, directly at the height of physical activity. Most often, such a load is walking, especially with a cold wind, after a plentiful meal, when climbing stairs.
The end of pain, as a rule, occurs immediately after a decrease or complete cessation of physical activity or 2-3 minutes after taking Nitroglycerin under the tongue.
Symptoms associated with myocardial ischemia are a feeling of lack of air, difficulty breathing. Dyspnea occurs under the same conditions as pain behind the sternum.
Angina pectoris in men is usually manifested by typical bouts of pain in the sternum.
Women, elderly people and patients with diabetes mellitus during myocardial ischemia may not experience any pain, but feel a frequent heartbeat, weakness, dizziness, nausea, increased sweating.
Some people with coronary heart disease do not experience any symptoms during myocardial ischemia (and even myocardial infarction). This phenomenon is called painless , “silent” ischemia.
Pain in the heart that is not associated with coronary insufficiency is cardialgia .
The risk of developing angina pectoris.
Risk factors are features that contribute to the development, progression and manifestation of the disease. Many risk factors play a role in the development of angina pectoris. Some of them can be influenced, others not, that is, factors can be removable or unremovable.
- Fatal risk factors are age, gender, race, and heredity. Men are more prone to angina than women. This trend persists until approximately 50–55 years, that is, until the onset of menopause in women. After 55 years, the incidence of angina in men and women is approximately the same. Black Africa rarely suffer from atherosclerosis.
- Removable causes.
- Smoking is one of the most important factors in the development of angina pectoris. Smoking with a high degree of probability contributes to the development of coronary heart disease, especially if combined with an increase in total cholesterol. On average, smoking shortens life by 7 years. Smokers also increase the content of carbon monoxide in the blood, which leads to a decrease in the amount of oxygen that can enter the body’s cells. In addition, nicotine contained in tobacco smoke leads to spasm of the arteries, thereby leading to an increase in blood pressure.
- An important risk factor for angina pectoris is diabetes . In the presence of diabetes, the risk of angina pectoris and coronary heart disease increases on average by more than 2 times.
- Emotional stress can play a role in the development of angina pectoris, myocardial infarction, or lead to sudden death. With chronic stress, the heart begins to work with increased stress, blood pressure rises, oxygen and nutrient delivery to organs deteriorates.
- Lack of exercise or lack of physical activity. It is another removable factor.
- Arterial hypertension is well known as a risk factor for angina pectoris and ischemic heart disease. Hypertrophy (enlargement) of the left ventricle as a result of arterial hypertension is an independent, strong prognostic factor for mortality from coronary disease.
- Increased blood clotting , can lead to thrombosis.