Angina pectoris: definition
Angina or "angina" is a lack of blood perfusion and thus oxygen to the myocardium (or heart muscle) due to a "contamination" of the coronary arteries (arteries of the heart) due to atherosclerosis .
This lack of perfusion did not feel at rest and is most evident in the efforts, when the heart muscle increases its oxygen consumption.
The blood supply of oxygen is insufficient for the needs of the heart muscle.
This imbalance results in a transient pain (few minutes) and reversible "angina".
It reflects the suffering of the heart.
Angina is almost always due to a clogged coronary arteries by atherosclerosis.
The coronary arteries are the heart and bring vascularize continuously oxygen and substances necessary for its contraction.
Atherosclerosis consists of deposits of excess cholesterol in the blood in the wall of all arteries, including coronary artery (the arteries of the heart).
These lesions progress slowly over years. They reduce the caliber of coronary and slow the flow of blood.
More rarely it may be the site of a clot that is formed rapidly, resulting in occlusion of a coronary artery responsible for infarction, that is to say, the destruction from lack of oxygen from one part ofheart muscle.
It is manifested by chest pain occurring during or just an effort of it waning.
Typically, the pain starts quite suddenly between the breasts, is felt as a tightness in the chest of every vice.
Then the pain can radiate into the throat, jaw, shoulders, arms or back.
Depending on the size of lesions of the coronary arteries, this pain can occur during minimal efforts (walking, bathing, dressing) or otherwise appear only during strenuous activity.
Factors such as cold, stress, walking against the wind or high temperatures can trigger attacks of angina.
The pain of angina disappears completely within minutes after stopping exercise or after taking nitroglycerin tablet or spray to be sprayed under the tongue.
This is the essential difference with the pain of infarction, which itself persists despite taking these drugs.
Diseases whose symptoms are similar?
Angina pectoris: Prevention
We must first correct the risk factors:
- Stop smoking, diabetes, balance, normalize your cholesterol, - have blood pressure and weight within normal limits, - regular physical activity in the form of endurance exercise (jogging, cycling, swimming. ..).
Compliance with these measures to slow the progression of atherosclerosis and significantly reduce the risk of developing angina.
The contributing factors (or risk factors for cardiovascular disease) the development of coronary atherosclerosis are:
- Age and male - tobacco - diabetes - high cholesterol, especially "bad cholesterol" - the existence of myocardial infarction, angina pectoris or arteritis of legs in the family - high blood pressure.
The diagnosis is mainly based on symptoms described to the doctor. Indeed, tests such as ECG or echocardiography are usually outside the normal crises.
We can support the diagnosis through a stress test done under medical supervision. This will be considered positive if there is any pain of angina associated with electrocardiographic changes.
Sometimes this stress test can be coupled with an ultrasound scan or a heart (for reviews see the heart in the form of images).
Coronary angiography is the gold standard for assessing the condition of the coronary and assess the severity of the disease. It is injected into the coronary arteries a product that can be seen on x-ray and so assess the condition of the coronary arteries.
In parallel, we performed a blood test to screen for diabetes or high cholesterol.
Prescribed treatments have three objectives: reduce the frequency of angina pectoris, reducing the risk of developing a heart attack and slow the progression of atherosclerosis.
Among the families of drugs most often prescribed include:
- In small doses of aspirin - beta-blockers which slow the heart, reduce his work and the protection against arrhythmia and against the attacks of angina. - A cholesterol-lowering statin family, after a diet of good conduct .- nitroglycerin spray or sublingual tablets or sometimes in stamps to stick on the skin.
There are also drug treatment, two therapeutic "mechanical" which are coronary angioplasty (which is to lead the coronary artery using a microprobe) and CABG (setting up a bridge between the aorta and coronary artery blocked).
Both techniques are more effective than medical treatment alone.
They are offered to patients with severe injuries or those poorly controlled by medical treatment.
However, it is necessary to continue medical treatment after angioplasty or bypass surgery.
What should you do?
If chest pain or persistent after taking anti-anginal, be extended by more than 15 minutes, immediately call the 15 (SAMU).
Some important recommendations for living his angina:
Stop smoking. To control your blood artérielle.Avoir regular physical activity (walking bike ..). Avoid violent sports (tennis. ..).Take the advice of the cardiologist before any sport régulière.Corriger overweight and cholestérol.Le strict salt-free diet is not required unless otherwise médecin.Ne not hesitate to seek advice from a doctor or nutritionist. A glass of red wine with every meal is allowed. Contrary to popular belief, sexual efforts pose no particular danger.
Professionally, consider a job change if it is physical work or conduct potentially dangerous machinery.
Do not stop treatment abruptly and not to "self-medication" without a doctor's approval. See a cardiologist every six months, or sooner if the frequency of attacks augmente.Signaler to any doctor, nurse, physiotherapist, pharmacist or dentist's cardiac history and treatment have on self pris.Toujours trinitrate spray or tablets and a recent electrocardiogram. It facilitates the diagnosis in case of occurrence of chest pain compared plots.
The disease generally progresses slowly, over several years of relatively stable. The symptoms almost always occur at the same level of effort and in circumstances well known to each patient.
Some of them even manage to reduce significantly the frequency of their seizures by sparing.
The decompensation are rare but unpredictable and may take the form:
- A worsening of symptoms, angina becoming very common, debilitating "least effort" to the point of not being able to have a normal life.
- A heart attack, he must suspect every time a pain lasts more than thirty minutes despite taking nitroglycerin.
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