Angina pectoris (angina pectoris) - attacks of sudden chest pain due to acute lack of blood supply to the myocardium - a clinical form of coronary heart disease.
In most cases, angina pectoris is due to atherosclerosis of the coronary arteries of the heart; the initial stage of the latter limits the expansion of the lumen of the artery and causes an acute deficiency of blood supply to the myocardium with significant physical and / or emotional stress; sharp atherosclerosis, narrowing the lumen of the artery by 75% or more, causes such a deficit even at moderate stresses.
The appearance of an attack is facilitated by a decrease in blood flow to the orifices of the coronary arteries (arterial, especially diastolic hypotension of any, including medicinal, origin or a drop in cardiac output during tachyarrhythmias, venous hypotension); pathological reflex influences from the biliary tract, esophagus, cervical and thoracic spine with their concomitant diseases; acute narrowing of the lumen of the coronary artery (non-occlusive thrombus, swelling of the atherosclerotic plaque).
With angina pectoris, pain is always distinguished by the following symptoms:
• Has the character of an attack, that is, it has a clearly defined time of onset and cessation, decay;
• Occurs under certain conditions, circumstances;
• It begins to subside or completely stops under the influence of nitroglycerin (1 - 3 minutes after its sublingual intake).
Conditions for the appearance of an attack of angina pectoris: most often - walking (pain when accelerating movement, when going uphill, with a sharp headwind, when walking after eating or with a heavy load), but also other physical effort, and / or significant emotional stress ... The conditionality of pain by physical effort is manifested in the fact that with its continuation or increase, the intensity of pain inevitably increases, and when the effort stops, the pain subsides or disappears within a few minutes.
Relief of an attack:
• Calm, preferably sitting position of the patient;
• Nitroglycerin under the tongue (1 tablet or 1 - 2 drops of 1% solution on a piece of sugar, on a tablet of validol), repeated administration of the drug if there is no effect after 2 - 3 minutes;
• Corvalol (valocardin) - 30 - 40 drops orally for sedative purposes;
• Arterial hypertension during an attack does not require urgent medical measures, since a decrease in blood pressure occurs spontaneously in most patients;
• If nitroglycerin is poorly tolerated (bursting headache), then a mixture of 9 parts of 3% menthol alcohol and 1 part of 1% nitroglycerin solution is prescribed, 3-5 drops on sugar per dose.
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