Angina pectoris (angina pectoris) - attacks of sudden chest pain due to an acute lack of blood supply to the myocardium - a clinical form of coronary heart disease.
In most cases, angina pectoris is caused by 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 shortage of blood supply to the myocardium with significant physical and/or emotional overstrain; sharp atherosclerosis, narrowing the lumen of the artery by 75% or more, causes such a deficit already at moderate stresses.
The onset of an attack is facilitated by a decrease in blood flow to the mouths of the coronary arteries (arterial, especially diastolic hypotension of any, including medicinal, origin or a drop in cardiac output with tachyarrhythmia, 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-obstructive thrombus, swelling of atherosclerotic plaque).
With angina pectoris, pain is always characterized by the following symptoms:
• It has the character of an attack, that is, it has a clearly defined time of occurrence and termination, remission;
• Occurs under certain conditions, circumstances;
• Begins to subside or completely stops under the influence of nitroglycerin (1 - 3 minutes after its sublingual intake).
Conditions for the onset of an attack of angina pectoris: most often - walking (pain when accelerating, when climbing uphill, with a sharp headwind, when walking after eating or with a heavy burden), but also other physical effort, and (and) 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 is stopped, 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 a 1% solution on a piece of sugar, on a validol tablet), repeated administration of the drug if there is no effect after 2 - 3 minutes;
• Corvalol (valocardin) - 30 - 40 drops inside with a sedative purpose;
• Arterial hypertension during an attack does not require emergency medical measures, since the 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 a 1% solution of nitroglycerin, 3 to 5 drops on sugar per reception, is prescribed.
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