Diagnosis of angina

When the patient's complaints of chest pain is one of the most important tasks of the doctor - to establish whether its cause heart problems. If it is determined that the patient has angina, you should determine its type; unstable angina may need urgent treatment to prevent a heart attack.

Be sure to carry out differential diagnosis of angina in which, first of all, you need to exclude a heart attack, as well as a number of other violations, among them - pericarditis, myocarditis, pleurisy, some types of pneumonia.

In the process of diagnosis the doctor may ask the patient about when (after which activities) he has a pain in his chest, and that helps to alleviate it, what is the nature of pain, in what areas of the body, she felt, how long the pain or discomfort in the chest. If, after a preliminary examination by a doctor there are reasonable grounds to believe that the patient has angina, he may appoint a special diagnostic procedures, such as:

• Electrocardiography (ECG). This procedure allows to evaluate the frequency and regularity of the heart rate, as well as to identify some well pass through the heart of the electrical pulses. The ECG can detect signs of heart muscle damage, past or current heart attack. ECG results in angina pectoris is often completely normal, but with the help of this procedure can distinguish angina from a heart attack, and to assess the functioning of the heart during an attack;
• Stress test. During this test, doctors monitor the patient's cardiac function at rest and during exercise, and then compare the results. This method often helps to establish the type of angina pectoris, a physician if there is any doubt about the diagnosis;
• Chest X-ray. With this procedure it is possible to detect signs of cardiac failure and certain lung diseases that can cause symptoms similar to the symptoms of angina pectoris;
• Coronary angiography. This procedure can be recommended if the physician suspects that the cause of angina is coronary artery disease. During angiography using X-rays to track the movement of the arteries of a special X-ray contrast agents. To introduce this material into the coronary arteries, cardiac catheterization performed. Catheter - a thin, flexible hollow tube - through the blood vessels in the hand, the groin or the neck is introduced into the coronary artery, after which there is administered a contrast agent. Watching him move, the doctor can evaluate how blood moves in the coronary arteries and the heart, and where the blood flow is broken;
• Computed tomography angiography or CT angiography - a less invasive version of coronary angiography. During this procedure the patient to make an intravenous infusion of a contrast agent, and track its movement through the CT scanner. When a person is inside the scanner, the machine makes numerous pictures of different parts of the heart, after which the computer connects them and provides a three-dimensional image of the heart;
• Blood angina done in order to determine the level of certain types of fats, proteins, cholesterol and blood sugar Blood sugar - a very important indicator . Blood test results help determine the cause of angina.

Complications Angina

The most serious complication of a heart attack is angina. The risk of heart attack is especially high in patients with unstable angina Unstable angina - alarm organism , In the elderly and in people with hypertension. Signs of a heart attack is very similar to the symptoms of angina pectoris: strong, pressing pain in the chest Chest pain is one symptom - a lot of diseases , The pain radiates into the hands of (most of all - to the left), neck, back, stomach and jaw, nausea, shortness of breath.

If the coronary arteries of human atherosclerotic plaques are formed, limiting blood flow to the heart, there is a small chance that one plaque rupture, and this will lead to the formation of blood clots that disrupt the blood supply to any part of the brain. This is called a stroke.

Life is such a violation, as angina, can cause a person a lot of stress How to beat stress? Create an oasis   and anxiety, which sometimes leads to the development of complications such as depression. It not only affects a person's mood, but also on their physical health. If you suspect depression as soon as possible to consult with a specialist: a real clinical depression - a serious disease that passes without treatment.

What is the pericardium

Pericardium or the pericardium - a tissue envelope surrounding the heart, the aorta and the pulmonary trunk. There are fibrous pericardium - it covers all of the heart and blood vessels, and serous, which consists of two plates, one of which lines the inside of the fibrous pericardium, and the other - the outer surface of the heart. Between these two plates has a slot-like space - the pericardial cavity.

Pericardium performs important functions: it secures the heart in the chest and keeps it in its normal position, acts as a barrier to the penetration of the chest infection in the heart, prevent excessive expansion of the heart, helps to maintain the desired pressure within the heart.

Inflammation of the pericardium

Pericarditis - an inflammation of the serous pericardium. Pericarditis is rare as an independent disease, it often occurs as a complication of various infectious and noninfectious diseases.

The causes of pericarditis may include:

• infection (virus - e.g., influenza virus, bacteria, fungi, protozoa);
• deep myocardial infarction Myocardial infarction - the most formidable diagnosis ;
• immune antigen-antibody complexes which are formed during allergic processes and are deposited in the tissues;
• effects on the body of certain poisons, which may act both outside and inside (for example, impaired renal function);
• the effects of trauma, and so on

When inflammation of the pericardium in the pericardial cavity may accumulate inflammatory (serous) or purulent fluid, blood, drop fibrin (a blood protein that provides its rolling property).

Pericarditis can be dry and exudative (with the presence of fluid in the pericardial sac).

Symptoms of dry pericarditis

Dry pericarditis begins with a dull monotonous pain in the chest. Most often these pains are mild, but sometimes very strong, so that they can be confused with angina Angina: When the heart needs help . A characteristic feature of pain is their relationship with the respiratory movements and the change in body position. The patient can not take a deep breath, breathing is superficial and often. The pain intensified and with pressure on the chest in the heart area.

At the same time it may be complaints of palpitations, shortness of breath, dry cough Dry cough - whether to worry about it?   malaise, chilling.

There are three variants of the end of the process:

• recovery;
• prolonged relapsing course (characteristic of autoimmune processes - allergy own tissues);
• transition to a pericardial effusion.

Signs of exudative pericarditis

Pericardial effusion - is the next stage after dry pericarditis. At the same time all the signs of pericarditis are amplified, shortness of breath becomes a constant expression. Squeezing of the trachea is a permanent enlargement of the heart, "barking" cough ringing. Compression of the esophagus leads to difficulty swallowing, laryngeal nerve compression - to change the voice or the complete absence. Due to the limited mobility of the diaphragm is no longer involved in abdominal breathing.

Growing pale with severe cyanosis of the lips, nose, ears. Due to the stagnation of blood in the veins become swollen tissue of head and neck, and sometimes swelling extend to the shoulders and arms. The patient may appear bouts of weakness, accompanied by a small, barely perceptible pulse and the fear of death, sometimes such an attack results in a loss of consciousness.

Chronic pericardial effusion often begins slowly and quietly, with a slight shortness of breath, fatigue, dull pain in the heart. All these signs are gradually increasing.

The outcome of acute pericarditis may be the formation of pericardial adhesions (adhesion), and the fusion of the pericardium with the other organs of the mediastinum, and the organs located near the heart, are united with him in the conglomerate.

Another outcome of pericarditis can be overgrowth of connective tissue and its calcification, which can also spread to adjacent organs (pleura, lung, diaphragm), as well as the muscle of the heart.

Diagnosis of pericarditis

Diagnosis is based on typical complaints of the patient, auscultation and percussion of the heart. Confirms the diagnosis of pericarditis ultrasound (sonography), radiographic and electrocardiographic (ECG) studies. Sometimes, to establish a definitive diagnosis is required pericardiocentesis. During the puncture into the pericardial cavity by inserting a needle and take part of the exudate for laboratory examination. The nature of exudate (signs of inflammation, pus, infection, and so on) allows accurate diagnosis.

Treatment of pericarditis

Treating pericarditis depends on the cause of his caller. Thus, in infectious processes prescribe antibiotics for allergic - drugs that suppress the antibody production and so on.

They are used as anti-inflammatory agents and protivoekssudativnoe. In severe cases, this purpose is prescribed glucocorticoid hormones. In addition, means are assigned eliminating heart pain Pain in the heart - always consult a doctor Restoring the activity of the heart and normalizes blood circulation.

Pericarditis - this is serious, it should be remembered and carefully treat any colds, which can give a complication of heart.

  Galina Romanenko