Microvascular angina is most often seen as a typical angina Angina - the consequences of the activity   or rest, but occasionally appear and atypical symptoms. Pain in heart attacks almost always when there are enough intensive and can significantly reduce the quality of life of the patient. One manifestation of microvascular angina patients is the increased sensitivity to pain.

What is microvascular angina, and the reasons for its development

Microvascular Angina - Angina is unaltered when the coronary arteries (there are no signs of atherosclerosis and coronary artery spasm). She also called cardiac syndrome X. The symptoms of this type of angina is sometimes difficult to distinguish from typical angina, in other cases they have their own characteristics.

Mechanisms of this kind of angina is not fully understood. Nevertheless, it is known that microvascular angina develops on the background of coronary microvascular dysfunction, causing them to improperly respond to vasodilator and vasoconstrictor substances produced by the body.

In women, coronary microvascular endothelial dysfunction may develop on the background of deficiency of female sex hormone estrogen during menopause and postmenopausal Postmenopause - is it possible to control it? . Risk factors are also endocrine diseases (obesity, diabetes Diabetes - threatening and incurable disease , Thyroid dysfunction), atherosclerosis, smoking.

The main symptoms

Symptoms of microvascular angina may be no different from the typical symptoms of coronary heart disease: they suddenly begin to increase the intensity of pain in the heart or chest, placed under the left shoulder blade and left arm, associated with exercise, stress, cold. It is significant that such attacks can occur at rest.

The peculiarity of these pains is their longer duration than with typical angina and less sensitivity to nitroglycerin (pain is not always or completely removed nitroglycerin, sometimes even worsen the condition of patients).

For microvascular angina attacks characterized by the availability of vegetative symptoms: excessive sweating, shaking the whole body, nausea and so on. Often these patients have a high level of anxiety Anxiety - how to distinguish normal from disease? , Anxiety, depression. It is also characteristic increased sensitivity to pain.

Diagnostics

Diagnosis is based on patient complaints and diagnostic studies. During the diagnostic tests reveal the condition of the heart muscle during the two-day and daily monitoring of ECG, ECG changes during exercise (eg, bicycle), no evidence of coronary atherosclerosis, and according to laboratory studies of blood.

Treatment of microvascular angina

Since microvascular angina therapy methods have not been developed, treatment is individually assigned in accordance with the symptoms of the disease and these diagnostic tests. Often, different groups of drugs given to patients by trial.

In any case prescribe drugs that reduce the burden on the heart muscle. When high blood pressure - a antihypertensive drugs, edema - drugs that restore the water-salt metabolism and so on. When expressed vegetative-dystonic symptoms prescribe sedatives.

Early treatment for removal of painful attacks designate short-nitrates (nitroglycerin), but they often have no effect. In most cases, are effective drugs from the group of beta-blockers - they are blocking action on the heart of the sympathetic nervous system (atenolol, metoprolol, bisoprolol, nebivolol).

Drugs such as long-acting nitrates and calcium channel blockers, which are the most effective in IBS, is not always effective in microvascular angina.

Microvascular angina - is a special kind of angina, which is still not fully understood. Treatment of the disease is selected doctor for each patient individually.

Galina Romanenko

Ischemia is a condition in which some organs is delivered enough oxygen; most often it is the violation affects the heart or brain. This occurs when blood flow to a particular organ is blocked or when the blood that flows to the body, a very low oxygen content. Oxygen is essential for normal functioning of all body tissues, so the ischemia can cause significant damage or even halt the work of some bodies.

Causes of ischemia

• Sickle cell anemia

When sickle cells take an irregular shape (the shape of a sickle, or the new moon), and easier to form clots, blocking the inflow of oxygen-rich blood to the heart, lungs or brain. In rare cases, clots can block blood flow to other organs such as the liver or kidney, and causing them considerable damage. Most people diagnosed with sickle cell anemia, has to regularly take anticoagulants to prevent ischemia.

• Ventricular tachycardia

Ventricular tachycardia Tachycardia - the body to the limit?   - A series of sudden disturbances in heart rate, which can lead to malfunction of the heart, or in the most severe cases, to a complete stop. One of the complications of ventricular tachycardia may be ischemia, since irregular contractions of the heart is limited to the flow of oxygen to various organs. Prolonged restriction of the flow of oxygen leads to severe and often irreversible damage to tissues.

• Constriction of blood vessels

Growth of different entities in the body may lead to contraction of blood vessels. Thus, the tumor can be trapped as small veins or large arteries and restrict blood flow to the tissues, rich in oxygen, leading to ischemia. In the absence of other causes episodes of coronary disease may indicate the presence of cancer or a benign tumor large.

• Blood clots

Blood clots may form due to the large number of platelets, or as a result of surgical procedures, as well as medication to increase clotting. Prolonged immobilization can also cause blood clots. In very rare cases, blood clots form in the legs during long flights, causing almost immediate attack ischemia.

• Low blood pressure

Lower blood pressure for heart disease suggests that the body's tissues do not receive enough oxygen. In the absence of this diagnosis and treatment can lead to ischemia.

• Congenital heart defects

The risk of ischemia is particularly high in people with congenital heart disease, as well as those who took the operation for the treatment of various diseases of the heart.

Types of ischemia

There are several types of ischemia; their names as generally associated with the body portion to which the other kind of way or the disease gives blood flow and, consequently, of oxygen. For example, such isolated disorders of this type, both the upper limb ischemia, legs, stomach, intestine, and so forth.

Ischemia of the optic nerve

Ischemia of the optic nerve, which is sometimes also called ischemic eye - a condition in which the operation is impaired optic nerve. A person can see because the optic nerve of the eye gives impulses to the brain where they are interpreted as images. Optic nerves are made up of millions of thin nerve fibers that their views and functions resemble wires. Numerous blood vessels to nourish the optic nerve, blood, oxygen-rich and various mineral substances. If the work of the optic nerve is disrupted, normal vision would be impossible.

Some ophthalmologists called ischemia, stroke, eye and optic nerve, in a sense, this is true, because stroke is also associated with the cessation of blood flow to the tissues that constantly need oxygen - only with the violation affected the brain, not the optic nerves.

There are two types of ischemic eye:

• Front visual neuropathy - a disorder in which restricted or terminated the flow of blood to the front of the optic nerve;
• Rear visual neuropathy - much less common type of this kind of ischemia, which interferes with blood flow to the rear portion of the optic nerve.

Ischemia of the eyes can be caused by a temporary decrease in blood pressure can be caused by a variety of factors. The most common diseases that increase the likelihood of developing this type of ischemia:

• Diabetes;
• rheumatoid arthritis Arthritis - a variety of forms and complications ;
• Shingles Ringworm - not only infectious disease ;
• Anemia;
• Syphilis;
• Severe forms of hypertension;
• Stomach ulcer;
• Some heart disease;
• Vasculitis;
• Migraine.

The symptoms of ischemia of the optic nerve may be a sudden loss of vision in one eye and blurred visible objects (usually the patient first notice these symptoms once in the morning after waking up). Even before the appearance of problems may occur such symptoms as weakness and malaise, fever, pain in the temples, neck and pain when chewing.

If you suddenly lost the vision, you should immediately consult a doctor. He will check visual acuity, measure intraocular pressure, and with the help of a special device will evaluate the condition of the optic nerve. Sometimes it takes other procedures, such as fluorescent angiography.

For the treatment of ischemia of the optic nerve, it is usually necessary to treat the underlying condition that caused it; In many cases, this allows you to control symptoms of ischemia and prevent further deterioration of vision. Sometimes it also requires the use of corticosteroids to prevent damage to the optic nerve health.

Therapies

For the prevention or treatment of ischemia using certain methods. People with an increased risk of heart attack or blood clots are usually assigned to receive appropriate drugs to reduce the likelihood of ischemia. It may be recommended a diet to lower cholesterol in the blood. Ventricular tachycardia can be controlled with special drugs, as well as an implanted pacemaker or defibrillator. Surgical correction of congenital defects can help with structural violations that impede blood flow to the organs. If ischemia is a major cause of tumor may require surgery or treatment with powerful drugs.

Ischemia in pregnant women and children

Many types of ischemia are the most common in middle-aged and elderly. Ischemia is diagnosed during pregnancy is very rare, but the most dangerous of its varieties, in particular coronary heart disease, can lead to serious consequences for both mother and fetus. To reduce the likelihood of serious problems during pregnancy, should undergo a thorough medical examination before conceiving a child. This is especially important for those who have serious chronic diseases (such as diabetes, heart disease, hypertension), which are associated with an increased risk of ischemia. However, in whose family history of coronary heart disease has also strongly encouraged to get tested.

Children ischemia - also, fortunately, quite rare. However, in newborns can occur such a dangerous form of the disorder is cerebral ischemia Cerebral ischemia - how to overcome illness   (particularly periventricular ischemia). Most often, it is diagnosed in premature infants and the underlying cause is considered to be a lack of oxygen in a given period of fetal development. As a result, impaired blood flow to certain parts of the brain. If this ischemia is not treated, it can lead to serious health problems in the child in the long run.