- Angina - the consequences of the activity
- Diagnosis and treatment
Diagnosis of angina
After the doctor listens to the patient (it is important that it is possible to tell in detail about their symptoms) and measure his blood pressure, may be assigned to such diagnostic procedures as electrocardiography (at rest and during exercise) coronary angiography, nuclear stress test, echocardiography.
It is of great importance and differential diagnosis of angina, in which the physician should rule out such conditions as anemia, anxiety disorders, aortic dissection, aortic stenosis, diabetes mellitus
Diabetes - threatening and incurable disease
1 and type 2 diabetes, peptic ulcer, gastroesophageal reflux disease, hiatal hernia, hypertension, hyperthyroidism, Kawasaki disease, mitral valve prolapse, pneumothorax
Pneumothorax - when help is needed immediately
, and others.
ECG angina is usually the first diagnostic method of choice, and one of the most reliable procedures for the diagnosis of this disorder. During the resting ECG in patient lies on a couch, and to its several places telts attached electrodes that register electrical activity of the heart. Incoming signals are read from the computer, and converts them into a curve, which is studying the cardiologist.
Quite often, an ECG at rest in patients with angina pectoris gives normal results, therefore, are commonly used for the diagnosis of multiple procedures.
EKG during exercise often reveals abnormalities, even for those who have a resting electrocardiogram was normal. During this procedure, the patient is usually involved in the simulator - usually on a treadmill or stepper. ECG is recommended prior to exercise or drink cold water - it can affect the test results. In addition, you must inform your doctor about any medications you are taking, some medications can also reduce the accuracy of the ECG.
A nuclear stress test or stress test with thallium carried out to assess how well blood flows to the heart muscle at rest and during exercise. It is carried out in several stages. First, the patient makes an intravenous injection of the drug containing a radioactive substance such as thallium. Dose it is small, and the risks associated with its use are minimal. The patient then lies down, and within 15-45 minutes special camera scans his heart; with the help of obtained image, which can be seen as a radioactive substance moves blood toward the heart. After that, as a rule, the patient for some time been on the treadmill. Usually it is asked from time to time to increase the speed and change the angle of the track - this lets you get an idea of the heart at different levels of physical activity.
If a person for any reason unable to perform the exercises on the simulator, he can give a drug to dilate blood vessels, or medication that increases the heart rate - after receiving the heart will work almost as well as during exercise. At this stage of the stress test the patient is permanently connected to the electrocardiograph, and doctors watched his heart rate. When the load on the heart becomes maximum, the patient again to inject a radioactive substance, and then for a further 15-45 minutes for the work of the heart would be observed with the help of a special chamber. After that the doctor compares the first and second series of shots; the results of such comparisons reveal the angina, set its shape as well as to determine whether the disease is compounded over time (if the stress test is carried out before).
In the stress test should wear comfortable clothes and shoes with non-slip soles. After midnight on the day of the procedure is not recommended to eat and drink. Within 24 hours prior to the stress test should refrain from caffeine (it should be remembered that it contained not only in coffee but also in tea, some kinds of carbonated drinks, chocolate and some painkillers). In addition, the doctor may advise the patient to stop taking medication for asthma and angina.
During the stress test, patients may experience chest pain, profuse sweating, and muscle cramps. Side effects of drugs, dilates blood vessels, can be a tingling and a feeling of warmth in the injection site, headache, and nausea.
If, during the test, you will feel severe pain in the chest
Chest pain is one symptom - a lot of diseases
, Dizziness, increased heart rate and irregular (palpitations), tell your doctor about it.
Treatment of angina
Only after careful and often quite lengthy examination, the doctor decides how to treat angina in a particular case, and explains in detail the treatment plan to the patient. It is important that the patient had a clear idea about what drugs he has to take, how often and in what quantities, what kinds of physical activity for a safe, and what - no, what changes should be made to the way of life, and when you need to call an ambulance.
Typically, patients are advised to limit alcohol consumption, stop smoking (those who can not quit on their own, should see a specialist), as far as possible to avoid severe and / or prolonged emotional stress. It is of great importance and proper nutrition: angina patients should avoid salty and fatty foods, fast food and other products containing large amounts of trans fats. If necessary, you can talk to a nutritionist to help you make it an optimal eating plan.
Work should be very carefully: as a rule, patients with angina are permitted load, during which they might normally, without shortness of breath to talk. More intense load may provoke chest pain. Sometimes the treatment of stable angina
Stable angina - one of the manifestations of coronary heart disease
stress involves the passage of a special rehabilitation program, during which the patient learns to gradually and safely, and increase physical activity.
In addition, patients can be assigned to the following drugs when angina:
- Nitroglycerin is used during attacks of angina pectoris;
- Aspirin, clopidogrel or prasugrel prevent the formation of blood clots in the arteries and reduce the risk of heart attack;
- ACE inhibitors lower blood pressure and prevent damage to the heart muscle;
- Beta-blockers - drugs that reduce the heart rate and lowers blood pressure;
- Nitrates reduce the likelihood of repeat strokes.
Even if any of these drugs cause side effects that are causing you discomfort, do not interrupt taking them without consulting your doctor. Abrupt discontinuation of certain drugs increases the likelihood of worsening symptoms of angina, and also increases the risk of heart attack.
If drugs do not bring significant relief may require surgical intervention.