Vasospastic angina is accompanied by bouts of pain in the heart caused by blood vessel spasms. These attacks are spontaneous, that is, they are not connected to any external factors. Danger vasospastic angina in the development of severe complications - cardiac arrhythmias, and myocardial infarction.
Why start vasospastic angina
Similarly, it is not known, since, unlike other forms of angina, organic changes in the coronary vessels in most cases are not detected. But today it is established that under the influence of various external and internal factors are changes at the biochemical level in the cells of the endothelium (the inner lining of the walls) of the coronary vessels. In the smooth muscle of blood vessel walls there is a large number of calcium channels, which contributes to calcium intake and smooth muscle spasm. In addition, endothelial cells stand out substances that contribute to spasm of blood vessels and inhibit the formation of vasodilator substances.
Symptoms vasospastic angina
Vasospastic angina (spontaneous, variant, Prinzmetal angina) may begin suddenly with the appearance of episodes of acute pain behind the breastbone or in the left side of the chest.
Heart attack pain typically occurs at night, at rest, in one and the same patient as it often appears in the same time. Pain can have a classical character: the sternum (in the upper or middle third of it) with irradiation (return) to the left shoulder and left arm.
But this is not always the case. Pain can be located just to the left, right, or even predominantly in the abdominal region, thus giving the lower limbs. Attacks may occur angina and pains, and their equivalents - severe weakness, feeling short of breath, sick and barely make a breath and exhale. Often these attacks are accompanied by dizziness, nausea and fainting.
Vasospastic angina may be complicated by heart rhythm disturbances - that this complication is often the cause of death of patients.
Vasospastic angina peculiarity is that in this form of the disease in the pathological process involves mainly large coronary vessels, which creates a significant risk of developing myocardial infarction macrofocal
Myocardial infarction - the most formidable diagnosis
. Predisposition to develop such complications seen on ECG during the attack and within 10 minutes after the film can be seen on symptoms of acute myocardial infarction, which subsequently disappear (which does not occur when the true myocardial infarction).
Treatment of vasospastic angina
Treatment of spontaneous angina
Spontaneous angina - the most rare form of this disease
It consists of the removal and prevention of heart attacks of pain. To remove the heart aches every patient should always carry nitroglycerin tablets or spray.
Nitroglycerin - a drug from the group of nitrates, providing rapid vasodilator effect, mainly in the veins. This improves the outflow of blood from the myocardium, the load reduction in ischemia
Ischemia - when the brain fails to work
. Nitroglycerin reduces myocardial oxygen demand and inhibits the action of the sympathetic nervous system to the blood vessels (SNA causes vasospasm). Simultaneously nitroglycerin causes vasodilatation of the brain and a sharp headache in some patients.
Most often take nitroglycerin tablets to 0, 5 ml under the tongue. The attack while docked in an average of 1, 5 minutes, the effect lasts from half an hour to an hour. The tablet kept under the tongue until complete resorption, without swallowing. If no effect during the first 5 minutes, one must take one tablet. If heartache is not removed after taking 2-3 tablets, you should immediately call an ambulance.
Nitroglycerin spray comprising 0 to 4 mg per dose. As soon as the first signs of an attack of angina pectoris
Angina - oxygen deficiency
, Must be applied by spray language by clicking on a monitor - three times (0, 4-1, 2 mg) within 15 minutes. It is better to do it in a sitting position, and be sure to hold your breath (spray should not be inhaled). After applying the spray you should close your mouth. If the pain is not removed, you should call an ambulance.
To prevent attacks vasospastic angina with medication nitroglycerin number of long-acting (kardiket, nitrosorbid). Prevent the development of angina attacks is also using drugs from the group of calcium antagonists, which in most cases are the drugs of choice (verapamil, nifedipine). These drugs cause relaxation of smooth muscles of the walls of the coronary vessels.
Sometimes, if the action of the first two groups of drugs is ineffective, prescribed drugs from the group of alpha-blockers, which suppress the action of the sympathetic nervous system, such as prazosin.
Vasospastic angina should be treated under the supervision of a specialist.