Angina pectoris (angina pectoris)

Attacks of sudden chest pain due to an acute lack of blood supply to the myocardium are a clinical form of coronary heart disease.

Pathogenesis. In most cases, angina is caused by atherosclerosis of the coronary arteries of the heart; in the initial stage, the expansion of the artery lumen is limited and an acute deficiency of blood supply to the myocardium occurs with significant physical and/or emotional stress; severe atherosclerosis with a narrowing of the artery lumen by 75% or more causes such a deficiency even under moderate stress.

Symptoms, course. With angina pectoris, pain is always distinguished by the following symptoms: 1) it is in the nature of an attack, that is, it has a clearly defined time of onset and cessation, subsidence; 2) arises under certain conditions and circumstances; 3) begins to subside or completely stops under the influence of nitroglycerin (1-3 minutes after its sublingual administration).

Treatment. The most important tactical point is the relief of pain attacks. If an attack develops during physical activity, the patient should stop, or better yet, sit down or lie down. Nitroglycerin in tablets of 0.0005 g has traditionally remained the main drug for relieving an attack of angina.

Treatment in the interictal period. Special studies have shown that the mortality rate of patients with angina pectoris can be reduced by constantly taking aspirin at a dose of 80-300 mg once a day, beta-blockers (for example, propranolol in an individually selected dose), and, if indicated, lipid-lowering drugs.

The prognosis in the absence of complications is relatively favorable. The ability to work is preserved, but with a limitation of work that requires significant physical effort.