Angina pectoris is one of the most common heart diseases. It is characterized by attacks of short chest pain, which is caused by physical or emotional stress, other factors leading to an increase in the metabolic needs of the myocardium. The pain is localized behind the sternum, gives to the left hand, the left half of the face, under the shoulder blade, to the neck. Sometimes the irradiation of pain is special - in the tooth, ear, tongue. The pain usually lasts 1-2, less often 10-15 minutes and quickly disappears after taking a tablet of nitroglycerin or other nitrates.
The basic principles of the treatment of angina pectoris:
- timely removal of a pain attack;
- prevention of new angina attacks;
- Nominalization of the rheological properties of blood and the prevention of blood clots.
Attack treatment and interictal therapy
Drug treatment of angina pectoris is aimed at improving coronary circulation, metabolism in the myocardium. It is divided into the treatment of an acute attack of angina pectoris and the treatment of the disease in the interictal period.
An attack of angina pectoris is stopped by taking nitroglycerin. The effect of the drug lasts up to 5 minutes. With continued pain, nitroglycerin can be repeated. You can also use sedatives, validol, beta-blockers and calcium antagonists. Drug treatment of angina pectoris during an attack can be supplemented with distracting therapy in the form of setting mustard plasters in the heart region and a hot heating pad or hand bath to the left hand.
In the interictal period, patients are prescribed nitrates of prolonged action. These drugs act like nitroglycerin, but for a longer time. They have a vasodilating effect, which leads to the accumulation of blood in the vein system and a decrease in its return to the heart. This causes a decrease in the volume and intensity of the left ventricle, as well as a decrease in the oxygen demand of the heart muscle. Reduced oxygen demand leads to a redistribution of blood flow in the myocardium in favor of areas suffering from ischemia.
Beta-blockers reduce heart rate and myocardial oxygen demand. The effectiveness of the treatment of angina pectoris increases significantly with the combination of prolonged nitrates and beta-blockers.
In the treatment of angina pectoris, calcium antagonists are also widely used , which are combined with drugs of the above groups.
Drug treatment of angina pectoris is carried out more intensively during periods of intensification and frequent attacks of the disease. After achieving a therapeutic effect and stable remission of the disease, the doses of medications are gradually reduced to minimally effective.
If drug treatment of angina pectoris is ineffective, surgical intervention is indicated. This type of treatment consists of coronary artery bypass grafting with limited damage to the large coronary arteries and vascular plasty and chronic aortic aneurysm.
Disease prevention
Angina pectoris is largely dependent on the development of atherosclerosis. Therefore, the primary prevention of angina pectoris comes down mainly to the prevention of atherosclerosis. Prevention of attacks, that is, secondary, should be aimed at the implementation of rational therapy for atherosclerosis, the treatment of pain. It is necessary to prevent and treat heart rhythm disturbances and heart failure.
Knowing how to treat angina pectoris, you can promptly provide first aid to yourself or relatives. To diagnose the disease and prescribe qualified treatment, you should consult a specialist.