Angina pectoris is a transient type of myocardial ischemia. There is a pathology due to emotional or physical overload, which provokes an increase in the oxygen demand of the heart muscle. Next, we consider in more detail how angina pectoris of voltage 2 FC is manifested, how it differs from other functional classes.
General information
Angina pectoris is a clinical form of coronary artery disease. The pathology is characterized by periodic attacks that appear against the background of an increase in the metabolic needs of the heart muscle. Symptoms of angina pectoris increase with exercise and decrease after the use of the drug "Nitroglycerin".
Prevalence
IHD, angina pectoris of FC 2 are often detected in the older age group. So, according to statistics, in patients aged 45-54, pathology is detected in 2-5% of men and 0.5-1% of women, in patients over 65 years of age - in 11-20% of men. and 10-14% of women. Before the onset of a heart attack, angina pectoris is diagnosed in 20% of cases, after it - in 50%. The most common disease is among men over 55.
Causes of pathology
Most often, the provoking factor is atherosclerosis, which affects the coronary arteries. It was found that the mismatch between the oxygen demand of the myocardium and its transportation appears with atherosclerotic narrowing in the lumen of the coronary vessels by 50-75%. Clinical signs of this disorder are angina attacks. Other potentially probable provoking factors include hypertrophic cardiomyopathy, severe arterial and primary pulmonary hypertension, stenosis at the mouth of the aorta, coronaritis, abnormalities in the coronary arteries of a congenital nature, aortic insufficiency. With the appearance of a partial or transient obstruction to blood flow, an attack can provoke acute coronary thrombosis. But, as a rule, this condition is observed accompanied by a heart attack.
Risk factors include smoking, age, family history, obesity and physical inactivity, diabetes and menopause. Hypoxia or severe anemia can aggravate the course of the pathology. Among the immediate causes of the attack, physical stress, emotional stress, temperature changes, overeating, a sharp change in climate and others are noted.
Classification
Pathology has four functional classes. They are determined in accordance with the tolerance of the loads. So, angina pectoris 1, 2 FC can be diagnosed. These forms are considered initial and in many cases can be adjusted. The first functional class is characterized by normal tolerance of a normal load. Attacks appear only with physical stress. For example, it can be a long activity, climbing stairs, brisk walking. Angina of exertion FC 2, 3 is characterized by the patient's ability to withstand loads. While in the second functional class, activity is moderately limited, then in the third it is essential. In the latter case, signs of coronary heart disease become quite pronounced.
Angina of exertion FC 2 may be accompanied by seizures if a person overcomes a distance of more than 500 meters without stopping. As in the third functional class, an aggravation of the state is likely during ascents by one flight. Of particular clinical importance are emotional stress, windy or cold weather. Angina of exertion FC 2 differs from the latter form in the frequency of occurrence of seizures. So, the fourth functional class is characterized by aggravation even with minor loads, and in some cases at rest. In this case, the physical activity of the patient is significantly limited.
Angina pectoris FC 2: signs
There are several common symptoms for all classes of pathology. These include, in particular:
- Shortness of breath.
- Heartache.
- A feeling of tightness and discomfort in the chest.
These symptoms are noted in cold weather or in the wind, after eating a large amount of food. Angina FC 2 manifests itself under stress. In particular, when climbing stairs or uphill, running, brisk walking. Angina of exertion FC 2 is accompanied by limited activity. This is due to poor tolerance of movements even on a flat road at distances of more than 500 meters or when climbing more than one flight.
Features of the influence of physical activity
In order for an attack to occur, additional factors are necessary that provoke an increase in the oxygen demand of the heart muscle. However, physical activity is considered the main cause of the attack. Only from stress or cold does it occur rarely. In some patients who are diagnosed with angina pectoris of stress 2 FC, in the morning hours tolerance to physical activity is reduced. However, during the day, tolerance returns to normal, as a person begins to gradually walk around. It should be noted that the severity of the clinical picture, which is accompanied by stable angina pectoris stress 2 FC, depends on the level of physical activity. In those people who exceed the constantly permissible limit, seizures can occur several times during the day. Those patients who are trying to adjust their regime so as to minimize stress, practically do not experience exacerbation.
Differential diagnosis
Angina of exertion is quite simple to confuse with other pathologies. In this regard, experts recommend that if there is pain or discomfort in the region of the heart, do not delay the visit to the hospital and undergo an examination. Often, when contacting a doctor, an angina of exertion of 2 FC is already detected. Disability is one of the most serious complications of pathology. It is to her that a late visit to the doctor leads and, as a consequence, untimely appointment of adequate therapy. Many pathologies are accompanied by the same symptoms as FC 2 angina pectoris. The medical history, test results, information obtained during ultrasound, Holter monitoring, ECG during an attack, coronary angiography are mandatory examined by a doctor. The specialist’s task is to exclude other cardiac and non-cardiac pathologies, including:
- Osteochondrosis and other diseases of the spine.
- Heart attack.
- Digestive system diseases (ulcers, disorders of the esophagus and others).
- Pulmonary pathologies (pneumonia, pleurisy and others).
The main difference between pain in angina pectoris is that it is quickly eliminated after the patient has taken Nitroglycerin. Relief also occurs at rest.
Angina pectoris 2 FC: treatment
Therapy for pathology should be aimed at reducing the frequency of seizures and improving the quality of life of the patient. With angina pectoris of 2 functional classes, experts recommend first of all to reconsider the lifestyle, reduce the number and severity of stresses that provoke seizures. Together with medications prescribed by a doctor, it is allowed to use folk remedies. However, they can only be an addition to the main therapy. Before using any product, consultation with a doctor is necessary.
Drug therapy
Before starting treatment, it is necessary to eliminate all provoking factors, if possible. The most effective way to stop the attack is the drug Nitroglycerin. It is taken sublingually (under the tongue). To prevent episodes of ischemia, nitrates of a long (prolonged) action are prescribed. These include drugs such as isosorbide mononitrate and dinitrate, nitroglycerin ointment or patch. The doctor may also recommend taking beta-blockers - Atenolol, Metaprolol, Betaxolol, calcium channel blockers - Diltiazem, Verapamil, antiplatelet drugs - Aspirin.
Surgical intervention
Surgical methods are indicated in case of ineffectiveness of drug therapy given above. Surgical intervention is also prescribed if, according to the results of angiography, there is a probability of death. In pathology, endovascular angioplasty and stenting, coronary artery and mammary coronary artery bypass grafting can be performed. The effectiveness of the intervention is about 90-95%. After surgery, complications may occur - a heart attack, re-development of angina pectoris, restenosis.