Angina pectoris attack

definition

Literally translated, angina pectoris means chest tightness. The symptoms are based on coronary artery disease (CHD), which leads to insufficient blood flow to the heart muscles. This causes chest pain and a feeling of tightness or pressure on the chest.
Such an angina pectoris attack usually occurs when the person concerned is physically active. In this situation, the heart needs better blood flow, which cannot be done because of the CHD. When you have a seizure, symptoms start suddenly and last for about one to five minutes. After that, the heart's need has been regulated down again and the symptoms disappear.

What are the typical signs of angina pectoris?

The typical signs of angina pectoris are chest tightness and chest pain. This pain can also radiate to the back, left arm / shoulder, jaw, or upper abdomen. The upper abdominal pain is often accompanied by nausea and vomiting. Typically, the chest pain is just behind the breastbone and is usually dull or stabbing and piercing.

The chest tightness feels like someone has put a heavy sack on the person's chest. This usually results in a feeling of shortness of breath, which can increase to an anxiety and panic attack. The symptoms usually appear for the first time during physical exertion; stress can also be a trigger for the symptoms. In most cases, angina pectoris occurs as a seizure.
Symptoms start suddenly and severely and last for about one to five minutes.

Learn more about this topic: Symptoms of angina pectoris

What is the course of a seizure?

The sudden onset of symptoms is characteristic of the angina pectoris attack. However, some people also feel slight omens before a seizure sets in. This includes stinging or pulling in the chest area, stomach pain and nausea can also indicate an angina pectoris attack. Typically, the seizure only lasts a few minutes.

The process varies from person to person. For some, the symptoms worsen in the first few minutes, only to subside after a "climax". Others suffer from constant pain and shortness of breath for about one to five minutes. In still others, the symptoms start suddenly and severely and get weaker over time until they go away.

A faster end to the attack can be brought about by nitro spray. This expands the coronary arteries and thereby leads to better blood flow to the heart muscles. As long as the seizures do not differ from one another in a person, one speaks of stable angina pectoris. If the seizures get worse over time or if they occur more frequently, the patient has unstable angina pectoris, which indicates that coronary artery disease is progressing.

You might also be interested in this topic: Chest pain

How long does a typical seizure last?

A typical attack of angina pectoris usually lasts about one to five minutes. However, there are deviations from this normal duration, so that in the case of seizures between 30 seconds and 30 minutes one still speaks about the presence of an angina pectoris attack.
How long the seizure lasts in a single person depends on many factors and cannot be clearly justified. What is certain, however, is that with stable angina pectoris the individual attacks do not increase in length and strength. If there is a change in the seizures that occur, an unstable angina must first be assumed.

What does the diagnosis look like?

To diagnose an angina pectoris attack, the symptoms are first determined in an anamnestic discussion. Above all, emphasis is placed on physical resilience and the associated complaints.

The physical examination usually does not reveal anything, but sometimes indications of a vascular calcifying disease can be found. These include flow noises in the carotid arteries and a lack of foot pulses.
The EKG is used in diagnostic equipment. This is often inconspicuous when at rest and is therefore usually also carried out under stress. Angina pectoris attacks, severe shortness of breath and oxygen deficiency as well as a drop in blood pressure can occur. In addition, there are pathological changes in the electrical currents in the heart, which are shown in the ECG.
An ultrasound from the heart is usually used for further diagnosis. This so-called echocardiography is also often carried out at rest and under exertion, since indications of angina pectoris disease can also be found here, especially under exertion.
A representation of the vessels in an MRT examination is also used for diagnosis. If angina pectoris complaints persist, a cardiac catheter examination is also carried out. This has diagnostic value on the one hand, but can also be used to treat the disease at the same time.

You can find more information here: Stress ECG

What does acute therapy look like?

A nitro spray is usually used for acute treatment of an angina pectoris attack. This contains nitroglycerin, which releases nitric oxide (NO) in the body. The NO acts on the muscle cells of the vessel walls and leads to a relaxation of these cells. This causes the coronary arteries to widen and better blood flow is possible.

An attack of angina pectoris can be ended very quickly. Since it can be very difficult for laypeople to distinguish between a seizure and a heart attack, an emergency doctor should be called. He can carry out further measures.
This includes, for example, the administration of oxygen. Fluid and various medications can also be administered directly to the person affected via a venous access. For example, it may be necessary to give sedatives if the pain is accompanied by fear or panic during an angina pectoris attack.

As soon as the first symptoms of an attack are noticed, any physical exertion must be stopped immediately. This is the only way to reduce the performance that the heart has to muster.
If the attack is the result of stable angina pectoris, the administration of nitroglycerin can be sufficient as acute therapy.
In the case of unstable angina pectoris, subsequent inpatient treatment is required for further clarification and to change the medication.

Learn more about this: Therapy of angina pectoris

What can I do to avoid another seizure?

Preventing an angina attack has many components. On the one hand, it is important to improve the general situation of the cardiovascular system. This includes a change in lifestyle (healthy and balanced eating habits, sufficient exercise, smoking cessation) and the treatment of all other illnesses (high blood pressure, diabetes mellitus = diabetes, hypercholesterolemia = high blood lipid levels, etc.).
On the other hand, specific risk factors such as partial stenosis (blockage) of the coronary arteries should be eliminated. Emergency medication such as nitrospray can treat an emerging seizure before it really breaks out.

The causes of an angina attack may help prevent another attack from occurring: Cause of angina pectoris

What is the risk of having a heart attack?

The risk of suffering a heart attack is generally increased in angina pectoris complaints, since both diseases are based on the same vascular changes. The best way to assess the risk is by dividing it into stable and unstable angina pectoris.
With stable angina pectoris, the disease does not progress, so that the risk of a heart attack is comparatively low. About 25% of those affected will have a heart attack within five years.
In unstable angina pectoris, the disease becomes increasingly severe, so that a heart attack is much more likely, if not inevitable, if the symptoms and the progression of the disease cannot be contained.

Read more on this topic: Heart attack risk