Angina is translated from Latin means “angina pectoris”. This disease, which is the main manifestation of the painful attack of the sternum, at least in the area of the heart.
The pain of angina is oppressive in nature, giving the jaw, back, arms, and even teeth. Sometimes these attacks are also accompanied by weakness, nausea, shortness of breath and excessive sweating. Typically, such a pain in the chest is the result of over-voltage, the stress and emotional agitation or after a hearty lunch.
Attack of 1-15 minutes duration. In order to reduce the pain, you need to calm down, sit or lie down, relax and try to relax. Also helping drugs that increase the blood supply to the myocardium and expanding vessels of the heart (usually as a first-aid doctors recommend nitroglycerin).
If a person experience such attacks, it requires a quality inspection. Diagnosis of angina consists of a visual examination by a doctor and a combination of clinical, laboratory, and special cardiological research methods.
The clinical examination includes a detailed survey of the patient and the drafting history of the disease. It is necessary to determine the cause, a preliminary assessment of disease severity and prognosis. We study the complaints of the patient, assess the intensity and location of pain, as well as ways to eliminate pain.
The doctor then determines the body mass index (since obesity is a predisposing factor for the development of angina pectoris). Count the heart rate (HR), the parameters of the pulse and blood pressure in both arms, and listens to the heart with a stethoscope.
Laboratory diagnosis is aimed at identifying the level of hemoglobin, cholesterol, glucose, lipids, creatinine, and certain other substances. These analyzes confirm the presence of atherosclerosis, angina pectoris as predisposing factors.
As diagnostic tool, it comprises: ECG, echocardiogram, chest x-rays, stress testing, Holter monitoring, coronary angiography and myocardial imaging.
12-lead electrocardiography is required by the research necessary for detection of myocardial ischemia (oxygen starvation of the heart muscle), typical for angina. Often, the ECG is not observed any change. It is possible for a study at rest. That is why it is so important and informative record ECG during pain attack.
X-ray of the chest
In patients with stable angina, this method does not really matter. It is conducted for suspected heart disease, lung disease or heart failure, angina entailed. Through this study can detect an increase in heart size, congestion in the lungs, the deposition of calcium in the cardiac muscle and an increase in fibrillation. All of this is important to determine the prognosis of angina.
Stress tests carried out in order to study how the heart responds to the patient for a particular load. To research the ergometer or treadmill (treadmill).
Holter monitoring this study, by means of which oversee the work of the heart during the day. Hand-held portable recorder holds-hour ECG recording and transmitting information about the work of the heart into the computer. Through this study captures all cardiac arrhythmia, painful and painless episodes of myocardial ischemia.
Coronary angiography is currently the main and most reliable way to diagnose the state of the heart vessels. It is conducted when necessary to resolve the issue of selecting the optimal treatment of angina pectoris: medication or surgery. Coronary angiography to determine the presence, location, extent and nature of the atherosclerotic lesion. As well as spasm of the arteries, thrombosis, ulceration, calcification and vascular malformations of the heart. Having determined the degree of narrowing of the vessel, it is possible to understand how it affects the blood supply to the heart. It is concluded that there is enough medication or required surgical replacement of vessels.
Multislice computed tomography of the heart and coronary vessels
Multislice computed tomography of the heart and coronary vessels (CT) is required to determine the atherosclerosis of the heart, detection of congenital and acquired defects, to study blood flow and detection of calcifications.
As a rule, appoint MSCT in the following situations:
1. A survey of women aged 55-75 and 45-65 men without established cardiovascular disease. The aim is to identify MSCT early signs of atherosclerosis basis of angina.
2. Patients over 65 years old, complaining of chest pain and not having thus established diagnosis of CHD (coronary heart disease).
3. For differential diagnosis of congestive heart failure and ischemic pain of different origins, such as myocarditis.
Endovascular echocardiography (echocardiography) provides the most comprehensive assessment of the nature of vascular lesions of the heart. Through this study, the doctors an opportunity to thoroughly evaluate and consider the atherosclerotic plaque, set the probability of formation of a blood clot. But at present, endovascular echocardiography is not included in the list of mandatory studies of angina patients and performed in case of need for doctor’s appointment.