Angina pectoris refers to the clinical syndrome of acute temporary myocardial ischemia and hypoxia that causes episodes of chest pain. In addition, aortic stenosis or insufficiency, hypertrophic cardiomyopathy, congenital coronary artery malformation, syphilitic coronary arteritis and rheumatic coronary arteritis can also be caused. Exertion, emotional excitement, satiety, cold and acute circulatory failure are common triggers. The main feature is paroxysmal retrosternal or precordial pain, which may radiate to the left arm or along the anteromedial side of the left arm to the little finger or ring finger. It is mostly heavy, crushing, burning, suffocating, stuffy or near-death feeling, and occurs mostly during labor. Be careful to differentiate it from ulcer disease, biliary tract disorders, reflux esophagitis, myocardial infarction, cardiac neurosis, etc.
Classify angina pectoris into three types.
1, stable angina pectoris.
2, unstable angina pectoris.
3, variant angina.
Unstable angina includes initial exertional angina, worsening exertional angina, pre-infarction state, post-infarction angina, whose common feature is susceptibility to acute myocardial infarction and sudden death, and should be promptly hospitalized.
Principle: Improve coronary artery blood supply and reduce myocardial oxygen consumption.
I. Treatment of myocardial ischemia in remission.
1.Nitrate.
2, β-blockers: can slow down the heart rate, reduce myocardial contractility, lower blood pressure and reduce myocardial oxygen consumption, in addition to preventing arrhythmias and inhibiting platelet aggregation. They are contraindicated in cardiac insufficiency, pathological sinus node and bronchial asthma. These preparations should start with a small dose, gradually increase the dose, to gradually stop the drug.
3, calcium channel blockers: dilate coronary arteries and release coronary spasm, reduce myocardial tone, dilate small arteries to reduce afterload.
4, platelet inhibitors (aspirin).
5, angiotensin-converting enzyme inhibitors.
6, percutaneous transluminal coronary angioplasty.
7, coronary artery bypass surgery.
8.Extracorporeal counterpulsation therapy.
Second, the treatment of acute attacks of angina pectoris.
1, nitroglycerin: 0.6mg sublingual, if 5 minutes does not work can contain another piece.
2.Anti-anginal: 5-10mg orally or 10-20mg orally.
The treatment of unstable angina must be treated as acute myocardial infarction, and the treatment should be continued for 3 to 6 months after discharge from hospital.
IV. Traditional Chinese medicine treatment:
The main treatment is to pass the symptoms during the painful period, and to treat the root cause during the remission period, with emphasis on tonics. The main methods are to activate blood circulation and remove blood stasis and aromatic warmth. Suhexiang pills, quick-acting heart pills, heart-preserving pills, musk heart-preserving pills, etc. are commonly used. In addition, acupuncture and massage of the Neiguan and Zhiyang points are also effective. The dosage and usage of the above drugs should be in accordance with the doctor’s prescription.