Angina pectoris is a clinical syndrome caused by insufficient blood supply to the coronary arteries.
Angina pectoris is a clinical syndrome caused by acute and temporary ischemia and hypoxia in the myocardium due to insufficient blood supply from the coronary arteries. It may be accompanied by cardiac dysfunction without myocardial cell necrosis.
Primary angina pectoris is defined as angina pectoris or myocardial infarction that has never occurred before within 1 month of the onset of the disease. Patients with stable angina who have had no episodes for several months are also categorized as having a sudden attack. There is no clear pattern to the attacks, which may occur during physical labor or activity, or at rest. The majority of patients with first-type angina pectoris later change to stable angina pectoris, while a few may develop into worsening angina pectoris or even myocardial infarction.
Causes
1. Vascular spasm after damage of coronary atherosclerotic plaque.
2. Physical labor or emotional excitement.
Symptoms
1. Symptoms
Episodic chest pain is a typical feature.
(1) Location: the upper and middle part of the sternal body may spread to the precordial area, with unclear boundaries, often radiating to the left shoulder, left upper limb, neck and pharynx.
(2) Nature: Chest pain is often characterized by pressure, compression or constriction, or burning sensation. In severe cases, it may be accompanied by a sense of dying.
(3) Duration: mostly 3 to 5 minutes, usually not more than 30 minutes.
(4) Relief: Taking nitrate drugs, sublingual nitroglycerin can be relieved in 30 seconds to several minutes.
2. Physical signs
Blood pressure rises and heart rate accelerates during an attack.
Examination
1. Electrocardiogram
Electrocardiography is the most commonly used method to diagnose angina pectoris. It includes asymptomatic electrocardiography, electrocardiography during angina attack, electrocardiographic stress test, and dynamic electrocardiography.
2. Echocardiography
Echocardiography can observe the size of the ventricular cavity, the thickness of the ventricular wall and the contraction state of the heart muscle.
3. Coronary CT angiography
It is used to determine the degree of coronary artery lumen narrowing and wall calcification.
4. Radionuclide examination
(1) Resting and loading myocardial perfusion imaging.
(2) Radionuclide cardiac angiography is helpful in understanding ventricular wall motion and showing localized dyskinesia.
5. Cardiac X-ray
There may be no abnormal findings, but enlargement of the heart shadow and widening of the aorta may also be seen.
6.CT examination
Multi-row spiral CT coronary angiography can be used to show plaques on the walls of the tubes, create three-dimensional images of the coronary arteries, and show the main branches.
Diagnosis
1. Clinical manifestations
Based on the clinical features of episodic chest pain, this disease can be considered.
2. Auxiliary examination
Echocardiography, electrocardiogram, radionuclide examination, CT and other examinations will be used to make the appropriate diagnosis.
Treatment
1. Immediate hospitalization is required.
2. Treatment with anti-vascular spasm, anti-thrombotic and drugs to reduce myocardial oxygen consumption.
3. Emergency intervention is feasible when angina attacks cannot be controlled by medication.