Angina pectoris is an attack of pain in the heart region caused by a spasm of the coronary vessels. Angina pectoris develops against the background of coronary heart disease (CHD) – this is one of the forms of its clinical manifestations. Coronary heart disease develops against a background of a number of diseases leading to coronary blood flow insufficiency.
Angina pectoris, causes, symptoms, first aid for angina pectoris.
At the heart of the development of coronary heart disease is a violation of the regulation of coronary circulation, as a result of which the lumen of the arteries supplying the heart itself begins to narrow when a maximum increase in blood supply to the heart muscle is required (during physical exertion, emotional arousal, negative effects of environmental factors). Atherosclerosis of the coronary arteries most often leads to coronary heart disease and, accordingly, oxygen starvation of the heart muscle.
. The depth of damage to the muscle layer of the heart and the prognosis of the disease largely depend on the rate of increase of coronary circulation insufficiency. The most common manifestation of CHD is angina pectoris..
Symptoms of angina pectoris.
Angina pectoris is characterized by paroxysmal pressing compressive pains behind the sternum, which appear with physical exertion, emotional stress (angina pectoris) and much less often – at rest (rest angina). Pain often radiates to the left shoulder, shoulder blade, half of the neck, sometimes to the left half of the lower jaw. At this time, patients feel shortness of breath, fear of death, they stop moving and freeze in a motionless position until the attack stops.
In elderly patients, the pain sensation is less pronounced, and the main signs of angina pectoris are shortness of breath, a sudden feeling of lack of air, which is combined with severe weakness. The main diagnostic differences between angina pectoris and myocardial infarction are the reduction or complete disappearance of pain after the use of nitroglycerin and the elimination of the factors that caused it. The duration of a typical attack of angina pectoris is 15-30 minutes.
First aid for angina pectoris.
First of all, the patient needs to create complete mental and physical peace. Under the tongue, give 1-2 tablets of nitroglycerin. You can not use nitroglycerin with its individual intolerance, with past brain injuries. Typically, these measures are effective for angina pectoris. If the pain persists, then you can take nitroglycerin again, no more than 3 times in 15 minutes.
If pain persists, there is a chance of developing myocardial infarction. In this case, 1 ml of 1% solution of promedol and 1-2 ml of diazepam are administered intramuscularly or intravenously. If there is no effect of the treatment, resort to the intravenous administration of a 0.005% solution of fentanyl and 0.25% solution of droperidol. With the development of severe mental arousal, anesthesia with anesthesia with a mixture of nitrous oxide and oxygen is used. Anesthesia for angina pectoris is facilitated by the supply of oxygen, which is especially necessary in the treatment of elderly patients.
From public places and from the street, the patient should be taken to the cardiology department of the nearest hospital for observation and treatment. If assistance is provided at home, the patient after removing the attack of angina pectoris can be left under the supervision of a local doctor only when the last attack along the course did not differ from previously observed attacks of angina pectoris. If the pain was stronger or the attack took longer, then the patient must be taken to a specialized hospital.
Hospitalization for angina pectoris is indicated if:
1. The duration of the attack was more than 30 minutes.
2. The attack developed for the first time in my life or the last attack was very long ago.
3. Nitroglycerin does not help.
4. An attack of angina pectoris occurred for the first time at rest.
5. There is a short-term loss of consciousness at the height of pain.
6. For the first time in my life, an attack of asthma, arrhythmia, rapid or slow heartbeat developed.
With angina pectoris, patients should be transported necessarily on a stretcher. Transportation of patients with a severe attack of pain and with the phenomena of severe disorders of the cardiovascular system is contraindicated.
Based on the book “Quick help in emergency situations”.