Cardiology: Angina pectoris (heart attack) — Сardiac catheterization with stent placement . Treatment
Angina pectoris is a heart disease manifested by a sense of discomfort and pain behind the breastbone. The risks of disease increases with age. For example, among people 40 to 50 years old, the number of cases does not exceed 1%, while in the next age group (50-60 years), this figure is 10%. When angina pectoris is detected, the patient is selected a set of therapeutic and preventive measures.
The physician suggests a diagnosis based on the patient's symptoms and case history data. To confirm the suspicions and obtain a full picture of the disease, a number of medical tests is prescribed:
- ECG at rest. The cardiogram of sick patients shows characteristic signs of myocardial ischemia.
- ECG with functional load. The patient exercises on a stationary bike, and a physician takes his/her ECG at regular intervals. This test is more sensitive for detection of ischemia.
- 24h (Halter) ECG monitoring. It allows recording changes in the heart rate occurring in a patient during the day (including during sleep).
- Myocardial scintigraphy. It detects structural changes in the heart muscle.
- Laboratory tests. They include blood tests to determine the level of cholesterol, glucose, creatinine, and so on. The studies to identify troponin are of particular importance. The presence of these proteins in blood indicates the myocardial injury.
- X-ray of the coronary artery. The contrast material is injected into coronary arteries and then a series of X-rays scans is made. Looking at the resulting images, the physician determines the degree of atherosclerotic vascular lesions.
To alleviate the attacks, the patients are recommended to take trinitrates. Expanding the coronary arteries, these drugs increase the blood inflow to the heart muscle and reduce its stress.
Preventive treatment of angina pectoris includes the administration of:
- di- and mononitrates with prolonged action,
- calcium channel blockers.
The drugs must be taken regularly according to the regimen prescribed by the doctor.
When the conservative measures prove to be ineffective, the surgery is possible:
- Coronary artery bypass grafting. A workaround is formed at the blocked portion of the coronary artery. The lower limb veins are commonly used for transplantation.
- Angioplasty. The tapered portion of the artery is expanded using a special balloon or laser.
See also for angina pectoris (heart attack):
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