Angor Din Dictionar Termeni Durere toracica ce poate iradia spre gat, maxilarul inferior sau brate, consecinta a unei proaste irigari a inimii. Angorul este o afectiune frecventa in tarile dezvoltate, unde reprezinta una dintre principalele probleme ale sanatatii publice. Cauze - Angorul se explica prin ingustarea anormala a uneia sau mai multor artere ale inimii, coronarele. In majoritatea cazurilor de angor stabil cronic si de angor instabil, aceste diminuari de calibru se manifesta in cursul efortului, cand necesitatile cardiace de oxigen sunt crescute. Atingerea arterelor coronare este, ca regula generala, consecutiva unui aterom depozit lipidic pe peretii arteriali , ai carui principali factori de aparitie sunt varsta, sexul angorul e mai tardiv la femei , hipertensiunea arteriala, diabetul, obezitatea, hipercolesterolemia, tabagismul si ereditatea.
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This can be caused by narrowing of the blood vessels; a decrease in radius. Myocardial ischemia also can be the result of factors affecting blood composition, such as reduced oxygen-carrying capacity of blood , as seen with severe anemia low number of red blood cells , or long-term smoking.
This imbalance can result from an increase in demand e. However, the pathophysiology of angina in females varies significantly as compared to males. Associated with exertion or emotional stress and relieved within several minutes by rest. Precipitated by cold weather or a meal. Some people present with atypical symptoms, including breathlessness, nausea, or epigastric discomfort or burning. These atypical symptoms are particularly likely in older people, women, and those with diabetes.
Antacids and simple analgesics do not usually relieve the pain. If chest discomfort of whatever site is precipitated by exertion, relieved by rest, and relieved by glyceryl trinitrate, the likelihood of angina is increased.
During periods of pain, depression, or elevation of the ST segment may be observed. Even constant monitoring of the blood pressure and the pulse rate can lead to some conclusion regarding angina.
The exercise test is also useful in looking for other markers of myocardial ischemia: blood pressure response or lack thereof, in particular, a drop in systolic blood pressure , dysrhythmia and chronotropic response. Other alternatives to a standard exercise test include a thallium scintigram or sestamibi scintigram in patients unable to exercise enough for the purposes of the treadmill tests, e.
In patients in whom such noninvasive testing is diagnostic, a coronary angiogram is typically performed to identify the nature of the coronary lesion, and whether this would be a candidate for angioplasty , coronary artery bypass graft CABG , treatment only with medication, or other treatments. In hospitalized patients with unstable angina or the newer term of "high-risk acute coronary syndromes" , those with resting ischaemic ECG changes or those with raised cardiac enzymes such as troponin may undergo coronary angiography directly.
Nitroglycerin should not be given if certain inhibitors such as sildenafil , tadalafil , or vardenafil have been taken within the previous 12 hours as the combination of the two could cause a serious drop in blood pressure. Treatments for angina are balloon angioplasty , in which the balloon is inserted at the end of a catheter and inflated to widen the arterial lumen. Stents to maintain the arterial widening are often used at the same time.
Coronary bypass surgery involves bypassing constricted arteries with venous grafts. This is much more invasive than angioplasty. The main goals of treatment in angina pectoris are relief of symptoms, slowing progression of the disease, and reduction of future events, especially heart attacks and death.
Beta blockers e. ACE inhibitors are also vasodilators with both symptomatic and prognostic benefit. However, in patients without established cardiovascular disease, the increase in hemorrhagic stroke and gastrointestinal bleeding offsets any benefits and it is no longer advised unless the risk of myocardial infarction is very high.
Though sometimes used by patients, evidence does not support the use of traditional Chinese herbal products THCP for angina. This means testing for elevated cholesterol and other fats in the blood, diabetes and hypertension high blood pressure , and encouraging smoking cessation and weight optimization. The calcium channel blocker nifedipine prolongs cardiovascular event- and procedure-free survival in patients with coronary artery disease.
Additionally, many women with angina are found to have cardiac ischemia, yet no evidence of obstructive coronary artery disease on cardiac catheterization. Evidence is accumulating that nearly half of women with myocardial ischemia suffer from coronary microvascular disease, a condition often called microvascular angina MVA.
Small intramyocardial arterioles constrict in MVA causing ischemic pain that is less predictable than with typical epicardial coronary artery disease CAD. The pathophysiology is complex and still being elucidated, but there is strong evidence that endothelial dysfunction, decreased endogenous vasodilators, inflammation, changes in adipokines, and platelet activation are contributing factors.
The diagnosis of MVA may require catheterization during which there is assessment of the microcirculatory response to adenoside or acetylcholine and measurement of coronary and fractional flow reserve.
New techniques include positron emission tomography PET scanning, cardiac magnetic resonance imaging MRI , and transthoracic Doppler echocardiography. Managing MVA can be challenging, for example, women with this condition have less coronary microvascular dilation in response to nitrates than do those without MVA.
Aggressive interventions to reduce modifiable risk factors are an important component of management, especially smoking cessation, exercise, and diabetes management. The combination of nonnitrate vasodilators, such as calcium channel blockers and angiotensin converting enzyme ACE inhibitors along with HMG-CoA reductase inhibitors statins , also has been shown to be effective in many women, and new drugs, such as Ranolazine and Ivabradine, have shown promise in the treatment of MVA.
Other approaches include spinal cord stimulators, adenosine receptor blockade, and psychiatric intervention. All people with suspected angina should be urgently referred to a chest pain evaluation service, for confirmation of the diagnosis and assessment of the severity of coronary heart disease.
The prevalence of angina rises with increasing age, with a mean age of onset of Men with angina were found to have an increased risk of subsequent acute myocardial infarction and coronary heart disease related death than women. Similar figures apply in the remainder of the Western world. All forms of coronary heart disease are much less-common in the Third World , as its risk factors are much more common in Western and Westernized countries; it could, therefore, be termed a disease of affluence.
The adoption of a rich, Westernized diet and subsequent increase of smoking , obesity , and other risk factors has led to an increase in angina and related diseases in countries such as China History[ edit ] The condition was named "hritshoola" in ancient India and was described by Sushruta 6th century BC.
Angina pectoris estável e instável | Sintomas e causas | Tratamento
Folosim cookies pentru a colecta statistici anonime, pentru a va oferi functii avansate, precum si pentru a va putea livra continut personalizat de marketing. Poti decide ce cookie-uri vrei sa fie active. Cauzele anginei pectorale Diagnosticul anginei pectorale Tratamentul anginei pectorale Preventia anginei pectorale Angina pectorala este denumirea stiintifica a durerii in piept. Nu trebuie ignorata deoarece poate fi cauzata de grave probleme de sanatate. Reprezinta cea mai frecventa manifestare a cardiopatiei ischemice, boala care duce la scaderea fluxului de sange prin arterele coronare vasele care hranesc inima. Ce este angina pectorala? Pacientii o descriu adesea ca: presiune, strangulare, constrictie, caldura, o banda in jurul pieptului sau o greutate in centrul toracelui.
Angina pectoris: Ursachen, Symptome und Behandlung
This can be caused by narrowing of the blood vessels; a decrease in radius. Myocardial ischemia also can be the result of factors affecting blood composition, such as reduced oxygen-carrying capacity of blood , as seen with severe anemia low number of red blood cells , or long-term smoking. This imbalance can result from an increase in demand e. However, the pathophysiology of angina in females varies significantly as compared to males. Associated with exertion or emotional stress and relieved within several minutes by rest. Precipitated by cold weather or a meal.