[ Physical Illness ]

* Illness of Heart & Vein *
Angina

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The detailed classification of heart diseases is wide-ranging as shown below.

Angina

Myocardial infarction

Heart failure

Endocarditis

Heart valve disease

Pericarditis

Congenital heart disease

Other heart diseases

Among them, angina and myocardial infarction are particularly important and attracting attention as heart diseases closely related to lifestyle-related diseases.

This page describes angina, which is especially important among heart, blood vessel, and blood diseases.

Illness of Heart and Vein

Angina

Myocardial Infarction

Hypertension

Heart Failure

Cardiac Arrhythmia

Pulmonary Embolism

Dissecting Aneurysm of Aorta

Essential Low Blood Pressure

Arteriosclerosis Obliterans
[ASO]

Varicose Vein of Lower
Extremity

A dedicated blood vessel for working the heart surrounds the heart and is called a coronary artery.

Angina is a condition in which the coronary arteries that supply blood to the heart itself become narrowed or blocked, and sufficient blood does not flow to the heart muscles that work the heart.

In angina, the blood vessels and heart muscles that work the heart become deficient in oxygen and nutrients due to insufficient supply of oxygen and nutrients, resulting in cell destruction and death.

The direct cause of angina is arteriosclerosis of the coronary arteries. The cause of arteriosclerosis is certainly the effect of aging, but the most important cause is improper lifestyle.

Angina causes paroxysmal chest tightness. Seizures disappear in 10 sec., to 10 - 30 minutes, but may be accompanied by dyspnea, headache, and vomiting.

In addition, if the symptoms of the attack are left untreated, there is a risk of developing more serious illnesses such as myocardial infarction and ventricular fibrillation.

According to Framingham Heart Study, about 500,000 people are newly diagnosed with angina each year in the United States.

[ A disease called Angina ]

What kind of disease is angina

The heart itself also needs oxygen and nutrients as an organ. The blood vessels that supply oxygen and nutrients to the heart muscle that functions the heart are called coronary arteries.

A disease in which there is a problem with the coronary arteries and insufficient oxygen and nutrients are delivered is called ischemic heart disease, and in severe cases, blood vessels and myocardium become necrotic.

A condition in which blood flow is insufficient but does not lead to necrosis is called "angina", and a condition in which necrosis occurs is a disease called "myocardial infarction".

An angina attack occurs when a person with arteriosclerosis in the coronary arteries is stressed by sudden exercise, strong stress, or bathing in a hot bath.

It starts with a mild pain in the heart, then becomes a tightening pain, and you may feel a strong sense of oppression. Pain and oppression disappear within 10 seconds if it is mild, and within 15 minutes at the longest. It does not exceed 30 minutes even when it is very bad.

Attacks of angina are rarely life-threatening, but if the symptoms of angina repeat many times, the risk of developing myocardial infarction (necrosis of the heart muscle, etc.) increases. Survival is extremely difficult in this case.

[ Symptom of Angina ]

Typical symptoms

The characteristic symptom of angina is that severe chest pain suddenly strikes and the pain lasts for a few seconds to 15 minutes and then disappears spontaneously. The degree of pain varies from mild to severe, and patients complain of chest tightness. It can be very painful and cold sweaty.

Chest pain

Discomfort

Pressure

Squeezing

Burning

fullness

Sweating

You may also have pain in your arms, neck, jaw, shoulder or back. Other symptoms that you may have with angina include:

Dizziness

Fatigue

Nausea

Shortness of breath

In this way, the most common symptom that many people feel is pain or pressure in the precordium around the back of the sternum, and pain in the entire chest, right or left chest, or epigastrium.

Pain often manifests as radiating pain towards the neck and left shoulder, sometimes reaching the back, throat, chin, etc., and some people feel that their teeth are floating. Occasionally, some people feel numbness from their left shoulder to their arms.

The frequency of angina attacks also varies from person to person. Some people do it a few times a month, while others do it many times a day.

Since the attack time of angina is within 15 minutes at the longest, if the pain continues for more than 15 minutes, the risk of causing myocardial infarction or ventricular fibrillation is extremely high, not just angina.

In particular, if you have symptoms such as severe headache, palpitation or arrhythmia, dyspnea, or vomiting, you must urgently call an ambulance to go to the hospital because it is life-threatening.

Types of angina

There are five types of angina:

Exercise angina

Rest angina

Variant angina

Stable angina

Unstable angina

< Exercise angina >

Physical exertion such as walking and climbing stairs, and mental excitement / stress are the incentives. After rest and stress relief, symptoms often improve within minutes, at most 15 minutes.

Normally, when the heart muscle becomes active due to exercise, etc., it needs sufficient oxygen and nutrients to maintain its normal function, and the peripheral part of the coronary artery expands to increase blood flow.

However, if the coronary arteries are narrowed due to arteriosclerosis, sufficient blood flow to the heart muscle cannot be delivered.

If the degree of stenosis is strong, only a small amount of movement will result in insufficient supply of oxygen to the heart muscle. Also, even if the degree of stenosis is mild, the same condition occurs when you exercise vigorously.

In other words, symptoms appear when the oxygen supply is insufficient for the amount of work done by the heart muscle.

< Rest angina >

Rest angina is angina that occurs regardless of exertion or stress. Atypical angina and unstable angina, which will be described later, belong to this category.

< Variant angina >

Atypical angina is angina caused by coronary spasm. It is characterized by many seizures at night and at dawn, regardless of exertion. In addition, administration of nitroglycerin significantly improves the condition.

< Stable angina >

Stable angina is angina with a constant incidence of seizures, and most exertional angina belongs to it.

< Unstable angina >

There are three types of this type of angina:

When symptoms of angina occur during light exertion or at rest.

If symptoms begin or become more likely to occur in the last month.

If seizures occur more than 3 times a day.

Compared to stable angina, severe stenotic lesions are often found in the coronary arteries, which is a condition that is more likely to develop into myocardial infarction.

[ Cause of Angina ]

Causes of angina

A direct cause of ischemic heart disease such as angina and myocardial infarction is coronary atherosclerosis.

Attracting this are risk factors such as hyperglycemia, hyperlipidemia, constitutional inheritance (family members with such people in the family), and special personalities.

People with special personalities are those who are confident, meticulous, enthusiastic about their work, hate to lose, have a strong desire for success and control, and have a strong temper, and those who are easily frustrated and angry.

People who are constantly exposed to intense stress and tension, and people who are addicted to alcohol and tobacco are also dangerous.

In any case, the number one cause of angina cannot be overlooked over the years of bad lifestyle habits.In addition, it is also important for a hard worker who is too careful to take a little care and relax.

[ Diagnosis of Angina ]

How to diagnose angina

There are two types of heart disease tests: general tests that are performed in daily preventive medical examinations, and urgent tests that are performed due to the occurrence of seizures.

The tests themselves include non-invasive tests that do not pierce the body directly with a needle or insert a tube, and invasive tests that do not pierce the body with a needle or insert a tube.

A non-invasive test is usually performed, and if an abnormality is found, an invasive test is also performed.

When testing for heart disease, a doctor will first ask you a question or auscultate. And since high blood pressure is one of the causes of heart disease, blood pressure is measured.

This will give you an idea of the current state of the heart and determine the effectiveness of medications such as blood pressure lowering agents. If any of these are abnormal, proceed to electrocardiography.

The figure below shows the sequence of signals flowing in the normal cardiac stimulation transmission system.

In electrocardiography, three waveforms, P wave, QRS wave, and T wave, are measured. The P wave indicates the electrical excitement of the atrium, and the QRS complex indicates the electrical excitement of the ventricles. The T wave is the waveform when the electrical excitement of the ventricles is restored.

When there is something wrong with the heart, a waveform peculiar to the abnormality appears, so a doctor can judge the heart disease and its progress by looking at the electrocardiogram.

For the diagnosis of ischemic heart disease such as angina, a measurement called exercise electrocardiography is performed while performing prescribed exercise and putting a burden on the heart.

Measure the electrocardiogram while doing a light exercise like walking on a conveyor belt.

Even with angina, there seems to be no particular change in electrocardiography in a quiet state without chest pain. However, an exercise electrocardiogram reveals a pattern peculiar to angina, which makes a correct diagnosis of angina.

The heart disease tests that can be performed at ordinary clinics are as described above, but there are various other methods as follows.

Echocardiography

Chest x-ray

Cardiac catheterization

Coronary angiography

Cardiac nuclear medicine examination

CT

MRI measurement

Multiple of these tests may be done, such as in the event of a real seizure.

[ Treatment of Angina ]
Treatment policy for angina	In order to prevent ischemic heart disease such as angina pectoris and myocardial infarction, it is necessary to keep in mind a modest daily life and pay attention to the following points. Drinking and eating Well-balanced diet No smoking Moderate exercise Adequate rest and sleep If you have an attack or symptom of ischemic heart disease such as angina or myocardial infarction, you should receive appropriate treatment early. Treatment methods include drug therapy, catheter treatment and surgery, depending on the symptoms and stage. If you have an angina or myocardial infarction attack, you should not hesitate to call an ambulance and be treated at a hospital with a CCU. The sooner the lifesaving rate increases. CCU stands for "Cardiac Care Unit", a coronary care unit.
Drug therapy	As drug therapy, the following drugs are used according to the symptoms. Vasodilators that dilate blood vessels to improve blood flow A blood pressure lowering agent that lowers blood pressure and reduces the burden on the heart Antiplatelet agent that lowers blood viscosity and makes blood smooth A diuretic that reduces the burden on the heart by producing a large amount of urine Cardiac stimulant that strengthens the work of the heart itself Antiarrhythmic agent that normalizes pulse disorder Emergency silver bullets for angina are nitrates (nitroglycerin tablets) as vasodilators and calcium channel blockers. Among them, nitrate sublingual tablets have an immediate effect and are particularly effective during an attack of angina. It can also be used just before a seizure is likely to occur. There are also patches and transdermal absorbents that are applied to the skin to absorb the drug components from the skin. This is a preventive drug and does not stop seizures, but it has a long-lasting effect, so if you apply it before bedtime, it will help prevent seizures in the early morning. The patch is applied to soft areas of the skin such as the upper abdomen, chest, and upper arms, but to avoid irritation to the skin, the place to apply should be changed little by little each time. In addition, this patch has side effects that tend to cause dizziness, light-headedness, lightheadedness, and decreased blood pressure. If you continue to apply it for a long time, you may have a severe headache. In addition, avoid sudden rises and violent movements. You also need to be careful when driving a car. If you experience side effects, it can be dangerous, so consult your doctor immediately.
Treatment with catheter	The treatment method using a catheter is to insert a small balloon with a diameter of 2 to 4 mm and a length of about 20 mm into the lesion of the damaged and narrowed coronary artery, which is the direct cause of angina and myocardial infarction, and inflate the coronary artery. It is a method of expanding from the inside. This catheter method is applicable to relatively mildly ill patients. After expanding the blood vessels, the balloons are contracted and removed. Another method is to insert a small tubular wire mesh called a stent inside the blood vessel to inflate it and leave it as it is.
Surgery	More severely ill patients require extensive surgical treatment called coronary artery bypass surgery. This method is a method to improve blood flow by connecting another blood vessel to the tip of a narrowed blood vessel or an occluded lesion to create a bypass path. Previously, this surgery was performed with a heart-lung machine that completely stopped the heart, but recent medical advances have made it possible to perform surgery without stopping the heart. However, in any case, there is no difference in surgery that requires extremely advanced equipment and techniques.

[ Physical Illness ]

* Illness of Heart & Vein * Angina

* Illness of Heart & Vein *
Angina