exertional angina
Introduction
Introduction to labor angina Labor angina refers to angina induced by increased myocardial oxygen demand due to physical labor or emotional agitation. The main reason for the abnormal coronary artery stenosis is that the blood flow cannot meet the required increase. basic knowledge Sickness ratio: 0.1% Susceptible people: no specific population Mode of infection: non-infectious Complications: angina pectoris unstable angina
Cause
Causes of exertional angina pectoris
In the case of physical activity such as cold wind, running, chasing a bus, riding a bicycle, lifting heavy objects, going up the stairs, etc., when the myocardial oxygen demand is increased, because the coronary artery has a lesion that cannot meet the oxygen demand, Chest pain can occur due to insufficient blood supply, which is labor angina.
Prevention
Labor angina prevention
1. Control salt intake
Eat less salt, the main component of salt is sodium chloride, long-term consumption of sodium chloride, high blood pressure, damage to the vascular endothelium. The daily salt intake of patients with angina should be controlled below 6 grams.
2, control fat intake
Eat less fat and reduce calorie intake. A high-fat diet increases blood viscosity and increases blood lipids. Hyperlipidemia is the cause of angina. The amount of cooking oil should be minimized, and oil is also an important substance for fat formation. However, vegetable oil containing unsaturated fatty acids can be selected instead of animal oil. The total daily oil consumption should be limited to 5-8 teaspoons.
3, avoid eating animal internal organs
Animal internal organs are rich in fatty alcohols such as liver, heart, kidney and the like.
4, quit smoking and alcohol
As we all know, tobacco and alcohol are harmful to the human body. It not only induces angina but also induces acute myocardial infarction.
5. Eat more foods rich in vitamins and dietary fiber.
Such as fresh vegetables, fruits, coarse grains, etc., eating more sea fish and soybeans is beneficial to the prevention and treatment of coronary heart disease.
6, eat more foods that help improve blood vessels
Such as garlic, onions, hawthorn, black fungus, jujube, bean sprouts, squid and so on.
7, avoid eating irritating food and flatulence food
Such as strong tea, coffee, pepper, curry and so on.
8, pay attention to eat less meals, avoid overeating
Dinner should not be too full to avoid acute myocardial infarction.
Complication
Labor angina complications Complications, angina pectoris, unstable angina
1, arrhythmia
The cause of arrhythmia caused by variant angina pectoris is coronary artery spasm, sudden occlusion of blood vessels, repolarization inconsistent reentry and myocardial electrical instability after myocardial ischemia and reperfusion, the longer the ischemic time, the higher the ST segment elevation Obviously, the more prone to arrhythmia, the cause of coronary artery spasm is a large number of smoking, alcohol and infection, etc., because coronary artery spasm occurs on the basis of coronary artery disease, so should actively prevent risk factors, such as: quit smoking, lipid-lowering , lowering blood pressure, lowering blood sugar, etc., coronary artery sputum can not only induce severe arrhythmia, but also can cause sudden death due to myocardial infarction, clinically should be highly valued, common ECG sometimes difficult to capture arrhythmia, dynamic electrocardiogram and ECG monitoring It can provide evidence of arrhythmia. Therefore, patients with variant angina should be closely monitored for ECG, early detection of malignant arrhythmia, early treatment to prevent sudden death.
2. myocardial infarction
Due to acute coronary occlusion, blood flow is interrupted, causing severe and persistent ischemic myocardial necrosis, clinical manifestations are sudden, severe and persistent post-sternal pain, characteristic electrocardiographic dynamic progression and increased serum enzymes, heart rhythm can occur Malfunctions such as dysfunction, heart failure, shock, etc., can often be life-threatening. About half of patients with acute myocardial infarction have prodromal symptoms 1 to 2 days or 1 to 2 weeks before onset, the most common being the original stable type. Angina pectoris becomes unstable, or there is no angina, and there is a sudden long-term angina. The typical symptoms of myocardial infarction include sudden and severe post-sternal compression pain, rest and nitroglycerin can not be relieved, often accompanied by irritability. Sweating, fear or sudden death; a small number of patients without pain, initially manifested as shock or acute heart failure; some patients with pain in the upper abdomen, mistaken for gastric perforation, acute pancreatitis and other acute abdomen, stroke-like episodes Can be seen in older patients, systemic symptoms: fever, increased white blood cells, increased erythrocyte sedimentation rate; gastrointestinal symptoms: more common in patients with inferior wall infarction Arrhythmia: seen in 75% to 95% of patients, occurring within 1 to 2 weeks of onset, but more common within 24 hours, anterior wall myocardial infarction prone to ventricular arrhythmia, inferior myocardial infarction prone to compartment Conduction block; heart failure: mainly acute left heart failure, occurring in the first few hours of onset, the incidence rate of 32% to 48%, manifested as dyspnea, cough, cyanosis, irritability and other symptoms.
Symptom
Symptoms of labor angina pectoris common symptoms tired chest pain chest tightness shortness tachycardia skin pale anxiety
The pain can be located in the lower sternum, the left anterior region or the upper abdomen, radiating to the neck, lower jaw, left scapula or right anterior chest. The pain can quickly disappear or only the left front chest is uncomfortable and nausea.
Examine
Examination of exertional angina
1, ECG examination.
2, cardiac X-ray examination.
3. Radionuclide inspection.
4. Coronary angiography.
5, intravascular ultrasound imaging examination.
6, angioscopy.
Diagnosis
Diagnosis and identification of labor angina
1, initial angina pectoris, refers to patients who have never had angina, labor angina occurred in the last month. This type of angina has a tendency to gradually increase, and is prone to myocardial infarction.
2, stable angina, the condition is stable for more than a month, that is, the frequency of angina attacks, incentives and seizure time are about the same. This chest pain episode has a clear labor or emotional incentive. The time of chest pain at each episode is relatively fixed, and the degree of pain is not much different. Chest pain is relieved quickly after rest or nitroglycerin in chest pain.
3, worsening angina pectoris, the original stable angina, and the frequency of recent angina attacks increased, the degree of aggravation, the duration of growth, can be caused by more and more light activities, even at rest, the use of nitroglycerin is not easy to relieve.
4, intermediate angina, occurred in one or several times of rest of the chest pain for more than 15 minutes, but no evidence of acute myocardial infarction. It is an intermediate type of myocardial ischemia between unstable angina and myocardial infarction.
5, angina after myocardial infarction, refers to recurrent angina after acute myocardial infarction.
