This disease is considered as a critical period of the onset of coronary heart disease, characterized by a high probability of myocardial infarction or death. Unstable angina is accompanied by a course of changes in the form and nature of angina attacks. Manifestations of pathology allow us to consider it as an intermediate between myocardial infarction and angina pectoris, but the degree of ischemia is not sufficient to cause myocardial necrosis.
Stable and unstable angina - differences
Stable angina pectoris arising from a certain physical load. For example, the patient knows that he will feel unwell, after walking half a kilometer. He also knows that it is possible to overcome the pain syndrome by taking nitroglycerin.
A peculiarity of the unstable course of angina is that its signs can manifest itself when a person is in a stationary state, and taking even two nitroglycerin tablets will not help get rid of the pain. This form of the disease also includes angina, which was first detected.
In general, the unstable form of the disease is a condition preceding the infarction . Therefore, after angina pectoris, either convalescence or myocardial infarction is possible.
Unstable angina pectoris - classification
Most often, when considering this disease use the classification developed by Braunwald, who identified three stages of the development of the disease. In this case, the higher the class, the more likely the occurrence of complications:
- The appearance of the first manifestations of unstable angina of tension for two months.
- The angina of rest, disturbing during the whole month except for the last 48 hours.
- The acute form of angina in the last 48 hours.
Unstable angina symptoms
The disease is accompanied by attacks, but when processing an anamnesis, you can identify signs of unstable progressing angina:
- Increased frequency of seizures and a change in the nature of their course, which was noticed in the last two months;
- the occurrence of seizures at night and at rest;
- about the first time manifested itself angina is the appearance of seizures;
- previously helped nitroglycerin lost its effectiveness.
Treatment of unstable angina
Detection of the symptoms of the disease provides for urgent hospitalization. Patients are prescribed ECG, blood donation for analysis, passage of myocardial scintigraphy. The treatment process should be under the watchful eye of doctors.
Treatment of pathology consists in relief of pain, prevention of new signs of unstable angina and stroke of the myocardium. Since the cause of the disease is most often the destruction of plaque formed as a result of atherosclerosis and the development of a thrombus, the patient is primarily prescribed aspirin, beta-blockers, nitrates.
Nitrates are actively used since the end of the 19th century. With their help, expand the veins, reducing the pressure experienced by the ventricles. These substances also possess a coronary dilating property and the ability to prevent the formation of thrombi.
The use of beta-adrenoreceptors can reduce the number of cardiac beats, thereby reducing the oxygen demand experienced by the myocardium. Also, the drug increases the duration of coronary perfusion, which contributes to the normalization of blood supply to the myocardium.
Aspirin inhibits the work of cyclooxygenase, which leads to the production of thromboxane, a substance that has a vasoconstrictor property. After using aspirin, the risk of thrombus formation is reduced.