Definition and cause
The heart is supplied with blood from his coronary arteries (coronary arteries). The driver of oxygen and nutrients to the heart muscle cells. Angina pectoris is chest pain. The pain occurs when ilttilbuddet to the heart is reduced.
By arteriosclerosis in the coronary artery pulse narrow these years, and the blood will find it difficult to pass (see article calcification of the coronary arteries). Most cases of heart spasm caused by arteriosclerosis, but can also be caused by other heart diseases, for example. cardiac diseases.
Increased metabolism (thyreotoksikose) can also strain the heart and give angina.
The pains occurs when the heart needs extra oxygen, which work by physical or mental strain. Some are experiencing angina in the cold, high heat or after large meals. The pains disappear completely at rest, often after 2-10 minutes, or by ingestion of a nitroglycerin tablet. The above namedstable angina pectoris.
In severe cases, pain upon even the slightest exertion or at rest (often at night), and this is called unstableangina pectoris.
Atherosclerosis and thus heart spasm associated with disponerende following reasons:
- Smokingis strongly associated with the disease, and of all ages significantly reduced the risk by smoking cessation.
- Male. Males develop diseases due to arteriosclerosis around. 10 years earlier than women.
- Hereditary conditions. There is an increased risk if arteriosclerosis occurs in the family.
- For high blood cholesterol, Particularly so-called LDL-cholesterol is bad.
- Lack of exercise. Even ½ -1 hour daily time is prevention of arteriosclerosis.
- High blood pressure.
- Using the pill.
Heart cramp is a frequent disease in Denmark and frameworks around. 2% of all 50-60-year-old men, and among 60-70-year-old is 4%. Both men and women can get the disease but the disease occurs later in women, and the above figures are the same for ten years older women. Women's risk increases after menopause.
Symptoms of heart spasm
Typically acting pain associated with physical activity or at the second load of the heart. The pain felt murrende and sultry behind the sternum (it feels as if the chest is laced together). The pains can jet off to the shoulders, arms, neck, jaw, back or abdominal region. Often, the radiation left side of the body.
If the symptoms occur at rest (eg. At night), it is a sign of severe narrowing of the coronary artery.
Beyond the pain may occur:
- Shortness of breath.
- Sweat Tours.
The first time Monday experiencing heart spasm, it can be very angstfremkaldende.
At a certain age have any greater or lesser extent arteriosclerosis. In most progressing so without symptoms, and you die of other causes. However, it is important to avoid as many of the above reasons operative as possible.
If you are not hereditary congested, there is very little risk from contracting the disease arteriosclerosis, particularly when there are normal weight, grows exercise, avoid stress and not smoking.
Have we diabetes (diabetes), it is important to pay extra attention to their blood pressure and signs of arteriosclerosis.
Has it been reported angina, it is very important that you follow this advice with regard to medication and physical exercise. It does not mean that we should refrain from physical activity (including sexual activity). You can indeed "push" the threshold for attacks, so they come less often if you regularly cultivate easy exercise such as cycling and walking.
The diagnosis made by the physician at the typical pain arising from the activity. When the patient comes to the doctor, the attack is typically passed over, and there is just nothing to see. During the attack, there will be changes typical to see an electrocardiogram (ECG). It will therefore often choose to make a so-called work test in which an ECG recorded during physical work, for example. on a kondicykel. This study gives the physician an idea of the seriousness of the disease.
If the test does not give a clear result, there are other ways to assess cardiac oxygen uptake and work capacity (skintigrafi, PET scanning) and echocardiography).
The doctor will take a blood test to check for elevated cardiac enzymes to rule out myocardial infarction (heart attack).
If the disease is not improved by medical treatment, will (especially among younger people) choose to perform a CAG (coronary angiography). Through a plug in an artery in the groin, a tube (a catheter) up to the heart. There sprayed a substance that lights up on X-ray pulse into the coronary arteries, and these can then be seen on an X-ray. Constrictions can be seen in this picture.
Treatment of heart spasm
Initially, your doctor will instruct in a healthier lifestyle by stopping smoking, change of diet (more green and more fiber diet), increased exercise and relaxation. Simultaneously dealt with an increased cholesterol with cholesterol-lowering medication (statins). Possibly high blood pressure are also addressed.
One suggested by the rest of signs of attack and always wearing nitroglycerin tablets to be melted under the tongue at the attack.
In more severe cases will be offered Monday ballonudvidelse operation with the narrowed artery. It is often inserted in the same context, a grill (a stent), which keeps åren constantly open. This operation is similar CAG through an artery in the groin.
Is ballonudvidelse not possible, you can choose a by-pass operation, where, by open surgery leads an artery from the chest down to the coronary artery after forsnævringspunktet to return blood to the heart. Another solution is to take a piece of blood vessel (vein) from the leg and sew it on coronary artery before and after throat, so the blood runs out of (town-match) throat.
Select and complications
One can without great problems of living with mild angina, and follow your doctor's prescription medicine and advice regarding lifestyle change, it is often possible to improve the condition.
Could this not be done, the solution is surgery, and there is little risk associated with a ballonudvidelse. The risk is somewhat higher at a by-pass operation. After successful surgery, the life cycle almost like the rest of the population.
Untreated can arteriosclerosis of the heart lead to the complete closing of the coronary arteries pulse and a blood clot with subsequent myocardial infarction.
Have we arteriosclerosis of the heart, there is great risk that we have it elsewhere in the body, and untreated are at high risk for particular stroke and kidney failure.