Indicates Of Angina Pectoris (Chest Tightness)

Severe chest pain with a characteristic feeling of tightness in the chest is an indication of angina pectoris. They can be the harbinger or symptom of a heart attack. Get to know symptoms, causes, and therapy. Angina pectoris (or stenocardia) literally means “tightness in the chest”. That also describes the complaints. Those affected report a seizure-like, sometimes violent, feeling of tightness in the heart or chest area. These pain attacks indicate a circulatory disorder of the coronary arteries and an insufficient supply of the heart muscle. Thus, they are an important and typical symptom of coronary heart disease (CHD). However, every attack of angina pectoris can also be a heart attack.

Synonyms

Chest tightness, tightness of the heart, stenocardia

Forms Of Angina Pectoris

Doctors differentiate between stable and unstable angina pectoris and the special form of Prinzmetal’s angina.

    • Stable angina pectoris: Stable angina pectoris occurs depending on the load and is triggered by various factors. These include physical activities, emotional stress, stress, cold or even lavish meals. The intensity of the complaints remains almost the same with every attack.
    • Unstable angina pectoris: The unstable angina pectoris occurs independently of stress and is also known as resting angina. Any new chest tightness or chest tightness with variable symptoms is also unstable angina pectoris. Angina nocturna is a special form. The symptoms mainly occur at night. When lying down, more blood flows back into the heart. This represents a higher requirement for the previously damaged heart muscles. This additional stress manifests itself as angina pectoris.
    • Prinzmetal angina: Prinzmetal angina (also called vasospastic angina) is a special form of angina pectoris. The chest complaints are felt independently of stress, often at night, and are caused by vascular spasms.

Symptoms of angina are the most characteristic. A rather dull pain begins behind the breastbone and spreads over the chest in the shape of a tire. Often these pains are perceived as extremely strong, oppressive, and threatening. They typically radiate into the left arm, upper abdomen, neck, or lower jaw. Radiation to other areas of the body is also possible. In addition, there is often shortness of breath and cold sweat, blood pressure soars, and the pulse races. Some patients are scared to death. Sometimes angina pectoris is misinterpreted as heartburn or heartburn is mistaken for angina pectoris. In English, heartburn is therefore also referred to as heartburn.

An attack of angina pectoris can pass within seconds, but it can also last for minutes, less often for hours. If an attack lasts more than 15 minutes, a heart attack is suspected.

Indicates Of Angina Pectoris

Causes

Most angina is caused by Coronary Artery Disease (CHD). The coronary arteries are narrowed as a result of arteriosclerosis. As a result, the heart muscle is only insufficiently supplied with oxygen, especially when it is exerted. This reduced blood flow and insufficient oxygen supply cause the symptoms.

Angina pectoris is not only triggered by physical activities such as climbing stairs or jogging. Cold or heavy meals can also provoke an angina pectoris attack. When it is cold, for example, the resistance in the blood vessels increases. This reduces the blood flow to the heart muscle, and chest problems occur.

Lush meals stimulate digestive activity, the stomach and intestines have to be supplied with more blood. The heart muscle then has less blood available, which leads to an attack of angina pectoris.

Vascular Spasms Lead To Prinzmetal’s Angina

An exception to angina pectoris is Prinzmetal’s angina. In this form, the insufficient supply of myocardium is triggered by vascular spasms in the coronary arteries. These vascular cramps (spasms) occur mainly at night and at rest.

Examination

Angina pectoris is diagnosed based on the typical symptoms. For further clarification, a blood test, an electrocardiogram (EKG), and an image of the coronary vessels (coronary angiography) can follow.

Treatment

The therapy for angina pectoris is different. Depending on the severity of the symptoms and the condition of the coronary arteries and the heart muscle, medicinal or surgical measures are initiated.

Medicines For Angina Pectoris

Various active ingredients are available to the doctor for the drug treatment of angina pectoris:

    • The narrowed coronary arteries are usually dilated with nitro-based vasodilators (such as isosorbide mononitrate and isosorbide dinitrate) or molsidomine.
    • In addition, beta-blockers (e.g. atenolol, bisoprolol, carvedilol, and metoprolol), calcium antagonists (such as verapamil or diltiazem), and dihydropyridines (such as amlodipine and nifedipine) are often used to lower blood pressure and heart rate.
    • If beta-blockers are not tolerated or must not be taken, the relatively new active ingredient ivabradine can help. Ivabradine lowers the heart rate without affecting blood pressure or the strength of the muscles in the heart.
    • The active ingredient Trapidil can improve the blood flow to the heart muscle.
    • In order to reduce the risk of a vascular occlusion and thus the risk of a heart attack, low doses of acetylsalicylic acid and anticoagulant agents such as phenprocoumon are used.
    • Cholesterol-lowering drugs from the group of statins, for example, atorvastatin, simvastatin, lovastatin, or pravastatin, help to lower the risk of atherosclerosis or to stop the course of atherosclerosis.

Operative Therapy

Occasionally, narrowed coronary arteries are surgically widened or renewed. The methods of choice for the surgical treatment of angina pectoris are so-called percutaneous coronary intervention (PCI) and bypass surgery. PCI is performed using a cardiac catheter. The doctor pushes a folded balloon up to the coronary arteries – usually through the inguinal artery. The balloon unfolds at the narrowed point (balloon dilatation) and holds the vessel open. A small lattice frame made of stainless steel (so-called stent) around the balloon sometimes secures this method.

In a bypass operation, a vascular blockage is bridged with another blood vessel.

Self Help

Even if an attack of angina pectoris feels threatening: keep calm. Sit up straight and try to breathe calmly and evenly. Usually, the pain goes away within a short time.

Patients with angina pectoris have spray or bite capsules with glycerol trinitrate (nitro spray, microcapsules) as emergency medication. After the application, the blood vessels dilate and breast problems usually improve quickly. If this is not the case, there could be a heart attack. In this case, please call the emergency doctor immediately.

Pay attention to the duration of the complaints. If the pain persists for more than 15 minutes, you should definitely alert the emergency services. Medical professionals refer to this condition as an acute coronary syndrome.

Prevention

Regular medical check-ups provide information on possible risk factors for angina pectoris (e.g. arteriosclerosis). If you are legally insured, you can have a check-up every two years from the age of 35 at Check-up 35. Above all, patients with diabetes and overweight as well as smokers should take advantage of this offer.

Smokers are also advised to stop using the vice. You can obtain information on this from your family doctor, health center or your health insurance company. Furthermore, you should pay attention to normal body weight and a healthy, varied diet. Patients with lipid metabolism disorders, high blood pressure values ​​, and diabetics should ensure normal blood values ​​and carefully follow their therapies.

Heart Valve Disease Symptoms And Treatment

Heart valve disease can affect any of the valves in the heart. The heart valves have flaps for opening and closing with each heartbeat, allowing blood to flow through the heart of the upper and lower chambers and the rest of the body.

The heart has four valves :

    1. Tricuspid valve located between the right atrium and the right ventricle
    2. Pulmonary valve located between the right atrium and the pulmonary artery
    3. Mitral valve, which is located between the left atrium, and left ventricle
    4. Aortic valve between the left ventricle and the aorta

Blood flows from the right and left atria across the tricuspid and mitral valve, allowing the blood to flow into the right and left ventricles. These valves then close the blood flowing back into the atria. Once the heart chambers are filled with blood, they begin to contract, forcing the lung and aortic valves to open. Blood then flows into the pulmonary artery and the aorta. The pulmonary artery carries oxygenated blood from the heart to the lungs and the aorta, the body’s largest artery, is responsible for carrying oxygen-rich blood to the rest of the body.

Basically, the heart valves work by making sure that blood flows in the forward direction and does not secure or leaks. If an individual has a valvular disease, the valve will not be able to do this job properly. This can be caused by regurgitation, stenosis or a combination of both.

Some individuals may experience no symptoms while other disorders such as strokes, heart attacks and thrombosis occur when the heart valve disease is left untreated.

valvular-heart-disease

Valvular heart disease

Mitral valve prolapse

This can also be called floppy valve syndrome, click marbles syndrome, balloon mitral valve or Barlow syndrome. It occurs when the mitral valve does not close properly, sometimes causing blood to flow back into the left atrium.

Most people with mitral valve prolapse do not require symptoms and no treatment as a result. However, symptoms such as palpitations, shortness of breath, chest pain, fatigue and coughing may indicate that treatment is necessary.

The treatment includes surgery to repair or replace the mitral valve.

Bicuspid aortic veins

This happens when a person is born with an aortic valve that has two valves instead of the usual three. In very severe cases, symptoms of this type of disorder are present at birth. However, some people may know that they have decades to go without this type of disorder. The valve is usually able to work for years without causing any symptoms, so most people with premolar aortic valve disease are usually diagnosed only in adulthood. According to the Cleveland Clinic, 80 percent of people with this form of heart valve disease will be operated to repair or replace the valve, which usually happens when they are in their 30s or 40s.

Symptoms include shortness of breath during exercise, chest pain and dizziness or fainting. Most people are able to successfully repair their aortic valve with surgery.

Valvular

This occurs when a valve is unable to fully open, which means that insufficient blood is able to flow through the valve. This can affect one of the heart valves, and can be caused by the heart valve thickening or stiffening.

Symptoms can include chest pain, shortness of breath, tiredness, dizziness and fainting. Some people do not need treatment. Other people may use valvuloplasty, which uses a balloon to inflate the valve or flap replacement surgery.

Valve insufficiency

This can also be called a “leaky valve” and occurs when one of the heart valves does not close properly, causing the blood to flow backwards. Symptoms include shortness of breath, coughing, tiredness, palpitations, drowsiness and swelling of the feet and ankles.

The effects of valve failure vary from person to person. Some people need to monitor their condition. Others may need prescribed medications to prevent fluid retention while others have valve repair or replacement.

heart-valve-disease-symptoms

Causes Of Valvular Heart Disease

There are a number of causes of various heart valve diseases. Causes can be :

    • birth defect
    • Endocarditis inflammation of the heart tissue
    • Rheumatic fever inflammatory disease brought on after group A streptococcal infection
    • Age-related changes, such as calcification
    • Heart attack
    • coronary artery disease
    • Cardiomyopathy degenerative changes in the heart muscle
    • Syphilis is a relatively rare sexually transmitted infection
    • hypertension
    • Aortic aneurysms abnormal swelling or protrusion of the aorta
    • Atherosclerosis Arteriosclerosis
    • myxomatous degeneration weakening of the connective tissue in the mitral valve
    • Lupus a chronic autoimmune disease,

Heart Valve Disease Symptoms

Symptoms of heart valve disorders according to the severity of the disease. Usually, the onset of symptoms indicates that the disorder is affecting blood flow. Many people with mild or moderate valvular heart disease experience no symptoms. However, symptoms can be :

    • shortness of breath
    • palpitation
    • fatigue
    • Chest pain
    • Dizziness and fainting
    • a headache
    • to cough
    • Water retention or swelling in the lower extremities and abdomen
    • Pulmonary edema or excess fluid in the lungs
How are heart valve diseases diagnosed?

If you have symptoms of heart valve disease, your doctor will start by listening to the heart using a stethoscope. He or she will listen for any heart rate abnormalities that might indicate a problem with the heart valves. Your doctor may also listen to the lungs to determine if there is fluid retention as well as check your body for signs of water retention, both symptoms of heart valve problems.

Other tests that can diagnose for valvular heart disease include :

    • Electrocardiogram is a test that shows the electrical activity of the heart. This test is used to check arrhythmia.
    • Echocardiography uses sound waves to create an image of the heart valves and chambers.
    • Cardiac catheterization is another test to diagnose valve disorders. This test uses a thin tube or catheter with a camera to take pictures of the heart and blood vessels. This can help to determine with your doctor the nature and severity of the disease valve.
    • A chest x-ray can be ordered to take a picture of your heart. This may be your doctor if your heart is enlarged.

Magnetic resonance imaging can create a more detailed picture of the heart. This can help to confirm a diagnosis and help your doctor determine how best to treat your valve disorder.

A stress test can also be used to determine how the symptoms are affected by physical exertion. The information from the stress test can help your doctor determine the severity of your condition.

Treatment Options

Treatments for heart valve disorders depend on the severity of the disease and symptoms. Most doctors recommend starting with conservative treatment. This includes :

    • consistent medical supervision
    • smoking
    • a healthy diet

Medications that are usually prescribed are :

    • Beta blocker and calcium channel blocker to help control heart rate and blood flow
    • Reduce diuretics for fluid retention
    • vasodilating drugs that open or dilate the blood vessels

Surgery may be needed if the symptoms increase in severity. This can be used to repair heart valves with patient’s own tissues or heart valve replacement with animal valves, donated valves, mechanical or valves.

Valvuloplasty can also treat the stenosis. A small balloon inserted into the heart, where it is slightly puffed up. The inflation will be the size of the opening in the valve and then the balloon is removed.

Cardiomegaly Heart Disease Expansion Cardiomyopathy

Cardiomegaly is not a disease, but the symptom of a problem with the heart, which causes it to become enlarged. Your heart may become enlarged during pregnancy, or due to a condition that puts stress on the heart, such as coronary artery disease, prolapse or stenosis of one of the heart valves, or problems in the electrical heart rhythm. Occasionally the cause of an enlarged heart may not be known.

The symptoms of cardiomegaly are variable. In the early stages, no symptoms will be felt. Then, as the heart continues to grow, some people will not experience any symptoms at all, while others experience shortness of breath, dizziness, an abnormal heart rate, cough, chest pain or swelling in the feet. The symptoms may be caused by the condition that causes the heart to be enlarged. For example, if your heart valves have been damaged by rheumatic heart disease, you may notice an irregular heartbeat, also called an arrhythmia. Some cardiac arrhythmias cause shortness of breath and dizziness.

High blood pressure causes the heart to work harder to pump blood through the body. When the heart needs to beat faster or harder, the muscles thicken producing cardiomyopathy or stiffening of the heart muscle, which can lead to cardiomegaly over time.

cardiomegaly-heart-disease-expansion-cardiomyopathy

A heart attack, infections, connective tissue disorders, congenital heart disease, certain medications, and cancer radiation can all damage heart, producing enlargement. Pulmonary hypertension, or high blood pressure in the lungs can increase the heart’s workload, causing the right side to be enlarged.

Iron deficiency anemia, resulting in a lack of red blood cells, produces a domino effect. If there are fewer red blood cells to transport oxygen, the heart must work harder to pump more blood to form the lack of oxygen. Over time, untreated anemia can lead to an enlarged heart. On the other hand, too much iron, or a problem with iron metabolism can put pressure on the left side of the heart, weakening the muscles and making balancing cardiomegaly.

Thyroid disorders, both a sluggish thyroid and an overactive thyroid can cause heart problems and cardiomegaly. A rare blood disorder called amyloidosis causes amyloids to build up abnormal proteins in the heart because of it’s enlargement.

Cardiomegaly may be asymptomatic or very serious, depending on the underlying cause or heart disease. The aim of the treatment is to control the symptoms and reduce whatever damage is caused by the factors causing enlargement of the heart. Cardiomegaly can not be cured, and usually can not be reversed, but it can be successfully treated and the symptoms controlled.