Symptoms and diagnosis of angina heart

Forms of angina pectoris

If the attack is associated with a rapid walk, haste, excitement, performing heavy physical work, form of the disease called "angina".

More severe "angina at rest". The attack occurs at rest, often at night. This is due to the predominance during sleep, the vagal tone. Patients Wake up from the beginning of the pain.

More modern names:

• stable angina — equivalent "angina", the favourable prognosis and treatment effects;
• unstable form — the occurrence of seizures not associated with any of the reasons for unfavorable, is often a harbinger of heart attack;
• progressive — accompanied by a long night of painful seizures, asthma, arrhythmias, difficulty in treatment.

The disease

In the course of the disease distinguish three periods with different symptoms.

1. The first period is characterized by a reversible (functional) changes, causing vascular spasm. The seizures are clearly linked to emotions, excitement in young and middle-aged who do not have manifestations of atherosclerosis. The first signs of angina are associated with Smoking in men, with climacteric neurosis in women.
2. Second period — long spasm of coronary vessels lead to the development of atherosclerotic narrowing, although the mechanism remains spasm. The fits are unstable.
3. Third period — the fore atherosclerotic changes, seizures, complicated by heart failure, arrhythmia. Repeated attacks lead to the development of small foci of infarction.

Intercostal neuralgia is a manifestation of osteochondrosis of the cervical-thoracic spine — for the purpose of differential diagnosis, you can ask the patient to bend down, turn aside. Is determined by tenderness in okolomatocnah the area where nerves branch out, in the course of the ribs. There is no typical seizures.

In acute cholecystitis, gallstones pain may resemble angina, but the patient interviews explains their relationship with food, diet violation. They are accompanied by nausea, vomiting, bitterness. Deep palpation of the abdomen helps to identify typical symptoms of irritation of the gallbladder.

Shoulder-scapular periarthritis of the left joint provokes pain when moving the left hand, gives tenderness to palpation.

Of importance, the difference from acute myocardial infarction. You should note that when a heart attack:

• pain have a significantly greater intensity, they are described by patients as "burning, stabbing, unbearable";
• appear more frequently undermorning, last several hours and days;
• not depend on the severity of the physical stress;
• not reduced under the action of nitroglycerin.

In diagnosis one should always bear in mind atypical manifestations of diseases. So skilled surgeon in the absence of full confidence in the defeat of the heart still hospitalitynet patient in a hospital, if he was taken Ambulance for observation and control. In such cases, overdiagnosis is justified.