Stable angina: its functional classes and the treatment

Classification

There is not one classification of stable angina. Often in medical practice in the assessment of severity and prediction used the division into functional classes I to IV.

1. I class. These include stable angina in a mild form. Rare attacks happen only when a significant physical exertion and at once disappear when the load reduction or cessation of work. Moderate physical activity, regular walking on a flat road and up the stairs do not cause any discomfort and is well tolerated.
2. Class II. Physical activity is limited: the speed when walking is not more than 4 km per hour. Signs of angina occur when passing briskly the two blocks on level ground or when climbing the stairs one floor.
3. Class III. Physical activity is significantly reduced – no more than 3 km per hour. Attacks of stable angina appear with the passage of the two quarters not a fast pace on a flat road and climb the stairs one floor. The pain quickly removed nitroglycerin.
4. Class IV. Angina during slow walking for a distance of 100 metres, with little physical work, for example when putting on shoes. Retrosternal pain may occur at rest.

Signs

The main symptom of stable angina is pain that occurs when walking, emotional stress, physical work. Patients may describe their feelings. It can be suffocation, heaviness or pressure behind the breastbone. Often complain of a clear pain that is compressing, burning, squeezing, arching. The pain may radiate to arm, shoulder blade, neck, epigastric area, jaw. During an attack of angina it is impossible to take a deep breath. Patients slow down the pace of walking, stop or try to sit, press a hand to his chest. The attack is accompanied by the following symptoms:

• the feelings of fear;
• excessive sweating;
• the feeling of fatigue;
• the increase or decrease of blood pressure;
• tachycardia;
• pallor of the skin;
• fading in one position;
• nausea, vomiting.

Nitroglycerin belongs to the short-range nitrates. It dilates blood vessels and stops the attack quickly – within one to three minutes. Taken sublingually (under the tongue) or in the form of a spray, its effect lasts for about half an hour. In chronic stable angina should always carry this drug. Make is only recommended when the pressure leads to pain syndrome. Reception under language are preferable.

Nitropreparatov long-acting take 1-4 times per day. Creams and skin patches with nitrates contribute to the flow of a drug through the skin inseveral hours. They are quite effective, but with constant use for a long time their effect may be reduced. Therefore, it is recommended to take breaks for 12 hours.

Beta-blockers

These drugs neutralize the effects of adrenaline on the heart. They reduce the need heart of oxygen, reduces the heart rate under load and at rest. Beta-blockers improve prognosis in coronary heart disease, reduce the risk of heart attack and sudden death.

Antiplatelet agents

Prescribed for coronary artery disease to reduce the risk of death. These include aspirin, which prevents the accumulation of platelets on vessel walls and their bonding. Patients with coronary artery disease are usually recommended to take 0.5–1 tablet daily. Intolerance of aspirin is prescribed its analogues, for example tiklopidin.

Calcium antagonists

The calcium channel blockers include drugs such as verapamil and diltiazem. They reduce the tone of blood vessels, prevent their contraction and spasms.