Vasospastic angina: symptoms and treatment
The main symptom of angina prinzmetals is a pain, while from the classical variant of the disease it is distinguished by several characteristics:
- pain syndrome occurs primarily at night, almost always at the same time;
- there is a clear link to the provoking factor;
- duration of attack no more than 15-20 minutes;
- passes quickly when taking nitroglycerin under the tongue;
- pain burning or pressing, is localized behind the breastbone or in the left half of the thorax, often radiates to the left arm.
ECG at the time of the attack will receive a ST-segment elevation, reaching 30 mm. In this case, it is a sign of damage to subepicardial (outer) layers of the myocardium. After the termination of the pain syndrome ECG fairly quickly returns to its original settings.
Very often the attack is complicated by the development of arrhythmia, including ginepraia. Just as a result of it and there is a loss of consciousness or fatal outcomes.
Difficulties with diagnosis are lack of objective methods of instrumental diagnostics. The most informative is the conduct of coronary angiography (study of blood vessels of the heart using contrast material and x-rays). In variant angina can reveal spasm of the vessel, which occurs in response to the introduction of a foreign object (catheter) or contrast in the coronary artery. For these purposes you can use a special drug (ergonovine), which causes smooth muscle contraction. If administered intravenously, nitroglycerin, the restriction in the vessel is fast disappearing.
To register characteristic ECG changes, patients with suspicion on this disease conduct daily Holter monitoring. This study allows to assess the ischemia during the day and at the moment of pain. It is very important that the patient kept a diary, which details hourly would describe their feelings and actions. Comparing the received ECG with these notes, the doctor will be able to get a full picture of the pathological state.