ANGINA PECTORIS: EARLY SIGNS OF CARDIOVASCULAR DISEASES

Аннотация

This article discusses the clinical manifestations, etiology, pathogenesis, diagnosis, and modern methods of treatment for angina pectoris (ischemic heart disease). Various forms of angina, including stable, unstable, and variant angina, are explored in detail. Preventive measures and new technologies used in treatment are also presented. The article is intended for cardiology specialists and medical university students. Keywords:Angina pectoris, ischemic heart disease, chest pain, cardiovasculardiseases, diagnosis, prevention, treatment, nitroglycerin, coronary arteries. Angina pectoris is one of the most common clinical manifestations of ischemic heart disease (IHD), resulting from insufficient blood supply to the heart muscle. This condition is often the first sign of ischemic heart disease. Pain or discomfort in the chest characteristic of angina pectoris not only diminishes patients' quality of life but can also lead to serious complications, such as myocardial infarction. Early diagnosis and treatment of angina pectoris play a key role in theprevention ofcardiovascular diseases. Types of angina pectoris The clinical classification of angina is based on symptoms, the nature ofepisodes, and theircauses. The main types ofangina pectoris are: *Stable angina: Symptoms occur during physical or emotional stress and are consistent in intensity. The pain is short-lived and resolves at rest or after taking nitroglycerin. Although stable anginais well-managed, itsprogression can increase therisk of myocardial infarction. * Unstable angina Characterized by new or worsening symptoms that can occur even at rest. This condition is a precursor to a heart attack or other acute complications and requires immediate treatment. *Vasospastic angina (Prinzmetal's angina) Occurs due tospasms in thecoronary arteries, often at rest. Symptoms usually manifest at night or early in themorning. Treatment includes calcium channel blockers and othermedications. Main causes ofangina: 1.Atherosclerosis: Formation of plaques in coronary arteries, disruptingbloodflow. 2.Arterial spasms: Temporary narrowing ofcoronary vessels. 3.Thrombosis:Formation ofa clot blocking blood flow. 4.Arterial Hypertension: High blood pressure increases stress ontheheart, leading toischemia. RiskFactors. Non-modifiable: Age: Risk increases after 45years. Gender: Men are more susceptible, but risk increases in women after menopause. Modifiable. Smoking: Nicotineconstricts coronary vessels. Poordiet:Excess fat increases cholesterol levels and plaqueformation. Sedentary lifestyle: Reduces theheart's functional capacity. Diabetes and obesity. 297 INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR RESEARCH & DEVELOPMENT SJIF2019:5.2222020:5.5522021:5.6372022:5.4792023:6.5632024:7,805 eISSN:2394-6334 https://www.ijmrd.in/index.php/imjrd Volume12,issue04(2025) Pathogenesis ofangina The mechanism of angina is based on the imbalance between myocardial oxygen demand and supply through coronary arteries. Atherosclerotic plaques narrow thearteries, reducing blood flow. Oxygen deficiency leads to anaerobic metabolism, lactate accumulation, and pain onset. During physical exertion or stress, the heart's oxygen demand increases, but narrowed vessels fail to deliver enough oxygen, triggering an angina attack. Clinical manifestations The primary symptoms of angina are chest pain or discomfort, but they may vary among patients. Classic Symptoms: A feeling of tightness, heaviness, or burning in the chest.|Pain radiates to the left arm, neck, jaw, orback.Worsens withphysical exertion and improves at rest. Atypical symptoms: Discomfort in the abdominal region or a feeling of heaviness. Shortness of breath and fatigue. Severe weakness ordizziness, especially in elderly patients. Diagnosticmethods: 1. Electrocardiography (ECG): Detects ischemic changes such as ST segment depression or T wave inversion. 2.Stress Test: Evaluates heart function under physical stress todetect ischemia. 3. Coronary Angiography: Identifies areas of coronary artery narrowing and guides treatment decisions. Surgicalmethods:1.Stenting: Placement ofastent to widen coronary vessels. 2.Coronary Artery Bypass Grafting (CABG): Creating abypass to restore blood flow. Stenting is a procedure aimed at widening narrowed or blocked coronary arteries to restore normal blood flow. It is often used to treat ischemic heart disease (IHD) or angina, as well as blockages caused by atherosclerotic plaques or clots. Stenting improves blood circulation, reduces anginasymptoms, and lowers the risk ofmyocardial infarction. Thestenting procedure isdivided into several stages: 1.Angioplasty (Percutaneous coronary intervention): This preparatory step involves inserting a balloon into the narrowed artery. The balloon is inflated to widen thevessel's lumen, after which a stentis placed to maintain theartery's expansion. 2.Stentplacement (with Balloon angioplasty): After the artery is widened with the balloon, a stent—typically a metal or p