The Definition:

•       It is when the heart muscle suffers from a sudden, severe decrease in the oxygen necessary for its functioning due to insufficient myocardial perfusion. Men are more susceptible than women, especially between the ages of fifty and fifty-eight.

Types of angina:

There are many different types:

1- Organic angina attacks (alarming syndrome):

The pain suddenly strikes the patient while resting, without any significant effort, and in the form of multiple and increasing attacks. This type is dangerous, as the pain may sometimes last for twenty minutes or more, and a nitroglycerin tablet may have no effect sometimes.

2- Constant stable angina pectoris:

This type can move, over a period of time, to a stage in which the patient adapts to his illness, and the time factor has played a role in the division and allowed the two compensating lateral divisions to grow. Thus, attacks of pain occur only rarely, and if they do occur, they are mild, and medical treatment often protects the patient and helps to provide complete comfort for the patient.

3- Cases of recurrent angina:

In this type, the patient suffers from more than one seizure per day, and his intake of nitoglycerin tablets increases, one after the other, until it sometimes reaches ten or twenty pills per day. This condition can last for several weeks, but one of two things is assumed to occur. Either it is an expression of multiple infections. It is important for the trunks of the three arteries, or the injury is normal, but the patient presents to it with an anxious disposition and a distinctive nervous state.

4- Convoluted or 'camouflaged' seizures:

These cases are of special importance, and we mean seizures that occur in patients suffering from problems and medical conditions other than coronary insufficiency. Pain in such cases often indicates, in its extension, times of occurrence, and changes, the location and causes of the injury or disease in question, as is the case, for example, in cases of rheumatism of the cervical spine (disc) or disorders of the digestive system, such as in stomach ulcers, and it must be investigated whether these conditions alone are responsible for what is happening. Is it a symptom or does it actually correspond to real coronary insufficiency, which increases its severity and importance?

Signs and symptoms of angina:

Angina pectoris attacks its owner in the form of painful attacks, and the pain appears in the front of the chest and behind the sternum. It grows and develops, but remains in the middle between the breasts, or spreads upwards towards the top of the sternum and neck, or towards the lower jaw on its side. The left arm often gets its share on the inner side opposite the torso, or in a Ring around the other two fingers of the left hand.

Most of the time, the pain is squeezing, and sometimes it is crushing, or it forms pressure or a pincer applied to the chest with force, or tightness, stretching, or heaviness on the chest, sometimes leading to a fire inside it.

The person is pale in color - increased sweating, an increase in the number of heartbeats, and heart disturbances.

Diagnostic methods for angina pectoris:

1- Medical history:

In it, the patient is given a complete history of his illness, in which the patient is described about the seizure and whether it accompanies effort/nervousness or after eating a fatty meal, in which the characteristics of the pain, its location, duration, and the areas in which it is tolerated and removed are described.

2- Chest X-ray:

It appears if there is an enlarged heart or congestion in the lungs.

3- Arteriography:

The patient is examined to diagnose him and select the patients for whom the by-pass (aortic-coronary) junction procedure is performed.

4- Stress EKG:

In it, the patient makes an effort while riding a certain bicycle or while walking in place on a moving electric carpet and in the opposite direction to his walking or climbing the stairs. As a result, there is an increase in the heart rate, blood pressure, and heart function, and then angina pectoris pain or changes in the electrocardiogram appear.

5- Normal EKG:

There is a decrease in the St Segment, and this occurs with T wave invsesion

Medical treatment for angina

1- Aspirin:

It works to prevent platelet aggregation and thus reduces the incidence of stroke and reduces the incidence of death in patients with angina.

2- Heparin:

It is given to prevent the occurrence of a clot, and 5,000 units are given intravenously every 4 to 6 hours, while an EKG is continued to determine the effectiveness of the action of heparin. PTT or PT is done two hours after heparin is given if it is given intravenously, every 4 hours and then daily.

3- Medications treating angina pain (Nitroglycerin) Nitroglycerin:

These medications appear to:

1-    They increase the expansion of the arteries and thus their ability to carry a larger amount of blood. These medicines and many other medicines, on the other hand, are considered by dilating the small arteries of the heart to help in the emergence and growth of the network of collateral arteries that carry blood to the places that lack perfusion and are called (the two collateral divisions). They also By expanding the surrounding body vessels, which reduces the pressure within them and thus the burden placed on the heart. These drugs enter into the work of the second category of drugs whose work is limited to reducing the work of the heart muscle and reducing its consumption of oxygen.

2-    Beta adrenergic blocking:

These medications are considered of great importance as they have the ability to reduce the number of heartbeats, blood pressure, and contractions (cardiac muscle). They also reduce the heart muscle’s need for oxygen. They also have the ability to prevent the occurrence of heart rhythm disturbances (arrhythmias) and reduce the incidence of heart attack and death. The sudden. Example tenormin.

5- Calcium channel blocking:

This group is considered one of the most important medications that have the ability to reduce the contraction of the heart muscle and relax the fine muscles present in the coronary and peripheral vascular smooth muscle. They also have the ability to control chest pain in unstable angina. Example: Thiazem.

6- Surgical treatment (aortic-coronary “bridging” operation):

It was given this name because it requires removing a vein from the patient’s own thigh, the “rotten vein,” and placing it as a bridge between a place in the aorta and another in the atherosclerotic coronary artery after the site of the narrowing in it.

After the transplantation process, blood flows through this venous 'air' bridge from the aorta, where the blood rushes forcefully towards the concerned cardiac muscle through the rest of the affected artery itself, leaving the narrowing itself alone and compensating for it by increasing the perfusion of this muscle and supplying it with oxygen.