Angina pectoris, a violent pain in the heart triggered by physical exertion

Angina pectoris, a violent pain in the heart triggered by physical exertion

Angina attacks are painful and almost always due to a partially obstructed coronary artery.
OUR HEALTH ADVICE - Its main complication is myocardial infarction. Knowing how to recognize your symptoms helps to avoid the worst.

One might, at first glance, confuse his symptoms with that of a myocardial infarction. Angina pectoris, otherwise known as angina, causes constrictive, vise-like pain that radiates into the arm or jaw and is accompanied by shortness of breath. "The difference is that angina occurs during an effort and gives way completely to its judgment," says Stéphane Manzo-Silberman, interventional cardiologist at Lariboisière Hospital.

But this is only the first stage ... or the stable form of coronary disease. "Angina corresponds to the progressive development of atheroma plaques by phenomena of microswitches and healing, explains the expert. These plates limit the passage of blood flow. "Beyond a certain threshold, the decrease in oxygen in the muscle causes an imbalance between its contributions and its needs. It is angina pectoris.

What risk factors?
"The development of atheromatous plaque is all the more marked as several risk factors such as smoking, hypercholesterolemia, diabetes, high blood pressure and hereditary factors are present," says Dr. Manzo-Silberman. A sedentary lifestyle also favors it. Women are also at risk, especially if they are on contraceptives and at the time of menopause.

But beware of the atypical symptoms in women, says Dr. Patrick Assyag, a cardiologist in Paris. "It can be fatigue that lasts, nausea and vomiting, pain in the arm, back or stomach. Signs sometimes ignored that can lead to infarction. "Severe stress or harsh effort can also trigger it.

Untreated, angina can develop, causing prolonged pain (more than ten minutes), which persists at rest. It is the acute coronary syndrome: the sign that an atheroma plaque is breaking, forming a clot in the artery. It's urgent.

"An artery that suddenly becomes blocked causes a myocardial infarction that can be complicated by cardiac arrest. The longer it gets clogged, the more necrotizing the cells will be and the heart muscle will not regenerate, turning into a scar and possibly leading to heart failure, "says Dr. Manzo-Silberman.

Diagnosis and treatment
To avoid this, it is imperative to properly control its risk factors and to quickly consult a cardiologist in case of pain or chest discomfort with the effort. To confirm the diagnosis, the electrocardiogram, sometimes even the exercise test is not enough. "We will prescribe more sensitive tests: exercise ultrasound, stress MRI or exercise myocardial scintigraphy," explains the cardiologist.

The lesions are identified during coronary angiography and should be treated by stent placement or surgical bypass revascularization. A platelet antiaggregant drug treatment with a statin is then prescribed for life.

More angina pectoris is diagnosed early with identification and treatment of the culprit lesion (s), and the more the infarction can be prevented. "There has to be some signs or an evocative context leading the doctor to suspect the diagnosis and to prescribe coronary angiography quickly," 


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