Stenocardia attack

Description:

Attacks of stenocardia can be rare (1-2 times a week) or frequent (many times in day). Usually one of heavy attacks comes to an end with emergence of the center of a necrosis in a cardiac muscle (myocardial infarction) with the subsequent education on this site of cicatricial fabric.

Stenocardia Attack symptoms:

Characteristic of an anginous attack:
1. Localization of pain behind a breast (it is most typical!), it can give to the area of a neck, to a mandible, and teeth, to a hand, as a rule, left, to a shoulder girdle and a shovel (is more often at the left);
2. The nature of pain — pressing, squeezing is more rare — burning (like heartburn) or feeling of a foreign body in a breast (the patient can sometimes feel not painful, but burdensome feeling behind a breast and then he denies existence actually of pain);
3. Stenocardias of increase in the ABP, simultaneous with an attack, pallor of covers, perspiration, pulse rate fluctuations, emergence of feeling of interruptions in area of heart. All above-mentioned characterizes, a so-called angina of exertion, that is option of the stenocardia arising at loadings.

Stenocardia Attack reasons:

The reasons - occlusion of coronary arteries - a spasm, аретосклероз, a thromboembolism, etc.
The attack can be provoked by exercise or psychoemotional stress.

Treatment of the Attack of stenocardia:

High-speed nitrates under language or in inhalations (1-3 inhalations at an interval of 30 sec. - one pressing release 1,25 mg of isosorbide of dinitrate).
The anginous pains which are not stopped repeated reception of nitrates are the indication for in/in introductions of narcotic analgetics. Their introduction can be repeated every 5-15-30 min. if it is necessary for elimination of a pain syndrome. It is necessary to enter morphine in/in, as well as the majority of drugs in a critical situation. At it is possible to find fractional doses in administration of drug most precisely and quickly individually sufficient dose. Usually for stopping of an anginous attack there are enough 4-8 mg of drug. If pain is not stopped completely, it is necessary to add 2 mg each 5 min. It is easier to dose morphine and more conveniently to enter if it is previously divorced in 9 ml of the distilled water or isotonic NaCl solution.
Antiagreganta. Aspirin inhibits effect of cyclooxygenase in thrombocytes, thereby interfering with synthesis of the A2 thromboxane possessing powerful vasopressor and aggregation action. It can independently be applied or in a combination with heparin.
The Antiagregantny effect of a tiklopidin is shown in 8-12 hours and at the continuing administration of drug reaches the maximum expressiveness by 3-5th days therefore it cannot be used for emergency treatment.
Now it is recommended to use at the patients hospitalized with Construction Department without growth of ST an aspirin combination with klopidogrely from the very beginning of treatment in cases when carrying out urgent operation of coronary shunting is not supposed and to pass to the isolated aspirin use not earlier than in 9-12 months.