Stable angina pectoris
Stable angina pectoris is characterized by the fact that it occurs repeatedly and behaves similarly each time it occurs. As a rule, this form of angina pectoris occurs particularly under physical stress. The severity of angina pectoris depends on the intensity of physical exertion at which the symptoms occur.
The first occurrence of angina pectoris is always considered unstable angina pectoris. In addition, an increasing severity of angina pectoris is called unstable. Unstable angina pectoris is part of the acute coronary syndrome.
Acute coronary syndrome refers to a disease of the heart vessels that supply the heart muscle with oxygen. In the course of arteriosclerosis, these vessels become blocked. If the vessels are blocked, the heart muscle is undersupplied with oxygen.
If there is a complete blockage of the vessel, it is a heart attack. Since the administration of nitroglycerine leads to a dilatation of the vessels, this drug can easily achieve a residual supply of oxygen to the affected heart muscle area in an angina pectoris attack. A The cause of the pain is the reduced supply of oxygen to the heart muscle.
If, as in the stable form, angina pectoris occurs consistently only under stress, one of the coronary arteries is very likely to be only partially blocked, so that under normal circumstances an adequate supply of oxygen is guaranteed. If the patient now strains himself, the supply is no longer sufficient and pain occurs. As soon as the load on the heart muscle is over, the supply is sufficient again and the pain subsides. In the event of a heart attack, the heart muscle behind the occluded vessel can no longer be supplied with oxygen and without an adequate supply, the heart muscle cells may die.
Prinzmetal Angina
This form of angina pectoris is a special form. Similar to unstable angina pectoris, there is also a change in the ECG, but unlike unstable angina pectoris, these changes are reversible. The affected patients very often have narrowed coronary vessels.
In the area of these constrictions (stenoses), spasm of the coronary vessels can then occur. Since this can also lead to a complete constriction, the area of the heart muscle behind it is less supplied with oxygen for the period of the vasospasm and the pain of angina pectoris occurs. The spasm in the vessels can be triggered by cold or cigarette smoke. It is typical for the affected persons to feel the pain when leaving a house in winter, for example.
Walking-through Angina
This type of angina pectoris is a painful period of chest pain that begins with exertion and then stops of its own accord. In this case, the body virtually takes over the therapy of the symptoms itself. At first, the constricted vessels cause the typical pain due to the lack of oxygen.
But then the body itself releases messenger substances that lead to a dilatation of the vessels, so that the affected heart muscle area receives enough oxygen again. In this way, the body supplies itself with a kind of nitroglycerine. As soon as there are enough messenger substances available to dilate the coronary vessels, the pain subsides despite stress. Nevertheless, affected patients should consult a doctor regularly, as they, like patients with print metal angina, have an increased risk of acute coronary syndrome.
