Huwebes, Hulyo 7, 2011

therapy treatment for angina

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Angina pectoris



From karapay/cavilla
Angina pectoris, commonly known as angina, is severe chest pain[1] due to ischemia (a lack of blood, thus a lack of oxygen supply) of the heart muscle, generally due to obstruction or spasm of the coronary arteries (the heart's blood vessels). Coronary artery disease, the main cause of angina, is due to atherosclerosis of the cardiac arteries. The term derives from the Latin angina ("infection of the throat") from the Greek ἀγχόνη ankhonē("strangling"), and the Latin pectus ("chest"), and can therefore be translated as "a strangling feeling in the chest".
There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle (i.e., there can be severe pain with little or no risk of a heart attack, and a heart attack can occur without pain).
Worsening ("crescendo") angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms ofunstable angina (usually grouped with similar conditions as the acute coronary syndrome). As these may herald myocardial infarction (a heart attack), they require urgent medical attention and are generally treated as  presumed heart attack.

Classification

Stable angina

Also known as effort angina, this refers to the more common understanding of angina related to myocardial ischemia. Typical presentations of stable angina is that of chest discomfort and associated symptoms precipitated by some activity (running, walking, etc.) with minimal or non-existent symptoms at rest. Symptoms typically abate several minutes following cessation of precipitating activities and resume when activity resumes. In this way, stable angina may be thought of as being similar to claudication symptom
Unstable angina
Unstable angina (UA) (also "crescendo angina;" this is a form of acute coronary syndrome) is defined as angina pectoris that changes or worsens.
It has at least one of these three features:
  1. it occurs at rest (or with minimal exertion), usually lasting >10 min;
  2. it is severe and of new onset (i.e., within the prior 4–6 weeks); and/or
  3. it occurs with a crescendo pattern (i.e., distinctly more severe, prolonged, or frequent than previously).
UA may occur unpredictably at rest which may be a serious indicator of an impending heart attack. What differentiates stable angina from unstable angina (other than symptoms) is the pathophysiology of the atherosclerosis. The pathophysiology of unstable angina is the reduction of coronary flow due to transient platelet aggregation on apparently normal endothelium, coronary artery spasms or coronary thrombosis.[2][3] The process starts with atherosclerosis, and when inflamed leads to an active plaque, which undergoes thrombosis and results in acute ischemia, which finally results in cell necrosis after calcium entry.[4] Studies show that 64% of all unstable anginas occur between 10 PM and 8 AM when patients are at rest.[5][6]
In stable angina, the developing atheroma is protected with a fibrous cap. This cap (atherosclerotic plaque) may rupture in unstable angina, allowing blood clots to precipitate and further decrease the lumen of the coronary vessel. This explains why an unstable angina appears to be independent of activity.

Microvascular angina

Microvascular Angina or Angina Syndrome X is characterized by angina-like chest pain, but have different causes.The cause of Microvascular Angina is unknown, but it appears to be the result of poor function in the tiny blood vessels of the heart, arms and legs.[7]Since microvascular angina isn't characterized by arterial blockages, it's harder to recognize and diagnose, but its prognosis is excellent. [8] [9] [10]

Signs and symptoms

Most patients with angina complain of chest discomfort rather than actual pain: the discomfort is usually described as a pressure, heaviness, tightness, squeezing, burning, or choking sensation. Apart from chest discomfort, anginal pains may also be experienced in the epigastrium (upper central abdomen), back, neck area, jaw, or shoulders. This is explained by the concept of referred pain, and is due to the spinal level that receives visceral sensation from the heart simultaneously receiving cutaneous sensation from parts of the skin specified by that spinal nerve's dermatome, without an ability to discriminate the two. Typical locations for referred pain are arms (often inner left arm), shoulders, and neck into the jaw. Angina is typically precipitated by exertion or emotional stress. It is exacerbated by having a full stomach and by cold temperatures. Pain may be accompanied by breathlessness, sweating and nausea in some cases. In this case, the pulse rate and the blood pressure increases. Chest pain lasting only a few seconds is normally not angina.
Myocardial ischemia comes about when the myocardia (the heart muscles) receive insufficient blood and oxygen to function normally either because of increased oxygen demand by the myocardia or by decreased supply to the myocardia. This inadequate perfusion of blood and the resulting reduced delivery of oxygen and nutrients is directly correlated to blocked or narrowed blood vessels.
Some experience "autonomic symptoms" (related to increased activity of the autonomic nervous system) such as nauseavomiting andpallor.
Major risk factors for angina include cigarette smokingdiabeteshigh cholesterolhigh blood pressuresedentary lifestyle and family history of premature heart disease.
A variant form of angina (Prinzmetal's angina) occurs in patients with normal coronary arteries or insignificant atherosclerosis. It is thought to be caused by spasms of the artery. It occurs more in younger women.

Cause

Major risk factors



  • Age (≥ 55 years for men, ≥ 65 for women)
  • Cigarette smoking
  • Diabetes mellitus (DM)
  • Dyslipidemia
  • Family History of premature Cardiovascular Disease (men <55 years, female <65)
  • Hypertension (HTN)
  • Kidney disease (microalbuminuria or GFR<60 mL/min)
  • Obesity (BMI ≥ 30 kg/m2)
  • Physical inactivity
Conditions that exacerbate or provoke angina
  • Medications
  • vasodilators
  • excessive thyroid replacement
  • vasoconstrictors
  • polycythemia which thickens the blood causing it to slow its flow through the heart muscle
One study found that smokers with coronary artery disease had a significantly increased level of sympathetic nerve activity when compared to those without. This is in addition to increases in blood pressure, heart rate and peripheral vascular resistance associated with nicotine which may lead to recurrent angina attacks. Additionally, CDC reports that the risk of CHD, stroke, and PVD is reduced within 1–2 years of smoking cessation. In another study, it was found that after one year, the prevalence of angina in smoking men under 60 after an initial attack was 40% less in those who had quit smoking compared to those who continued. Studies have found that there are short term and long term benefits to smoking cessation.[13][14][15][16]

Other medical problems

  • profound anemia
  • uncontrolled HTN
  • hyperthyroidism
  • hypoxemia

Other cardiac problems

  • tachyarrhythmia
  • bradyarrhythmia
  • valvular heart disease
  • hypertrophic cardiomyopathy 
Myocardial ischemia can result from:
  1. a reduction of blood flow to the heart that can be caused by stenosis, spasm, or acute occlusion (by an embolus) of the heart's arteries.
  2. resistance of the blood vessels. This can be caused by narrowing of the blood vessels; a decrease in radius,.[19] Blood flow is inversely proportional to the radius of the artery to the fourth power [20]
  3. reduced oxygen-carrying capacity of the blood, due to several factors such as a decrease in oxygen tension and hemoglobin concentration.[21] This decreases the ability to of hemoglobin to carry oxygen to myocardial tissue.[22]
Atherosclerosis is the most common cause of stenosis (narrowing of the blood vessels) of the heart's arteries and, hence, angina pectoris. Some people with chest pain have normal or minimal narrowing of heart arteries; in these patients, vasospasm is a more likely cause for the pain, sometimes in the context of Prinzmetal's angina and syndrome X.
Myocardial ischemia also can be the result of factors affecting blood composition, such as reduced oxygen-carrying capacity of blood, as seen with severe anemia (low number of red blood cells), or long-term smoking.

Angina Complications

Complications of angina and heart attack include:
  • Cardiac arrhythmias:
  • Congestive heart failure
  • Dressler's syndrome
  • Myocardial infarction 
  • Mitral regurgitation:
    • Papillary muscle rupture
  • Pericarditis
  • Pulmonary embolism
  • Shock
  • Stroke
  • Sudden death:
  • Ventricular aneurysm
  • how jesoga70therapy medical create speed the healing both the stable and unstable angina?
  • Well angina it's not heart attack ,you tell yourself .Maybe not but whatever it is , it's grabbing you chest like a massive fist and squeezing hard , but at one single touch jesoga70therapy compromised your total remission. If you've ever suffered from these condition like this patient  working at camp crame Quezon city it's crucial to find your good doctor. BUT the most powerful treatment seem to be tested by mr juan d la cruz a policeman owner of pj grocery at BCDA DEIGO SILANG BRGY USUSAN BCDA TAGUIG CITY, he use to recovered even exerting any hard activities than before, same when he's at resting., he can do more radical exercise or physical exertion , even though at high level  with no problem. jesoga70therapy always progressively working at the 14vitality abdominal impulses functioning system , including the solar plexus diaphragm , and chest lung heart, and shoulder arms and neck thoracic and and cervical spine intestine with emphasis on sigmoid colon and adrenal gland. all these practices thin the blood and cure angina instantly. who  ever experiencing the terror of angina attack that even you expert  doctor  fails your total remission I challenges all you out there , witness these therapeutic miracles ,probably you will remember it as the fruitful time of your life be bless gods is always with us bro and sisters. tnx 
  • jesoga70aguado the compound of adenosine is a long proper medical treatment  try it.
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