Angina myocardial infarction

Angina myocardial infarction is a condition in which the myocardium (heart muscle) does not receive enough oxygen and nutrients due to limited blood supply. This can occur due to partial blockage of the coronary arteries that supply blood to the heart.

The main characteristics of anginous myocardial infarction include:

1. Chest pain: Patients feel a squeezing, pressing, or burning pain in the chest that may spread to the neck, jaw, shoulders, back, or arms. The pain may be triggered by physical activity or stress and usually improves at rest or after taking nitroglycerin.
2. Feeling of choking or shortness of breath: Patients may feel choking or difficulty breathing.
3. Hyperhidrosis (excessive sweating): Increased sweating may occur in some patients.

Angina myocardial infarction can be caused by atherosclerosis (deposition of cholesterol and other substances in the walls of arteries), which leads to the formation of plaques that reduce the lumen of blood vessels and impair blood supply to the heart. This condition can lead to serious complications, including myocardial infarction (death of heart muscle tissue), arrhythmias (heart rhythm disorders), and heart failure. [1]

Treatment for angina myocardial infarction may include drug therapy, lifestyle changes (such as smoking cessation, blood pressure control, proper diet and exercise) and sometimes revascularization procedures (such as angioplasty and arterial stenting or coronary artery bypass grafting). It is important to seek immediate medical attention if an angina myocardial infarction is suspected, as this condition requires immediate intervention. [2]

Symptoms of the anginous myocardial infarction.

These symptoms may be similar to those seen in normal angina pectoris, but they are often more intense and prolonged. [3] Symptoms of angina myocardial infarction may include:

1. Chest pain: One of the most common symptoms. It can be described as a feeling of pressure, tightness, burning pain or distention in the chest area. The pain may spread to the neck, jaw, left arm or back.
2. Shortness of breath: Shortness of breath that may occur even at rest or with little exercise.
3. Loss of consciousness: In some cases of angina myocardial infarction, loss of consciousness may occur due to inadequate blood supply to the brain.
4. Indisposition: Feeling of general weakness, nausea, vomiting, dizziness or involuntary defecation.
5. Fear and anxiety: Many patients describe feelings of mortal threat or uncertain anxiety.

It is important to note that the symptoms of anginous myocardial infarction can vary greatly from person to person, and they can change depending on age, gender, and other factors. If you experience any of these symptoms or suspect an anginous myocardial infarction, seek medical attention immediately. This condition requires immediate treatment and delay can be life-threatening.

Diagnostics of the anginous myocardial infarction.

Diagnosis of anginal myocardial infarction (MI) is critical, and it involves several methods and steps to accurately detect and evaluate the infarction. Diagnostic methods and steps include the following:

1. History taking and assessment of symptoms:

   • The doctor gathers information about the patient's medical history, including the presence of risk factors for heart disease, previous heart attacks or heart surgery.
   • It is important to find out what symptoms the person is experiencing. Typical symptoms of anginous IM include burning or pressing chest pain that may spread to the left arm, neck, jaw, back or abdomen, and may be accompanied by nausea, vomiting, loss of consciousness and loss of breathing.

2. Electrocardiogram (ECG):

   • ECG is the primary method for diagnosing MI. It is a non-invasive test that records the electrical activity of the heart.
   • In MI, characteristic changes such as ST-segment elevation (ST-segment elevation) and changes in T teeth may be seen on the ECG.
   • ECG can be performed several times at intervals to reveal the dynamics of changes.

3. Blood work:

   • Determining the level of markers of cardiac muscle damage such as troponin I and troponin T, creatine kinase-MB (CK-MB) and myoglobin.
   • These markers are usually elevated in the blood when the heart muscle is damaged.

4. Instrumental methods:

   • Coronarography (cardiac catheterization): A study that visualizes the coronary arteries and determines the presence and location of blockages.
   • Echocardiography: Ultrasound of the heart to evaluate the function of the heart chambers and valves.

5. Magnetic resonance imaging (MRI) or computed tomography (CT):

   • MRI or CT scans can be used to visualize the heart and coronary arteries and evaluate areas of damage.

Diagnosis of anginoid myocardial infarction requires prompt and accurate diagnosis, as prompt initiation of treatment can significantly reduce damage to the heart muscle and improve prognosis. [4]

Differential diagnosis

The differential diagnosis of anginous myocardial infarction (MI) is the process of ruling out other conditions that may mimic the symptoms of MI but have different causes and require different treatment approaches. When anginous MI is suspected, doctors must perform a thorough diagnostic workup to make an accurate diagnosis. Here are a few conditions that can mimic the symptoms of MI and require differential diagnosis:

1. Angina: This condition is also associated with chest pain that may be similar to that of MI. However, angina pectoris is usually relieved by rest and taking nitrates, whereas MI pain may not resolve or may worsen.
2. Gastroesophageal reflux (GERD): Gastroesophageal reflux can cause burning chest pain that can resemble angina pains. However, GERD is often accompanied by heartburn, and the pain usually gets worse after eating.
3. Muscle pain or injury: Chest pain can be caused by muscle strains, injuries, or other mechanical causes. These pains often have the character of muscle aches and may be aggravated by movement or pressure on the chest.
4. Pleurisy: Pleurisy is an inflammation of the lining of the lungs (pleura) that can cause sharp chest pains. These pains may get worse when breathing in and out.
5. Pericarditis: Pericarditis is inflammation of the lining around the heart (pericardium). It can cause chest pain that can be similar to the pain of MI.
6. Respiratory Diseases: Some respiratory diseases, such as pneumonia or bronchial diseases, may be accompanied by chest pain and difficulty breathing.

Doctors usually use various methods such as ECG (electrocardiography), biomarkers (cardiac marker test), history, physical examination, and clinical symptoms to make a differential diagnosis when anginous MI is suspected. Accurate diagnosis of anginous IM usually requires a comprehensive approach and may include additional tests, such as stress tests or coronarography, to more accurately assess the condition of the heart and coronary arteries.

List of authoritative books and studies related to the study of angina myocardial infarction

1. "Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine" (Braunwald's Cardiology: A Textbook of Cardiovascular Medicine)

   • Author: Douglas P. Zipes, Peter Libby, Robert O. Bonow, et al.
   • Year: 2021

2. "Stable Ischemic Heart Disease."

   • Author: Simon C. Body, Kim A. Eagle, Deepak L. Bhatt
   • Year: 2019

3. "Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty" (Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty)

   • Author: Leonard S. Lilly
   • Year: 2018

4. "Stable Coronary Artery Disease: Treatment Options and Future Directions" (Stable Coronary Artery Disease: Treatment Options and Future Directions)

   • Author: Manel Sabate, David Garcia-Dorado
   • Year: 2018

5. "Chronic Coronary Artery Disease: A Companion to Braunwald's Heart Disease".

   • Author: James L. Januzzi Jr., Ron Blankstein
   • Year: 2017

6. "Ischemic Heart Disease: A Rational Basis for Clinical Practice and Clinical Research" (Ischemic Heart Disease: A Rational Basis for Clinical Practice and Clinical Research)

   • Author: Robert A. O'Rourke
   • Year: 2016

7. "Coronary Heart Disease: Clinical, Pathologic, Imaging, and Molecular Profiles" (Coronary Heart Disease: Clinical, Pathologic, Imaging, and Molecular Profiles)

   • Author: Valentin Fuster, Eliseo Guallar, Jagat Narula
   • Year: 2015

8. "Stable Ischemic Heart Disease: A Case-Based Approach" (Stable Ischemic Heart Disease: A Case-Based Approach)

   • Author: Jerome L. Fleg, Michael S. Lauer
   • Year: 2014

9. "Stenosis of the Coronary Arteries: From Risk Factors to Prevention, Diagnosis, Treatment" (Stenosis of the Coronary Arteries: From Risk Factors to Prevention, Diagnosis, Treatment)

   • Author: Luigi M. Biasucci, Francesco Crea
   • Year: 2012

10. "Chronic Total Occlusions: A Guide to Recanalization" (Chronic Total Occlusions: A Guide to Recanalization)

    • Author: Ron Waksman, Shigeru Saito
    • Year: 2013

Literature

• Shlyakhto, E. V. Cardiology: national guide / ed. By E. V. Shlyakhto. - 2nd ed., revision and supplement. - Moscow: GEOTAR-Media, 2021
• Cardiology according to Hurst. Volumes 1, 2, 3. GEOTAR-Media, 2023.