Angina pectoris expresses myocardial ischemia, and its diagnosis is based primarily on the evaluation of patient-reported complaints. Angina can be related to exercise. There can be many different causes: it can be chronic atherosclerosis, but coronary artery spasm is also possible in the absence of atherosclerotic lesions. The main diagnostic question lies in the correct interpretation of anginal pain. In the absence of appropriate diagnostic tools, initial suspicion can be confirmed by regression of anginal pain after sublingual administration of nitroglycerin.
Symptomatology and diagnosis
The pivotal symptom is the pain, which can take on connotations that vary from case to case. The reaction patient’s instinct is to remain motionless. Other symptoms include pallor and skin sweating, atrial gallop, abnormal pulse rate, paradoxical splitting of the second tone and increased pressor values.
As for the instrumental diagnosis the main examination to be done is the electrocardiogram, from perform under stress. Radioisotopic investigations should also be done and coronarography.
Principles of therapy
Therapy involves taking nitroglocerin sublingually at the onset of anginal pain. In case of ineffectiveness, isosorbide dinitrate can be used. For chronic treatment one can use: nitroderivatives, calcium channel blockers, beta blockers, antiplatelet agents.
Source: Medical Guard Handbook edited by Piercarlo Salari (Mediserve)
