Stable angina

Stable angina is a clinical manifestation of ischemic heart disease characterized by temporary insufficiency of coronary blood supply. This syndrome manifests itself in the form of episodes of pain or discomfort in the chest, most often caused by physical exertion or emotional stress, which pass at rest or after taking nitrates. Stable angina, in contrast to unstable angina, leads to predictable and regular symptoms, which allows the patient and physician to plan possible measures to control the disease. In the absence of adequate therapy, this condition can progress, which leads to a deterioration in the quality of life and an increased risk of acute coronary events, such as myocardial infarction.

History of the disease and interesting historical facts

Angina as a medical term was first described in the writings of ancient Greek physicians. Later, in the 18th century, English physician William Harvey made significant contributions to the understanding of systemic circulation, which contributed to the study of heart disease. The 19th century saw significant advances in pathophysiology, when scientists discovered that angina is caused by a lack of oxygen in the myocardium. In the 20th century, especially with advances in technology, techniques such as electrocardiography (ECG) and coronary angiography changed the way angina is diagnosed and treated, allowing physicians to better understand the nature of the condition and improve the way it is managed.

Epidemiology

According to statistics, stable angina occurs in approximately 4-7% of the adult population in developed countries. It is more common in men than in women, especially in the age group of 40 to 70 years. Epidemiological studies show that previous risk factors such as hypertension, diabetes, and hyperlipidemia increase the likelihood of developing stable angina. It is noted that as the population ages, the number of cases of this pathology increases, which is associated with an increase in the prevalence of atherosclerosis.

Genetic predisposition to this disease

Genetic factors play an important role in the predisposition to stable angina. Research shows that hereditary factors influence the development of atherosclerosis and, therefore, the risk of coronary heart disease. The genes involved include those such as the apolipoprotein E (APOE) gene, genes associated with lipid metabolism, and genes for inflammatory markers. Some mutations in these genes can lead to increased blood cholesterol levels and the development of atherosclerotic plaques, which increases the risk of stable angina.

Risk factors for the development of this disease

Risk factors for stable angina include both physical and chemical factors. The main risk factors include:

• Hypertension – high blood pressure damages the walls of blood vessels.
• Dyslipidemia – elevated levels of cholesterol and triglycerides in the blood contribute to the formation of atherosclerotic plaques.
• Smoking – tobacco smoking is a powerful proatherogenic factor that contributes to the development of angina.
• Obesity – being overweight is an indirect factor that contributes to metabolic disorders.
• Diabetes mellitus – diabetes causes damage to blood vessels and increases the risk of coronary disease.
• Heredity – the presence of cardiovascular diseases in the family increases the likelihood of the disease.
• Lack of physical activity – a sedentary lifestyle also increases the risk of developing angina.

Diagnosis of this disease

Diagnostics of stable angina includes several stages and methods. The main symptoms include:

• Pain or discomfort in the chest, often occurring during physical activity.
• Pain radiating to the shoulder, neck, jaw or back.
• A feeling of tightness or heaviness behind the breastbone.
• Shortness of breath or difficulty breathing for a short period of time.

Laboratory tests may include:

• General and biochemical blood tests to assess lipid and glucose levels.
• A coagulogram to assess blood clotting.

Radiological examinations may include:

• Electrocardiogram (ECG) to detect ischemic changes.
• Stress tests to assess the heart's response to physical activity.
• Coronary angiography to visualize the coronary arteries.

Other diagnostic methods may include echocardiography and magnetic resonance imaging (MRI). It is also important to conduct a differential diagnosis, excluding other possible causes of chest pain, such as gastritis or osteochondrosis.

Treatment

Treatment of stable angina involves a combination approach based on the clinical presentation and severity of the disease. General recommendations include:

• Lifestyle changes, including stopping smoking, losing weight, and increasing physical activity.
• Correction of risk factors, such as control of blood pressure and blood sugar levels.

Pharmacological treatment may include:

• Nitrates to relieve angina symptoms.
• Beta blockers to reduce the frequency and severity of attacks.
• Antianginal drugs such as potassium channel blockers and ACE inhibitors.
• Aspirin and other anticoagulants to reduce the risk of blood clots.

Surgical treatment, in turn, may include:

• Coronary angioplasty with stent placement.
• Coronary artery bypass grafting to restore blood supply to the myocardium.

Other treatments may include physical therapy and rehabilitation.

List of medications used to treat this disease

Medicines used in the treatment of stable angina include:

• Nitroglycerine
• metoprolol
• Atenolol
• Aspirin
• ACE inhibitors such as lisinopril
• Statins such as atorvastatin
• Panolazine

Disease monitoring

Monitoring of the patient's condition includes regular visits to a cardiologist, functional tests, and laboratory studies. The prognosis for stable angina can be favorable with adequate treatment and adherence to recommendations. However, without proper monitoring, there is a risk of disease progression and the development of serious complications, such as myocardial infarction or heart failure.

Age-related features of the disease

Stable angina manifests itself differently depending on age group. In younger patients, symptoms may be milder and less predictable. Older people have a higher risk of complications, such as acute coronary syndrome. In addition, aging is associated with an increased incidence of comorbidities, which can worsen the course of angina.

Questions and Answers

• What is stable angina? Stable angina is a form of coronary heart disease that causes chest pain or discomfort during physical exertion or stress that is relieved by rest.
• What are the main risk factors for stable angina? The main risk factors include hypertension, dyslipidemia, smoking, obesity, diabetes mellitus and heredity.
• How is stable angina diagnosed? Diagnosis includes history taking, physical examination, electrocardiogram, stress tests, and coronary angiography if needed.
• How is stable angina treated? Treatment includes lifestyle changes, drug therapy including nitrates and beta blockers, and in severe cases, surgical procedures such as coronary angioplasty.
• What is the prognosis for patients with unstable angina? The prognosis is favorable with adequate monitoring and control of risk factors, but there are risks of progression and complications.