Cardiology / English / Атеросклероз на английском языке для иностранцев

Stable angina:

I functional class - habitual physical activity, such as walking or climbing stairs, does not provoke an attack of angina pectoris. Angina pectoris occurs with more intense or prolonged exercise.

II functional class - a slight restriction of the usual physical activity. Angina pectoris occurs when walking more than 300 distances, climbing more than one floor on regular steps at a normal pace, or quickly climbing stairs or uphill.

III functional class - significant limitation of habitual physical activity. Angina pectoris occurs when walking 150 - 300 m ascending one floor at a normal pace.

IV functional class - impossibility of any physical activity without discomfort. Angina pectoris can occur at rest.

Diagnosis of angina pectoris is based on clinical criteria:

-careful questioning (anamnesis);

-pain assessment;

-identification of risk factors for ischemic heart disease;

-use of available instrumental methods.

So, pain syndrome:

-paroxysmal pain

-in the upper or middle part of the sternum or retrosternal, along the left edge of the sternum, in the atrial region

Atypical localization:

-the inner surface of the left hand with numbness IV-V fingers

-over the entire half of the chest

-on the left side of the neck

-jaws, tongue, teeth

-larynx, epigastrium - less often in the right half of the chest

The persistence of the causes of pain is maintained. As a rule:

-physical activity

-nervous overload

-change of weather (cold, wind)

-intake of plentiful, special cold food

-alcohol

-smoking (tobacco toad)

-tachyarrhythmias

Duration of pain from a few seconds to 20 - 30 minutes.

An objective examination of the patient in the early stages of the disease does not always support the diagnosis.

The nature:

-pressing

-tearing

-less often stabbing or by type "Clogged cola", heartburn, sore throat.

It arises stereotypically: it gradually increases and quickly stops after taking nitroglycerin or eliminating the cause that caused it (stopping when walking, stopping the load).

Emotional coloration - anxiety, fear of death, sometimes general excitement, trembling, sweating, redness or paleness, shortness of breath, arrhythmias, increased blood pressure.

In the figurative expression of D.D. Pletneva - with angina pectoris, two realities - "Pain and death"

In some cases, you can find signs characteristic of atherosclerosis, in general, other changes in the heart.

In addition to complaints, instrumental methods and functional tests are the most evidential. The most widely used is ECG diagnostics. However, even in individuals with severe angina pectoris, there may be no changes on an ECG recorded at rest outside of an attack. But they will always be found during an attack or during physical exertion.

I Step - test - a technique standardized for functional loading (Master's test) using two steps, each 22.5 cm high. The number of stairs is determined according to the table, taking into account gender, age, body weight within 1.5 - 3 minutes

II Bicycle ergometry - more accurate IIITreadmill - treadmill

IV - Teleelectrocardiography - recording of an ECG at a distance with a transmitter mounted on a belt.

Terms:

-at least 2 hours after eating

-do not smoke or drink on the day of the study take medications - antianginal, cardiac glycosides.

Criteria for positive functional loading:

1.Development of an angina attack

2.The appearance of severe shortness of breath

3.Decrease in blood pressure by 25 - 30% 4.Reduction of the ST segment by 1 mm or more

5.The rise of the ST segment by 1 mm and boe.

24-hour Holter ECG monitoring:

Daily activity recording in V2 - V5 from a portable monitor. The patient keeps a diary, noting the condition.

Medication tests with curantile:

The phenomenon of intercoronary robbery with ergometrine with izadrin, nitroglycerin.