Stable angina pectoris management

Abstract

Introduction: Stable angina pectoris is the most common form of ischemic heart disease, characterized by constrictive retrosternal pain of short duration, with irradiation to the jaw, shoulders, back or arms, typically occurring with exertion or emotional stress, and improved by rest or nitroglycerin administration. The incidence of angina pectoris in most European countries is between 20,000 and 40,000.Its prevalence is from 2-5% in men of 45-54 years up to 10-20% in men of 65-74 years; from 0.1-1% in women aged 45-54 years up to 10-15% in women of 65-74 years. Purpose and Objectives: Studying the risk factors, clinical and paraclinical features, and treatment of the patients with stable angina pectoris. Materials and Methods: The study was conducted on a sample of 124 patients with stable angina pectoris, hospitalized in MCH "Holy Trinity" during November, 2012 - February, 2014. The patients were divided into 2 groups, of 62 patients (50.0%) each: group 1 - men and group II - women. Results: In the patients of the study, the clinical picture was determined by the pain syndrome with the predominance of retrosternal pain in 81 (65.32%) cases, in 15 (46.87%) patients the pain irradiating in the left shoulder. Access duration was of 6-10 minutes in most of the cases - 71 (57.26%), yielding to nitroglycerin in 52 (41.94%) cases. Among other clinical signs, the prevailing ones were fatigue in 110 (88.70%) and dyspnea in 99 (79.84%) cases. The analysis of the risk factors for angina pectoris in the both groups emphasized the importance of the: age, family history of cardiovascular diseases, arterial hypertension, diabetes mellitus, dyslipidemia, smoking, obesity. On ECG, pathological changes were present in 96 (77.42%) cases, with ST segment depression in 20 (20.83 %) patients, with the predominance of the supraventricular disorders over the junctional and ventricular ones, and with the prevalence of incomplete right bundle branch block in 31 (32.29%) cases. On Echo-CG, the following deviations were detected: aorta induration in 33 (86.84%) cases, low ejection fraction in 16 (42.11%) cases, left ventricular hypertrophy in 30 (78.95%) cases. Most of the patients - 96 (77.4%) - were administered inpatient treatment with4drugs. Conclusion: Considering that angina pectoris is a pathology with an increased incidence and prevalence, the awareness of the physicians and patients, regarding the early diagnosis and proper management of hypertension and stable angina, has a major value in preventing the development of acute myocardial infarction, acute stroke and other complications.