Progressive angina - what is it? Characteristics, classification and methods of treatment

2024 Author: Howard Calhoun | [email protected]. Last modified: 2023-12-17 10:16

Registered as I20.0 in ICD 10, progressive angina pectoris is a severe heart disease. The disease is observed against the background of vascular atherosclerosis, gradually progresses, so the patient's condition worsens. It is frankly not easy to achieve stabilization and improvement. You will have to introduce nutrition control, change your lifestyle. The doctor will select the appropriate therapeutic course. The main task of treatment is to prevent the progress of the disease.

About manifestations

Progressive angina code I20.0 provided for in ICD 10 implies a disease that gradually becomes more and more severe for a person. Progressive is a subspecies of unstable angina. Often this is observed with angina pectoris. In any of the options, the pathological condition develops quite quickly, accompanied by more frequent attacks, quite long and difficult to tolerate.sick. Classical drug therapy does not give the desired result, the effectiveness of the funds gradually decreases. The clinical picture is rather specific.

Progressive angina pectoris, hidden under the I20.0 code in the ICD, is a disease that appears against the background of an unstable course: its character changes. There are frequent attacks, hard tolerable, prolonged, observed at low loads. If earlier the attacks were characterized by a rather strong tension, gradually the patients note that less and less effort is needed for the deterioration to begin. The attack is accompanied by manifestations, previously uncharacteristic. There is not enough air, the body is covered with cold sweat, the person is sick, vomits. There is more and more pain spreading through the body.

Features: how to notice?

It is possible to assume that there is progressive angina pectoris (ICD code I20.0) if nitroglycerin, which previously helped the patient well, loses its effectiveness. It either does not work at all, or the result of its administration is extremely weakly noticeable. To stop the attack, you have to take a very large amount of medication.

With an unstable course, seizures appear unpredictably. It is not possible to notice the root causes, they are not related to physical activity. Sometimes seizures can appear due to stress, but its presence is not necessary - an unpredictable start is possible at any time.

Research of the state shows changes on the cardiogram. Possible severe deteriorationwell-being of the patient even in a state of complete rest. As you progress, the heart receives less and less blood. The attack is accompanied not only by pain, but also by a violation of the rhythm of heart contractions. The areas covered by pain are becoming more and more significant. Nocturnal anginal attacks are possible, which are extremely difficult for the patient due to the increased intensity of sensations.

Current

Progressive angina pectoris that appears against the background of coronary artery disease develops for months. Transformation into a pathological state of rest is possible. At the same time, the pain becomes stronger, the duration of each attack exceeds 30 minutes, the patient is frightened, feels weak. The study shows pressure drops, an increase in the speed of heart contractions. This suggests an increased risk of heart attack. It is noted that with the considered variant of the course of angina pectoris, a heart attack is observed in a fairly large number of patients, which forces an ambulance to be called at the first suspicion of angina pectoris. If a person does not receive adequate treatment, the prognosis is poor.

A relatively positive course, timely assistance can stabilize the condition, return a person to normal life. An unstable type of the disease is transformed into a stable type with the possibility of increasing the functional class. There are known cases of absolute remission, in which the person no longer experienced bouts of pain.

State Differentiation

For the layman, the manifestations of unstable progressive angina pectoris are in many ways similar tosymptoms of a heart attack. It is necessary to consult a doctor who can explain in detail to a person how to distinguish between these two pathologies. The main feature of a heart attack is the duration of an uncomfortable state. An attack with a heart attack lasts from 30 minutes or more. In this case, nitroglycerin does not give any effect, its reception does not allow to stop the problem.

To confirm a heart attack, special studies are done. Electrocardiography, blood tests are shown. Laboratory measures in this case will show an increase in ESR, an increase in the concentration of specific cardiac enzymes and troponin T.

What provokes?

You need to know where the disease comes from in order to prevent the appearance of progressive angina in your medical history. This pathological condition is due to the development of atherosclerosis, which affected the vascular system that feeds the heart. This leads to a decrease in arterial lumens due to the appearance of plaques here. Among the factors aggravating the case are high blood pressure in the arteries, overload: mental and emotional. Tachycardia may play a role. If the risk of developing pathology is assessed as relatively high, stressful situations should be excluded from your life and treatment of atherosclerosis should be started.

About categories

Several clinical forms of pathology are known. Belonging to a particular category is determined by the predominant manifestations: it is possible to change the frequency or characteristics of their course. Whenprogressing angina in the history of the disease may be mentioned more frequent attacks while maintaining the stability of the disease. It is possible to increase the duration, severity of each individual case with the same frequency. There is a possibility of a combination of angina pectoris and rest. Perhaps a course in which there are more attacks, each of them is more intense, their duration increases.

To assess the severity of the condition, the division into three categories is accepted: progressive (recently appeared pathological condition), subacute and acute.

What to do?

Treatment of progressive angina pectoris is chosen based on the category of the case and the characteristics of the patient's condition. The task of the patient is to seek qualified help in time. The person may have taken some medication before. The doctor will determine which ones need to be replaced, which dose should be increased. If you do not take the help of a doctor, the risk of unpredictable death or a severe course of a heart attack increases. Without adequate care, each attack is accompanied by risks of pulmonary edema, cardiac asthma, ischemia, and stroke. There is a danger of the formation of blood clots and their blocking of the ducts of blood vessels. The location of thrombosis is unpredictable. The therapeutic course is practiced in a hospital setting. Regular medical monitoring of the patient's condition is necessary.

Outside the hospital walls

Progressive angina pectoris is corrected by complex measures. First of all, you need to reconsider your lifestyle. Alcoholic drinks should be excludedbeverages and avoid tobacco products completely. Remove passive smoking from your life. It is important to adequately assess physical activity, responsibly correlate emotional experiences and one's own capabilities. If some events, facts, movements provoke an attack, you need to completely exclude those from everyday life. To stabilize he alth, it is necessary to introduce into the daily habit of walking, slowly and without worrying, enjoying the fresh air. Any physical activity cannot be completely ruled out - loads should be, they are useful, but only in reasonable amounts.

About Methods

Formulating the diagnosis, the doctor will immediately explain what it is. Progressive angina requires the patient to understand the diagnosis and realize the relevance of the correction. The cardiologist will select a drug course that is optimal for a particular case. Preparations are chosen so that they expand the vascular lumens, make the walls of the system more elastic. As a result, the heart will receive enough oxygen.

Very well on the patient's condition will affect dosed physical activity. You can practice gymnastics. Regular exercise will help stabilize the rhythm of heart contractions, leaving shortness of breath in the past. With the diagnosis under consideration, skiing, swimming, and walking are most useful. The course of physiotherapy exercises will be developed by a cardiologist. At first, you need to practice under the supervision of a doctor or other person with a specialized education. The complex is formed individually, if necessary, corrected,monitoring the reaction of the patient's body.

Surgical treatment

Cardiac surgeons are very well aware of the disease in question - they have to deal with people suffering from progressive angina pectoris. What it is and why it requires surgery, a qualified doctor will explain to the patient at the appointment. If the course of the case is severe, it cannot be corrected by conservative methods, surgery is indicated. The classic intervention is coronary artery bypass grafting. Separate blocks of the vascular system are exchanged for he althy tissues from another part of the body. At the same time, areas affected by cholesterol deposits are removed. An alternative surgical option is angioplasty. This is a method of expanding the vascular lumen mechanically. A special tube is implanted into the area, preventing the problem of narrowing in this area from returning.

About the rules of nutrition

To clarify what to do in case of illness, you need a doctor - he will also explain what it is. Progressive angina obliges the patient to take a very responsible diet in order to reduce the risk of an attack. Changing the diet is one of the basic measures in the framework of non-drug treatment. The diet is enriched with protein nutrition, foods containing magnesium and potassium compounds. Completely eliminate fatty foods. It is important to leave excess kilograms in the past, introduce regular weight control into the rule and keep it normal. A low calorie diet will help. The task of the patient is to eat in small portions and often. It is important to remember aboutdietary balance. It is necessary to consume foods in such a way that the body receives all the important nutritional compounds.

If diagnosed, you need to find out everything about progressive angina: what it is, what restrictions it imposes, what risks it carries. To form a diet, it is reasonable to contact a nutritionist. If possible, exclude from the diet or at least greatly reduce the amount of fatty meat, poultry. It is necessary to remove offal and any offal, butter, margarine from dishes. If possible, only proteins are eaten from eggs, but yolks are harmful. It is recommended to abandon fatty dairy products, cheeses, and whole milk. They exclude mayonnaise, refuse sweets, first of all - cakes, cakes.

What is useful?

According to experts, the menu should be diversified with seafood, vegetables and berries, all kinds of fruits. Greens are useful, egg whites will bring no less benefit. You should regularly eat sea fish, chicken, turkey. Eat white meat whenever possible. Skin is banned. Useful beans, soy. It is recommended to cook dishes with beans, eat bread from coarsely ground flour, bran. Among the drinks, green tea is the most useful. For salads and other dishes, vegetable oil is used as dressing - obtained from corn, olive, rapeseed, soy, sunflower. Dairy products are eaten only fat-free. Allowed fat content is 1%.

If an attack started

If there is a suspicion of the onset of an attack with progressive angina pectoris (according to ICD 10 code - I20.0), you need to immediatelycall an ambulance. The task of a person is to put a nitroglycerin tablet under the tongue. A therapeutic course using medications is practiced in a hospital setting. The needy is administered drugs that reduce blood clotting. Glycopeptide inhibitors, nitrates are shown.

In some cases, there is a need for urgent introduction of ACE inhibitors, beta-blockers. It is possible to treat with the use of calcium antagonists and agents that prevent and weaken the arrhythmia. To correct atherosclerosis, a long course of statins is prescribed. Thrombolytics are prescribed to rule out thrombosis.