Fachbereich

Car­dio­lo­gy

Chest pain / an­gi­na pec­to­ris

Chest pain" (an­gi­na pec­to­ris) is cau­sed by an un­der­sup­ply of oxy­gen to the heart mus­cle.

The heart is our most important muscle, whose main task is to maintain blood circulation and thus ensure the transport of oxygen-rich blood and the removal of oxygen-poor blood in the body.

Cau­ses

The cause of chest pain / angina pectoris is usually the narrowing of the coronary arteries due to arteriosclerosis.

Sym­ptoms

Angina pectoris is characterised by seizure-like chest pain with severe pressure, tightness or burning behind the breastbone during exertion or in cold weather. The pain can radiate to the neck, jaw, arms, shoulders or abdomen and be associated with shortness of breath.

Dia­gno­sis

  • Measurement of the heart rate at rest (resting ECG)
  • Exercise ECG (ergometry)
  • Cardiac ultrasound examination (echocardiogram)
  • Blood test
  • Medical history of the affected patient (family history)

Additional further investigations:

  • Myocardial scintigram
  • MRI with visualisation of the coronary vessels (angio-MR)

Cardiac catheterisation (coronary angiography) provides precise information about the existing stenoses in the coronary arteries and the performance of the heart.

The­ra­py

Conservative
Acute chest pain is treated with nitrates (nitoglycerin). If a heart attack is suspected
myocardial infarction, aspirin and heparin are administered to "thin the blood".
In long-term therapy, drugs with different modes of action are used to relieve the heart (beta blockers, calcium channel blockers)
The causes of arteriosclerosis are treated by changing the diet (balanced, low-fat, low-salt), exercise therapy, stopping smoking, weight regulation and optimising blood pressure and blood sugar control in diabetics in order to prevent or slow down the progression of the disease.

Interventional
A cardiac catheterisation can be used to determine whether significant constrictions in the coronary vessels are impairing blood flow. Such constrictions can usually be treated by widening and inserting a stent.

Surgical treatment
If there are constrictions in all three coronary arteries, these are bridged with a piece of vein or artery during bypass surgery.

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