The main clinical manifestation of angina is chest pain. However, there are many diseases that manifest as chest pain. There are some characteristics of angina that can help us to recognize whether it is an angina attack. From the angina attack triggers, site, the nature of the pain, duration and relief of five aspects to recognize, in layman's terms, that is, how to trigger, where the pain, how the pain method, how long the pain, how to relieve.

First, the pain of angina occurs most often at the time of labor or during emotional excitement, and occurs at that time, not after exertion or emotional excitement.

Secondly, angina is located behind the sternum and can spread to the precordial area, which is roughly the size of the palm of the hand, and the pain can radiate to the left shoulder, the inside of the left arm, all the way up to the ring and little fingers, and also to the cervico-pharyngeal region or the jaw.

Thirdly, the nature of pain in angina is mostly characterized by a feeling of pressure, where the patient feels tightness in the chest and a sense of constriction. The pain of angina is usually not the kind of sharp pain, such as non-needle stabbing knife-like pain.

Fourth, angina usually lasts three to five minutes, or more than ten minutes, and rarely more than half an hour.

Fifth, angina attacks can often be relieved by stopping labor or stabilizing emotions, and can be relieved by taking nitroglycerin.

Clinically there are more serious acute myocardial infarction also mainly manifested as chest pain, but the pain of myocardial infarction is more intense, long duration, often for an hour, or even several hours, containing nitroglycerin often can not be relieved.

Another cardiac neurosis and angina pectoris is also very similar to the performance of the patient is often feel chest pain, after fatigue rather than labor, the site in the heart beat, or the site is not fixed, the pain is often a vague pain, a flash of pain or persistent pain, containing nitroglycerin has no effect or more than ten minutes to feel the symptoms of relief, and the patient often like to sigh and long out of the performance of the breath.

If the above manifestations occur, (it is recommended to go to the hospital, combined with electrocardiogram, CT, coronary angiography, laboratory tests to confirm the diagnosis, timely treatment.

Respondent: Guo Jizhen, M.S., M.A.

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　　Angina pectoris is a clinical syndrome caused by insufficient blood supply to the coronary arteries and acute temporary ischemia and hypoxia of the myocardium. Most patients can be relieved or disappear after timely treatment, but angina pectoris type of coronary heart disease, myocardial infarction or sudden death may occur. Therefore, early diagnosis and treatment of angina is particularly important. So, how to quickly recognize angina? Now make a discussion, can be reference.

　　I: Angina site. Most episodes of angina are located behind the sternum or in the precordial area of the chest, but can also occur anywhere between the upper abdomen and the pharynx. If pain is felt in these locations, be alert.

　　II: Range of angina. Angina pain tends to be widespread and patchy. Patients often feel an area of tingling, rather than pain confined to a point, these phenomena can not be clearly identified "pain point" is most likely to be caused by angina.

　　Third: the nature of angina. The nature of angina in older people is often dull and burning, and the pain is not as intense as in younger people. Sometimes angina in the elderly is not a painful sensation, but an indescribable uncomfortable feeling. It should be noted that the pain, if the pain for the needle-like, knife-like or pain like a flash of lightening like a fleeting person, often not angina, may be from other organs of the pain.

　　IV: Angina radiating area. In addition to the chest, angina pain often radiates to the shoulders, upper extremities, neck or spine. The most common radiating part of angina is the left shoulder or the left upper limb, from the inner forearm to the range of the little finger and ring finger.

　　V: Angina onset symptoms. Angina pectoris at first pain is mild, after a few minutes to reach the peak, and the time of typical angina pectoris is often about 3 to 5 minutes, rarely more than 10 to 15 minutes. Only a few variant angina and angina before myocardial infarction longer.

　　In addition, the onset of pale; limbs begin to cold, especially hands and feet; pulse, heartbeat is relatively weak; accompanied by a drop in "blood pressure".

　　Warm tips: prevention of angina, should pay attention to dietary regulation, less salt, less fat, less spicy, less food, avoid overeating; eat more fresh fruits and vegetables; quit smoking and alcohol.

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Every time we go to the hospital, we hope that our diseases can be diagnosed, recognized and treated quickly! Unbeknownst to us, sometimes illnesses are not as typical as they are described in books, but rather they take on a variety of manifestations, making it necessary for doctors to use more thought, more tests, and more consultations to identify them! Only then can we recognize the true nature of the disease!

Since the questioner's question is how to quickly recognize angina, let's get back to the point and discuss how to quickly recognize angina!

What is angina? Angina pectoris is a type of coronary heart disease, but also the most common type of disease in cardiology, which is a transient ischemia of the heart due to various reasons, because of myocardial ischemia, thus leading to heart symptoms of a disease! In essence, it is a series of symptoms caused by myocardial ischemia!

So how do you quickly recognize angina?

I. Identification of high-risk groups

People at risk have a higher probability of being coronary angina! Example: If it is a young man in his teens, then the probability of it being angina is greatly reduced! What kind of people are at risk? Men, old age, smoking and drinking and other bad habits, hypertension, diabetes, hyperlipidemia, high incidence of coronary heart disease family history of patients, patients who have suffered from coronary heart disease or cerebrovascular disease and so on, such a crowd, if the chest pain to the doctor, then, the possibility of angina attack is very high! Serious vigilance is needed!

II. Recognizing typical symptoms

There are a few typical symptoms of an angina attack that need to be present!

1, the classic way of triggering: after the activity, after a full meal, after exertion, when cycling, when going uphill and up stairs, are the typical way of triggering angina pectoris!

2, the classic onset of the site: angina pectoris good site, more common to the anterior region of the heart, the back of the sternum, the back of the place, the left shoulder and the neck is more common!

3, the classic onset characteristics: angina tends to have a short onset, minutes to half an hour, rarely more than half an hour, and rarely a second or two! Onset after activity and relief after rest are also typical relief features of angina! In fact, there are other onset characteristics that are unique to classic angina!

III. Identification of positive tests

There are a number of common positive tests that can determine that it is angina:

1, electrocardiogram: electrocardiogram changes need to be vigilant, no matter which kind of change! In fact, typical angina pectoris electrocardiogram changes, the main st depression and elevation, t-wave low flat inversion, q-wave and so on!

2, cardiac ultrasound: cardiac ultrasound suggests abnormal ventricular wall motion, often suggesting the possibility of coronary heart disease!

3, elevated cardiac enzymes: angina pectoris with myocardial injury will also have enzymatic elevation, but not too high! So, having elevated enzymology is also a characteristic change, but not all angina is elevated!

In fact, angina can be recognized in a few words in a more typical patient!

Patients who are atypical may not be recognized by the many tests done!

The determination of angina requires a concerted effort by both the patient and the physician to avoid misdiagnosis or underdiagnosis!

I believe our doctors, all of them, will find them through their efforts!

With the promotion of health education in recent years, many people know that the occurrence of chest tightness and chest pain may be a problem with the heart. So, let's talk today about the signals when the heart cries out to us for help - angina pectoris.

Why does it "hurt" when a blood vessel is blocked?

Fat continues to be deposited in the blood vessels and the blood vessels of the heart gradually narrow, eventually causing insufficient blood supply to the heart. The anaerobic metabolism of the myocardium produces certain products (e.g., acids such as lactic acid, pyruvic acid, or kinin-like polypeptides) that stimulate afferent nerve endings in the heart and often travel to superficial cutaneous nerves in the same spinal cord segments, causing pain to radiate.

Angina is actually a sign of myocardial ischemia, and insufficient blood supply to the myocardium mainly originates from coronary heart disease, so we can also think of angina as a danger sign of coronary heart disease (of course, some other diseases can also lead to angina, and what you need to do is to consult a doctor as soon as possible, so that the doctor can make a judgment).

How does angina "hurt"?

Sometimes when a patient is told in the outpatient clinic that his symptoms are angina pectoris, some people immediately object and say, "No, I don't have pain, I just have chest tightness. Yes, angina is not necessarily pain, chest tightness and chest pain are all manifestations of angina, but we call it "pain". Where the following refers to "pain", it can also include "tightness".

There are several features of typical angina:

Most angina pectoris attacks occur suddenly and are triggered by over exertion, exertion, emotional stress, fullness, constipation, high or low blood pressure, sudden cold or sudden heat, and so on. Severe cases may also have attacks at rest or at night.

(Image from the Internet)

The typical site of pain is the retrosternal or precordial area, and the pain extends to an area rather than a point. The pain may emit to the left shoulder, left arm, and even radiate to the little and ring fingers, sometimes to the neck, pharynx, jaw, and teeth or radiate backward to the left scapula or downward to the upper abdomen.

(Image from the Internet)

Pain can be mild or severe, depending on the person, depending on the degree of the disease, mostly heavy pressure, tightness or burning sensation, but also some people feel suffocated, and sometimes there is a sense of fear of dying. Usually the patient unconsciously stops activities, unwilling to talk, accompanied by pale, anxious expression, and even cold sweat. Angina is usually not a pain like a pinch. Often many lesbians in their forties and fifties say, "I have a pain like a pinprick at this one point." Such pain is basically not angina.

(Image from the Internet)

The duration of the pain is usually 1 to 5 minutes, but occasionally it can last up to a quarter of an hour or so. If it does not subside, be alert for acute myocardial infarction and seek immediate medical attention.

Generally, it relieves itself with rest or quiet or removal of the triggering factor, and sublingual nitroglycerin provides rapid pain relief.

What to do during an angina attack?

Because of the high mortality rate of acute myocardial infarction, the management of angina pectoris is very important, and the operation is very simple: keep quiet and rest, call "120", and take medicine!

Angina pectoris, acute myocardial infarction is due to myocardial ischemia, we can not increase the blood supply for the heart before waiting for treatment outside the hospital, even if there is no nitroglycerin and other drugs around, but to keep quiet can greatly reduce the heart's need for blood and oxygen to gain time for the next step in the treatment. And in recent years on the network circulated a lot of heart attack self-help methods, methods including coughing, beat, bloodletting and so on a variety of strange, without exception will let the heart increase oxygen consumption, are absolutely wrong!

The correct way to save yourself is:

Patients who have had an attack of angina should avoid factors that can trigger and aggravate angina as much as possible, such as preventing overwork, overfeeding, emotional excitement, avoiding dry stools, etc. Smokers should quit smoking, and pay attention to warmth in winter to prevent overheating and overcooling. Carry "nitroglycerin" with you.

Well, in this installment, we have learned the characteristics of typical angina and the first aid measures during an angina attack. However, in the real world, coronary heart disease does not always behave so typical, so, next Thursday we will bring "coronary heart disease atypical symptoms of what", together to identify which easily misdiagnosed coronary heart disease.

[Answered on 2018-02-17 by Chinese Medical Sciences] as the question, thanks for the invitation, to answer this question, it is good to recognize angina in young patients with typical symptoms, and it is difficult to recognize it early in older patients with multiple underlying systemic diseases, such as a history of diabetes mellitus pain insensitivity.

Hope you can help, welcome to pay attention to the "Chinese medical science platform" headlines, to get more professional and original medical science knowledge, this article for the original content, unauthorized refused to reproduce.

Dr. Zhang Liang, Deputy Chief Physician, Department of Cardiovascular Medicine, East China Hospital, Fudan University, introduced:

Answering this question is quite complex and rigorous. The average patient cannot draw a definitive conclusion about whether or not angina is present based on his or her symptoms alone. Therefore, it is recommended that susceptible groups, such as people with three high blood pressure, people with a family history of early onset of the disease, and patients with bad habits, such as smoking, should seek medical attention as soon as possible if they experience recurrent typical or suspected chest pain, so that the doctor can screen or confirm whether it is angina. If the patient has a history of previous myocardial infarction or cardiac vascular surgery, such as stenting or cardiac bypass, the possibility of angina pectoris will be prioritized clinically.

The following is a hard labor type angina grading, it is developed by the Canadian Society of Cardiology for clinicians to assess the severity of angina, because it is all symptom-guided, so it is introduced to the majority of patients, but also to facilitate self-testing at home. First-degree angina is generally manifested in daily activities, such as walking, climbing stairs will not cause angina, often occurring in the intense rapid or prolonged physical labor or exercise, in this stage of angina, the patient will not usually cause enough attention. Second-degree angina occurs when light physical labor in daily life is mildly limited, occurs after fast walking, climbing stairs, eating, or walking in the cold air, walking against the wind or emotional fluctuations, there will be chest pain. Some patients who are more alert and sensitive are likely to come to the hospital at this stage.

Grade 3 angina manifests itself as a marked restriction of daily activities, and can be triggered by an attack of angina when walking at an average speed on a level road, or when walking a kilometer or up a flight of stairs on level ground under normal conditions. Often, this symptom alerts the patient, and the number of patients seen at this stage of the disease is relatively high.

Grade 4 angina is a little more intense, and can be triggered by light activity, with the patient unable to do any physical activity.

What are the details of life in which angina can "lurk"? How can we recognize it quickly?

Angina pectoris is a clinical syndrome characterized by episodes of chest pain or chest discomfort due to insufficient blood supply to the coronary arteries and acute, temporary ischemia and hypoxia of the myocardium.

Simply put, there are two types of angina: stable angina and unstable angina.

To recognize angina, first look at what symptoms angina has.

Episodic chest pain is a classic symptom of angina pectoris, usually found in the precordial area, in the middle of the chest, in an area the size of the palm of the hand, and can be characterized by a feeling of pressure, tightness, and burning.

Not all people with angina experience chest pain; some only experience chest tightness and discomfort.

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Chest pain and tightness usually do not last long, quiet rest or nitroglycerin containing, within 3-5 minutes, the symptoms will gradually disappear.

Chest pain episodes are often triggered byMostly induced by physical labor or emotional excitement, mostly occurring at the time of labor, exercise, or excitement, not afterwards.

Radicular pain is also a common symptom of angina pectoris, which typically radiates to the left shoulder, the inside of the left arm up to the ring and little fingers, the neck, throat, and jaw, and manifests itself as a dull ache, swelling, numbness, or burning sensation.

There are three characteristics of angina that make it easy to ignore it and give it a chance to become a disease.

First, pain is good.

Angina usually does not last long, rest for a few minutes will not hurt, the patient often think it is not serious, or the past, and can not talk about going to the hospital for examination.

Second, it's all about the name.

Angina was a bad name in the first place, you think pain counts, but actually chest tightness counts, and a lot of angina is painless yo!

Third, the sound bite.

Do you think angina is just a symptom of the heart or the heart's mouth? No, it can morph into pain in your arms, shoulders and back, and you'd never think it was something wrong with your heart!

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Angina pectoris is due to insufficient blood supply to the coronary arteries. If the blood vessels are chronically under supplied with blood, the heart muscle cells are starved of 10 today and 5 tomorrow, and as the days and months go by, there will be very little left, which is theheart failureUp.

If the blood vessels are suddenly blocked, then the cardiomyocytes are going to be deprived of food, and a large number of cardiomyocytes die in a short period of time, which messes with theheart attackLa.

If the blood vessels responsible for the supply of large areas of heart muscle cells were suddenly blocked, this wouldsudden death (in medicine, sporting competitions etc)La!

Angina pectoris, don't ignore it, watch it and don't let it go oh!

Angina pectoris is caused by insufficient blood supply to the coronary arteries, acute and temporary ischemia and hypoxia of the heart muscle, mainly manifested as episodes of chest pain or chest discomfort. Coronary heart disease, i.e. coronary atherosclerotic heart disease, is a heart disease caused by atherosclerotic lesions in the coronary arteries that result in narrowing or blockage of the lumen of the arteries, resulting in myocardial ischemia, hypoxia or necrosis. Although angina pectoris is the most common symptom of coronary heart disease, not all patients with angina pectoris suffer from coronary heart disease.

We know that the most typical symptom of angina is pain in the chest, you may feel a painful sensation behind the sternum, it may spread to the shoulders, arms, neck, back, etc. Men often feel pain in the chest, neck, and shoulders, women may feel discomfort in the stomach, neck, jaw, throat, or back, and you may also have shortness of breath, sweating, or dizziness. Stable angina often gets better with rest, unstable angina may not and may get worse.

Not everyone has typical symptoms, and not all chest pain or discomfort is angina.If you have chest pain that lasts longer than a few minutes and doesn't go away when you rest or take angina medication, it may be a sign that you are having a heart attack. Call 120 for emergency medical help. If chest discomfort is a new symptom for you, be sure to see your doctor to find out if it is causing your chest pain and to get treatment.

Angina pectoris is a clinical syndrome caused by insufficient blood supply to the coronary arteries and acute temporary ischemia and hypoxia of the myocardium, which is often characterized by chest pain or chest discomfort. Angina pectoris mostly occurs during labor, cold stimulation or emotional excitement, and can last for 3 to 5 minutes, mostly in patients with coronary heart disease.

How should angina be recognized?

Angina pectoris is a subjective sensation that may vary from person to person, and in most cases is typical, and patients need to recognize it on the basis of their own performance.

1. The site of the pain:Mostly in the retrosternal or precordial area, it may radiate to the upper abdomen, teeth, pharynx, and shoulders.

2. Range of pain:The patient can describe the approximate location but cannot point to the exact point of pain, which manifests as a large area of pain.

3. Nature of pain:It is commonly characterized by dull, burning pain, with some older adults experiencing only discomfort. The pain generally ranges from mild to severe and peaks in a few minutes.

4. Duration of pain:Most of them last about 3~5min, and only a few variants of angina last longer. The frequency of attacks varies among patients, with some having only 1-2 attacks in a few months or even a year, and others having several attacks in a day.

5. Pain triggers:It occurs most often with overwork, exercise, emotional stress, satiety, and cold stimulation.

6. Pain relief:Generally eliminate the triggers, rest can be relieved, more serious patients can contain nitroglycerin to see the effect.

7. The effect of body position:The patient's lying down often aggravates angina symptoms; standing or sitting positions are instead more favorable.

It should be noted that not all chest pain is angina pectoris, instant disappearance or persistent pain, no obvious cause and not related to activities, no discomfort during daytime activities, and discomfort at night when resting, often not related to the heart, mostly due to nerve and muscle strain, but also may be pneumonia,Costochondritis,intercostal neuritis, gastritis, etc. It is also important to note that when a patient has an angina attack, he or she should immediately stop the activity, rest on the spot, and take nitroglycerin for relief.