Walking through anginaI20.8
Synonym(s)
DefinitionThis section has been translated automatically.
Walking through angina is an angina pectoris that occurs at the beginning of a physical exertion and decreases in the course of the physical exertion (Siegenthaler 2005).
ClassificationThis section has been translated automatically.
Walking through angina is a stable AP (Renz- Polster 2008).
EtiopathogenesisThis section has been translated automatically.
The pathophysiological mechanism shows different explanations.
According to Siegenthaler (2005), the recruitment of collaterals occurs under stress, which after a certain time supply the ischemic area of the myocardium with sufficient oxygen.
Douglas (2013) considers increased peripheral vasodilation at the beginning of physical exertion to be the cause of AP attacks.
Recent literature describes the release of vasodilatory metabolites (Herold 2020).
Clinical featuresThis section has been translated automatically.
Initially, there is a typical symptomatology of angina pectoris under physical strain with
- retrosternal localized pain, which can radiate in
- Neck / Neck
- Lower jaw
- Teeth
- Shoulder area
- both (!) arms (with focus on the ulnar sides of the forearms), which can radiate into the ulnar fingertips
- Pain in the epigastrium (rarely also below the navel) (Kasper 2015)
The symptoms typically disappear again on their own under constant physical strain - without drug treatment (Herold 2020).
TherapyThis section has been translated automatically.
If a short-acting nitro preparation is administered immediately after the occurrence of AP, an immediate improvement occurs (Schunkert 2013). In earlier literature an extended warm-up phase is recommended to avoid the initial period of ischemia (Schulte 1991).
LiteratureThis section has been translated automatically.
- Douglas G et al (2013) Macleod's Clinical Examination e-book. Churchill Livingstone Elsevier Publisher 100
- Herold G et al (2020) Internal medicine. Herold Publisher 240
- Kasper D L et al (2015) Harrison's Principles of Internal Medicine. Mc Graw Hill Education 1580
- Renz- Polster et al. (2008) Basic textbook on internal medicine: compact, tangible, understandable. Elsevier Urban and Fischer 64
- Schulte K L et al (1991) Cardiac risk at Sprot Steinkopff Verlag 85
- Schunkert H et al (2013) Rational diagnosis and therapy of coronary heart disease. Springer Publishing House 85
- Siegenthaler W et al (2005) Siegenthaler's differential diagnosis: Internal diseases - from symptom to diagnosis. Georg Thieme Publisher 227