Angina is a typical chest pain that usually lasts for a few minutes,
most commonly occurring during exercise and relieving at rest. Angina pectoris
occurs when the balance between myocardial oxygen supply and myocardial oxygen demand is disturbed.

Angina pectoris is considered stable when its symptoms do not change and are predictable (localization,
nature and duration of sensation, the intensity of inducing load, response to treatment). She often gets sick
patients with multiple risk factors for cardiovascular disease (dyslipidemia,
diabetes mellitus, primary arterial hypertension, smoking, obesity and early
coronary heart disease found among close relatives).

Coronary artery disease symptoms

Because coronary heart disease can develop over many years, symptoms are often not felt until the blockage becomes critical. First, you’ll notice that your heart works harder than usual with simple physical work. However, symptoms can also occur with rest or no physical activity.

Each person may experience different symptoms, but the most common are:

• Chest discomfort or pain (angina)
• Shortness of breath
• Extremely tired
• Swelling of the feet
• Arm or shoulder pain
• Women may experience atypical chest pain. It can be short-lived or a sharp sensation in the abdomen, back or arm.
• Women are more likely than men to experience dangerous signs of a heart attack, including nausea and back or jaw pain. Sometimes myocardial infarction occurs without any symptoms.
• Be sure to contact your doctor if you experience symptoms of coronary heart disease.

Risk factors

The process of vascular calcification inevitably occurs with age, however, certain risk factors accelerate this process:

• Age (over 45 for men, over 55 for women)
• Family history of heart disease
• Smoking
• High blood pressure
• High LDL (low-density lipoprotein) “bad” cholesterol and low HDL (high-density lipoprotein) “good” cholesterol
• Diabetes
• Overweight or obesity
• Absence of exercise
• Some radiation therapy to the chest
• Stress
• Men are at higher risk of developing coronary heart disease than women. After menopause, the risk of getting sick in women increases.

Diagnosis of Microvascular Coronary Disease

If your doctor suspects you have coronary heart disease, he or she will refer you to a cardiologist who specializes in diagnosing and treating heart disease.

Your doctor will find out about your symptoms, medical history and risk factors. Depending on the information you receive, your doctor will order tests to determine the condition of your arteries. Such studies may include:

• Electrocardiogram (ECG)
• Echocardiogram (ECHO)
• ECG exercise sample
• Nuclear stress test
• Magnetic resonance angiography (MRA)
• Angiography
• Intravascular ultrasound examination (IVUT)
• X-ray
• Blood test
• Computed tomography angiography

Treatment

There are many things you can do to slow the progression of cardiovascular disease – take medication, follow a diet, exercise more; however, if such lifestyle changes do not work, your doctor will recommend a stenting or bypass procedure. Only a doctor can decide which treatment is most appropriate, taking into account your medical condition and the potential risks in the future.

MEDICAL THERAPY

When atherosclerosis is detected at an early stage, medications such as nitrates, beta blockers, calcium channel blockers, aspirin, or cholesterol-lowering medications may be prescribed. These medicines slow down the progression of the disease or reduce the symptoms.

Blood Vessel Shunt

Coronary artery bypass grafting is a common type of heart surgery, an open surgery in which a surgeon takes a portion of a healthy blood vessel from your leg, chest, or arm. This creates a new “bypass” for the flow of blood.

Non-cardiac surgery

This surgery is performed without cardiac arrest and requires some equipment to allow the surgeon to operate on the heart by beating it. Beating heart surgery is not suitable for all patients.
Cardiac Arrest – Most bypass surgeries are performed in an open manner (the chest is opened), where the heart is stopped and a special cardiopulmonary resuscitation machine is used to maintain blood flow.