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Stabile Angina

  • Elisabeth von der Lohe
Chapter
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Zusammenfassung

Definition und Pathophysiologie der Angina pectoris Angina pectoris ist ein durch myokardiale Ischämie bedingter Symptomenkomplex. Der Angina pectoris liegt in den meisten Fällen eine atherosklerotisch bedingte Verengung der Koronargefäße zugrunde, die bei körperlichem oder emotionalem Stress ein Ungleichgewicht zwischen myokardialem Sauerstoffverbrauch und Sauerstoffangebot nach sich zieht. In seltenen Fällen ist sie durch Vasospasmus (sog. PrinzmetalAngina) oder durch endotheliale Dysfunktion (z. B. beim Syndrom X) bedingt. Bei der chronisch stabilen Angina pectoris wird der ischämische Thoraxschmerz entweder durch einen erhöhten Sauerstoffbedarf bei Tachykardie, einer erhöhter myokardialen Wandspannung oder durch eine verstärkte myokardiale Kontraktilität ausgelöst. Er ist in direkter Korrelation zum Ausmaß der Belastung reproduzierbar. In der Regel sind die Beschwerden 3 min nach der Belastung verschwunden. Ruhebeschwerden sind kein Zeichen einer stabilen Angina, sondern entweder Ausdruck eines akuten Koronarsyndroms, eines Vasospasmus oder einer Arrhythmie. Schmerzen, die länger als 30 min dauern, sind sehr verdächtig für einen Myokardinfarkt. Die typische Angina pectoris ist ein belastungs abhängiges retrosternales Druckgefühl mit Ausstrahlung in den linken Arm oder Hals.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2002

Authors and Affiliations

  • Elisabeth von der Lohe
    • 1
  1. 1.Wishard Health ServicesKrannert Institute of CardiologyIndianapolisUSA

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