The progressive angina fixed by code I20.0 in the ICD 10 is a severe heart disease. The disease is observed against the background of vascular atherosclerosis, gradually progresses, so the patient's condition worsens. It is frankly difficult to achieve stabilization and improvement. We'll have to introduce nutrition control, change the lifestyle. The doctor will choose the appropriate therapeutic course. The main objective of treatment is to exclude the progress of the disease.
About manifestations
The code for progressive angina I20.0 provided in ICD 10 implies a disease, the course of which is gradually becoming more and more difficult for a person. Progressive is a subspecies of unstable angina pectoris. Often this is observed with angina pectoris. In any of the options, the pathological condition develops quite quickly, accompanied by increasing seizures, rather long and difficult to tolerate patients. Classical drug therapy does not give the desired result, the effectiveness of funds is gradually falling. The clinical picture is quite specific.
The progressive angina, hidden under the code I20.0 in the ICD, is a disease that appears against the background of an unstable course: its nature is changing. Frequent seizures appear, difficult to tolerate, prolonged, observed with small loads. If earlier the attacks differed in quite a strong tension, gradually the patients note that less and less effort is needed to start the deterioration. The attack is accompanied by manifestations previously uncharacteristic. Not enough air, the body is covered with cold sweat, a person is sick, vomits. A new pain is spreading throughout the body.
Features: how to notice?
It is possible to assume that progressive angina pectoris occurs (ICD code I20.0) if nitroglycerin, which previously helped the patient well, loses its effectiveness. It either does not work at all, or the result of its administration is extremely weak. To stop the attack, you have to take a very large amount of medication.
With an unstable course, seizures appear unpredictably. It is not possible to notice the root causes, they are not associated with physical activity. Sometimes attacks can occur due to stress, but its presence is optional - an unpredictable start is possible at any time.
Examination of the condition shows changes in the cardiogram. Perhaps a sharp deterioration in the patient's well-being, even in a state of complete rest. As the heart progresses, it receives less and less blood. The attack is accompanied not only by pain, but also a violation of the rhythm of heart contractions. The areas affected by pain are becoming more significant. Possible night angina attacks, extremely difficult for the patient due to the increased intensity of sensations.
Flow
Appearing against the background of CHD, progressive angina pectoris develops for months. Transformation into a pathological state of rest is possible. In this case, the pain becomes stronger, the duration of each attack exceeds 30 minutes, the patient is afraid, feels weak. The study shows pressure drops, an increase in heart rate. This suggests an increased risk of heart attack. It is noted that with the considered variant of the course of angina pectoris, a heart attack is observed in a fairly large number of patients, which forces an ambulance to be called up at the first suspicion of angina pectoris. If a person does not receive adequate treatment, the prognosis is poor.
A relatively positive course, timely assistance provided can stabilize the state, return a person to a normal life. An unstable type of disease is transformed into a stable one with the possibility of increasing the functional class. There are known cases of absolute remission, in which a person no longer encountered bouts of pain.
State differentiation
For the layman, the manifestations of unstable progressive angina are in many ways similar to the symptoms of a heart attack. It is necessary to consult a doctor who will be able to convey in detail to a person how to distinguish these two pathologies. The main feature of a heart attack is the duration of an uncomfortable condition. An attack with a heart attack lasts from 30 minutes or more. In this case, nitroglycerin does not give any effect, its reception does not allow to stop the problem.
To confirm a heart attack, do special studies. Showing electrocardiography, a blood test. Laboratory measures in this case will show an increase in ESR, an increase in the concentration of specific cardiac enzymes and troponin T.
What provokes?
You need to know where the disease comes from in order to prevent progressive angina pectoris in your medical history. This pathological condition is due to the development of atherosclerosis, which affects the vascular system that feeds the heart. This leads to a decrease in arterial clearance due to the appearance of plaques here. Among the factors that aggravate the case, there is an increase in blood pressure in the arteries, and overload: mental and emotional. Tachycardia can play its role. If the danger of developing pathology is assessed as relatively high, stressful situations should be excluded from your life and treatment of atherosclerosis should be started.
About categories
Several clinical forms of pathology are known. Belonging to a specific category is determined by the prevailing manifestations: a change in the frequency or characteristics of their course is possible. In case of progressive angina pectoris, an increase in seizures while maintaining the stability of the disease may be mentioned in the medical history. It is possible to increase the duration and severity of each individual case at the same frequency. There is a possibility of combining angina pectoris and rest. Perhaps a course in which there are more attacks, each of them is becoming more intense, their duration is increasing.
To assess the severity of the condition, a division into three categories is accepted: progressive (a recent pathological condition), subacute and acute.
What to do?
Treatment of progressive angina pectoris is selected based on the category of the case and the characteristics of the patient's condition. The patient's task is to seek qualified help on time. Probably, a person previously took some medications. The doctor will determine which ones to replace, the dose of which ones to increase. If you do not take the help of a doctor, the risk of unpredictable death or severe heart attack increases. Without adequate assistance, each attack is associated with risks of pulmonary edema, cardiac asthma, ischemia, and stroke. There is a danger of the formation of blood clots and their blocking of the ducts of blood vessels. The unpredictable location of thrombosis. The therapeutic course is practiced in a hospital setting. Regular medical monitoring of the patient's condition is necessary.
Outside the hospital walls
Progressive angina pectoris is corrected by complex measures. First of all, you need to reconsider your lifestyle. Alcoholic beverages should be excluded and tobacco products completely abandoned. It is necessary to remove passive smoking from your life. It is important to adequately assess physical activity, responsibly correlate emotional experiences and their own abilities. If some events, facts, movements provoke an attack, you need to completely exclude those from everyday life. In order to stabilize health, it is necessary to enter into a daily habit of walking, without rushing and without worrying, taking pleasure in being in the fresh air. Any physical activity cannot be completely ruled out - loads should be, they are useful, but only in reasonable amounts.
About Methods
Formulating the diagnosis, the doctor will immediately explain what it is. Progressive angina pectoris requires the patient to understand the diagnosis and to recognize the relevance of the correction. The cardiologist will select the drug course that is optimal for a particular case. Drugs are chosen so that they expand the vascular lumens, make the walls of the system more elastic. As a result, the heart will receive enough oxygen.
Very well on the patient's condition will affect dosed physical activity. You can practice gymnastics. Regular exercises will help stabilize the rhythm of heart contractions and leave shortness of breath in the past. With the diagnosis in question, skiing, swimming, walking are most useful. A course of physiotherapy will be developed by a cardiologist. At first, you need to deal with the supervision of a doctor or other person with a specialized education. The complex is formed individually, if necessary, corrected by monitoring the reaction of the patient.
Surgical treatment
Heart surgeons know very well about the disease in question - they have to deal with people suffering from progressive angina pectoris. What it is and why it requires surgery, a qualified doctor will explain to the patient at the reception. If the course of the case is severe, it is not possible to correct it with conservative methods, surgery is indicated. The classic option for intervention is coronary artery bypass grafting. Separate blocks of the vascular system are exchanged for healthy tissue from another part of the body. At the same time, zones affected by cholesterol deposits are removed. An alternative option for surgery is angioplasty. This is a method of expanding the vascular lumen mechanically. A special tube is implanted into the site, preventing the return of the narrowing problem in this area.
About nutrition
Clarify what to do in case of illness, you need a doctor - he will explain what it is. Progressive angina pector obliges the patient to take a very responsible diet, in order to reduce the risk of an attack. Changing the diet is one of the basic measures in the framework of non-drug treatment. The diet is enriched with protein nutrition, products containing magnesium and potassium compounds. Fatty foods are completely eliminated. It is important to leave in the past excess kilograms, introduce regular weight control into the rule and maintain it normal. A low-calorie diet will come to the rescue. The patient's task is to eat in small portions and often. It is important to remember a balanced diet. It is necessary to consume foods so that the body receives all the important nutritional compounds.
If a diagnosis is made, you need to find out everything about progressive angina pectoris: what it is, what limitations it places, what risks it carries. To form a diet, it is wise to consult a nutritionist. If possible, exclude from the diet or at least greatly reduce the volume of fatty meat, poultry. It is necessary to remove from the dishes the giblets and any offal, oil, margarine. If possible, only squirrels eat eggs, but yolks are harmful. It is recommended to refuse fatty dairy products, cheeses, as well as whole milk. They exclude mayonnaise, refuse sweet, first of all, cakes and cakes.
And what is useful?
According to experts, the menu should be varied with seafood, vegetables and berries, all kinds of fruits. Useful greens, egg whites will bring no less benefit. You should regularly eat sea fish, chicken, turkey. If possible, eat white meat. Leather is prohibited. Useful beans, soy. It is recommended to cook dishes with beans, eat bread from coarsely ground flour, bran. Among the drinks, green tea is the most useful. For salads and other dishes, dressing uses vegetable oil - obtained from corn, olive, canola, soy, sunflower. Dairy products are eaten only nonfat. Permissible fat content is 1%.
If an attack begins
If there is a suspicion of an onset of an attack with progressive angina (according to ICD 10 code - I20.0), you must immediately call an ambulance team. The task of a person is to put a nitroglycerin tablet under the tongue. A therapeutic course using medicines is practiced in a hospital setting. Drugs that reduce blood coagulation are administered to a needy. Glycopeptide inhibitory agents, nitrates are indicated.
In some cases, there is a need for urgent administration of ACE inhibitors, beta-blockers. It is possible to use calcium antagonists and agents that prevent and reduce arrhythmia. For the correction of atherosclerosis, a long course of statins is prescribed. To exclude thrombosis, thrombolytics are prescribed.