Heberden recognized that the pain of angina always got better within a minute or so after the precipitating activity was stopped. For example, the individual might be quite well, but on walking up an incline, especially against the wind, he or she developed discomfort in the chest. If the individual stopped the walk immediately and rested a minute, thus allowing the heart work to decrease, the discomfort disappeared immediately.
This concept of oxygen supply versus its demand by the heart muscle is the hallmark of angina. Make a long list of what precipitates the pain and what relieves it, but the one important clue to help the diagnosis is that the pain or discomfort is precipitated by a particular activity and, once the activity is stopped, the pain disappears within minutes.

B. Activities that Precipitate Angina
These precipitating activities include:
1. Walking up a hill
2. Walking against the wind
3. Running with some associated anxiety for a bus or to a place, especially while carrying a bag; anxiety is made more profound if the individual is late and must rush, thus, there is exertion and emotional stress
4. A brisk walk or similar exertion soon after eating; this does not include bending and stooping, which can precipitate indigestion

Страницы: 1 | 2 | 3 | 4