Early manifestations of atherosclerosis of heart vessels may include dyspnea, palpitations and heartache usually occurring with physical or psychoemotional loads, which did not produce these symptoms in the past. The patient may also complain of leg swelling, feeling of heart function interruption and shortness of breath. Heartache is generally thought to be the direct sign of cardiac disease. Why then does the physician hold off on setting a diagnosis and carry out differential diagnostic procedures to rule out other non-cardiac diseases, e.g. intercostal neuralgia?
Heartache in coronary (heart) vessels damage is very specific, rarely occurs in the region of the heart or persists. In case of coronary vessels damage the person presents with discomfort or squeezing, burning retrosternal pain normally associated with physical and/or psychoemotional loads. This pain may also appear following food intake or breathing of cold air, and radiate to the left shoulder, neck, low jaw, interscapular region, left infrascapular region. Usually, the symptoms last for maximum 10-15 minutes and resolve rather quickly, within several minutes at rest or following administration of nitroglycerin.
WHY DOES ADMINISTRATION OF NITROGLYCERIN LEAD TO HEADACHE AND WHY IS THIS MEDICINAL PRODUCT INEFFECTIVE IN SOME PEOPLE?
Well-known medicinal product nitroglycerin is manufactured in the form of small tablets for sublingual use, where it rapidly absorbs through mucosa and immediately gets into the blood. Its effect can be seen in as little as 1-2 minutes after administration and results in rapid elimination of vascular spasm and associated retrosternal pain. As for the headache following intake of nitroglycerin, it really occurs and is attributable to a very potent and sharp vasodilatation.
Some people may face another problem associated with the administration of this medicinal product: 60-70% patients regularly treated with nitroglycerin develop resistance (tolerance) to this drug and in 10-15% patients nitroglycerin may totally lose its activity.
There is only one way to restore the sensitivity to nitroglycerin – the patient should try to make interval in the administration of this product for several days and then the sensitivity of receptors recovers spontaneously.
Yet the question remains – what should do those who cannot go a day without nitroglycerin?
Tivortin Aspartate is not a substitute for nitroglycerin. However, Tivortin Aspartate is able to decrease the need for nitroglycerin administration as shown in the clinical studies and reduce discomfort associated with its use. Consequently, the lower the frequency of nitroglycerin intake, the smaller the risk for development of tolerance.
Important for women: the typical (described above) retrosternal pain in case of coronary vessels damage is not characteristic for many women. The common “female” symptoms are dyspnea (feeling shortness of breath), sharp fatigue and pain in the stomach region.