Call your doctor if you experience chest pain, even if you think you are too young to have angina pectoris and no history of heart problems in his family. Your doctor will recommend the next steps depending on how you describe your symptoms and risk factors.

Forecast

In people with coronary disease, the outlook depends on many factors, including the location and severity of the narrowing of the artery, and the number of coronary arteries involved. Proper treatment greatly improves the outlook for people with coronary artery disease.

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* Changes in lifestyle, including weight loss for obese patients, smoking cessation therapy, drugs to reduce high cholesterol, regular exercise program to reduce high blood pressure and stress reduction techniques.

* Nitrates: nitroglycerin including: nitrates are medications that widen blood vessels (vasodilators). Increase blood flow in coronary arteries provide the heart and pumping blood to the rest of the body.

* Beta blockers: atenolol (Tenormin) and metoprolol (Lopressor, Toprol-XL). These medications decrease the heart’s workload by decreasing heart rate and lessen the force of contractions of this, especially during exercise.

* Calcium channel blockers, such as nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem, Tiazac), amlodipine (Norvasc). These medications can help improve the efficiency of heart muscle function and may reduce the number and severity of episodes of chest pain.

* Aspirin: Aspirin helps prevent blood clots in narrowed coronary arteries, which can reduce the risk of heart attacks in people who already have heart disease.

If you changed your lifestyle and medications do not improve angina or when the risk of a heart attack is high, your doctor may recommend a balloon angioplasty or heart bypass surgery.

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A crisis of angina usually lasts less than five minutes. Pain that lasts longer than that or acute may suggest a more significant decrease in blood flow to heart. This can happen when someone is having a heart attack or unstable angina.

Prevention

You can help prevent angina, which causes blockage of arteries caused by coronary heart disease by controlling your risk factors.

* High cholesterol: follow your doctor about a diet low in fat and cholesterol, if necessary, take medications to lower cholesterol.

High blood pressure: follow your doctor’s recommendations to modify your diet and take your medicine.

* Smoking: If you smoke, quit. If you do not smoke, do not start.

* Diabetes: check your blood sugar frequently, follow your special diet and take insulin or oral medication (pills) as prescribed by your doctor.

It is advisable to exercise regularly and maintain a healthy weight. If emotional stress provokes the crisis of angina pectoris, learning to manage stress or relaxation techniques can help.

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Check your blood pressure and pulse, and examine your heart and lungs. You may need one or more diagnostic tests to determine if you have coronary artery disease. Tests may include:

* Electrocardiogram (EKG) is a record of electrical impulses from your heart. It can identify problems in the frequency and heart rate. Sometimes it can show changes that indicate a blocked artery.

* Stress test: If your ECG is normal and can walk, ask for a stress test. Walk on a treadmill while monitoring your heart rate. Other stress tests use drugs to stimulate the heart, injecting contrast material (dye) to detect blockages and take ultrasound images to provide more information.

* Coronary angiography: the x-ray of the coronary arteries are the most accurate way to measure the severity of coronary disease. This inserts a thin tube, long and flexible (called a catheter) through an artery in the arm or groin. The doctor guides the catheter into the heart using a special camera. Once the catheter is placed, the dye is injected to show the blood flow inside the coronary arteries, highlighting any areas that are narrowed or blocked.

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Coronary heart disease is usually caused by atherosclerosis, a disease in which fatty deposits (called plaque) on the inner walls of blood vessels. Although angina most commonly affects middle-aged men or older, can occur in both sexes and all ages. Angina is also known as angina pectoris.

Normally, this disease is manifested by pressure, burning, or tightness in the chest. The pain is usually under the breastbone, but may radiate to the throat, arms, jaws, between the shoulders (shoulder) or into the stomach. Other symptoms that may accompany angina include nausea, dizziness, difficulty breathing or shortness of breath and sweating.

Doctors divided angina into two types:

* Stable angina: chest pain following a specific pattern, which occurs when someone has an intense physical activity or have an extreme emotion. Other situations that trigger include smoking cigarettes or cigars (cigars), cold weather, a large meal or try to go to the bathroom. The pain usually disappears when the employer or the cause that triggered it are completed.

* Unstable angina symptoms are less predictable and if the note, you should call your doctor immediately. This chest pain occurs when a person is resting, sleeping, or very often, performing minimal effort. The discomfort may be prolonged and may be intense.

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The handle and short apophysis Hammer (one of three small bones that allow the transmission of sound to the inner ear) are clearly visible, being in a laid back position at the top of the eardrum.

Pneumatic otoscopy (when inflated with air the ear canal) is very useful for evaluating middle ear disease. Gently applying positive and negative pressure air, you can determine the mobility of the tympanic membrane.

Abnormal findings include:

- A perforation (hole) in the eardrum

- An acute middle ear infection (acute otitis media)

The appearance of the eardrum in acute otitis media depends on the time elapsed since the onset of infection. Typically, the eardrum begins to be red or yellow and is cloudy, with a deformed or absent light reflex and typical signs of this disease. Insufflation may show decreased mobility.

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The normal ear canal is air and often a wax layer that varies from yellow to dark brown. The total length of the ear canal in adults is about 2.5 centimeters, which produces a resonance frequency of about 3,000 Hz, a frequency range important for understanding speech.Abnormal findings include:

- A layer dry, flaky, suggestive of eczema (seborrhea).

- A conduit inflamed, swollen and narrowed, possibly with a production of secretion, indicating infection (otitis externa).

- Wax obscuring the eardrum.

- A foreign body such as an eraser.

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Otoscopy is an examination that is performed by an instrument called an otoscope and used to examine the external auditory canal and middle ear assess through direct visualization of the eardrum.

An otoscope consists of 3 parts:

- The handle, which contains the battery to the light source.

- The head, which contains the bulb and a magnifying glass.

- The cone is inserted into the ear canal.Inspection of the outer ear (pinna)

Before inserting the otoscope into the ear canal, the pavilion is inspected for any signs of disease that may be related to the patient’s symptoms. For example, if the complaint is pain in the ear, may be evidence to the naked eye from an infection of the outer ear that is responsible.

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- For reasons of health.

- For environmental conservation ideas as plant food production is more environmentally friendly animal production.

- Out of respect for animal life.

For whatever reason, the number of people who describe themselves as vegetarian has increased in recent years and up to 5% of people in England, Germany and Australia say they are vegetarians. In the U.S. a 1985 study indicated that there were 6.6 million people rose to 12.4 vegetarian million in 1995.

A vegetarian diet can contain all the necessary nutrients, but as it becomes more strict and more food are excluded, it is more difficult to combine basic foods allowed in such a way that they cover all the nutrient needs of a person. This situation, therefore, is more common in strict vegetarians and especially in the raw foodist and frugivores, as well as those with greater risk of deficiencies, including pregnant women, children, elderly or infirm.

Vegan diets may have difficulty achieving the necessary input of calories, protein, magnesium, iron, zinc and especially calcium, vitamin D and vitamin B12. The lacto not have problems to meet the needs of protein, calcium and vitamin D. However, the risk of B12 deficiency affects all vegetarian supplements and spirulina (an algae that contain substances similar to vitamin B12, but no biological activity) not only do not solve the problems of lack of vitamin B12, but may also hinder the detection of the lack of this vitamin in the blood.

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The term vegetarian diets include many different diets, characterized by preferential consumption of plant foods. The fidelity with which vegetarians follow these rules is variable:

- Vegan not take any food derived from animals and diet excludes eggs, milk and even honey;

- Vegetarians with such strict habits, as some drink milk (lacto-vegetarians), or milk and eggs (ovo-lacto-vegetarians) or who habitually take plant foods but in some cases, may take some meat or fish . In fact, in the U.S. to 20% of people who consider themselves vegetarian eat meat on occasion.

Within there are also vegan raw foodist, which also take raw foods, or fruit bats, which take only fruits, or foods that are the fruit of the plant (tomatoes, eggplants, etc …).

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