The origin of angina pectoris

But V. I.
(E- mail: vit.but@mail.ru)
Department of physiology IEM Russian Academy of Medical Science
Saint Petersburg

We observed patients with ischemia illness of heart. Practically all periodically

had pains in the field of heart. Patients describe a angina pectoris as «spasmodic»,
«strong compression». Naturally there is a question on an origin of these pains. It
is known, that similar pains arise at a spasm muscles of calf, smooth muscles of a
gullet.
« Now the receptors of pains in the heart is not known » [3]. Where and how
the receptors, informing about damage of a myocardium have an ending on
periphery? On what they inform?
On this question the answer is given in E.K .Plechkovoj's works and other
authors [5]. Receptors on myocardial cells are free, the endings such as « muscular
spindles » [fig. 1].
The endings closely adjoin to myocardial cells and can, similarly to
« muscular spindles » in skeletal muscles to testify to process of a spasm
myocardium’s cells.
Frequency of impulses on the sensitive nervous terminations on muscular cells
everywhere sharply amplifies at a pressure of these cells (2).
Who has felt pains at a spasm muscles of calf know that the pain can arise
sharply and suddenly. It reminds a pain in the field of heart.
The ischemia of the free nervous terminations, for example, in a skin, does
not result in a pain. Everyone can check up it on himself, having compressed on 10
minutes a site of a skin between fingers. Only the arrangement of the endings on a
muscular cell can result in sensation of a pain.
Such pain can be observed and at a spasm to smooth muscles of a gullet. This
pain also is removed by nitroglycerine, induced by cold drinks, negative emotions,
gives to the left hand, it happens at night more often.
Contraction a part myocardium does not surprise. About it wrote:
1. F.Z.Meerson at experimental stress at dogs,
2. I.K. Bogdanovich, etc. [1] marked: « In a fabric of a myocardium at sudden
death and a heart attack of a myocardium it was observed damage myocardial cells
with rough strips of reduction ».
3. L.M. Nepomnyaschy [4] writes that in experiment and on body material the
following types of damage myocardial cells arisen primarily are observed, first
minutes of an ischemia: contraction myocardial cells 1 both 11, and 111 degrees
with the further outcome in partial infarction with contraction separate groups
myocardial cells.
The muscular spasm myocardial cells allows to explain such kinds of pains in
the field of heart, as a angina pectoris on a cold, a angina on physical loading, to
similarly muscular spasm calf muscles at swimming.
The angina pectoris, stenocardia, attack pain in a myocardium, , sometimes
observed by us at patients with « ischemia illness of heart », are caused by a
sudden spasm of myocardial cells with a simultaneous spasm coronary arteries
with the subsequent ischemia causes sometimes the sudden death.

Conclusion

The angina pectoris , stenocardia arises in area of « muscular spindles », the

ending on myocardial cells .

The literature

1. Bogdanovich N.K., etc., In the book: Sudden death, Vilnius, 1984.

2. But V. I., Physiol. J., 57, 1, 85-88,1971.
3. Kozlov K.L., V. Shanin. Ischemic illness of heart, 2002.
4. Nepomnjashchih L.M. The major pathological processes in heart, 1991.
5. Plechcova E.K. Nervous of heart, Klin. Medicine, 33, 19,
p. 28,1941.
7. Shvalyov V.N., etc. Morphological bases nervous hearts, M., 1991.

Fig. 1 Sensitive ending in a myocardium, a «nervous - muscular spindle».