Angina pectoris, Ursachen

Die häufigste Ursache dafür, dass das Herz nicht ausreichend mit Blut versorgt wird, ist die koronare Herzkrankheit (KHK) durch Verkalkung und Verengung der Arterien (Arteriosklerose).

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Ursache

Bei einem Angina pectoris Anfall verspürt der Patient meist Brustschmerzen, welche durch eine Unterversorgung des Herzmuskelgewebes mit Sauerstoff ausgelöst werden. Die häufigste Ursache hierfür ist eine mangelnde Durchblutung durch Verkalkung und Verengung der Herzkranzgefäße, auch Arteriosklerose genannt. Arteriosklerose kann alle Gefäße des Körpers betreffen. Sind die Herzkranzgefäße beteiligt spricht man von einer koronaren Herzkrankheit.

Bei Arteriosklerose kommt es zu Fettablagerungen und Entzündungen in den Gefäßwänden. Derartige Fettablagerungen, auch Plaque genannt, können den Blutfluss durch die Gefäße behindern. Forschungsergebnissen zufolge beschleunigen Rauchen, ein hoher Cholesterinspiegel, Diabetes und Bluthochdruck die Entwicklung einer Arteriosklerose und so die Entstehung einer koronaren Herzkrankheit. Umgekehrt kann das Fortschreiten der Erkrankung durch Beeinflussung dieser sogenannten Risikofaktoren gebremst werden, beispielsweise durch ein Aufhören mit dem Rauchen.

Eine weitere, weitaus seltenere Ursache für eine Angina pectoris sind Krämpfe (Spasmen) der Herzkranzgefäße. Die Gefäße ziehen sich zusammen, wodurch der Blutfluss stark reduziert wird und das dahinterliegende Herzmuskelgewebe nicht mehr ausreichend Sauerstoff und Nährstoffe erhält. Diese Erkrankung nennt man Prinzmetal-Angina. 

Was löst einen Angina pectoris Anfall aus?

In den meisten Fällen liegt die Ursache für die Angina pectoris Anfälle also in einer Arteriosklerose. Abzugrenzen hiervon sind die Auslöser eines akuten Anfalls. Häufige Auslöser sind unter anderem körperliche Anstrengung, psychischer Stress oder Kälte. Einige Patienten berichten auch von Beschwerden nach großen Mahlzeiten. In diesen Situation muss das Herz kräftiger schlagen, wofür es mehr Energiezufuhr und Sauerstoff durch eine bessere Blutversorgung benötigt. Aufgrund der verengten Blutgefäße kann die Blutzufuhr jedoch nicht ausreichend gesteigert werden - Brustschmerzen treten auf.

Auch wenn Ihr Blut weniger Sauerstoff als normal enthält, kann dies zu Angina pectoris Anfällen führen. Betroffen sind beispielsweise Raucher und Patienten, die sich in sauerstoffarmer Luft, z.B. in Höhenlagen, aufhalten.

Weiterführende Informationen

Autoren

  • Dietrich August, Arzt, Freiburg im Breisgau

Literatur

Dieser Artikel basiert auf dem Fachartikel Angina pectoris, stabile. Nachfolgend finden Sie die Literaturliste aus diesem Dokument.

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