ANGINA PECTORIS
our therapeutic area

DISEASES OF THE HEART AND CIRCULATION

The heart is the most important muscle in the human body. Permanent stress, heavy smoking, severe overweight, high blood lipid (fat) levels, high blood pressure, lack of exercise and many other factors are risk factors for cardiovascular disease.
Do not ignore any warning signs from your body, and discuss them with your doctor. The following explanations will help you better understand and categorise the different diseases.

ARTERIOSCLEROSIS

Translated literally, arteriosclerosis actually means ‘hardening of the arteries’. But what is really meant is a narrowing of the arteries because of deposits on their inside. In arteriosclerosis, water collects in the interior walls of arteries, and proteins and especially fats – mainly cholesterol – are deposited on their interior surfaces. These deposits can build up in arteries throughout the whole body. The consequence is that the organs supplied do not receive enough blood.

Particularly if the body is under stress, this can lead to acutely inadequate circulation in the organs concerned. Also, hardening of the arteries can also roughen the texture of the artery walls. Large amounts of blood platelets can collect on these roughened wall surfaces in clumps, and parts of these clumps can break off into the circulation. These are ‘blood clots’ and can block blood vessels elsewhere in the circulation, causing life-threatening conditions.
progressive coronary occlusion

Coronary heart disease and angina pectoris

Coronary heart disease (CHD) is what doctors call poor circulation that has a negative effect on the coronary arteries, e.g. because of hardening of the arteries. If the arteries have narrowed by less than 50–60%, they can still function well. If the narrowing increases to 70% or more, however, blood flow is significantly reduced. Eventually, a sensation of pressure will be felt around the heart, which will no longer be able to operate properly. This is also frequently associated with shortness of breath.

This disease is generally known as angina pectoris.If the angina pectoris is stable, attacks of pain are experienced after specific types of exertion, such as climbing stairs or running fast. Other causes may be extreme mental stress, excitement, happiness or anger. Even if the risk of a heart attack in this situation is only slightly increased, the attacks are a warning signal to the body that it is time to pull the emergency brake and make some major changes –
perhaps adoption of a healthier lifestyle, taking more exercise and definitely stopping smoking. Lifestyle changes are particularly effective because the risk of a heart attack is only slightly increased in this situation. 

The pain associated with angina pectoris is not necessarily limited to the area around the heart. For example, it can also spread into the arms or back, or occurs as stomach pain or toothache. Because of this, many ‘heart conditions’ are not detected at all.

Examination using a catheter in the heart is frequently performed today to exactly locate the weak points in the coronary arteries. In many examination centres, patients can actually see the narrowed areas of the arteries which are responsible for their symptoms.

 

 
Baldurat® – Active ingredient: dry extract of valerian root (3 - 6 : 1) [extraction agent: 70% ethanol (V/V)]. Indicated for the treatment of restlessness and disturbances in going sleep of nervous origin. For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, D-25551 Hohenlockstedt, Germany (July 2001).

Nitrolingual akut® Spray – Active ingredient: glyceryl trinitrate. Composition: 1 metered dose oromucusal spray contains 0.4 mg glyceryl trinitrate. Other ingredients: medium-chain triglycerides and partial glycerides, ethanol anhydrans, peppermint oil. Indications: prophylaxis and treatment of acute attacks of angina pectoris, acute myocardial infarction, acute left-ventricular heart failure, catheter-induced coronary spasms. Contraindications: hypersensitivity to any of the ingredients or other nitrate compounds, acute circulatory failure, cardiogenic shock, marked hypotension (syst BP < 90 mmHg), intake of phosphodiesterase inhibitors for the treatment of erectile dysfunction or pulmonary arterial hypertension. Caution in cases of hypertrophic obstructive cardiomyopathy, constrictive pericarditis, pericardial tamponade, low filling pressures (e.g. in cases of acute MI; avoid syst BP < 90 mmHg), aortic and/or mitral stenosis, orthostatic circulatory disorders, increased intracranial pressure. During pregnancy and breast-feeding, only after careful consideration whether the benefits outweigh the risks. Side effects: headache very frequent at the start of treatment, frequent hypotension with reflex tachycardia, drowsiness, dizziness and weakness. Occasional nausea, vomiting, flush, allergic skin reactions, marked decreases in blood pressure with exacerbation of angina pectoris symptoms, bradycardia with fainting. Very rare, exfoliative dermatitis. Development of tolerance and cross tolerance possible, avoid continuous high dosing. Hypoxaemia and ischaemia may occur in CHD. The ability to drive vehicles or operate machines may be impaired, especially in combination with alcohol consumption. PO. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (1).
GeloMyrtol® forte – Active ingredient: distillate of a mixture of rectified eucalyptus oil, rectified sweet orange oil, rectified myrtle oil and rectified lemon oil (66:32:1:1) (Myrtol® standardized). Indicated for acute and chronic bronchitis and inflammation of the maxillary sinuses (sinusitis). For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (01/6).
Laxopol® 1.0 g – Active ingredient: refined castor oil. For the short-term treatment of constipation. Medical advice should sought for constipation that lasts for longer than 1 week. For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (6).
GeloBronchial®-Saft – Active ingredient: liquid extract of thyme. Indications: common cold like disorders of the airways with catarrh, alleviation of symptoms of bronchitis. Warning: Ingredients include invert sugar syrup and 6.3 Vol.-% alcohol. Diabetics: sugar content of 0.75 BEU per 15 mL syrup. For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (01/11).
GeloDurat®-Salbe – Active ingredient: eucalyptus oil and levomenthol. For external use to alleviate the symptoms of  respiratory tract infections (common cold, hoarseness and uncomplicated bronchial catarrh). For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (01/5).

Nitrolingual® infus. – Active ingredient: glycerol trinitrate. Composition: 1 ml infusion solution contains 1 mg glycerol trinitrate. Other ingredients: glucose monohydrate (Ph.Eur.), 10% hydrochloric acid solution (for pH adjustment), water for injections. Indications: severe angina pectoris, acute myocardial infarction, acute left-ventricular heart failure, hypertensive crisis with acute heart failure, controlled hypotension. Contraindications: hypersensitivity to any of the ingredients or other nitrate compounds, acute circulatory failure, cardiogenic shock, toxic pulmonary oedema, marked hypotension (syst BP < 90 mmHg), disorders with increased intracranial pressure, intake of phosphodiesterase inhibitors for the treatment of erectile dysfunction or pulmonary arterial hypertension. Caution in cases of hypertrophic obstructive cardiomyopathy, constrictive pericarditis, pericardial tamponade, low filling pressures (e.g. in cases of acute MI; avoid syst BP < 90 mmHg), aortic and/or mitral valve stenosis, tendency to orthostatic circulatory disorders, severe liver or kidney disturbances. During pregnancy and breast-feeding, only if prescribed by a physician. Side effects: headache very frequent at the start of treatment; hypotension with reflex tachycardia may occur. Occasional nausea, vomiting, flush, allergic skin reactions, marked decreases in blood pressure with exacerbation of angina pectoris symptoms, bradycardia with fainting and synopses. Very rare, exfoliative dermatitis. Development of tolerance and cross tolerance possible, avoid continuous high dosing. Hypoxaemia and ischaemia may occur in CHD. The ability to drive vehicles or operate machines may be impaired, especially in combination with alcohol consumption. PO. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (July 2008).
GeloVital® Lebertrankapseln – 0.5 g/1.0 g – Active ingredient: Codliveroil for general strengthening and invigoration. For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (01/5/2).

GeloNasal®- 0.05%/-Spray 0.10% – Active ingredient: xylometazoline hydrochloride. Indications: for local application in  the nose. Contains the alpha-sympathomimetic xylometazoline. This substance narrows the blood vessels thereby reducing swelling of the mucous membrane. GeloNasal®-Tropfen 0.05%: for children between 2 and 6 years; GeloNasal®-Spray 0.10%: for schoolchildren older than 6 years and adults. For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany (01/13/13).
Gelo®-Bronchialtee 400 – Active ingredients: dry extract of thyme (6.0 – 10.0:1) [70% (V/V) ethanol] and ivy leaves (4.0 – 7.5:1) [30% (V/V) ethanol]. Indications: common cold and upper respiratory tract infections (catarrh), alleviation of symptoms of bronchitis. For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt (01/01).