What is Angina?
Angina is a tightness or pain in the chest that occurs when an area of the heart muscle receives less blood oxygen than normal. Angina is not a disease, but a symptom of coronary artery disease. When experienced on its own, it is not a life-threatening condition.
What are the types of angina?
Stable or chronic angina
This occurs when the heart is working harder than usual, for instance, during exercise. It has a regular form and can be projected to happen over months or even years. Symptoms can be relieved by getting sufficient rest or medication.
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Unstable angina cannot be relieved with rest or medication. It does not follow a regular pattern. It can occur when at rest and is considered less common and more serious. Unstable angina can be a sign of a future heart attack withing hours or weeks.
Variant and microvascular angina
Variant angina, also called Prinzmetal’s angina and microvascular angina are uncommon and can occur at rest without any primary coronary artery disease. This angina is usually due to unusual narrowing or relaxation of the blood vessels, reducing blood flow to the heart. It can be relieved by taking medication.
What are the symptoms of angina?
Angina is usually felt in the chest region as:
- shortness of breath
- burning or aching across the chest, usually starting behind the breastbone
This pain often spreads to the neck, jaw, arms, shoulders, throat, back, or even the teeth.
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Patients may also complain of symptoms including:
Stable angina commonly lasts a short period and may feel like gas or indigestion. Unstable angina occurs at rest, is surprising, lasts longer, and may deteriorate over time. Variant angina occurs at rest and is usually severe.
What are the causes of angina?
The coronary arteries supply the heart with oxygen-rich blood. When cholesterol collects on the artery wall and hard plaques form, this causes the artery to narrows.
- The arteries become too narrow and it is gradually difficult for oxygen-rich blood to reach the heart muscle.
- Damage to the arteries from other factors, such as smoking and high levels of fat or sugar in the blood, can cause plaques to build up where the arteries are damaged.
- These plaques narrow the arteries or may break off and form blood clots that block the arteries.
The actual angina attacks are the result of this reduced oxygen supply to the heart. Common triggers include:
- heavy meal
- Tobacco smoking
- physical exertion
- severe emotional stress
- exposure to very high temperatures
When blood clots partly or wholly block an artery, it may result to unstable angina. Larger blockages may lead to heart attacks. As blood clots accumulate, dissolve, and form again, angina can occur with each blockage.
Variant angina occurs when an artery experiences a spasm that causes it to become narrow and taut, thereby unsettling the blood supply to the heart. This can be triggered by exposure to stress, cold, smoking, medicines, or the use of cocaine.
A correct diagnosis is important because it can predict the chance of having a heart attack. The process will start with a physical exam as well as a discussion of symptoms, risk factors, and medical history of family.
One or more of the following tests will be conducted if your doctor suspects angina:
- Electrocardiogram (EKG):Records electrical activity of the heart and can detect when the heart is starved of oxygen.
- Stress test:Blood pressure readings and an EKG while the patient is increasing physical activity.
- Chest X-ray:This enables the doctor to see structures inside the chest.
- Coronary angiography:Dye and special X-rays are used to show the inside of coronary arteries.
- Blood tests:These check levels of cholesterol, fat, sugar, and protein.
Angina risk factors
Those at an increased risk of coronary artery disease are also at an increased risk of angina. Risk factors include:
- high blood pressure
- tobacco smoking
- unhealthy cholesterol levels
- sedentary or inactive lifestyle
- being overweight or obese
- metabolic syndrome
- being over 45 years of age for men and over 55 years of age for women
- a family history of early heart disease
How to prevent Angina
Angina can be prevented by changing lifestyle factors and by treating related conditions that worsen angina symptoms. To prevent or delay angina:
Eat healthfully by including fruits, vegetables, and whole grains in your meals. Avoid consuming large meals
- Quit smoking
- Exercise regularly
- Learn how to manage stress.
- Receive proper treatment for obesity, high blood cholesterol, high blood pressure, and diabetes.
Treatment of angina
Angina treatments helps to prevent symptoms, reduce pain, and prevent or lower the risk of heart attack. Lifestyle changes, medications, and medical procedures may all be employed.
Lifestyle changes recommended to treat angina include:
Nitrates, such as nitroglycerin, are most often prescribed for angina. Nitrates prevent or ease the intensity of angina attacks by relaxing and widening blood vessels.
Other medicines may be used such as:
- beta blockers
- calciumchannel blockers
- angiotensin-covering enzyme (ACE) inhibitors
- oral anti-platelet medicines
High blood pressure medications may also be prescribed to treat angina. These medicines are designed to lower blood pressure and cholesterol levels, slow the heart rate, relax blood vessels, reduce strain on the heart, and prevent blood clots from forming.
Surgical procedures are necessary to treat angina in some severe cases. A heart specialist may recommend angioplasty. Coronary artery bypass grafting is another standard procedure.