Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. Angina is a symptom of a condition called myocardial ischemia. It occurs when the heart muscle (myocardium) doesn’t get as much blood (hence as much oxygen) as it needs. This usually happens because one or more of the heart’s arteries (coronary blood vessels that supply blood to the heart muscle) is narrowed or blocked. Insufficient blood supply is called ischemia.Angina also can occur in people with valvular heart disease, hypertrophic cardiomyopathy (this is an enlarged heart due to disease) or uncontrolled high blood pressure.
When the heart muscle has to work harder, it needs more oxygen. Symptoms of angina occur when the coronary arteries are narrowed or blocked by hardening of the arteries (atherosclerosis), or by a blood clot.
The most common cause of angina is coronary heart disease (CHD). Angina pectoris is the medical term for this type of chest pain.
The risk factors for coronary heart disease include:
- Family history of coronary heart disease before age 50
- High blood pressure
- High LDL cholesterol and low HDL cholesterol
- Male gender
- Not getting enough exercise
- Over Smoking
- Excessive Use of Fats.
- Abnormal heart rhythms
- Coronary artery spasm (also called Prinzmetal’s angina)
- Heart failure
- Heart valve disease
- Over Mental Stress.
The most common symptom is chest pain that occurs behind the breastbone or slightly to the left of it. The pain of stable angina usually begins slowly and gets worse over the next few minutes before going away.
The pain may feel like tightness, heavy pressure, squeezing, or crushing pain. It may spread to the:
- Arm (usually the left)
- A feeling of indigestion or heartburn
- Dizziness or light-headedness
- Nausea, vomiting, and sweating
- Shortness of breath
- Unexplained tiredness after activity (more common in women)
- Heart attack(Myocardial Imfarction)
- Sudden death caused by abnormal heart rhythms (arrhythmias)
- Unstable angina
Your health care provider will perform a physical exam and measure your blood pressure. The following tests may be done to diagnose or rule out angina:
- Coronary angiography
- Coronary risk profile (special blood tests)
- Exercise tolerance test (stress test or treadmill test)
- Stress echocardiogram
- Thallium stress test
What is Stable Angina?
People with stable angina (or chronic stable angina) have episodes of chest discomfort that are usually predictable. They occur on exertion (such as running to catch a bus) or under mental or emotional stress. Normally the chest discomfort is relieved with rest, nitroglycerin or both.
People with episodes of chest discomfort should see their physician for an evaluation. The doctor will evaluate the person’s medical history and risk factors, conduct a physical exam, order a chest X-ray and take an electrocardiogram (ECG).
The options for treating angina include medications and surgery.
Medicines used to treat angina include:
- Blood thinners, including aspirin and clopidogrel (Plavix)
- Cholesterol-lowering drugs
- Blood pressure medicines, including calcium channel blockers, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors
Some patients may need surgery to help improve the flow of blood through the coronary arteries, such as:
- Coronary artery bypass grafting (CABG)
Angioplasty with stenting can be a life-saving procedure if you are having a heart attack.
What is Unstable Angina:
In people with unstable angina, the chest pain is unexpected and usually occurs while at rest. The discomfort may be more severe and prolonged than typical angina or be the first time a person has angina. The most common cause is reduced blood flow to the heart muscle because the coronary arteries are narrowed by fatty buildups (atherosclerosis). An artery may be abnormally constricted or partially blocked by a blood clot. Inflammation, infection and secondary causes also can lead to unstable angina. In a form of unstable angina called variant or Prinzmetal’s angina, the cause is coronary artery spasm.
Unstable angina is an acute coronary syndrome and should be treated as an emergency.
They’re at increased risk for:
- acute myocardial infarction (heart attack).
- severe cardiac arrhythmias. These may include ventricular tachycardia and fibrillation.
- cardiac arrest leading to sudden death.
The best way to prevent angina is to lower your risk for coronary heart disease:
- Control blood pressure, diabetes, and cholesterol
- Lose weight if you are overweight
- Stop smoking
If you have one or more risk factors for heart disease, talk to your doctor about possibly taking aspirin or other medicines to help prevent a heart attack. Aspirin therapy (75 mg – 325 mg a day) or a drug called clopidogrel may help prevent heart attacks in some people.