Angina is chest pain, tightness or discomfort.
It may occur in the form of an angina attack, pain, or chest discomfort which usually lasts from 1 to 15 minutes. The disorder is graded into stable, unstable, and variant angina by pattern of attack.
Fast facts on angina
- Angina is not a disease in itself, but a symptom of heart disease.
- Attacks are caused by reduced oxygen in the blood reaching the heart.
- Symptoms include tightness and difficulty breathing.
- Treatment options can range from lifestyle changes to medications.
What is angina?
Angina is not a disorder by itself but a possible symptom of coronary artery disease.
It is a tightness, pain, or chest discomfort that occurs when an part of the heart muscle receives less oxygen than normal in the blood.
If encountered alone it is not a life-threatening disease.
If a person develops angina, however, it is a clear sign that he has a form of heart disease.
There are several types of angina.
Stable or chronic angina
Stable angina happens, for example during exercise, when the heart is working faster than normal. It has a normal pattern, which can be predicted for months or even years to come. Rest or treatment helps to alleviate symptoms.
Unstable angina follows no normal pattern. It may happens at rest, and is considered less severe and more serious because it is not cured by rest and medication. In a short period – hours or weeks – this version will signify a potential heart attack.
Variant and microvascular angina
Angina and microvascular angina of variant or Prinzmetal are uncommon and can occur at rest without any underlying coronary artery disease. This angina is typically caused by an irregular narrowing or relaxation of the blood vessels, which decreases blood flow to the brain. Medicine will soothe it.
Angina is usually felt in the chest region as:
- 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.
Patients may also complain of symptoms including:
- shortness of breath
Stable angina typically lasts for a short time and can sound as though it were gas or indigestion. Unstable angina takes place at rest, is unexpected, lasts longer and can get worse over time. Variant angina takes place at rest, and is typically serious.
Angina medications aim at reducing discomfort, avoiding complications and eliminating or decreasing the risk of heart attack. Medicines, improvements in lifestyles, and medical procedures can all be included.
Recommended lifestyle improvements to combat angina include:
- stopping smoking
- controlling weight
- regularly checking cholesterol levels
- resting and slowing down
- avoiding large meals
- learning how to handle or avoid stress
- eating fruits, vegetables, whole grains, low-fat or no-fat dairy products, and lean meat and fish
Nitrates like nitroglycerin are most commonly prescribed for angina. By stimulating and widening the blood vessels, nitrates avoid or reduce the severity of angina attacks.
Other medicines may be used such as:
- beta blockers
- calcium channel blockers
- angiotensin-covering enzyme (ACE) inhibitors
- oral anti-platelet medicines
Medications with high blood pressure can also be recommended for treating angina. These drugs are intended to lower blood pressure and cholesterol rates, slow heart rate, relax blood flow, minimize heart pain and avoid the formation of blood clots.
In some cases the diagnosis of angina involves surgical procedures. An Angioplasty may be advised by a heart specialist. The common treatment is coronary artery bypass grafting. This is surgery where the narrowed arteries in the heart are bypassed by another part of the body using a safe artery or vein.
Most usually angina is the result of underlying coronary artery disease. The coronary arteries carry oxygen-rich blood to the heart. As cholesterol aggregates and hard plaques form on the artery wall, then the artery narrows.
- It is increasingly difficult for oxygen-rich blood to reach the heart muscle as the arteries become too narrow.
- 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 real angina attacks result from this decreased supply of oxygen to the heart. Common causes are to:
- physical exertion
- severe emotional stress
- a heavy meal
- exposure to extreme temperatures
- smoking may trigger angina attacks
Unstable angina is often caused by blood clots which block an artery in part or in full. Larger blockages can cause a heart attack. As blood clots form, dissolve, and form again with each blockage angina can occur.
Variant angina occurs when an artery experiences a spasm that tightens and narrows it, restricting the flow of blood to the heart. This can be caused by the use of cold, heat, pharmaceutical products, smoking, or cocaine.
A proper diagnosis is important, because it can predict the risk of a heart attack. The review will begin with a physical examination as well as a discussion of symptoms, risk factors and medical history of the family.
A doctor who is wary of angina will prescribe one or more of these tests:
- 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 to show the inside of coronary arteries.
- Blood tests: These check fat, cholesterol, sugar, and protein levels.
People at higher risk for coronary artery disease may have increased angina risk. Factors at risk include:
- unhealthy cholesterol levels
- high blood pressure
- tobacco smoking
- being overweight or obese
- metabolic syndrome
- sedentary lifestyle
- being over 45 years of age for men and over 55 years of age for women
- a family history of early heart disease
Angina can be prevented by changing factors in the lifestyle and treating related conditions which worsen or contribute to the symptoms of angina. Eat well, stop smoking, be physically active and learn how to manage tension to avoid or postpone angina.
Always, ensure that you are treated properly for increased blood cholesterol, increased blood pressure, diabetes and obesity.