Angina is a pain or discomfort in the chest that often has a squeezing or pressure-like quality. This discomfort can also be felt in the shoulders, arms, neck, jaws, or back. Anginal pain usually lasts for no more than 2–10 minutes, and is relieved by rest or nitroglycerin,
- Stable Angina
Has a predictable pattern. A person with stable angina can usually predict what type and level of activity will cause angina, and what level and length of discomfort such activity will produce. Anginal pain goes away within minutes with rest or the use of a medication called nitroglycerin. It occurs when the heart's need for blood and oxygen is increased by:
- Exercise, exertion
- Cold weather
- A large meal
- Emotional stress
- Unstable Angina
Is used to describe more unpredictable or severe angina. Chest pain may occur while resting or even sleeping (nocturnal angina), and the discomfort may last longer and be more intense than that of stable angina. Stable angina becomes unstable when symptoms occur more frequently, last longer, or are precipitated more easily. Unstable angina may be a sign that a heart attack is possible. It should be treated as an emergency.
- Variant or Prinzmetal's Angina
Is usually caused by a spasm of a coronary vessel. It occurs when people are at rest, most often in the middle of the night, and can be quite severe. It may indicate one of the following conditions:
- Coronary artery disease
- Extremely high blood pressure
- Hypertrophic cardiomyopathy
- Diseases of the heart valves
Pressure or squeezing chest pain–While this is the classic description of chest pain due to coronary artery disease, some people do not experience the pain as being so severe. Elderly people, women, and people with diabetes may be more likely to have atypical or subtle symptoms. Some people have "silent ischemia" and experience no symptoms of chest pain. Chest pain of any kind deserves a medical evaluation to determine its cause.
Chest pain or discomfort is the hallmark symptom of angina. When chest discomfort is severe, lasts more than 15 minutes, and is accompanied by other symptoms listed below, then the likelihood of a heart attack, versus an anginal episode, is increased.
- Pain in the shoulder(s) or arm(s) (often the left shoulder or arm), or into the jaw
- Shortness of breath
Angina occurs when the blood vessels leading to the heart are blocked. This results in less blood, and therefore less oxygen, reaching the heart muscle. When the heart muscle is deprived of oxygen, chest pain and other symptoms result.
A chest pain is an emergency; some tests will be done right away to see if there is an episode of angina or a heart attack. Health professionals will ask about symptoms and medical history, and perform a physical exam.
Tests may include:
- Blood Tests to look for certain heart attack markers in the blood; helps determine if you are having angina or an acute heart attack
- Electrocardiogram (ECG, EKG)–records the heart's activity by measuring electrical currents through the heart muscle. This test can reveal evidence of past heart attacks, acute heart attacks, and heart rhythm problems.
- Echocardiogram–uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart. Provides information about the structure and function of the heart.
Exercise Stress Test–records the heart's electrical activity during increased physical activity
Fo Treatments for angina include:
- Nitrate Medications
- Nitroglycerin is usually given during an acute attack of angina. It can be given as a tablet that dissolves under the tongue or as a spray. There are also longer-lasting types that can be used to prevent angina before you participate in an activity known to cause it. These may be given as pills, or applied as patches or ointments.
- Blood Thinners
- A small, daily dose of aspirin has been shown to decrease the risk of heart attack. Patients who have had unstable angina or a heart attack may benefit from the addition of warfarin (ie, coumadin), though there is an increased risk of bleeding with this medication
- Beta-blockers and Calcium-channel Blockers
- When used regularly (not as treatment for acute angina), these medications may reduce the occurrence of angina.
- Cholesterol-lowering Medications
These may prevent the progression of coronary artery disease and may even improve existing coronary artery disease.
Patients with severe angina or unstable, progressing angina may benefit from a coronary artery bypass graft or coronary angioplasty
In case of angina, prevent its onset by being aware of the activities or conditions which tend to bring it on.
Steps to prevent coronary artery disease include managing Risk Factors:
- Maintain a healthy weight.
- Begin a safe exercise program
- Stop smoking.
- Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
- Appropriately treat high blood pressure and/or diabetes.
- Appropriately treat abnormal cholesterol levels or high triglycerides.
The main complication of angina is heart attack.
All types of angina can lead to heart attack if left untreated, although unstable angina and variant angina may be more likely to result in a heart attack.
Major risk factors for coronary artery disease (CAD) include the following:
- Male gender
- Advancing age
- Strong family history of heart disease
- Obesity and overweight
- High blood pressure
- Sedentary lifestyle
- High blood cholesterol (specifically, high LDL cholesterol and low HDL cholesterol)
- Excessive alcohol intake
Most people survive their first heart attack and return to their normal lives to enjoy many more years of productive activity.
But having a heart attack does mean a need to make some changes in your life.
A diagnosis of coronary artery disease can be hard to accept and understand especially when there are no symptoms, and can lead to other health problems.Lifestyle changes are important: