Angina

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Overview

Angina (or Angina Pectoris) is a type of squeezing, tightening sensation or chest pain that occurs when your heart is not getting enough blood supply. The resultant chest pain can be new, or recurrent that goes away with medication. It is one of the most common symptoms of coronary heart disease. In any instance of unexplained chest pain, it is advised to seek medical attention immediately.

Causes

The most common cause of restricted blood flow to the heart is coronary heart disease (CAD) in which fatty plaque or thrombus may form within the arteries of the heart, creating an obstruction and reducing blood supply. This condition is called atherosclerosis. Several risk factors can pre-dispose a person to this disease:

  • Tobacco use or smoking
  • Diabetes
  • High blood pressure
  • Advanced Age
  • Male gender
  • Family History
  • Obesity
  • High cholesterol levels
  • Stress
  • Lack of exercise and physical activity

Symptoms

There are three types of angina: stable, unstable, and variant. In all types following symptoms are common:

  • Chest pain – squeezing, tightening or burning in character
  • Pain in arms, back, neck, shoulders or jaw accompanying chest pain
  • Shortness of breath
  • Sweating
  • Nausea
  • Fatigue

Stable Angina in particular occurs upon physical exertion or strenuous activity/stress, and subsides on rest or upon medication use.

Unstable Angina, however, is a medical emergency that occurs unexpectedly at rest, is more severe in intensity, and can lead to a full-blown heart attack.

Prinzmetal or Variant Angina is a third, rare and severe, type that occurs due to arterial spasm and can be relieved by specific angina medication.

Diagnosis

After a diagnosis, focusing on family history and risk factors and physical examinations, following tests can be conducted:

  • Electrocardiogram (ECG)
  • Echocardiogram
  • Stress test
  • Nuclear stress test
  • Blood tests for cardiac enzymes
  • Chest X-Ray
  • Coronary Angiography
  • Cardiac CT/MRI

Treatment

Treatment includes lifestyle modification, strict diet control, an increase in physical activities, eliminating smoking, alcohol, and drug abuse etc. Several types of medication are used for angina:

  • Nitrates
  • Aspirin
  • Beta Blockers
  • Calcium Channel Blockers
  • Statins
  • Clot-preventative drugs

Two cardiac procedures can also be carried out to prevent further angina attacks if need be: Coronary artery bypass surgery or Angioplasty/Stenting (PCI – Percutaneous Coronary Intervention).

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