Angina Pectoris

Angina is a kind of chest pain that results from diminished circulation of blood to the heart. Angina is a sign of coronary arterial disease.

Angina is also known as angina pectoris, is usually described as pressure, squeezing, tension, or tightness in your chest. People who experience angina symptoms feel like they are in the chest is squeezed by a vise or a weighty weight resting across their chest. Angina could be a brand new pain that should be examined by a physician or it could be a recurring discomfort that subsides after treatment.

Although angina is fairly common however, it is difficult to distinguish from other kinds of chest pains, like the discomfort caused by indigestion. If you are experiencing unresolved chest pain, you should seek medical attention as soon as you can.

Symptoms

Angina symptoms can include symptoms of chest discomfort and pain often described as pressure burning, or squeezing.

There may be an injury to your neck, arms jaw, shoulder, or back.

Other signs you could experience with angina include:

• Nausea
• Dizziness
• Fatigue
• Breathing shortness
• Sweating

The symptoms should be assessed promptly by a physician who will determine if you suffer from stable angina or unstable angina, that could indicate an attack on your heart.

The most frequent kind of angina. It typically occurs when you are exerting yourself and disappears after rest. For instance it is possible to feel pain while walking uphill, or during colder conditions could be angina.

The characteristics of stable angina

• It occurs when your heart is working more efficiently, for example, when you work out or climb stairs.
• It is usually possible to predict and the pain can be like other kinds of chest pain you’ve experienced.
• The duration is short of perhaps just five or so minutes
• It will be more apparent If you take a rest or are taking your medication to treat angina

The intensity, duration, and the type of angina differ. A new or different symptom could indicate a more serious type of angina (unstable angina) or heart attack.

The characteristics of angina that is unstable

• Pain at rest
• Are you experiencing a change in your regular pattern of angina?
• Is unexpected
• It is usually more severe and will last longer than stable angina, perhaps 30 minutes or more
• It is not guaranteed to disappear after rest or the use of angina medications
• Could signal heart attack

Another type of angina is known as variant angina also known as Prinzmetal’s Angina. This kind of angina is less common. This is caused due to a spasm of the heart’s arteries, which temporarily decreases blood flow.

The characteristics of angina variants (Prinzmetal’s angina)

• Most often, it happens when you’re resting.
• It is often extremely
• Angina may be relieved with angina medication

Angina in women

The symptoms of angina for women may differ in the same way that angina symptoms occur in males. These variations can result in delay when seeking medical attention. For instance chest pain may be the most frequent indication for women suffering from angina however it might not be the sole symptom or the most common female symptom. Women can also experience symptoms like:

• Nausea
• Breathing shortness
• Abdominal pain
• The neck or jaw
• Stabbing pains instead of chest pressure

When should you seek medical help?

If the pain in your chest lasts more than a few minutes, and it doesn’t disappear even after resting or taking your angina medicine this could be an indication of an attack on your heart. Get medical assistance in an emergency. Make arrangements for transportation. You should only drive to the hospital in case of emergency.

If chest pain is a new symptom that’s been noticed by you, it’s crucial to consult your physician to find out the reason for the chest pain, and receive the proper treatment. In the event that you’ve been identified as having stable angina and it continues to get worse or worsens you, get medical attention right away.

Causes of angina pectoris

Angina is caused due to a decreased blood flow to the heart muscle. The blood supply of oxygen to the heart muscle and oxygen, which the heart muscle requires to function properly. If your heart muscle isn’t receiving sufficient oxygen supply, this can cause an issue known as Ischemia.

The most frequent cause of diminished circulation of blood to your heart muscles is called coronary artery disease (CAD). The heart (coronary) vessels can be narrowed due to fatty deposits known as plaques. This is known as atherosclerosis.

When you’re experiencing low demand for oxygen such as when you’re laying down at home, for instance your heart muscle might be able to function with the lesser blood flow, without experiencing symptoms of angina. However, when you increase the amount of oxygen you require for example, during exercise, you could experience angina.

• A stable angina. Stable angina is typically triggered by physical activity. If you take a step or exercise in the air, your heart is requiring more blood. However, narrowed arteries reduce the flow of blood. Apart from physical exercise and other triggers like anxiety or cold temperatures, large meals , and smoking may also reduce blood flow and cause angina.
• Angina that is unstable. If fatty deposits (plaques) within the blood vessel break and a blood clot develops and blocks or slow down the flow of blood through an artery that has narrowed. It can be sudden and cut the flow of blood to the heart muscle. Angina that is unstable can result from blood clots which block or block a portion of the blood vessels in your heart.The condition gets worse and cannot be eased by rest or regular medications. If blood flow doesn’t increase, your heart is deficient in oxygen and a heart attack can happen. Angina that is unstable is risky and requires urgent treatment.
• Prinzmetal’s Angina. This type of angina is caused by a sudden spasm of an artery in the coronary system, which causes the narrowing of an artery to a certain extent. The narrowing decreases the flow of blood to your heart, leading to extreme chest pain. The most common occurrence of Prinzmetal’s Angina is in the evening, usually overnight. Angina attacks usually occur in groups. Stress, smoking drugs that make blood vessels more tight (such as migraine medications) and the use of cocaine, an illegal drug, can trigger angina caused by Prinzmetal.

Risk factors

Risk factors like the following can increase your chance of developing angina and coronary artery disease:

• Smoking tobacco. Chewing tobacco, smoking, and prolonged exposure to secondhand smoke can damage the arteries’ interior walls — including the arteries that connect to your heart , allowing cholesterol deposits to build up and stop blood flow.
• The disease of diabetes. Diabetes increases the risk of developing coronary artery disease which can lead to heart attacks and angina. It does this through the speed of atherosclerosis, and boosting cholesterol levels.
• The blood pressure of high. Over time, high blood pressure can damage arterial walls by speeding up the hardening process of the arteries.
• Blood cholesterol levels are high levels or the levels of triglycerides. Cholesterol is a significant component of deposits which reduce the artery flow all over your body. This includes the ones which provide your heart. A high amount of low-density lipoprotein (LDL) cholesterol often referred to in the field of “bad” cholesterol, increases the risk of developing heart attacks and angina. A high amount of triglycerides (a kind of blood fat linked to your diet, is also unhealthy.
• Heart disease in the family. If a family member suffers from coronary artery disease or suffered a heart attack you’re at greater chance of having angina.
• Aged older. Men older than 45 and women who are older than 55 are at greater risk of developing cancer than younger adults.
• Inactivity. An inactive lifestyle can lead to high cholesterol levels and blood pressure. It also contributes to type 2 diabetes, and overweight. But, it’s crucial to speak with your doctor prior to starting any exercise routine.
• Obesity. Obesity is linked to high blood levels of cholesterol, elevated blood pressure and diabetes, all of that increase the chance of suffering from heart disease and angina. If you’re obese, your heart needs to work harder to provide blood to your body.
• Afraid. Stress can increase your chance of suffering from angina or heart attacks. A lot of stress and anger, can also raise the blood pressure. Hormones released by stress can enlarge your arteries and cause worsening of angina.

Complications

The chest pain associated due to angina may make regular actions, such as walking difficult. The most serious result is a heart attack.

The most common indications and symptoms for a heart attack are:

• The sensation of fullness, pressure, or a squeezing sensation in the middle of your chest, which lasts for longer than a couple of minutes
• The pain can extend beyond your chest , to your arm, shoulder or back, or up to your jaw and teeth
• The frequency of chest pain is increasing.
• Nausea and vomiting
• The pain is persistent in the upper abdomen.
• Breathing problems
• Sweating
• Fainting
• The looming fear of doom
• Arrhythmias

If you experience one of the symptoms listed above, you should seek urgent medical attention.

Prevention

It is possible to prevent angina through the same changes to your lifestyle that can alleviate your symptoms if already suffer from angina. This includes:

• • Quitting smoking.
  • Controlling and monitoring other health issues including hypertension, cholesterol levels and diabetes.
  • A healthy diet is essential to keeping an appropriate weight.
  • Increase your physical activity once you have received your doctor’s approval. You should aim for 150 hours of moderate physical activity every week. It is also advised to do 10 minutes of strength-training each week. Also, stretch out three times per week for 5 to 10 minutes each.
  • Reducing your stress level.
  • Limiting the consumption of alcohol up to 2 drinks or less each day for men and one drink daily and less for ladies.
  • Get a flu shot every year to prevent heart problems from the virus

Diagnosis

In order to diagnose angina it is best to start by conducting a physical exam and then asking about the symptoms you experience. Additionally, they will inquire about your potential risk factors, like whether you have any family medical history with heart problems.

There are a variety of tests that your doctor can conduct to confirm if you suffer from angina

• • Electrocardiogram (ECG or EKG). Each beat of your heart is activated via an electrical signal that originates by special cells within your heart. An electrocardiogram tracks the electrical signals that move through your heart. Your doctor can search for patterns in these heartbeats to determine if the blood flow in the heart is slow or disrupted or if you’re suffering from an attack of the heart.
  • Exercise stress test. Angina can be easier to recognize in the event that your heart has been working more. When you take a stress test you run on a treadmill or riding on a stationary bicycle. The blood pressure and ECG Readings are monitored while you exercise. Other tests can also be performed simultaneously as an exercise test. If you’re in a position to’t exercise, you could receive a prescription drug that causes the heart muscle to be more active for exercising , which is followed by an imaging exam.
  • Echocardiogram. An echocardiogram uses sound waves to create pictures of your heart. The doctor can utilize these images to detect issues related to angina, such as the damage to your heart muscle because of low circulation of blood. Echocardiograms can be performed in a stress test and it can reveal the regions of your heart which aren’t receiving sufficient blood.
  • Nuclear stress test . A nuclear stress test is a way to measure the flow of blood to your heart muscle when you are not stressed and also during your rest. It’s similar to a regular stress test, however in the nuclear stress test an irradiated drug is in the bloodstream of your.The substance is mixed with the blood of your body and then is transported to the heart. A specific scanner which can detect radioactive substances within your heart will show how the substance is moved along with blood flowing through the muscle of your heart. A lack of blood flow to any area of the heart is evident in the scans because less of the radioactive substance is moving through the blood vessels.
  • Chest Xray. This test takes photographs of your heart as well as your lung. It is used to determine other issues that may be behind your symptoms , and also to determine whether you have an increased heart.
  • The blood tests. Certain heart enzymes slowly leak into your bloodstream if you have suffered damage to your heart as a result of an attack on your heart. The blood samples you collect are tested for whether these proteins are present.
  • Coronary angiography. Coronary angiography uses X-rays to study the insides of your blood vessels in your heart. It’s part of a broad set of procedures referred to by the name cardiac catheterization.During coronary angiography an angiographic dye visible to X-ray machines is injected into blood vessels in your heart. The X-ray machine quickly takes an array of images (angiograms) which provide an in-depth look at the insides of the blood vessels.
  • Computerized Cardiac Tomography (CT) scanning. In a cardiac CT For the scan, you lay on a table within the shape of a doughnut. A X-ray tube in the machine spins around your body and captures images of your chest and heart and chest, which will reveal the coronary arteries have narrowed or the heart is larger.
  • Cardiac MRI . In a cardiac MRI You lie on a couch inside an enormous, tube-like machine that creates detailed images of your heart’s anatomy and the blood vessels.

Treatment

There are a variety of alternatives for treating angina which include lifestyle changes or medications, angioplasty the use of stenting or surgical coronary bypass. The main goals of treatment is to lessen the number and severity of your symptoms, and reduce the risk of suffering a heart attack or death.

If you experience angina pain that’s not the usual like in the absence of in a resting state, you must seek medical attention in the hospital.

Medications

If lifestyle changes don’t alleviate angina, you might need to consider taking medication. This could include:

• • Nitrates. Nitrates are often utilized in the treatment of angina. Nitrates relax and expand the blood vessels of your heart and allow greater blood flow into your heart muscle. You may consider taking a nitrate whenever you feel chest discomfort due to angina or prior to performing an activity that triggers angina (such for physical exercise) or as a preventative measure for a long time. The most popular type of nitrate that is used for treating angina are nitroglycerin tablets which are placed in your mouth.
  • Aspirin. Aspirin reduces the capacity of blood to clot. This makes it much easier that blood flow can be facilitated through the narrowed heart blood vessels. The prevention of blood clots may also lower your risk of suffering heart attacks. Don’t take a daily aspirin without consulting your physician first.
  • Clot-preventing medications. Certain medications such as Clopidogrel (Plavix) and the prasugrel (Effient) as well as ticagrelor (Brilinta) will help to stop blood clots by making the blood platelets less likely form a clot. One of these medicines could be recommended if you’re unable to take aspirin.
  • Beta blockers. Beta blockers work by blocking the effects of the hormone epinephrine also called adrenaline. This causes the heart beats slower and at a lower rate and this reduces blood pressure. Beta blockers also aid in helping the blood vessels to relax, and expand to increase blood flow, which can result in making it easier to prevent or reduce the risk of angina.
  • Statins . Statins are drugs that are used to reduce blood cholesterol. They do this by blocking the chemical your body requires to produce cholesterol. They also assist the body to resorb cholesterol that has built up within plaques on your artery walls, which can prevent any further blockage of the blood vessels. Statins have a variety of positive effects on the arteries of your heart.
  • Blockers of calcium channels. Calcium channel blockers often referred to as calcium antagonists are able to relax and expand blood vessels through affecting muscles cells that line the arterial wall. This improves blood flow to the heart, which can reduce or eliminating angina.
  • Blood pressure-lowering drugs. If you have high blood pressure, diabetes, indications of heart failure , or chronic kidney diseases, then your physician is likely to prescribe a medicine that will lower blood pressure. There are two main classes of drugs to treat blood pressure: angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).
  • Ranolazine (Ranexa). Ranexa can be taken on its own or in conjunction with other angina medicines including beta blockers, or Nitroglycerin.

The medical procedure and surgical procedures

Lifestyle modifications and medication are often employed to treat angina that is stable. But medical procedures , such as coronary artery bypass surgery could be employed to treat angina.

• • Stenting and angioplasty. During an angioplasty — also known as PCI, also known as percutaneous coronary intervention (PCI) is when the balloon is introduced into the narrowed arterial. The balloon is then inflated to increase the size of the artery and then a steel mesh (stent) is typically placed to ensure that the artery remains open.This procedure boosts the flow of blood in the heart, which can reduce or eliminating the symptoms of angina. Stenting and angioplasty is an effective treatment in the event of unstable angina, or if medication and lifestyle changes don’t effectively address your persistent, stable angina ß.
  • Coronary artery bypass. During coronary artery bypass surgery, an artery or vein that originates from another area of your body is utilized to clear the heart’s narrowed or blocked artery. Bypass surgery improves the flow of blood to the heart and decreases or eliminates the symptoms of angina. It’s an option to treat both unstable angina and stable angina that hasn’t been treated with other methods.
  • Counterpulsation from the outside (ECP). With ECP Blood pressure cuffs of the type are put around the calves, thighs , and pelvis to improve oxygen flow into the heart. ECP require multiple sessions for treatment. It is recommended to have multiple treatment sessions. American College of Cardiology, American Heart Association and other heart organizations state that the condition requires multiple treatment sessions. ECP could help alleviate symptoms in those suffering from refractory angina.

Lifestyle modification

Since heart disease is usually the reason for angina, you can lessen or even prevent angina by reducing the risk factors that increase your risk of heart disease. Making changes to your lifestyle is the most crucial option you have.

• • If you smoke, stop smoking. Beware of exposure to secondhand smoke.
  • If you’re overweight or obese, consult your physician about options for losing weight.
  • A healthy diet should include low amounts of saturated fats and a lot of whole grains and plenty of vegetables and fruits.
  • Consult your doctor about establishing a healthy fitness program.
  • Because angina can be caused by exercise It’s best to take your time and make breaks for rest.
  • Manage conditions or diseases which increase the risk of developing angina including diabetes or high blood pressure. Also, treat the presence of high cholesterol in your blood.
  • Avoid eating large meals as they can make you feel bloated.
  • Stress reduction is more easy to do than it is done However, you can find ways to be relaxed. Consult your doctor regarding techniques to reduce stress.
  • Limit alcohol consumption to 2 drinks or less a day for men and one drink daily at most for females.