Angina : A common heart condition that can be very painful

Reduced blood flow to the heart is the cause of angina. Angina is a sign of coronary artery disease. Angina pectoris is another name for angina.

Squeezing, pressure, heaviness, tightness, or discomfort in the chest are common descriptions of angina symptoms. It could seem like a big weight is resting on your chest. Angina might be a new discomfort that has to be evaluated by a doctor or a persistent pain that gets better with treatment.

Even while angina is a reasonably common condition, it can be challenging to distinguish it from other types of chest pain, such as the discomfort associated with indigestion. 

Seek immediate medical attention if you are experiencing inexplicable chest pain.

Causes

Reduced blood supply to the heart muscle is what causes angina. The oxygen that the heart muscle requires to survive is carried by blood. Ischemia is the medical term for the disorder brought on by inadequate oxygen delivery to the heart muscle.

The most common cause of reduced blood flow to the heart muscle is coronary artery disease (CAD). The heart's (coronary) arteries might narrow due to the fatty deposits known as plaques. Atherosclerosis is the term for this.

A blood clot or plaque rupture in a blood vessel can abruptly restrict or stop blood flow through a constricted artery. Blood flow to the heart muscle may suddenly and significantly drop as a result.

While there is little oxygen demand,  when you are at rest, the heart muscle might still be able to function.

How to check if you have Angina?

It may be an indication of a heart attack if your chest discomfort persists for more than a few minutes and does not go away after you rest or take your angina treatments. Contact emergency medical services. If there is no other way to get there, only drive yourself to the hospital.

It is crucial to see your doctor if chest discomfort is a new symptom for you in order to identify the cause and receive the right care. If you have stable angina and it worsens or changes, you should see a doctor right away.

Symptoms

Pain and discomfort in the chest are angina symptoms. The chest discomfort or pain could feel like:

The arms, neck, jaw, shoulder, or back may experience burning fullness, pressure, or squeezing pain.

Other angina symptoms include:

• Dizziness
• Fatigue
• Nausea
• Breathing difficulty
• Sweating

Angina can range in intensity, duration, and type. It is possible for new or different symptoms to be a sign of unstable angina, a more dangerous form of angina, or a heart attack.

You should see a doctor right away if you experience any new or worsening angina symptoms so they can diagnose you with stable or unstable angina.

Women's angina symptoms can differ from those of men with the condition. These discrepancies may result in therapeutic delays. For instance, even though women with angina typically suffer chest pain, it may not be the only symptom or the one that has the greatest impact on them.

Women may also experience symptoms like:

• Neck, jaw, teeth, or back discomfort
• Nausea
• Breathing difficulty
• Instead of chest pressure, a stabbing pain
• Abdominal (tummy) pain

Risk Factors

The following factors may increase the risk of angina:

Advancing years. Adults 60 years of age and older are particularly susceptible to angina.

Heart disease in the family history. If your mother, father, or any of your siblings have ever suffered from heart disease or a heart attack, let your healthcare professional know.

Using tobacco. Smoking, chewing tobacco, and extended exposure to secondhand smoke can damage the lining of the arteries, which makes it easier for cholesterol deposits to accumulate and lead to heart disease obstruct blood flow.

Diabetes. Diabetes accelerates atherosclerosis and raises cholesterol levels, increasing the risk of coronary artery disease, which causes angina and heart attacks.

Elevated blood pressure. By promoting artery hardening over time, elevated blood pressure harms arteries.

High triglyceride or cholesterol levels. Too much low-density lipoprotein, or bad cholesterol Blood levels of (LDL) can constrict arteries. People with high LDL levels are more susceptible to angina and heart attacks. Additionally unhealthy are excessive blood triglyceride levels.

Other health issues. Chronic renal disease, peripheral artery disease, metabolic syndrome, and a history of stroke all raise the risk of angina. Obesity, type 2 diabetes, high blood pressure, and high cholesterol are all consequences of a unhealthy lifestyle. 

Obesity. Heart disease, which is at risk due to obesity, can cause angina. When a person is overweight, the heart has to work harder to pump blood throughout the body. 

Prevention

You can help prevent angina by making the same lifestyle changes that are employed in its treatment. These consist of:

• Stopping smoking.
• Consuming a balanced diet.
• Limit or stay away from alcohol.
• Doing regular exercise.
• The upkeep of a healthy weight.
• Taking care of various medical conditions related to heart disease.
• Lowering stress
• Get the appropriate vaccinations to prevent cardiac issues.

Treatments 

Treatment options for angina include:

• Alterations in way of life
• Medications
• Vascular surgery and stenting
• Heart surgery, open (coronary bypass surgery)

The objectives of treating angina are to lessen its frequency and severity as well as the risk of mortality and heart attack.

If you experience unstable angina or angina pain that differs from your typical angina discomfort, you should seek emergency medical attention.

Medications

Medication may be required if lifestyle modifications, such as eating well and exercising, fail to improve heart health and reduce angina pain. Among the medications used to treat angina:

Nitrates. Angina is frequently treated with nitrates. So that more blood can flow to the heart, nitrates relax and widen the blood vessels. Nitroglycerin is the kind of nitrate that is most frequently used to treat angina.  A nitrate may be used as a long-term prophylactic measure or before activities that frequently cause angina, such as exercise.

Aspirin. Because aspirin lessens blood clotting, blood can flow more easily through constricted heart arteries. Blood clot avoidance can lower the risk of a heart attack. Never begin taking an aspirin everyday without first consulting your doctor.

Clot-resisting medication. Blood does not clot because certain drugs, including clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta), reduce the likelihood that blood platelets will adhere to one another. If you can not take aspirin, one of these medicines might be advised.

Beta blockers. Beta blockers reduce blood pressure by causing the heart to beat more gradually and gently. Additionally, these medications relax blood vessels, which enhances blood flow. 

Procedures and Surgery

If lifestyle changes, medications, or other treatments are unable to relieve angina pain, open-heart surgery or a catheter operation may be necessary.

The following surgeries and methods are employed to treat angina and coronary artery disease:

Stenting along with angioplasty. An extremely small balloon is put into the constricted artery during an angioplasty, also known as a percutaneous coronary intervention (PCI). A small wire mesh coil (stent) is typically introduced after the balloon has been inflated to expand the artery in order to keep it open.

Angina is lessened or completely eliminated after an angioplasty with stenting. If lifestyle modifications and medicines are ineffective at treating chronic, stable angina, angioplasty with stenting may be a useful alternative.

Coronary artery bypass graft surgery. A blocked or congested heart artery is bypassed during coronary artery bypass surgery using a vein or artery from another part of the body. The heart receives more blood after bypass surgery. It can be used to treat stable angina as well as unstable angina that has not responded to other therapies.

Complications of Angina

Angina can cause chest pain, which can make some activities, including walking, problematic. The most dangerous side effect, though, is a heart attack.

Heart attack warning signs and symptoms include:

• The centre of the chest feels full, compressed, or pressured for more than a few minutes.
• The shoulder, arm, back, teeth, and jaw might all hurt in addition to the chest.
• Fainting
• Sense of impending doom
• Increasing number of chest discomfort episodes
• nausea and diarrhoea
• Ongoing discomfort in the upper belly (abdomen)

If you experience any of these signs, you should get emergency medical help right once.

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