About Angina:
There are many diseases related to the heart, one of which is angina. Angina is a serious heart disease.
Angina is a type of chest pain that occurs when blood flow to the heart is reduced. Angina pain is characterized by a feeling of squeezing, pressure, heaviness, tightness, and pain in the chest. Angina is also called angina pectoris or ischemic chest pain. Angina is a symptom of coronary artery disease.
The pain caused in this heart disease occurs repeatedly and it is an emergency problem, in which case the doctor should be consulted as soon as possible. Once you have had angina, there is a possibility of it happening again and again. Not only this, its many types make it even more serious.
Types of Angina :
The types of angina depend on the causes of this disease related to the heart. There are mainly four types of angina.
Stable angina :
Stable angina is the most common form of angina. It usually occurs during activity (training) and goes away with rest or angina medication. For example, pain when you are walking uphill or in cold weather could be angina. Stable angina pain is predictable and is usually similar to previous episodes of chest pain. Chest pain usually lasts a short time, perhaps five minutes or less. The pain may last longer if the condition is severe, but this is a rare occurrence during the course of the condition.
Unstable angina :
Unstable angina is unpredictable and occurs at rest. In this type of angina, the pain gets worse even when you are not doing any physical activity that causes the pain. It is usually severe and lasts longer than stable angina, perhaps 20 minutes or longer. This type of pain does not go away with rest and taking common angina medicines. If blood flow does not improve, the heart becomes deficient in oxygen and a heart attack occurs. Unstable angina is dangerous and requires emergency treatment.
Variant angina :
Variant angina, also known as Prinzmetal angina, is not caused by coronary artery disease. It is caused by a spasm in the arteries of the heart that temporarily reduces blood flow. Severe chest pain is the main symptom of variant angina. It often occurs in cycles, usually with long periods of rest (sleep or overnight) and pain can be relieved by taking angina medication.
Refractory angina :
Refractory angina is a condition that often persists despite a combination of medications and lifestyle changes.
Symptoms of Angina:
The condition of angina can cause any of the following problems in the chest:
Feeling of squeezing problem.
Feeling pressured
Stiffness in the chest.
Chest feeling tight.
Burning or pain in the chest.
Feeling of pain in the neck and throat.
Pain in arms and shoulders.
Pain in the upper part of the back.
Persistent pain in the jaw.
Spreading pain in the teeth.
Apart from these symptoms, other possible symptoms may also appear such as:
Sour belching
Burning sensation in the stomach.
Feeling weak
Persistent sweating
Having a problem with nausea.
Cramping
Difficulty in breathing
The duration of these symptoms depends on the type of angina. Anyone who experiences severe or persistent chest pain should contact a doctor as soon as possible.
Symptoms of angina in women:
The symptoms of angina in women can be different from the classic angina symptoms. These differences can lead to a delay in seeking treatment. For example, chest pain is a common symptom in women with angina, but it may not be the only symptom or the most prevalent symptom for women.
Women may also have the following symptoms:
Feeling of pain in the neck and throat.
Pain in the upper part of the back.
Persistent pain in the jaw.
Nausea problem.
Difficulty in breathing
Stomach irritation or abdominal pain or both together.
Stabbing pain rather than pressure in the chest.
Causes of Angina:
Angina is caused by decreased blood flow to the heart muscle. Blood does the job of carrying oxygen, which the heart muscle needs to survive. When the heart muscle does not get enough oxygen, it causes a condition called ischemia.
The most common cause of reduced blood flow to the heart muscle is coronary artery disease. Heart (coronary) arteries can become narrowed by fatty deposits called plaque, which is called atherosclerosis.
If plaques break off or a blood clot forms in a blood vessel, it can quickly block or reduce flow through the narrowed artery. This can cause a sudden and severe decrease in blood flow to the heart muscle.
During times of low oxygen demand: While resting, for example - the heart muscle may still be able to function on a reduced amount of blood flow without triggering angina symptoms. But when the demand for oxygen increases, such as during exercise, angina can occur.
Risk factors for angina:
Certain factors can increase the risk of heart disease such as angina:
Increasing age: Angina is most common in adults 60 years of age and older.
Family history of heart disease: If someone in your family has had a heart disease or heart attack in the past, then you are more likely to develop this heart disease.
Tobacco use: Smoking, chewing tobacco and long-term exposure to secondhand smoke can damage the lining of the arteries, causing cholesterol to build up and block blood flow. All of these health conditions carry a risk of getting angina.
Diabetes: Diabetes significantly increases the risk of coronary artery disease which causes angina and heart attack by accelerating atherosclerosis and raising cholesterol levels.
High blood pressure: Over time, high blood pressure damages the arteries by accelerating the hardening of the arteries.
High cholesterol or triglycerides: Too much bad cholesterol – low-density lipoprotein (LDL) – in the blood can cause the arteries to narrow. A high LDL increases the risk of angina and heart attack. High levels of triglycerides in the blood are also unhealthy.
Other health conditions: Chronic kidney disease, peripheral artery disease, metabolic syndrome or a history of stroke increase the risk of angina.
Not getting enough exercise: An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes, and obesity. Because of this, you are at risk of having angina problem.
Obesity: Obesity is a risk factor for heart disease, which can lead to angina. Being overweight makes the heart work harder to supply blood to the body.
Emotional stress: Too much stress and anger can increase blood pressure. The increase in hormones produced during stress can cause narrowing of the arteries and can lead to severe angina.
Medications: Medications that constrict blood vessels, such as some migraine medications, can trigger Prinzmetal angina.
Drug abuse: Cocaine and other stimulants can spasm blood vessels and trigger angina.
Cold temperatures: Prinzmetal angina can be triggered by exposure to cold temperatures.
Complications of angina:
Chest pain that accompanies angina can make certain activities, such as walking, uncomfortable. However, the most dangerous complication is a heart attack. During this time the person may have to face the following other complications:-
Pressure, fullness, or squeezing pain in the center of the chest that lasts for more than a few minutes.
The pain extends beyond the chest to the shoulders, arms, back, or even the teeth and jaw.
fainting.
the impending sense of doom.
Increasing episodes of chest pain.
sea sickness.
Vomiting
Persistent pain in the upper stomach area (abdomen).
Breathing difficulty.
to sweat.
If you are experiencing any of the above mentioned complications then you need to seek emergency medical attention as soon as possible.
Diagnosis of Angina :
You should see a doctor as soon as possible if you think you have symptoms of angina. Your doctor will ask you about your symptoms of angina and ask you about your family heart disease history, as well as whether you have ever had any heart disease. According to this, you can ask to get the following tests done: -
Electrocardiogram: This quick and painless test measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes on the arms and legs. Wires connect the electrodes to a computer, which displays the test results. An ECG may show that the heart is beating too fast, too slow or not at all. Your health care provider may also look at patterns in the heart rhythm to see if blood flow through the heart is slowed or obstructed.
Chest X-ray: A chest X-ray shows the condition of the heart and lungs. A chest X-ray may be done to determine if other conditions are causing the symptoms of chest pain and to see if the heart is enlarged.
Blood tests: Certain heart enzymes enter the bloodstream when the heart muscle is damaged, such as from a heart attack. A cardiac enzyme blood test can help detect these substances.
Stress test: Sometimes it is easier to diagnose angina when the heart is working harder. A stress test usually involves walking on a treadmill or riding a stationary bike while the heart is monitored. Other tests may be done at the same time as the stress test. If you can't exercise, you may be given medicines that mimic the effects of exercise on the heart.
Echocardiogram: An echocardiogram uses sound waves to create images of the heart in motion. These pictures can show how blood flows through the heart. An echocardiogram may be done during a stress test.
Nuclear stress test: A nuclear stress test helps measure blood flow to the heart muscle at rest and during stress. It is similar to a regular stress test, but during a nuclear stress test, a radioactive tracer is injected into the bloodstream. A special scanner shows how the tracer moves in the arteries of the heart. Areas with little or no amount of the tracer indicate poor blood flow.
Cardiac computerized tomography: For this test, you usually lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine moves around the body and collects pictures of the heart and chest. A cardiac CT scan can show whether the heart is enlarged or if any heart arteries are narrowed.
Cardiac magnetic resonance imaging (MRI): This test uses a magnetic field and radio waves to create detailed images of the heart. You usually lie on a table inside a long, tubelike machine that produces detailed images of the heart's structure and blood vessels.
Coronary angiography: Coronary angiography uses X-ray imaging to examine the inside of the blood vessels of the heart. It is part of a general group of procedures known as cardiac catheterization.
A health care provider threads a thin tube (catheter) through a blood vessel in the arm or groin into an artery of the heart and injects dye through the catheter. The dye makes the arteries of the heart show up more clearly on X-rays. Your health care provider may call this type of X-ray angiogram.
Treatment of Angina :
Angina is treated in a number of ways, but before starting the treatment, it is very important to assess the current condition, as it is the condition that determines the type of treatment to be given to the patient.
If the patient has unstable angina or angina pain that is different from your usual, you will need immediate treatment.
In case of angina, the patient can be treated in the following ways:
Medicines :
If the angina patient makes lifestyle changes such as eating healthy and exercising etc. But even after this, if there is no relief from heart health and angina pain, then medicines may be required. The following can be used in these medicines:-
Nitrates: Nitrates are often used to treat angina. Nitrates relax and dilate blood vessels, allowing more blood to flow to the heart. The most common form of nitrate used to treat angina is nitroglycerin. A nitroglycerin tablet is placed under the tongue. Your health care provider may recommend taking nitrates before activities that commonly trigger angina (such as exercise) or on a long-term preventive basis.
Aspirin: Aspirin reduces blood clotting, making it easier for blood to flow through narrowed heart arteries. Preventing blood clots can reduce the risk of heart attack. Do not start taking a daily aspirin without first talking to your health care provider.
Anticoagulants: Clopidogrel (Plavix) – Some drugs, such as clopidogrel, prasugrel and ticagrelor, make it less likely for blood platelets to stick together, so the blood doesn't clot. One of these medicines may be recommended if you can't take aspirin.
Beta blockers: Beta blockers cause the heart to beat more slowly and with less force, which lowers blood pressure. These drugs also relax the blood vessels, which improves blood flow.
Statins: Statins are drugs used to lower blood cholesterol. High cholesterol is a risk factor for heart disease and angina. Statins block a substance that the body needs to make cholesterol. They help prevent blockage in the blood vessels.
Calcium channel blockers: Calcium channel blockers, also called calcium antagonists, relax and widen blood vessels to improve blood flow.
Other blood pressure medications: Other medications that lower blood pressure include angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). Your health care provider may prescribe one of these types of drugs if you have high blood pressure, diabetes, symptoms of heart failure, or chronic kidney disease.
Ranolazine: This drug may be prescribed for chronic stable angina that doesn't get better with other medications. It may be used alone or with other angina medicines, such as calcium channel blockers, beta blockers or nitroglycerin.
Therapy :
Sometimes, a nondrug option called enhanced external counterpulsation (EECP) may be recommended to increase blood flow to the heart. With EECP, a blood pressure-type cuff is placed around the shins, thighs, and pelvis. EECP requires several treatment sessions. EECP may help to reduce symptoms in people with persistent, uncontrolled angina (refractory angina).
Surgeries and procedures:
If lifestyle changes, medications, or other treatments do not reduce angina pain, a catheter procedure or open-heart surgery may be needed. Surgeries and procedures used to treat angina and coronary artery disease mainly include the following:-
Angioplasty with stenting: During angioplasty, also called percutaneous coronary intervention (PCI): in this procedure a small balloon is inserted into the narrowed artery. The balloon is inflated to widen the artery, and then usually a small wire mesh coil (stent) is inserted to keep the artery open.
Angioplasty with stenting improves blood flow to the heart, reducing or eliminating the risk of angina. Angioplasty with stenting may be a good treatment option for people with unstable angina or if lifestyle changes and medications do not effectively treat chronic, stable angina.
Open-heart surgery (coronary artery bypass surgery): During coronary artery bypass surgery, a vein or artery from elsewhere in the body is used to bypass a blocked or narrowed heart artery. Bypass surgery increases blood flow to the heart. It is a treatment option for both unstable angina and stable angina. It is done when there is no benefit from any other treatment method.
Important lifestyle changes and home remedies:
Heart disease is often the cause of angina. Making lifestyle changes to keep your heart healthy is an important part of treating angina. For this you can adopt the following methods:-
Don't smoke and avoid exposure to secondhand smoke. If you need help quitting, talk with your health care provider about smoking cessation treatment.
Eat a healthy diet low in salt, saturated and trans fats and rich in whole grains, fruits and vegetables.
Manage other health conditions. Diabetes, high blood pressure and high blood cholesterol can cause angina.
Practice stress relief. Getting more exercise, practicing mindfulness, and connecting with others in support groups are some of the ways to reduce emotional stress.
Avoid or limit alcohol. If you are used to drinking alcohol, do so in moderation.
Exercise and manage weight. As a general goal, aim for at least 30 minutes of moderate physical activity every day. If you are overweight, talk with your health care provider about safe weight loss options. Ask your health care provider what weight gain is best for you.
Measures to prevent angina:
It is better to prevent any disease than to cure it. Angina is a heart related disease which can be easily prevented.
To prevent angina, you can adopt the following measures: -
Eat all types of nutrients and vitamins rich food, so that your heart will always be healthy.
People addicted to smoking try to quit smoking.
Do yoga or exercise daily.
Avoid taking stress. Some or the other situation comes in life due to which stress is inevitable, in such a situation, try to stay away from stress as much as possible. At the same time, you can also adopt meditation, music and diet for this.
If you are suffering from problems like diabetes, high blood pressure, high cholesterol and metabolic syndrome, then keep all these conditions under control.
If you consume alcohol, beer or any other type of intoxicant, it is best to stay away from them. If it is not possible for you to do this, then start reducing their quantity. 