What is angina?
Angina is chest pain that occurs because there is not enough blood in the part of your heart. It may feel like a heart attack, with pressure or tightness in the chest. It is sometimes called angina pectoris or ischemic chest pain.
It is a symptom of heart disease and occurs when something blocks the arteries or there is not enough blood flow in the arteries that carry oxygen-rich blood to the heart. Angina usually goes away quickly. Still, it can be a sign of a dangerous heart problem. It is important to know what is happening and what you can do to prevent a heart attack.
Medicines and lifestyle changes can usually control angina. If it’s more serious, you may also need surgery. Or you may need what’s called a stent, a tiny tube that holds open arteries.
Symptoms of angina
Angina involves any of the following sensations in the chest:
Burning or pain in the chest, which usually begins behind the breastbone. The pain frequently spreads to the neck, jaw, arms, shoulders, throat, back, or teeth.
Other possible symptoms include:
- Difficulty breathing
The period of these symptoms depends on the type of angina. Anyone experiencing severe or persistent chest pain should call 911 or seek emergency care.
Symptoms in women
In anyone, angina can be due to coronary heart disease or cardiovascular disease. MVD affects women more often than men, and as a result, explains the American Heart Association (AHA), women can experience different symptoms that accompany angina.
In addition to chest pain, which can be severe, a woman with angina may experience:
- Nausea and vomiting
- Abdominal pain
- Difficulty breathing
The AHA urges women to seek help for symptoms of heart disease. They highlight that cardiovascular disease is the leading cause of death among women in the United States, occurring in nearly half of African American women.
Types of angina
Stable angina: This is the most common. Physical activity or stress can trigger it. It usually lasts a few minutes and disappears when you rest. It is not a heart attack, but it may be a sign that you are more likely to have one. Tell your doctor if this happens to you.
Unstable angina: You can have this while you are resting or not very active. The pain can be strong and long-lasting, and it can come back again and again. It can be a sign that you are about to have a heart attack, so see a doctor immediately.
Microvascular angina: With this kind, you have chest pain but no coronary artery blockage. Instead, it happens because your smaller coronary arteries aren’t working the way they should, so your heart isn’t getting the blood it needs. Chest pain usually lasts more than 10 minutes. This type is more common in women.
Prinzmetal’s angina (variant angina): This guy is weird. It can happen at night while you sleep or rest. The arteries in your heart suddenly contract or narrow. It can cause a lot of pain and should be treated.
Causes of angina
The heart gets its blood supply from the coronary arteries that branch off the aorta just as it exits the heart. The coronary arteries run along the surface of the heart, branching out into smaller and smaller blood vessels as they complement each muscle cell in the heart. The most common reason a patient complains of angina is due to narrowing of the coronary arteries caused by atherosclerotic heart disease (ASHD).
Cholesterol plaque gradually builds up on the inner lining of a coronary artery, narrowing its diameter and decreasing the amount of blood that can flow past the blockage. If the heart is asked to do more work and pump harder and faster, it may not be possible to deliver enough oxygen beyond the blockage to meet the myocardial energy demand and this can cause symptoms of a heart attack. angina.
If a plaque ruptures, a blood clot can form, completely occluding the coronary artery and preventing blood flow to the section of the heart muscle that supplies the artery. This is called a heart attack or myocardial infarction and is a medical emergency. The heart muscle that loses its blood supply will die and be replaced by scar tissue that cannot contract. This can decrease the heart’s ability to pump as hard as before.
Also, the heart muscle that loses its blood supply can become irritable and cause heart rhythm disturbances such as ventricular fibrillation or ventricular flutter that can result in sudden cardiac death. Because each heartbeat not only sends blood to the body, but also to itself, there are a variety of systems in the body and within the heart that have to function normally to supply oxygen to the heart muscle. If any of them, either individually or in combination, do not work properly, angina can occur. Examples include the following:
The heart’s electrical system must be able to generate a heartbeat that is neither too sluggish (bradycardia) nor too fast (tachycardia). There may be an intrinsic problem with the electrical conduction system of the heart.
Atrial fibrillation with the rapid ventricular response, atrial flutter, and ventricular tachycardia are extremely fast rates that can be associated with chest pain, shortness of breath, and other symptoms of angina. Complete heart block can cause the heart to beat too slowly. The abnormal heart rhythm may be due to electrolyte or hormone abnormalities, medications, or ingestion of toxins (for example, cocaine overdose).
Heart valves need to allow blood to flow between the heart chambers and into the body and lungs in the right direction and at the right speed. This is especially true in the case of the aortic valve that controls the blood that leaves the heart and into the aorta. Severe aortic stenosis or narrowing of the aortic valve may not allow enough blood to flow out of the heart with each beat to provide blood flow to the coronary arteries.
The heart muscle must be able to have adequate contraction or force to pump blood. The lack of this ability may be due to cardiomyopathy (damaged heart muscle). There need to be enough red blood cells in the bloodstream to carry oxygen. Patients who have anemia can grow shortness of breath, fatigue, and chest pain with activity.
The lungs need to work to deliver enough oxygen to the body. Patients with COPD or emphysema may not be able to extract enough oxygen from the air to meet the body’s needs. In most cases, these patients have shortness of breath, but they can also develop angina. Certain poisonings, including carbon monoxide, can prevent oxygen from sticking to red blood cells and cause shortness of breath and chest pain.
If any of these steps fail, the heart muscle may not get enough oxygen and the patient may experience pain or discomfort called angina.
Risk factors of angina
The following risk factors increase your risk for coronary artery disease and angina:
Tobacco: Chewing tobacco, smoking, and prolonged exposure to secondhand smoke damage the inner walls of the arteries, including the arteries of the heart, allowing cholesterol deposits to build up and block blood flow.
Diabetes: Diabetes increases the risk of coronary artery disease, which principals to angina and heart attacks by accelerating atherosclerosis and cumulative cholesterol levels.
Hypertension: Over time, high blood pressure damages the arteries by accelerating the hardening of arteries.
High cholesterol: Cholesterol is an important part of the deposits that can narrow arteries throughout the body, including those that supply the heart. A high level of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, increases the risk of angina and heart attacks. A high level of triglycerides, a type of fat in the blood related to your diet, is also not healthy.
Family history of heart disease: If a family member has coronary artery disease or has had a heart attack, you are at higher risk of developing angina.
Advanced age: Men over 45 and women over 55 are at higher risk than younger adults.
Lack of exercise: An inactive lifestyle donates to high cholesterol, high blood pressure, type 2 diabetes, and obesity. However, it is important to speak with your doctor before beginning an exercise program.
Obesity: Obesity is linked to high blood cholesterol levels, high blood pressure, and diabetes, all of which increase the risk of angina and heart disease. If you are over heavy, your heart has to work harder to supply blood to the body.
Stress: Stress can increase the risk of angina and heart attacks. Too much stress, as well as anger, can also increase your blood pressure. The sudden increases in hormones produced during stress can narrow the arteries and make angina worse.
Diagnosis of angina
All chest pain should be seen by a healthcare provider. If you have chest pain, your doctor will want to know if it is angina and if it is, if the angina is stable or unstable. If it is unstable, you may need emergency medical treatment to try to prevent a heart attack.
Your physician will most likely perform a physical exam, ask about your symptoms, and ask about your risk factors and family past for heart disease and other cardiovascular conditions.
Treatment of angina
Treatment for stable angina includes lifestyle changes, medication, and surgery. You can usually predict when the pain will occur, so reducing exertion can help control chest pain. Discuss your exercise and diet routine with your doctor to determine how you can safely adjust your lifestyle.
Lifestyle: Certain lifestyle alterations can help prevent future episodes of stable angina. These changes may include exercising regularly and eating a healthy diet of whole grains, fruits, and vegetables. You should also stop smoking if you are a smoker.
These habits can also lower your risk of developing chronic (long-term) diseases, such as diabetes, high cholesterol, and high blood pressure. These conditions can affect stable angina and can eventually lead to heart disease.
Medicine: A drug called nitroglycerin effectively relieves pain associated with stable angina. Your physician will tell you how much nitroglycerin to take when you have an affair with angina. You may need to take other medications to control underlying conditions that contribute to stable angina, such as high blood pressure, high cholesterol, or diabetes.
Tell your physician if you have any of these conditions. Your doctor may prescribe certain medications that can help stabilize your blood pressure, cholesterol, and glucose levels. This will reduce your risk of experiencing more episodes of angina. Your doctor may also prescribe blood-thinning medications to prevent blood clots, a contributing factor to stable angina.
Surgery: A slightly invasive procedure called angioplasty is often used to treat stable angina. Throughout this procedure, a surgeon places a small balloon confidential your artery. The balloon is inflated to widen the artery, and then a stent (a small coil of wire mesh) is inserted. The stent is permanently placed in your artery to keep the duct open.
Blocked arteries may need to be repaired surgically to prevent chest pain. Open heart surgery may be done to perform a coronary artery bypass implant. This may be essential for people with coronary heart disease.
Complications of angina
The chest pain that happens with angina can make responsibility some normal activities, such as walking, uncomfortable. Though, the most dangerous complication is a heart attack.
Common signs and symptoms of a heart bout include:
- Pressure, fullness, or a squeezing pain in the center of the chest that lasts more than a few minutes.
- Pain that extends beyond the chest to the shoulder, arm, back, or even to the teeth and jaw
- Increased episodes of chest pain.
- Nausea and vomiting
- Prolonged pain in the upper abdomen.
- Difficulty breathing
- The impending sense of doom
If you have any of these symptoms, seek spare medical attention immediately.
Prevention of angina
You can help prevent angina by creation the same lifestyle changes that might improve your symptoms if you already have angina. These include:
- Give up smoking.
- Monitor and control other health situations, such as high blood pressure, high cholesterol, and diabetes.
- Eat a healthy diet and preserve a healthy weight.
- Increase your physical activity after getting approval from your doctor. Try to get 150 minutes of moderate activity each week. Additionally, it is recommended that you do 10 minutes of strength training twice a week and stretch three times a week for five to 10 minutes each time.
- Reduce your stress level.
- Limit alcohol consumption to two drinks or less a day for men and one drink a day or less for women.
- Get an annual flu shot to prevent heart complications caused by the virus.