Sun
19
Apr
Angina
Angina is a recurring pain or discomfort in the chest.
Causes
Angina is usually a symptom of coronary artery disease. It occurs when
the blood vessels leading to the heart are blocked. This results in less blood,
and therefore less oxygen, reaching the heart muscle. When the heart muscle is
deprived of oxygen, chest pain and other symptoms result.
Types of angina include:
Stable Angina – occurs at predictable times. The pain goes away with rest or the use of a medication called nitroglycerin. It occurs when your heart's need for blood and oxygen is increased by:
Variant or Prinzmetal's Angina – occurs when you are at rest. It often occurs in the middle of the night. It can be quite severe. It may indicate that you have one of the following conditions:
Types of angina include:
Stable Angina – occurs at predictable times. The pain goes away with rest or the use of a medication called nitroglycerin. It occurs when your heart's need for blood and oxygen is increased by:
- Exercise, exertion
- Cold weather
- A large meal
- Emotional stress
Variant or Prinzmetal's Angina – occurs when you are at rest. It often occurs in the middle of the night. It can be quite severe. It may indicate that you have one of the following conditions:
- Coronary artery disease
- Extremely high blood pressure
- Hypertrophic cardiomyopathy
- Diseases of the heart valves
Risk Factors
A risk factor is something that increases your chance of getting a disease or
condition.
- Sex: Male
- Advancing age
- Obesity
- Smoking
- High blood pressure
- Sedentary lifestyle
- High blood cholesterol (specifically, high LDL cholesterol and low HDL cholesterol)
- High blood triglycerides
- Diabetes
- Stress
Symptoms
- Crushing or squeezing chest pain - While this is the classic description of chest pain due to coronary artery disease, some people do not experience the pain as being so severe. Chest pain of any kind deserves a medical evaluation to determine its cause.
- Pain in the left shoulder, down the left arm, or into the jaw
- Weakness
- Sweating
- Nausea
- Shortness of breath
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a
physical exam.
Tests may include:
Blood Tests – to look for certain heart attack markers in the blood; helps determine if you are having angina or a heart attack
Urine Tests – to look for certain heart attack markers in the urine; helps determine if you are having angina or a heart attack
Electrocardiogram (ECG, EKG) – records the heart's activity by measuring electrical currents through the heart muscle
Echocardiogram – uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
Exercise Stress Test – records the heart's electrical activity during increased physical activity
Thallium Stress Test – thallium is used to scan the myocardium, the middle layer of the heart
Nuclear Scanning – radioactive material is injected into a vein and observed as it is absorbed by the heart muscle
Electron-beam CT Scan – a type of x-ray that uses a computer to make pictures of the inside of the heart
Coronary Angiography – x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries
Tests may include:
Blood Tests – to look for certain heart attack markers in the blood; helps determine if you are having angina or a heart attack
Urine Tests – to look for certain heart attack markers in the urine; helps determine if you are having angina or a heart attack
Electrocardiogram (ECG, EKG) – records the heart's activity by measuring electrical currents through the heart muscle
Echocardiogram – uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
Exercise Stress Test – records the heart's electrical activity during increased physical activity
Thallium Stress Test – thallium is used to scan the myocardium, the middle layer of the heart
Nuclear Scanning – radioactive material is injected into a vein and observed as it is absorbed by the heart muscle
Electron-beam CT Scan – a type of x-ray that uses a computer to make pictures of the inside of the heart
Coronary Angiography – x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries
Treatment
Treatments for angina include:
Nitrate Medications
Nitroglycerin is usually given during an acute attack of angina. It can be given as a tablet that dissolves under the tongue or as a spray. There are also longer-lasting types that can be used to prevent angina before you participate in an activity known cause it. These may be given as pills, or applied as patches or ointments.
Aspirin
A small, daily dose of aspirin has been shown to decrease the risk of heart attack. Ask your doctor before taking aspirin daily.
Beta-blockers, Ace-inhibitors, and Calcium-channel Blockers
When used regularly (not as treatment for acute angina), these medications may reduce the occurrence of angina.
Cholesterol-lowering Medications
These may prevent the progression of coronary artery disease and may even improve existing coronary artery disease.
Surgery
Patients with severe angina or unstable, progressing angina may benefit from:
Nitrate Medications
Nitroglycerin is usually given during an acute attack of angina. It can be given as a tablet that dissolves under the tongue or as a spray. There are also longer-lasting types that can be used to prevent angina before you participate in an activity known cause it. These may be given as pills, or applied as patches or ointments.
Aspirin
A small, daily dose of aspirin has been shown to decrease the risk of heart attack. Ask your doctor before taking aspirin daily.
Beta-blockers, Ace-inhibitors, and Calcium-channel Blockers
When used regularly (not as treatment for acute angina), these medications may reduce the occurrence of angina.
Cholesterol-lowering Medications
These may prevent the progression of coronary artery disease and may even improve existing coronary artery disease.
Surgery
Patients with severe angina or unstable, progressing angina may benefit from:
- Coronary bypass graft
- Coronary angioplasty
Prevention
If you already have angina, you can prevent its onset by being aware of the
activities or conditions which tend to bring it on.
If you don't have angina, preventing the development and/or progression of coronary artery disease may reduce your chance of getting angina.
Steps to prevent coronary artery disease include:
If you don't have angina, preventing the development and/or progression of coronary artery disease may reduce your chance of getting angina.
Steps to prevent coronary artery disease include:
- Maintain a healthy weight.
- Begin a safe exercise program with the advice of your doctor.
- Stop smoking.
- Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
- Appropriately treat high blood pressure and/or diabetes.
- Ask your doctor if you should take cholesterol-lowering medications.