Angina pectoris is a medical condition wherein the victims suffer from pain in the middle of the chest. This medical term is in Latin, which means tight chest. This means that in this disease, the chest gets narrowed and tight; however, the pain might also become repressive such that one can feel that something is squashing the chest.

In angina pectoris, the pain commences in the chest’s middle portion that exists at the back of the breastbone (sternum) or on the left side of the front chest. On the way of its progress, the pain can extend to the other regions of the body such as arms, shoulders, and stomach.

Angina Types

Listed below are the three types of angina.

• Stable Angina
  In this type, the chest pain occurs when there is load on the heart to function even harder.
• Unstable Angina
  In this type, the chest pain can occur even when the heart is at rest, the pain remains for a longer time, and symptoms are comparatively severe than the stable angina.
• Variant Angina
  In this type, a sudden, severe spasm of a coronary artery occurs that involve relatively small contraction due to fatty deposits. The artery seems to work well, but in real, it is not so, which is medically also termed as the Prinzmetal angina. This type of pain can occur even when the heart is resting, for example, in the early morning.

Angina Pectoris Causes

Mostly, the major cause of angina pectoris is the coronary atherosclerosis that refers to the thickening of arteries that are associated with the heart and control blood supply. This thickening occurs when fatty matters such as plaques or atheroma deposit over the time narrowing the arteries and thereby reducing the blood flow.

When your heart attempts to propel flood faster to fulfill the increased demands of the body, the contracted arteries puts in great effort to meet the levels. In doing so, the heart obtains very small quantity of oxygen that results in pain often experienced as chest pain. If this also occurs when heart relaxes, it is referred to as the severe case of angina pectoris.

Listed below are certain triggers that indirectly indicate more blood supply to heart and the shortage of which results in angina.

• Physical exercise
• Climbing
• Stress
• Extreme cold
• A heavy meal

If these factors are avoided immediately or are halted, the pain will disappear rapidly normally in 10 minutes. There are some illnesses that can provoke angina pectoris, which are listed below.

• A persistent rapid heartbeat
• Anaemia (thin blood)
• Heart valve diseases, for instance, severe aortic stenosis that involves narrowing of the outflow valve
• Thickening of the heart muscle (hypertrophy), that is due to the high blood pressure over many years

Risk Factors Causing Angina

This is true that to some extent, we all have deposits of fatty substances in our arteries. However, atherosclerosis might commence even in our 20s and progress as the time passes by. Keeping this mind, there are certain risk actors that stimulate the increase of fatty deposits, which needs to be known and managed. Listed below are these factors.

• A family history of atherosclerosis
• Increased levels of LDL cholesterol in the blood
• High blood pressure
• Smoking
• Diabetes
• Obesity
• Stress
• Irregular or no exercise

Angina Pectoris Symptoms

Listed below are the symptoms of angina pectoris that get worse in winter or windy weather and after excessive eating.

• Physical hard work, exertion, or emotional stress
• A squeezing or heavy sensation on the chest
• Increased difficulty in breathing on exercise
• A feeling of heaviness or numbness, more often on the left side of the arms, shoulder, elbow, or hand
• A sensation of contraction in the gullet (throat)
• Spread of distress until ears, teeth, jaw, both the arms, stomach, and rarely in between the shoulder blades
• Rupturing of fatty acids in a few cases, after which clotting of blood occurs that on getting larger can block the blood supply causing unstable angina or heart attack

The above symptoms are also applicable to unstable angina at rest.

Angina Pectoris Diagnosis

The diagnosis of angina pectoris is done based on three factors, which are listed below.

• The incidence of usual symptoms
• Medical history
• The effect of glyceryl trinitrate on the pain (is it relieving or no)

Based on the results of these factors, following ways are implemented to confirm angina pectoris.

• An ElectroCardioGram (ECG)
  This supports diagnosis when done during the pain. In this test, the doctor examines the electrical movement of the heart.
• ECG Exercise
  Here, the test is done using a treadmill or an exercise bike (a stress test). A specialist in the hospital performs this test to identify whether the heart muscle is the origin of the pain.
• A Coronary Angiogram
  Coronary angiogram is a test in which the patient is injected with a liquid dye so that the coronary arteries are easily seen in X-ray. This is usually performed in the hospital.

Angina Pectoris Treatment

Your need to consult your GP to determine and minimize risk factors such as controlling high BP and cholesterol, prescribe medicines to gain relief, and refer a cardiologist, who is a heart specialist, for more assessments if required. Listed below are different medicines that can be prescribed to improve the symptoms and consequently the condition of angina.

• Aspirin
  If this is given in low doses, it minimizes the likelihood of small blood cells known as platelets to bind to each other. This aids in blocking the production of blood clots.
• Glyceryl Trinitrate (GTN)
  This medicine is available as a spray or sublingual tablet that calms down the arteries and relieves angina attacks.
• Long-acting Nitrates
  These medicines are available as tablets or patches, which are effective in minimizing the incidence of angina attacks. They cause headache as the side effect, which mostly faded away once the medicine is taken for a few weeks.
• Beta-blockers
  These medicines prevent the outcome of the negative action of the adrenaline hormone. This slows down the pulse and lowers the blood pressure, which indicates that the heart does not require more amount of oxygen. Such a decrease in demand increases the blood supply for the heart muscle. Not only this, these medicines play an important role in safeguarding the heart once the victim suffered from an attack.
• Calcium-channel Blockers
  These medicines minimize the muscle tension in the arteries, which results in overruling the contraction with expansion, resulting in more space. They are also good at relaxing the heart muscle up to a very small extent that reduces blood pressure and the need of more oxygen for the heart.
• Potassium-channel Activator
  This is Nicorandil (Ikorel) that minimizes the muscle tension existing in the walls of the blood vessels, which results in expanding them and thereby, improving the blood flow and oxygen supply.

Surgery as the Treatment

In case you are not responding to the medications effectively or are suffering from severe angina, the cardiologist might opt for the surgery to regain the heart to its normal state and minimize the chances of a heart attack. Listed below are the two surgeries recommended for angina pectoris.

• Angioplasty
  In this operation, the narrowed artery is widened using a balloon. This is followed by a small tube known as a stent been entered into the artery to block any kind of narrowing down later.
• Bypass
  In this operation, an apparent blood vessel from another part of the body is connected to the coronary artery to evade the hindrance to blood flow.

Preventing Angina Pectoris

Listed below are a few guidelines that can help you in controlling the risk factors.

• Opt for a varied, healthy diet that includes a lot of leafy vegetables.
• Stay away from sweet items and saturated fats (in meat and full-fat dairy products).
• Keep away from smoking. Consult your doctor or pharmacist to suggest you about stop-smoking programmes and medicines that can make you stop smoking.
• Reduce your weight if obesity is present.
• Exercise regularly.
• Walk for at least 30 minutes daily, more preferably an early morning walk.
• Keep diabetes or high blood pressure in control by continuing with the medicines.

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