Last updated date: 28-Aug-2023
Originally Written in English
Angina, a form of chest pain, occurs due to a reduced level of blood flowing into the heart. It’s mostly associated with coronary artery disease. Squeezing, heaviness, pressure, tightness, and pain around the chest are all common effects of angina. Some describe angina symptoms as a vise squeezing or a heavy weight resting on the chest.
Angina might be a new pain that requires medical attention or chronic pain that responds to the medication. Even though it is fairly common, it can be difficult to differentiate from other forms of chest pain, including indigestion discomfort. Therefore, if you are experiencing unexplained angina chest pain, consult a medical provider right away.
Types of Angina
The main types of angina include the following;
- Stable angina
When the heart is functioning faster than normal, such as during exercise, stable angina develops. It lasts about five minutes on average. Furthermore, it follows a standard pattern and can last for months or even years. Symptoms are also relieved by rest and treatment.
- Unstable angina
Unstable angina has no standard pattern and typically happens while you are at rest. It is caused primarily by atherosclerosis, which is characterized by a blockage that prevents blood from getting to the heart. The discomfort can last for an extended period and can get worse with time. Rest and treatment might not be enough to alleviate the symptoms.
Unstable angina can be a sign of a heart attack risk. Therefore, any person who develops sudden angina should seek immediate medical attention.
- Microvascular angina
Coronary microvascular disease may cause microvascular angina, affecting the minute coronary arteries. One may also experience the following symptoms in addition to chest pain:
- Fatigue and exhaustion
- Sleeping disorders
- Breathing problems
Microvascular angina is more likely to recur compared to stable angina. It usually lasts more than 10 minutes, and on other occasions, more than 30 minutes.
- Variant angina
Variant angina is a rare condition. Also referred to as Prinzmetal angina, it occurs while the body is at rest, usually about midnight or early in the morning. It normally develops if a spasm in the coronary arteries emerges. Cold exposure, medications, stress, smoking, and cocaine use are all potential causes. While it is a long-term illness, medicine will help you control it.
Signs and Symptoms of Angina
Angina can be associated with any of the following chest sensations;
- An inflammation or aching sensation on the chest that typically begins behind the breastbone
The chest pain normally radiates towards the neck, arms, chin, shoulders, back, throat, or teeth. Other potential symptoms can include heartburn, indigestion, sweating, weakness, cramping, nausea, and shortness of breath.
The period you experience the symptoms typically depends on the form of angina. Seek immediate medical attention if you experience serious or persistent pain in the chest.
Angina Symptoms in Women
The angina symptoms in women may vary from the symptoms of angina in men. These distinctions can result in inappropriate delays in seeking medical care. While chest pain can be a popular symptom in angina women, it isn't always the only or most common symptom. Other symptoms that women can experience include;
- Feeling nauseated
- Breathing problems
- Pain in the abdomen
- Pain in the spine, jaw, or back
- A sharp pain rather than chest pressure
Causes of Angina
Reduced flow of blood towards the heart muscle causes angina. The blood usually transports oxygen to the heart muscle, which is necessary for survival. Ischemia is a disease that occurs if the heart muscle does not receive sufficient oxygen.
Coronary artery disease is the most prevalent trigger of decreased blood flow into the heart muscle. As a result, fatty deposits known as plaques will narrow down the heart (coronary) arteries. This condition is referred to as atherosclerosis.
During periods of limited oxygen demand, such as when you are sleeping, the heart muscle might be able to work with less blood flow without causing any angina symptoms. Angina can develop when the need for oxygen increases, for instance, when working out.
Risk Factors of Angina
The risk factors that can increase the possibility of developing angina and coronary artery disease include;
- Tobacco use
- Having diabetes
- Having high blood pressure
- Having high blood cholesterol (triglyceride levels)
- Old age
- Family background of heart condition
- Obesity or overweight
- Lack of exercise
The medical provider will begin by performing a physical test and inquiring about the symptoms in order to diagnose angina. They can also ask you about any potential risk factors, such as a family record of the heart condition.
Your medical provider can order a variety of tests to determine if you have angina. They include;
Electrocardiogram (ECG or EKG): An electric impulse produced by specialized cells within the heart triggers every heartbeat. An electrocardiogram takes a record of such electric signals as they pass through the heart. When the blood flow via the heart slows down, gets interfered with, or if you experience a heart attack, the doctor will check for patterns between the heartbeats.
Echocardiogram: This involves the use of sound waves to create pictures of the heart. The images will help the doctor spot angina-associated issues. This includes damage to the heart muscle caused by inadequate blood flow. During a stress test, the doctor can use an echocardiogram to see if any parts of the heart aren't receiving sufficient blood.
Stress test: While the heart is functioning harder, it's sometimes easier to detect angina. You exercise by pedaling a stationary bicycle or walking on a treadmill during a stress test. While you exercise, the blood pressure, as well as ECG readings, are observed.
A nuclear stress test: This measures the flow of blood to the heart muscle both at rest and when you're stressed. A nuclear stress test is similar to a regular stress test, except that it involves injecting a radioactive agent into the bloodstream.
Blood tests: When your heart has been affected by a heart attack, some heart enzymes gradually leak into the bloodstream. The existence of these enzymes can be determined using blood sample tests.
X-ray of the chest: This procedure involves taking pictures of the lung and heart. This is to rule out any other factors that may be causing the symptoms and to determine whether or not you have an enlarged heart.
Coronary angiography: This technique examines the inner part of the heart's blood vessels using x-ray imaging.
Cardiac computerized tomography (CT) scan: You will lie down on the table in the doughnut-shaped equipment during this procedure. The x-ray tube in the device then rotates in the body, capturing pictures of the chest and heart.
Angina treatment aims to help lower the frequency and seriousness of the symptoms. It also reduces risks like heart attack and even death.
The treatment options can include the following;
Aspirin: Reduce the possibility of blood clotting and allow easy flow of blood via the narrowed arteries of the heart. This also lowers the chances of having a heart attack.
Nitrates: Relaxes and expands the blood vessels, making it possible for enough blood to flow into the heart muscle.
Clot preventing medication: Helps prevent the formation of blood clots by making the platelets less likely to stick.
Beta-blockers: Function by blocking the impacts of the hormone epinephrine (adrenaline). This causes the heart to beat slowly with lesser force, hence minimizing the blood pressure.
Statins: Helps reduce blood cholesterol by blocking certain substances the body requires to produce cholesterol.
Blood pressure-lowering drugs: Having diabetes or high blood pressure can sometimes indicate chronic kidney disease or heart failure risk. The doctor can thus recommend some drugs to help lower the blood pressure.
Calcium channel blockers: Helps relax and broaden the narrowed blood vessels by influencing the muscle cells within the artery wall.
Surgery and other procedures:
Sometimes, a stable angina cure involves a combination of lifestyle changes and drugs. The doctor can also recommend treating angina with surgical procedures if the medications are not effective. These procedures include;
Angioplasty and stenting: An angioplasty, also known as a percutaneous coronary intervention (PCI), involves inserting a small balloon into a narrowed artery. The artery is widened with a balloon, and a thin wire mesh coil (stent) is normally inserted to hold it intact.
Coronary artery bypass surgery: This procedure involves using a vein or artery from another part of the body to bypass a narrowed or blocked heart artery. Bypass surgery improves the flow of blood into the heart, reducing or eliminating angina. It can be beneficial for treating both unstable and stable angina that is not responsive to other treatment options.
Angina is characterized by discomfort, squeezing, and pressure around the chest caused by insufficient oxygen getting to the heart muscle. While it is not always harmful, it can be a symptom of heart disease.
Angina is a manageable or preventive condition, especially with effective medical therapies and lifestyle changes. Anyone with unexpected, unexplainable, or worsening chest pain should seek medical help as soon as possible.