Angina

What is Angina

Angina is chest pain or discomfort that occurs when your heart muscle does not get enough blood. Angina may feel like pressure or a squeezing pain in your chest. The pain may also occur in your shoulders, arms, neck, jaw, or back. It may also feel like indigestion. Angina is a symptom of coronary artery disease, the most common type of heart disease. CAD occurs when plaque builds up in the coronary arteries. This buildup of plaque is called atherosclerosis. As plaque builds up, the coronary arteries become narrow and stiff. Blood flow to the heart is reduced. This decreases the oxygen supply to the heart muscle.

What are the Symptoms of Angina

• A heavy or constricting feeling in the chest. This pain or discomfort can spread anywhere between the belly button and the jaw, including to the shoulder, arm, elbow or hand (usually on the left side).
• The type of pain caused by angina is continuous, not stabbing.
• Breathlessness, especially following exercise.
• Nausea or dizziness.

In most cases, these symptoms occur due to some sort of exertion or psychological stress. If you suffer from angina you may find it gets worse during cold weather.

What are the Causes of Angina

Angina is usually caused by atherosclerosis (a narrowing of the arteries which supply blood to the heart).

The heart is responsible for pumping blood around the entire body, however it also needs its own blood supply. It gets this blood supply through the coronary arteries. If these arteries become narrow, the heart can't get enough blood (and therefore oxygen) during exercise or exertion, such as running for a bus. Angina is like a warning system telling a person to stop what they are doing as the heart is not getting enough oxygen and therefore cannot cope.

Any condition which causes the heart to need more blood, or which reduces the blood supply, can also cause angina. Examples of this include high blood pressure and anaemia.

Since angina is usually caused by atherosclerosis, reducing your risk factors associated with this will help to prevent angina.

The risk factors associated with atherosclerosis are high blood pressure, a high cholesterol level, smoking, obesity, stress and lack of exercise. By eliminating these risk factors, you will greatly lower the chances of getting atherosclerosis or angina. These measures will also help if you already have angina.

Traditional Medical Treatments for Angina

The main goals of treatment in angina pectoris are relief of symptoms, slowing progression of the disease, and reduction of future events, especially heart attacks and of course death. An aspirin (75 mg to 100 mg) per day has been shown to be beneficial for all patients with stable angina that have no problems with its use. Beta blockers (eg. propranolol,atenolol etc.) are some few examples, have a large body of evidence in morbidity and mortality benefits (fewer symptoms and disability and live longer) and short-acting nitroglycerin medications are used for symptomatic relief of angina. Calcium channel blockers (such as nifedipine (Adalat) and amlodipine), Isosorbide mononitrate and nicorandil are commonly used in chronic stable angina. ACE inhibitors are also vasodilators with both symptomatic and prognostic benefit and lastly, statins are the most frequently used lipid/cholesterol modifiers which probably also stabilise existing atheromatous plaque.Other interventions include angoiplasty and coronary artery stenting whereby the arteries are widened by inflating a small balloon within the coronary artery and this can be maintained by placing a small stent in the location of the narrowed artery.If the arteries are blocked to a large degree it may be necessary for coronary artery bypass grafting.