What You Should Know About Angina

1. What You Should Know About Angina Angina is chest pain or discomfort caused when heart muscle doesn't get enough oxygen-rich blood because of deposition of waxy substance called plaque in the coronary arteries. Patient feels discomfort in shoulder, arms, neck, jaw, or back squeezing, bursting, gas or indigestion. Angina can also be a symptom of coronary disease. Angina can also be a symptom of coronary microvascular disease. Types of angina  angina pectoris  unstable angina  variant angina  micro vascular angina Angina pectoris Pericardial chest pain is usually precipitated by stress or exertion relieved rapidly by rest or nitrates. It is usually due to atherosclerotic heart disease. Unstable angina Unstable angina does not follow a regular pattern. It can occur when at rest and is considered less common and more serious because rest and medication does not relieve it. This can signal a future heart attack within a short time - hours or weeks.

2. Variant and microvascular angina Variant (Prinzmetal's) angina and microvascular (smallest vessels) angina are rare and can occur at rest without any underlying coronary artery disease. This angina is usually due to abnormal narrowing or relaxation (spasm) of the blood vessels, reducing blood flow to the heart. It is generally relieved by medicine. Causes of angina Angina is most frequently the result of underlying coronary artery disease. The coronary arteries supply the heart with oxygen-rich blood. When cholesterol aggregates on the artery wall and hard plaques form, the artery narrows. Because of deposition of waxy substance it is very difficult for oxygen-rich blood to reach the heart muscle as the arteries become too narrow. The plaque narrows the arteries or may break off and form blood clots that block the arteries. The actual angina attacks are the result of the reduced oxygen supply to the heart. Common triggers include: Physical exertion is a common trigger because the heart needs more oxygen than it receives  in order to work harder Severe emotional stress  A heavy meal  Use of fast foods  Exposure to extreme temperatures.  Smoking may trigger angina attacks.  Symptoms of angina Angina is usually felt in the chest region as: squeezing  pressure  heaviness  tightening  burning or aching across the chest, usually starting behind the breastbone. This pain often  spreads to the neck, jaw, arms, shoulders, throat, back, or even the teeth. Patients may also complain of symptoms including:

3. indigestion  heart burn  weakness  sweating  nausea  cramping  shortness of breath  Occasionally, a gallop rhythm and an apical systolic murmur due to transient mitral regurgitation from papillary muscle dysfunction are present during pain only. Supraventricular or ventricular arrhythmias may be present, either as precipitating factor or as a result of ischemia. Diagnosis of angina All the chest pain may not be angina. It may be gas, peptic ulcer , chronic cholecystitis esophageal spasm, or functional gastrointestinal disease. A correct diagnosis for chest pain is important because it can predict the likelihood of having a heart attack. The process will start with discussion of symptoms, risk factors, and family medical history. Here are the some test which are required to diagnose this disease: Blood tests - to check levels of fats, lipid, cholesterol, sugar, and proteins  electrocardiography- records the changes in myocardial infarction atrioventricular or intra  ventricular conduction defects and changes of left ventricular hypertrophy echocardiograph- image the left ventricle and reveal segment wall motion abnormality  which may indicate ischema or prior infraction Electrocardiogram (EKG) - records electrical activity of the heart and can detect when the  heart is starved of oxygen. cardiac magnetic resonance imaging (MRI)- is an evolving modality that provides high  resolution image of the heart and great vessels without radiation exposure

4. Stress test - blood pressure readings and an EKG while the patient is increasing physical  activity. Chest X-ray - to see structures inside the chest  Coronary angiography - dye and special X-rays to show the inside of coronary arteries (dye  is inserted using cardiac catheterization). Prevention control unhealthy cholesterol levels  control hypertension  quit tobacco smoking  control diabetes  control being overweight or obese  metabolic syndrome  avoid sedentary lifestyle  remain physically active  learn how to handle stress, eat fruits, vegetables, whole grains, low-fat or no-fat dairy  products, and lean meat and fish. Treatment 1-treatment of acute attack- Sublingual nitroglycerine is the drug of choice. It acts in about 1-2 min. Nitrate decreases arteriolar and venostone , reduces preload and afterload and lower the oxygen demand of heart. As soon as the attack begins, one fresh tablet is placed under the tongue. Nitrates prevent or reduce the intensity of angina attacks by relaxing and widening blood vessels. 2-prevention of further attack aggravating factor  long acting nitrates 

5. beta-blockers  calcium channel blockers  ACE (angiotensin-covering enzyme) inhibitors  oral anti-platelet medicines  anticoagulants  Medicine which lowers the cholesterol levels are also given by the specialist. In some cases angioplasty or coronary artery bypass grafting is recommended by the specialist. Original Article Source: https://goo.gl/c5G7qB