Angina

The discomfort or chest pain caused due to the lack of oxygen to the heart because of reduced supply of blood is called Angina. It is a major symptom of the coronary disease of the heart.

The coronary arteries supplying blood to the heart narrows in size. This reduces the flow of blood to the heart, causing the heart to beat at a slower rate. .This causes the pain. It occurs due to exertion. Angina cannot be considered as heart attack, as it is only a temporary situation. But angina is a symptom which shows an increased risk in developing heart attack.

Symptoms

The symptoms of angina can include:

• Discomfort or pain in the middle chest,
• pain in the neck and throat,
• Pain in the jaw, arms, stomach and between shoulder blades,
• breathlessness
• Choking
• sweating,
• feeling sick
• Exhausted.

Angina can be stable, unstable or variant.

Stable angina is triggered by exertion and has regular pattern.

Unstable angina does not follow any pattern.

Variant angina, also known as Prinzmetals angina, which affects women more than men, attacks without any warning.
Causes

The most common reason for the narrowing of the coronary arteries is due to the existence of the coronary disease of the heart known as the atherosclerosis.

Unstable angina occurs mainly due to narrowing of coronary artery which caused by the breaking open of a plaque and formation of blood clot on top of it.

Variant angina occurs due to contraction of the coronary arteries due to sudden spasm.

Less popular causes of angina are:

Squeezing of the arteries by foreign substances.
Infection or inflammation of the coronary arteries.
Abnormal rhythms of the heart

Factors triggering angina are:

• Belonging to the middle age group.
• being male.
• smoking,
• persons with high level of cholesterol
• people with high blood pressure
• people who are obese
• People with no physical activity
• a family history of heart attacks,
• having diabetes.

Treatment

Glyceryl trinitrate, in the form of sprays or tablets, is administered for controlling the pain by improving the blood supply to the heart. But it acts for a very short span of time only. People who have the tendency of angina are advised to have the drug with them always.

For long term prevention of angina and its symptoms, two or three medicines like beta blockers, long acting nitrates, potassium channel activators as well as calcium channel blockers are administered.

For the prevention of the worsening of arteriosclerosis statins like pravastatin, are used. Anti-platelets usage reduces the risk of a person with angina developing heart attacks.

Surgery is advised in case of severe angina. Angioplasty is done to open the coronary artery for widening the narrowed arteries.

Another option is Coronary artery bypass graft (CABG) which creates a new channel for the blood to flow into the arteries which are blocked.

Unstable angina is treated immediately by administering a dosage of 300mg of aspirin to relieve the pain. Anticoagulants as well as nitrates and beta blockers can also be used.