Written by eHealth Navigator

What is angina?
Angina (or angina pectoris) is recurring chest pain or discomfort that happens when some part of the heart does not receive enough blood and oxygen. Angina is a symptom of coronary heart disease (CHD), which occurs when arteries that carry blood to the heart become narrowed and blocked due to atherosclerosis or a blood clot.

What is the difference between Angina vs a Heart Attack
Angina may have similar symptoms to a heart attack, such as a crushing, squeezing pain in the chest; a feeling of pressure in the chest; and pain radiating in the arms, shoulders, jaw, neck, and/or back.

However, unlike the chest pain associated with a heart attack, the pain from angina usually goes away within a few minutes with rest or with the use of nitroglycerin.

What are the symptoms of angina?
Angina occurs when the heart muscle (myocardium) does not receive an adequate amount of blood and oxygen needed for a given level of work (insufficient blood supply is called ischemia). The following are the most common symptoms of angina. However, each individual may experience symptoms differently. Symptoms may include:

•  A pressing, squeezing, or crushing pain, usually in the chest under the breast bone, but may also occur in the upper back, both arms, neck or ear lobes
•  Pain radiating in the arms, shoulders, jaw, neck, and/or back
•  Shortness of breath
•  Weakness and/or fatigue

The chest pain associated with angina usually begins with physical exertion. Other triggers include emotional stress, extreme cold and heat, heavy meals, excessive alcohol consumption, and cigarette smoking. Angina chest pain is usually relieved within a few minutes by resting or by taking prescribed cardiac medications, such as nitroglycerin.

The symptoms of angina may resemble other medical conditions or problems. Always consult your physician for more information.

Does angina indicate a higher risk for heart attack?
An episode of angina does not indicate that a heart attack is occurring, or that a heart attack is about to occur. Angina does indicate, however, that coronary heart disease is present and that some part of the heart is not receiving an adequate blood supply. Persons with angina have an increased risk of heart attack.

A person who has angina should note the patterns of his/her symptoms - what causes the chest pain, what it feels like, how long episodes usually last, and whether medication relieves the pain. Call for medical assistance if the angina episode symptoms change sharply.

How is angina diagnosed?
In addition to a complete medical history and medical examination, a physician can often diagnose angina by noting the patient's symptoms and how/when they occur.  Certain diagnostic procedures may also determine the severity of the coronary heart disease, and may include:

•  Electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
•  Stress test (usually with ECG; also called treadmill or exercise ECG) - A test that is given while a patient walks on a treadmill or pedals a stationary bicycle to monitor the heart during exercise. Breathing and blood pressure rates are also monitored. A stress test may be used to detect coronary artery disease, and/or to determine safe levels of exercise following a heart attack or heart surgery.
•  Cardiac catheterization - With this procedure, x-rays are taken after a contrast agent is injected into an artery to locate the narrowing, occlusions, and other abnormalities of specific arteries.

Types of Angina:

Stable (SA) – chronic stable angina is angina which follows a precipitating event (exercise like stair climbing or walking up a hill, after a heavy meal, after sexual intercourse, after emotional stress, after being out in the cold weather). This form of angina is characterized by repeated similar attacks and is relieved by the same number of nitroglycerin pills. It is usually caused by a fixed obstruction of the coronary artery secondary to atherosclerosis.

Unstable (USA)(Rest or Crescendo Angina) – which is defined as Class I or II angina that started or progressed within the last 2 months or with chest pain at rest for greater then 20 minutes. (This form of angina is of recent origin and is of increasing severity, frequency, duration, and more nitroglycerin pills are needed to control it.)

Prinzmetal’s Variant Angina – is angina that occurs at rest, with electrocardiogram showing episodes of ST elevations, with ventricular arrhythmias often occurring in these patients, and caused by coronary artery spasm with or without superimposed coronary artery disease.

What are the treatments of angina?
Specific treatment for angina will be determined by the physician based on:

•  Your age, overall health, and medical history
•  Extent of the disease
•  Your tolerance for specific medications, procedures, or therapies
•  Expectations for the course of the disease
•  Your opinion or preference

The underlying coronary artery disease that causes angina should be treated by controlling existing risk factors: high blood pressure, cigarette smoking, high blood cholesterol levels, high saturated fat diet, lack of exercise and excess weight.

There are many options for angina treatment, including lifestyle changes, medications, angioplasty and stenting, or coronary bypass surgery. The goals of treatment are to reduce the frequency and severity of your symptoms and to lower your risk of heart attack and death.

Medications may be prescribed for people with angina. The most common is nitroglycerin which helps to relieve pain by widening the blood vessels. This allows more blood flow to the heart muscle and decreases the workload of the heart.

However, if you have unstable angina or angina pain that's different from what you usually have, such as occurring when you're at rest, you need immediate treatment in a hospital.



Last Updated on Thursday, 21 November 2013 4:47PM