Angina (Chest Pain): Symptoms, Causes & Treatment

What are the symptoms of angina?

Angina is chest pain or discomfort that occurs when the heart muscle does not receive enough oxygenated blood. The primary symptom of angina is chest pain or discomfort, but there can be other associated symptoms as well. The symptoms of angina typically include:

  1. Chest pain or discomfort: This is the main symptom of angina. The pain or discomfort is usually described as a squeezing, pressure, heaviness, or tightness in the chest. It can radiate to the shoulders, arms, neck, jaw, or back.
  2. Shortness of breath: Some individuals with angina may experience shortness of breath, especially with exertion or physical activity.
  3. Fatigue: Angina can cause feelings of extreme tiredness or exhaustion, especially during physical activity.
  4. Nausea: Nausea or vomiting can sometimes accompany an episode of angina.
  5. Sweating: Excessive sweating or cold sweats may occur during an angina attack.
  6. Dizziness or lightheadedness: Some people may feel dizzy or lightheaded due to the reduced blood flow to the brain during an angina episode.
  7. Palpitations: Irregular or rapid heartbeats (palpitations) may be experienced during or after an angina attack.

The severity of symptoms can vary from person to person, and some individuals may experience only mild discomfort or atypical symptoms, such as arm pain or indigestion-like symptoms.

Angina symptoms typically occur with physical exertion, emotional stress, or after a heavy meal and usually subside with rest or medication. However, if the symptoms are severe, persistent, or accompanied by other concerning symptoms (such as shortness of breath, sweating, or nausea), it may indicate a heart attack, and immediate medical attention is necessary. Consult your healthcare provider immediately.

It’s important to note that some people, particularly women, the elderly, and those with diabetes, may experience atypical or silent angina without experiencing significant chest pain or discomfort.

What are the causes of angina?

Angina is caused by an imbalance between the supply of oxygenated blood to the heart muscle (myocardium) and the heart’s demand for oxygen. The most common causes of this imbalance include:

  1. Coronary artery disease (CAD):
    This is the most common cause of angina. CAD occurs when the coronary arteries that supply blood to the heart become narrowed or blocked due to the buildup of plaque (atherosclerosis). This reduces the flow of oxygen-rich blood to the heart muscle, leading to angina during periods of increased oxygen demand, such as physical activity or emotional stress.
  2. Coronary artery spasm:
    In some cases, angina can occur due to a temporary constriction or spasm of the coronary arteries, even in the absence of significant atherosclerosis. This is known as variant angina or Prinzmetal’s angina.
  3. Aortic stenosis:
    This condition involves the narrowing of the aortic valve, which can restrict blood flow from the heart and increase the workload on the heart muscle, leading to angina.
  4. Hypertrophic cardiomyopathy:
    This inherited condition causes the heart muscle to become abnormally thick, making it harder for the heart to pump blood effectively, potentially causing angina.
  5. Anemia:
    Severe anemia (low red blood cell count) can reduce the oxygen-carrying capacity of the blood, leading to an inadequate supply of oxygen to the heart muscle and potentially causing angina.
  6. Thyroid disorders:
    Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can affect the heart’s workload and oxygen demand, increasing the risk of angina.
  7. Uncontrolled hypertension (high blood pressure):
    Persistent high blood pressure can increase the workload on the heart and contribute to the development of coronary artery disease, increasing the risk of angina.

Identifying and addressing the underlying cause of angina is crucial for effective treatment and prevention of potential complications, such as heart attack or heart failure.

What is the treatment for angina?

The treatment for angina aims to relieve the symptoms, improve blood flow to the heart muscle, and reduce the risk of future complications. The specific treatment approach depends on the underlying cause, severity, and individual circumstances. Common treatments for angina include:

  1. Lifestyle modifications:
  1. Medications:
  • Nitrates (e.g., nitroglycerin): These medications dilate the blood vessels, improving blood flow to the heart and relieving angina symptoms.
  • Beta-blockers: They slow the heart rate and reduce the heart’s workload, decreasing oxygen demand.
  • Calcium channel blockers: These drugs help relax and widen blood vessels, improving blood flow.
  • Angiotensin-converting enzyme (ACE) inhibitors: By lowering blood pressure, they can reduce the heart’s workload.
  • Antiplatelets (e.g., aspirin): These medications help prevent blood clots and reduce the risk of heart attack.
  • Cholesterol-lowering medications (e.g., statins): These drugs help lower cholesterol levels and reduce the progression of coronary artery disease.
  1. Procedures:
  • Angioplasty and stenting: This procedure involves inflating a balloon to widen narrowed or blocked coronary arteries and inserting a stent (a small mesh tube) to keep the artery open.
  • Coronary artery bypass graft (CABG) surgery: This surgical procedure creates new routes for blood to flow around blocked arteries by using healthy blood vessels from other parts of the body.
  1. Enhanced external counterpulsation (EECP):
    This non-invasive treatment uses specialized cuffs that inflate and deflate in sync with the heart’s rhythm, increasing blood flow to the heart muscle.
  2. Transmyocardial revascularization (TMR):
    In this procedure, a laser is used to create channels in the heart muscle, allowing oxygenated blood to flow directly from the heart’s chamber to the oxygen-deprived areas.

The treatment plan is tailored to each individual’s specific needs and may involve a combination of lifestyle changes, medications, and procedures. Regular follow-up with a healthcare provider is essential to monitor the effectiveness of the treatment and make any necessary adjustments.

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