Blood flow is important for all parts of the body, particularly to the heart. When the flow of blood to the heart is reduced, it causes chest pains. Angina Pectoris is one such type of a chest pain. When the oxygen-rich blood supply in the arteries is reduced or hindered, chest pain like Angina pectoris happens. People often confuse it with a heart attack as the feeling might be similar.
Patients who suffer from Angina Pectoris can either feel heaviness in their chest or it could be a type of pressure on their heart, a feeling of tightness or simply a pain in the chest. Some patients have reported that they feel as if some heavy weighted piece is placed on their chest or something is putting the pressure on it. Angina pectoris can be a recurring issue which might temporarily disappear when the treatment is provided to the patient. This disease is commonly found in many people but since chest pain is a generic symptom of multiple diseases, it becomes difficult to distinguish it from other pains such as pains which are resultant of indigestion. Most of the times, this problem goes away quickly but an unexplained chest pain should immediately be reported to the doctor so that the medical examination can be done.
There are basically three types of angina pectoris:
1. The most common is known as stable angina. This can be caused by extreme stress or physical activities which puts considerable amounts of pressure on the heart. Most of the times, this kind of pain lasts for a few minutes and goes away when the person take rest or mentally relax their mind. This kind of a pain is also a sign that the person is more prone to having a heart attack, which is why this pain should not be neglected.
2. Another type is called unstable angina. As opposed to stable angina, this pain might happen when the person is already at rest or mentally fine. Also, unlike stable angina, this pain can last for a long time and can also appear repeatedly. The intensity of this pain is considered to be more than that of stable angina pain. This pain is also a sign that a heart attack can occur, so action must be taken as soon as possible.
3. The last type is Prinzmetal's angina. This type of angina pectoris is also called as variant angina and is a rare problem. This might happen when the person is sleeping or is at rest. In this type of angina, the arteries of the heart tighten up suddenly, which triggers the pain.
The most expected symptom for this problem is the chest pain. A kind of discomfort in the chest is reported by patients who feel this pain. It is also described as a feeling of a squeezing, burning, pressure and fullness in the chest. The burning sensation might be mistaken as heartburn, but it might not be true. Other symptoms of this disease are as follows:
1. Pain in the shoulder, arms, jaw, neck or even back. This is usually with the chest pain.
2. Tiredness and fatigue
3. Shortness of breath
The symptoms also vary between males and females. Males tend to feel the pain right in the chest or neck and shoulder areas. Females might feel it in their back, jaw, throat or even belly. It is also observed that when women describe this pain, they use the words "pressing" or "crushing" more often than men do. If anyone is having these symptoms, then consulting the doctor on an immediate basis is advised because it could be a potential heart attack.
The basic reason behind the occurrence of this pain the reduction in the blood flow to the muscles of the heart. The blood which carries oxygen to those muscles is most essential to breathe and live. When there is an improper flow of that oxygen-rich blood, it causes a condition which is known as ischemia.
There could be various reasons for the hindrance in the proper blood flow. The most popularly known reason is coronary artery disease. In this disease, the arteries of the heart become very narrow and this happens because of the fact that accumulates on them. Those are known as plaques. This narrowing of arteries due to fat deposits is called as atherosclerosis.
The reduced blood supply can be an ongoing condition, but it does not always trigger the pain of angina pectoris. When the person is at rest, they need less amount of oxygen which the narrowed arteries might be able to provide. It is when the person does some heavy physical work which would require the body to have more oxygen. This is when the arteries fail to provide the required amount of oxygen-rich blood and can trigger the angina pain.
There are generic causes of Angina pectoris and then there are certain specific ones based on the type of angina pain. The generic causes are:
1. Blockage in the artery of the lungs.
2. Heart enlargement.
3. Narrowed valves, also known as aortic stenosis.
4. The sac surrounding the heart might get swelling as well.
5. Aortic dissection in which the wall of the aorta gets damaged.
1. Stable Angina: This kind of pain occurs when the person is involved in a physical activity which leads to exertion in the body. Even simple things like climbing up the stairs, exercising or brisk walking might cause this pain. This is because, during these activities, the body demands more oxygen. Conditions like depression or stress, weather which is too cold or eating heavy meals can also be responsible for this pain. It is also known that smoking also aids in triggering it.
2. Unstable Angina: When the fat deposit causes a blood clot to form, it can rupture the blood vessel. When that happens, the blood flow through the artery is rapidly blocked or significantly reduced. This is when the heart stops getting the blood in quantities required by it. Depending upon the size of the clot, this condition can become very serious. It could be a case of partial blockage or complete blockage. In this kind of pain, the relief does not come when the person tries to take rest or take the usual medicines. There must be a treatment for improving the blood flow else chances of a heart attack greatly increases. Therefore, emergency treatment is required when this fatal pain occurs.
3. Prinzmetal's angina: When the coronary artery contracts involuntarily and suddenly, the blood flow is hindered. This sudden contraction or spasms can be caused by smoking, emotional and mental stress and could also be because of the use of illegal drugs like cocaine etc.
The first step of diagnosing this problem is a check for risk factors which are mainly responsible for this kind of chest pain. The risk factors are:
1. Old age
3. Emotional stress or depression
4. The family history of this problem or heart-related issues.
5. High blood pressure
6. High cholesterol
8. Use of illegal drugs or tobacco.
If any of the above risk factors are positive in the patient, the following tests might follow:
1. Electrocardiogram (also known as ECG): The ECG machine records each electrical impulse which is generated in the heart and causes the heart to beat. The patterns of those heartbeats help the doctor to make out whether the blood supply is proper or hindered.
2. Test for stress: It is not the mental stress, but the physical stress on the heart. It becomes easier for the doctors to diagnose the pain when the heart is under pressure and demands more oxygen. In this test, doctors make the patient do some physical exercise, like walking on a treadmill or using the exercise bike and then they perform the measurements to gather useful information. There are some people who might not be able to do any physical work. For such people, the doctors might give a drug which will cause their heart to react as if the body is physically exercising. There is another test like a stress test and that is known as a nuclear stress test. The blood pressure and flow are measured when the patient is doing an exercise, and when they are at rest. This is done by injecting a radioactive substance into the body of the patient. As this substance tries to reach the heart through the bloodstream, a scanner detects its path and the image of the heart muscle is clearly brought out. If there is any place through which the substance is unable to pass through, the doctors will make it out from the imagery.
3. Echocardiogram: With the help of echocardiogram, the condition of the heart muscle can be found out and an idea of the presence/absence of angina can be taken. This test is based on sound waves which produce the imagery of the heart. This is sometimes also used in the middle of a stress test. When stress test and echocardiogram are combined, it becomes possible to find out angina and its cause.
4. Chest X-ray: This one is a basic test which shows the image of the heart as well as lungs. This helps the doctors in checking if there are any symptoms present which can cause angina.
5. Coronary Angiography: This testing also uses X-ray, but it is meant for the heart's blood vessels. The machine takes many pictures (angiograms) of blood vessels which helps in identifying their current condition.
Apart from these tests, some other basic tests like blood tests, CT scan and MRI are also performed on the patient to find out the condition of the blood vessels.
This problem of chest pain can be prevented by adopting simple and basic lifestyle changes:
1. Avoiding smoking completely.
2. Regular check-ups to measure the blood pressure, cholesterol levels and routine health check-up.
3. Maintaining the weight as per the Body-mass index.
4. Doing physical exercises as approved by the doctor, depending upon the individual's condition. The minimum required physical activity can be advised by the doctor as per the person's weight, height, gender, age and medical history.
5. Staying away from stress and trying to stay mentally fit and happy.
6. Limit/stop alcohol intake.
7. Taking the flu shots from medical practitioners to ensure the virus does not cause any problems.
The treatment of this condition highly depends on the severity of its existence. In all cases, doctors will advise bringing changes in the lifestyle. Chances are that they will prescribe medicines as well. For patients who are at an alarming stage, steps like angioplasty, bypass surgery or insertion of stent might be the option. For some cases, the treatment might be slow and gradual but if the case is serious, then immediate action or surgery might be required.
The most common complication of angina is the chances of heart attack and chances of this are high. Also, if the stable angina is ignored, then its chances of becoming unstable angina also increases. Other complications of angina pectoris are as similar to the symptoms like shortness of breath, sweating, fainting, nausea and vomiting etc.
Often, people believe that mental stress has nothing to do with angina. This is not correct as emotional stress can play a big role in this. Some people also believe that this problem can only occur to those people who are middle-aged or old. While it is true those women older than the age of 55 and men older than 45 have more risk of getting it, but this can happen with even young adults. Chances of young adults getting it are less, but it does not mean that it cannot happen with them. Therefore, precautions are necessary and reporting to the doctor in case any symptom appears is even more important.
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