CVD - Angina Pectoris

Angina Pectoris

What is angina pectoris?
Angina pectoris (or simply angina) is recurring chest pain or discomfort that happens when some part of the heart does not receive enough blood. 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.

What are the symptoms of angina pectoris?
Angina pectoris occurs when the heart muscle (myocardium) does the adequate amount of blood it needs 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

pain radiating in the arms, shoulders, jaw, neck, and/or back

chest pain usually begins with physical exertion, although, other triggers include emotional stress, extreme cold and heat, heavy meals, excessive alcohol consumption, and cigarette smoking

chest pain associated with angina is usually relieved within a few minutes by resting or by taking prescribed cardiac medication

Angina Vs. Heart Attack

Angina may have similar symptoms as a heart attack, such as:

a crushing, squeezing pain in the chest

a feeling of pressure in the chest

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 a cardiac prescription medication (i.e., nitroglycerin).

Angina pectoris and heart attack risk:
An episode of angina does not indicate that a heart attack is occurring, nor 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 had 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 medications relieves the pain. Call for medical assistance if the angina episode symptoms change sharply.

Diagnosing angina pectoris:
In addition to a complete medical history and medical examination, a physician can often diagnose angina pectoris 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 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.

coronary arteriogram (or angiogram)
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.

Treatment of angina pectoris:
Specific treatment will be determined by the physician(s) based on:

patient’s age, overall health, and medical history
extent of the disease
expectations for the course of the disease
patient’s tolerance for specific medications, procedures, or therapies
patient’s 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, and excess weight.

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 work load of the heart.

Other types of angina pectoris:
There are two other forms of angina pectoris, including:

Variant angina pectoris
(or Prinzmetal's angina):

is rare

occurs almost exclusively when a person is at rest

often does not follow a period of physical exertion or emotional stress

attacks can be very painful and usually occur between midnight and 8 a.m.

Microvascular angina:

a recently-discovered type of angina

patients with this condition experience chest pain but have no apparent coronary artery blockages

physicians have found that the pain results from poor function of tiny blood vessels nourishing the heart as well as the arms and legs

can be treated with some of the same medications used for angina pectoris

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