What is Angina Pectoris?
Angina pectoris or angina, also known as ischemic chest pain, is a type of chest pain or chest discomfort that occurs as a result of decreased blood flow to the heart. Angina pectoris is usually a sign of an underlying heart condition and is often triggered by emotional stress or physical activity. It is most commonly manifested by sensations of squeezing, tightness, heaviness, pressure, or pain in your chest.
Causes of Angina Pectoris
Blood carries oxygen from the lungs and delivers it to all the cells in the body. A shortage of blood supply to the heart means that your heart muscle is not getting adequate oxygen. This occurs when the heart’s arteries are constricted due to formation of plaques (deposits of cholesterol, fat, calcium, and other substances in the blood) that prevent sufficient blood flow to the heart. Some of the lesser known causes of angina pectoris include:
- Aortic stenosis (narrowing of the aortic valve in the heart)
- Pericarditis (swelling of the sac around the heart)
- Pulmonary embolism (blockage in the primary artery of the lungs)
- Hypertrophic cardiomyopathy (a thickened or enlarged heart)
- Rupture in the wall of the aorta (the largest artery in the body that transports blood away from the heart to the rest of the body)
Symptoms of Angina Pectoris
Angina pectoris may be stable or unstable in character. Stable angina is of a predictable pattern that lasts for 5 minutes or less and is relieved by rest. Unstable angina is much more serious in character in that it is unexpected, more severe, lasts longer, and occurs even at rest.
In general, symptoms of angina pectoris include:
- Shortness of breath
- Chest discomfort or pain
- Pain radiating to arms, neck, jaw, back, or shoulder
Risk Factors for Angina Pectoris
Some of the risk factors of angina pectoris include:
- High blood pressure
- High cholesterol
- Heavy meals
- Consuming too much alcohol
- Extreme heat or cold
- Advanced age
- Lack of physical exercise
Diagnosis of Angina Pectoris
In order to diagnose angina pectoris, your doctor will review your medical and family history, signs, symptoms, and conduct a thorough physical examination. To further confirm the diagnosis, your doctor may order diagnostic tests and procedures, such as:
- ECG or EKG to measure your heart’s rhythm and electrical activity
- Blood tests to check for heart enzymes that may have leaked into your blood from the damaged heart muscle
- Stress test to check the working condition of your heart while you exercise
- Imaging tests, such as chest X-rays, CT and MRI scans to create detailed images of your heart to detect specific problems causing your chest pain
- Coronary angiography, in which a dye is injected into the blood vessels of your heart to create detailed images of your blood vessels
- Cardiac catheterization, in which a thin, long tube is passed into an artery in your leg and guides it up to your heart to check for blood flow and pressure
Treatment for Angina Pectoris
The treatment for angina pectoris depends upon the severity of the condition. Mild cases of angina can be addressed by medications and lifestyle changes, whereas serious cases may require surgery.
- Calcium channel blockers or nitrates to ease and widen blood vessels to enable more blood flow to the heart
- Antiplatelet medications or blood thinners to avert blood clots
- Statins to reduce cholesterol levels and stabilize plaques
- Beta-blockers to slow down heart rate as well as the force of heart muscle contractions
- Certain lifestyle changes that can address episodes of angina pectoris, include:
- Consuming a heart-healthy diet, such as fruits and vegetables, lean meat, fish, and whole grains
- Regular exercise
- Practicing stress management measures, such as meditation, yoga, and deep breathing
- Smoking cessation
- Regular visits to your doctor to check your heart health
- Keeping a healthy weight
- Angioplasty: This is a minimally invasive surgical procedure in which a small balloon is passed through an artery up to your heart. The balloon is inflated to open up the artery and a stent is permanently placed to keep the artery passageway open.
- Coronary artery bypass graft (CABG) or bypass surgery: This is a surgery performed to re-establish adequate blood flow to deliver nutrients and oxygen to the heart muscle by surgically repairing blocked arteries to prevent chest pain. It is mostly performed on people with coronary heart disease.