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Angina

Angina is chest pain or discomfort that occurs when your heart isn't getting enough oxygen because of reduced blood flow to the heart. It is common in people over the age of 50. The term derives from the Greek ankhon ("strangling") and the Latin pectus ("chest"), and can therefore be translated as "a strangling feeling in the chest". Angina is a symptom of a condition called myocardial ischemia.  The pain may also occur in your shoulders, arms, neck, jaw, or back. Patients may also complain of indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath. Angina is a symptom of coronary artery disease (CAD) , the most common type of heart disease. Your doctor will also check if you have any conditions that can increase your chance of heart disease. There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle ie there can be severe pain with little or no risk of a heart attack, and a heart attack can occur without pain) Worsening ("crescendo") angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina (usually grouped with similar conditions as the acute coronary syndrome ). As these may herald myocardial infarction (a heart attack), they require urgent medical attention and are generally treated as a presumed heart attack

Angina pectoris is the result of myocardial ischemia caused by an imbalance between myocardial blood supply and oxygen demand. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of arteriosclerosis (see below). This pain is known as angina. It is more likely to occur during exertion (e.g. walking, climbing stairs) when the heart muscle needs more blood and oxygen as it works harder. Angina usually occurs during exertion, severe emotional stress, or after a heavy meal. During these periods, the heart muscle demands more blood oxygen than the narrowed coronary arteries can deliver. Angina is common. It affects about 1 in 50 people and there are estimated to be 1.2 million people with angina in the UK. It is more common in men than women and the likelihood of it occurring increases with age. Angina also can occur in people with valvular heart disease, hypertrophic cardiomyopathy (this is an enlarged heart due to disease) or uncontrolled high blood pressure. Typical angina is uncomfortable pressure, fullness, squeezing or pain in the center of the chest. Many types of chest discomfort aren't related to angina.  Acid reflux (heartburn) and lung infection or inflammation are examples.  

Causes of Angina

The common Causes of Angina :

  • Heart failure
  • Narrowing of the aortic heart valve
  • Anaemia,
  • Abnormal heart rhythms
  • Fast, abnormal heart rhythms,
  • Diseases of the heart muscle.
  • Coronary artery spasm (also called Prinzmetal's angina)

Symptoms of Angina

Some Symptoms of Angina :

  • Shortness of breath
  • Nausea
  • Feeling of moderate to severe indigestion that is persistent
  • Perspiration
  • Sharp, burning or cramping pain
  • Numbness or a loss of feeling in your arms, shoulders or wrists.
  • May also occur in the arms, shoulders, neck, jaw, throat, or back
  • Usually start in the chest behind the breastbone

Treatment of Angina

  • Eliminating or minimizing risk factors of coronary artery disease by treating high blood pressure, lowering high cholesterol levels, quitting smoking, exercise and weight loss if needed.
  • Drug therapy, including beta-blockers, nitrates (such as nitroglycerin), calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors and anti-clotting drugs
  • Rest.
  • Angiography may be performed if symptoms do not improve to help determine if coronary artery bypass surgery or angioplasty is needed
  • Transmyocardial laser revascularization (TMR) is a new technique for relieving severe angina or coronary artery disease in patients unable to have bypass surgery or angioplasty.
  • Lowering LDL cholesterol levels as much as possible using drugs .
  • Hospitalization if the symptoms get worse quickly.

 

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