ANGINA: symptoms, treatment, types, risk factors, prevention and treatment.
Angina also called angina pectoris, it is a condition marked by severe pain in the chest, it is the tightness, squeezing or pressure in the chest. It occurs when an area of the heart muscle receives less blood oxygen than usual. Some people with angina symptoms say angina feels like a heavy weight lying on their chest.
Types of angina
There are four basic types of angina; their classifications are based on their triggers
- Stable angina.Stable angina is usually triggered by physical activity. When you climb stairs, exercise or walk, your heart demands more blood, but narrowed arteries slow down blood flow. Besides physical activity, other factors such as emotional stress, cold temperatures, heavy meals and smoking also can narrow arteries and trigger angina.
- Unstable angina.If fatty deposits (plaques) in a blood vessel rupture or a blood clot is formed, it can quickly block or reduce flow through a narrowed artery. This can suddenly and severely decrease blood flow to your heart muscle. Unstable angina worsens and isn’t relieved by rest or your usual medications. If the blood flow doesn’t improve, your heart is starved of oxygen and a heart attack occurs. Unstable angina is dangerous and requires emergency treatment.
- Variant angina. Variant angina is Doctors sometimes call it Prinzmetal angina, and it can develop when the body is at rest, often around midnight or the early morning. It happens when a spasm occurs in the coronary arteries. Possible triggers include exposure to cold, stress, medicines, smoking, or cocaine use. It is a chronic condition, but medication can help manage it.
Angina tends to appear during physical activity, emotional stress or exposure to cold temperatures or after big meals. Symptoms of angina includes:
- Pressure, aching or burning in the middle of the chest.
- Pressure, aching or burning in the neck, jaw, and shoulders (usually the left shoulder) and even down the arm.
- A sense of anxiety or uneasiness.
The pain of angina is not sharp; instead it is a sense of pressure and squeezing. Sometimes it is just an uncomfortable sensation, not really pain. Angina is not affected by the position of your body or by taking a deep breath. Angina attacks lasts only a few minutes. If it was triggered by exertion, it usually subsides within few minutes as you rest. When such pain lasts for more than 10 minutes, it could indicate a heart attack. Call your country emergency number.
What Are The Risk Factors For Angina?
Age and Gender
Angina (pectoris) is more common in men than women before the age of 75. After the age of 75 it is more common in women. The main reason for this difference is that atherosclerosis (the buildup of fatty deposits in the arteries which causes angina) usually occurs earlier in men than it does in women. This is also why heart attacks in women tend to occur later in life than they do in men. When this buildup occurs it is referred to as coronary heart disease (CHD). Angina, which occurs before the age of 50 in women is more likely to be diagnosed as Prinzmetal’s angina.
Family History of Heart Disease
Heart disease in women can run in the family. Researchers are still not sure why this is, whether it is due to some genetic mutation that is passed down from generation to generation or whether it is environmental (for example, mothers who cook fatty foods are likely to pass those cooking habits onto their daughters). If there is a history of early heart disease in your family it may be worth talking to a genetic advisor who can assess your personal risks and offer prevention advice as well as any necessary health screenings.
Menopause symptoms such as weight gain and hot flashes appear at root to be linked to falling levels of estrogen, which occurs when we stop ovulating and periods cease. Micro vascular angina (where the main arteries appear unblocked and free of disease but there may be some dysfunction in the tiny arteries which cannot be easily found by heart disease tests) often appears in or around menopause suggesting it may have something to do with falling levels of estrogen.
People with uncontrolled (not well managed) diabetes are at increased risk of developing CHD, one of the main causes of angina. This is because if diabetes is not managed it can damage the blood vessels and lead to atherosclerosis. People with diabetes are also more likely to have high blood pressure and high cholesterol levels, both of which among others are considered causes of CHD. If you are diabetic, it is important to ensure you manage your condition properly.
High Cholesterol Levels
High levels of ‘bad’ LDL cholesterol in the bloodstream are harmful because excess lipids (fat) can be dumped along the lining of the arteries causing blockages (atherosclerosis). For this reason it is worth having an annual blood test to check your cholesterol levels; if levels are high you may be offered cholesterol drugs to reduce your levels as well as given advice on lifestyle changes. If you also smoke, have high blood pressure or diabetes then high cholesterol levels will multiply your overall risk factors for heart disease and stoke significantly.
High Blood Pressure
Uncontrolled high blood pressure is a significant risk factor for CHD, as well as being one of the main causes of heart failure. As symptoms of high blood pressure (also called hypertension) are not always obvious, it is sometimes called the ‘silent killer’. If blood pressure is high, over the years it can cause damage to the artery walls making it easier for fatty deposits to build up and blood clots to form. Do have your blood pressure checked regularly. If it is high your doctor will recommend treatment and lifestyle changes.
Smoking cigarettes raises the risk of atherosclerosis. Heavy smokers are also more likely to experience artery spasms (Prinzmetal’s angina). Quitting smoking will immediately reduce your risks of all sorts of diseases.
Other Risk Factors
The other risk factors for heart disease also apply to angina. These include:
Obesity in women: Obesity is defined as having a body mass index (BMI) of over 30. Losing weight if you are overweight or obese will reduce your overall risks of angina. It may also help reduce symptoms of angina in those already diagnosed with the condition.
Angina is more likely to be triggered by emotional stress in women than in men. See; is there an online test for stress? as well as the dangers of stress for women. Depression can also have an effect on the heart, causing angina-type pain. Read about the effects of depression.
Lack of Exercise
People who are sedentary (do not exercise much) are twice as likely to die of a heart attack as those who exercise regularly.
Drinking Too Much
Drinking too much alcohol can cause raised cholesterol and blood pressure.
Prevention of angina
Reduce the stress levels – learn ways to handle stress and relax your body.
Monitor and control your other health conditions such as diabetes, high cholesterol levels.
Take your medicines as per prescription.
Avoid angina triggers.
· Maintain A Healthy Weight.
· Reduce Alcohol Consumption.
· Quitting Smoking.
· Healthy And Balanced Diet
Treatments aim to reduce pain, prevent symptoms, and prevent or lower the risk of a heart attack. A doctor may recommend medication, lifestyle changes, a surgical procedure, or a combination.
The application of a few life style changes can help in the reduction of angina attacks, they include;
- Stop smoking
- Managing weight
- Regularly checking cholesterol levels
- Resting when necessary
- Getting regular exercise
- Learning how to handle or avoid stress
- Having a diet that is rich in fruits, vegetables, whole grains, low-fat or no-fat dairy products, and lean sources of protein
Doctors often prescribe nitrates, such as nitroglycerin, for angina. Nitrates prevent or reduce the intensity of angina by relaxing and widening the blood vessels.
Other drug options include:
- Calcium channel blockers
- Angiotensin covering enzyme inhibitors
- Oral antiplatelet medications
- Statins, which are cholesterol-lowering medicines
- Medications to managehigh blood pressure may help manage angina. These aim to lower blood pressure and cholesterol levels, slow the heart rate, relax blood vessels, reduce strain on the heart, and prevent blood clots from forming.
Generally people with controllable angina benefit from drug therapy. Among the most effective drugs are nitrates, beta-blockers and calcium-channel blockers. Just which drug is suitable will vary according to the person’s overall health. The medications work in one of two ways: (1) by increasing blood flow through the arteries or (2) by reducing the amount of blood and oxygen needed by the heart.
If symptoms due to Chronic Heart Disease do not respond to medication, surgery may be necessary.