Angina is a condition that occurs when the heart receives an inadequate supply of oxygenated blood. This causes the heart to work harder to try to compensate for the lack of oxygenated blood and this in turn may result in pain. The severity of the pain varies from case to case. It should be noted that angina is not a disease, it is a symptom of coronary artery disease.
What Does Angina Feel Like?
The nature and intensity of the pain vary depending on the severity of the condition. Many people describe it as chest pain and others as pressure in the chest cavity. Since people describe the pain in different ways, defining the nature of the pain is difficult. The pain typically begins behind the breastbone, but it may be noticed in other parts of the chest. The pain and discomfort often spread to other parts of the upper body such as the jaw, neck, shoulders, arms, abdomen and back. The low oxygen supply to the heart can also result in shortness of breath, vomiting and nausea, excessive sweating and moderate to severe fatigue.
Types of Angina
Angina comes in different forms including:
- Stable Angina: This is the most common form of the condition. It usually occurs during physical activity and fades away with rest or medication. A patient with this form of angina is often able to predict when the next episode will occur.
- Unstable Angina: This is the most dangerous form of angina. It can occur at any time and predicting it is not possible. The pain is usually severe and lasts for 20 minutes or more. Rest and medication do not relieve the pain. If the blood flow remains restricted, a heart attack can occur. Unstable angina requires emergency treatment.
- Variant Angina or Prinzmetal Angina: This form of angina is not due to coronary heart disease. It occurs when the arteries spasm which causes a reduction in the blood flow. The pain is often very severe and occurs in cycles, often at rest or while sleeping.
What Causes Angina?
The heart muscles need a steady supply of oxygenated blood to survive and function properly. When there is an inadequate supply of oxygen, the heart muscles and cells are overly stressed, resulting in pain. The most common cause of angina is coronary artery disease which is said to manifest when fatty deposits, called plaque, cause narrowing of the arteries supplying blood to the heart. This condition, known as atherosclerosis, results in the blood flow being restricted. In some cases, the plaque may break away in the form of a clot which can cause a sudden and severe restriction in the flow of blood. There are several risk factors associated with the development of angina including:
- A family history of heart disease
- Diabetes
- Increasing age
- High blood pressure
- Tobacco use in the form of smoking, chewing or exposure to secondhand smoke
- Recreational drug use
- High levels of LDL cholesterol
- Inadequate exercise
- Obesity
- Stress
- Certain prescription medications can cause restrictions in the flow of blood to the heart
Also Read: All You Need To Know About Coronary Artery Disease
Diagnosing Angina
The process of diagnosing angina begins with the doctor asking about the symptoms, lifestyle factors (that may contribute to the development of angina) and family medical history. The next stage is conducting various tests to confirm the presence of the condition. The tests may include:
- Electrocardiogram (ECG or EKG): This measures the electrical activity of the heart to find out any irregularities in the heart beat. It can also show if a patient has had a heart attack.
- Chest X-Ray: This will allow the doctor to see the condition of the heart and lungs. This is useful in determining if other conditions may be causing the chest pain.
- Stress Tests: The functioning of the heart is monitored while the patient is undergoing a specified form of physical exercise. This will allow the doctor to evaluate the functioning of the heart while it is working hard.
- Nuclear Stress Test: This is similar to the standard stress test but in this case, a radioactive tracer is injected into the bloodstream. A scanner then shows how the tracer moves through the heart and arteries.
- Echocardiogram: This uses sound waves (like an ultrasound) to create images of the heart as it is pumping and the blood moves through it.
- Cardiac Computed Tomography (CT) or Magnetic Resonance Imaging (MRI): These tests create detailed images of the heart. These assist in both diagnosing and evaluating the severity of any existing heart damage.
- Coronary Angiogram: This is a form of x-ray that is used to create images of the inside of blood vessels so that the flow can be evaluated.
In most cases, a combination of diagnostic tests is used to confirm the existence of angina.
Angina Treatment
The objective of angina treatment is to improve blood flow and reduce stress on the heart. After all the tests and evaluations are done, the doctor will decide on the form of treatment. This may include one or more of the following:
- Anticoagulants to reduce the risk of blood clots
- Medication to control blood pressure
- Medication to control cholesterol levels
- Specific medications for managing angina
- Lifestyle changes to reduce strain on the heart
- Surgical options including coronary artery bypass grafting and coronary angioplasty and stenting
The doctor will provide the patient with complete information on the reasons for a specific course of action and the expected results.
Also Read: 10 Common Myths About Cardiovascular Disease
Angina may cause severe pain that limits movement or it may be mild and fade away without treatment. Whatever be the nature of the pain, it should be investigated without delay. Angina is often a sign of coronary disease and this could become a life-threatening condition. There is no need to panic if you experience pain that may be angina. Once the condition is diagnosed, it can be treated and managed, and patients can get back to leading active and full lives. The importance of obtaining a quick and accurate diagnosis to confirm the presence of angina cannot be overstated. It is essential that the diagnosis be done at a reputed multispecialty hospital where there are highly qualified and experienced cardiologists, the best and latest diagnostic facilities and a cardiology department where the best treatment and care are available. The advantage of a multispecialty hospital is that a range of other medical specializations is also available at the same place to treat any other issues that may be contributing to angina.
With the correct treatment and care, angina patients can live full and active lives.
Frequently Asked Questions
1. What is angina, and what causes it?
Angina is chest pain caused by inadequate oxygenated blood flow to the heart. It is usually a symptom of coronary artery disease.
2. What are the types of angina?
Angina is categorized as:
Stable angina: Occurs during activity and subsides with rest.
Unstable angina: Severe and unpredictable; needs emergency care.
Variant angina: Caused by artery spasms, often at rest.
4. How does angina feel?
Angina typically causes chest pain or pressure, often spreading to the jaw, neck, shoulders, arms, or back. It can also lead to nausea, sweating, and shortness of breath.
5. How is angina diagnosed?
Doctors use tests like ECG, stress tests, chest X-rays, or coronary angiograms to confirm angina and assess its severity.
6. What is the treatment for angina?
Treatment includes medications for blood pressure, cholesterol, and blood thinning, lifestyle changes, or surgeries like angioplasty or bypass surgery.
7. When should I see a doctor for angina?
Seek immediate medical help if you experience severe or persistent chest pain, as it could indicate a heart attack.