Angina happens when a part of your heart doesn’t get enough oxygen. It can feel like squeezing, pressure, or pain in your chest. Angina itself is not a disease; it’s a sign that something else is wrong with your heart.
In this article, you will learn about the different types of angina. Doctors categorize these types based on when and how often they occur.
We will also talk about the specific symptoms that women might experience when it’s important to see a doctor, how to recognize an emergency, and the various treatments available.
What is Angina Pectoris?
Angina feels like squeezing, tightness, pain, or pressure in the chest. It happens when part of your heart muscle doesn’t get enough oxygen-rich blood.
It is not a disease on its own; it’s a sign that something is wrong. It usually occurs because the coronary arteries, which supply blood to the heart, become small or blocked. This condition is often linked to coronary heart disease (CHD).
By itself, angina is not dangerous, but it can feel like a heart attack and indicates heart disease.
You should seek medical help if angina happens suddenly, doesn’t go away, or doesn’t get better with rest or treatment.
Types
There are some types of angina, each with distinct characteristics:
Stable Angina
This type happens when the heart is functioning harder than normal, such as during exercise. It typically lasts almost five minutes and has a predictable pattern, occurring over months or years. Symptoms are often relieved by rest or medicines.
Unstable Angina
Unlike stable angina, unstable angina does not follow a predictable pattern and typically happens during rest. It is mainly caused by atherosclerosis, where blockages stop blood from going to the heart. The pain lasts more than five minutes and can become bad over time, with rest and medicines often proving ineffective. Unstable angina is a serious condition that can indicate a chance of a heart attack, requiring immediate emergency care.
Microvascular Angina
This type is associated with coronary microvascular disease (MVD), affecting the smallest coronary arteries. Besides chest pain, symptoms include extreme tiredness, low energy, sleep problems, and breath shortness. Microvascular angina seems to be more continuous than stable angina, often lasting longer than 10 minutes and sometimes over 30 minutes.
Variant Angina
It is also known as Prinzmetal angina, this rare type usually develops while the person is at rest, often around early morning or midnight. It occurs due to spasms in the coronary arteries and can be triggered by cold exposure, stress, certain medications, cocaine use, or smoking. Though chronic, variant angina can be managed with medication.
Symptoms
Angina can cause various sensations in the chest, including pressure, squeezing, tightening, heaviness, or an aching or burning feeling, typically starting at the back of the breastbone. The pain always spreads to other areas, such as the jaw, neck, arms, throat, shoulders, back, or even teeth.
Besides chest pain, angina may come with additional symptoms like indigestion, sweating, heartburn, weakness, cramping, nausea, and shortness of breath. The time period of these symptoms varies depending on the kind of angina.
Anyone experiencing severe chest pain should call 911 or seek emergency care immediately.
Treatments for Angina
Treatments for angina focus on reducing pain, preventing symptoms, and lowering the risk of a heart attack. A healthcare provider may suggest lifestyle changes, medication, surgical procedures, or a combination of these approaches.
Lifestyle Changes
Certain lifestyle strategies can significantly help manage angina:
- Stop smoking.
- Maintain a healthy weight.
- Regularly check cholesterol levels.
- Rest when necessary.
- Get regular exercise.
- Learn to handle or reduce stress.
- Eat a diet rich in vegetables, fruits, whole grains, no-fat dairy products, and protein.
Medications
Doctors often recommend nitrates, like nitroglycerin, to stop or decrease the intensity of angina by widening and relaxing the blood vessels. Other medications may include:
- Calcium channel blockers
- Beta-blockers
- Anticoagulants
- Oral antiplatelet medications
- Angiotensin-converting enzyme inhibitors
- Statins (cholesterol-lowering medicines)
Medications to handle hypertension may also help, as they hypotension and cholesterol levels, slow the heartbeat, relax blood vessels, decrease strain on the heart, and stop blood clots from creating.
Alternative Treatments
If medications are not effective, other treatments may include:
- Enhanced External Counterpulsation Therapy: This procedure entails using a device similar to a blood pressure cuff to enhance oxygen delivery to the heart.
- Spinal Cord Stimulators: These devices stop the sensation of pain but do not actively enhance heart health.
- Transmyocardial Laser Therapy: This procedure stimulates the development of new blood vessels or improves blood delivery in the heart.
Surgical Procedures
In several cases, surgery is necessary. A cardiologist might suggest an angioplasty, potentially with stent placement, to open narrowed arteries. Alternatively, coronary artery bypass grafting (CABG) may be suggested. In this procedure, a surgeon uses a healthy vein or artery from another area of the body to restore the narrowed arteries in the heart.
Causes of Angina
Angina is usually caused by coronary artery disease (CAD).
The coronary arteries are responsible for supplying the heart with oxygen-rich blood. When cholesterol builds up on the artery walls, it forms hard plaques, which reduces the wideness of the arteries.
Additional factors, like arterial damage and smoking, elevate the likelihood of plaque accumulation.
When the arteries become narrow, it is difficult for oxygen-rich blood to arrive at the heart. Plaques can also break off and create clots that block the arteries.
Without enough oxygen, the heart muscle cannot function properly, leading to angina.
Risk Factors for Angina
Angina can develop due to various factors, including lifestyle choices and underlying health conditions. Key risk factors include stress, recreational drugs or overuse of alcohol, and smoking. Exposure to particle pollution, such as at work, and low physical activity levels also contribute to the risk.
An unhealthy diet, increasing cholesterol levels, and being overweight or obese increase the likelihood of developing angina. Genetic factors can play a role as well.
Certain health conditions, such as diabetes, heart disease, hypotension, metabolic syndrome, and anemia, are associated with a higher risk of angina. Age is another factor, with males over 45 and females over 55 being more susceptible. Additionally, certain procedures and medical treatments may increase the risk of angina.
Triggers for Angina
Angina occurs when there is a decrease in the oxygen delivery to the heart. For individuals with stable angina, certain factors can trigger an attack. These triggers include stress, physical exertion, and disclosure of low temperatures.
Diagnosis of Angina
A correct diagnosis is crucial as it helps foretell the chance of a heart attack.
To diagnose angina, the doctor will conduct various assessments. They will start with a physical examination and inquire about the symptoms experienced. Additionally, they will discuss any risk factors present and review the individual’s family and personal medical histories.
If angina is suspected, the doctor may recommend several tests to confirm the diagnosis. These tests may include blood tests to check levels of fat, sugar, cholesterol, and protein. An electrocardiogram (EKG) will be performed to record the heart’s electrical activity and detect any oxygen deficiency.
Further evaluations may involve stress testing, which includes physical activity, blood pressure measurements, and monitoring with an EKG. Alternatively, a nuclear stress test may be conducted to identify abnormalities in blood run to the heart during physical exercise.
Additional imaging tests such as a chest X-ray may be ordered to visualize the structures inside the chest. In some cases, coronary angiography may be necessary. This procedure utilizes dye and special X-rays to provide detailed images of the inside of the coronary arteries, aiding in the diagnosis of angina.
Prevention of Angina
Preventing angina involves adopting various strategies to promote heart health and reduce risk factors.
A key aspect of prevention is maintaining a varied and nutritious diet that supports heart health. This includes consuming foods rich in nutrients and avoiding excessive intake of unhealthy fats and sugars.
Another crucial step is to avoid smoking or quitting if already smoking, as smoking significantly increases the risk of developing angina and other cardiovascular diseases.
Regular exercise plays a vital role in preventing angina by improving overall cardiovascular fitness and reducing the likelihood of plaque buildup in the arteries.
Learning and practicing stress management techniques can also help prevent angina, as stress can exacerbate heart-related symptoms.
Additionally, individuals should ensure they receive consistent and effective medication for cardiovascular diseases and other conditions associated with metabolic syndrome. This includes managing high blood cholesterol, hypertension, diabetes, and obesity through appropriate medical interventions and lifestyle modifications.
Summary
Angina, characterized by chest pain, results from reduced oxygen supply to the heart due to factors like coronary artery disease. Diagnosis involves various tests including blood tests and imaging procedures. Lifestyle changes like a healthy diet, exercise, and stress management are crucial in prevention. Risk factors such as smoking, obesity, and high cholesterol levels contribute to angina development. Identifying triggers like physical exertion and stress helps manage angina effectively. Consistent treatment for related conditions like diabetes and high blood pressure is essential for angina prevention.
