What is Angina?
Angina is a manakin of chest annoyance or discomfort , as a result of reduced roue supply to heart muscles . This reduced blood supplying results in reduced O supply to bosom muscle and as a result deficient waste remotion from heart brawn precede to chest pain or irritation . The most common reasonableness for this is some class of obstruction of coronary arterial blood vessel due to medical status like atherosclerosis , which cramp blood supplying to heart muscle lead in ischemia .
Angina is more often than not presented as uncomfortableness , parsimony , heaviness adept rather than total pain . Angina occurring at sleep and decline in quality is suggestive of an MI ( substance attack ) and ask instant medical care and if left untreated causes dying . Angina generally happen with elbow grease , extreme tenseness , after heavy meal , in cold temperatures when heart muscle expect more O and the block coronary arterial blood vessel are not able to do it . Anginal pain generally cease in 15 minute and is allay up by resting or by place a Nitro lozenge under knife , which helps in relaxing blood vas and reduces blood pressure with accompanying less demand for oxygen by nerve muscles .
Pathophysiology of Angina
Angina develop due to myocardial ischemia and this materialise when the coronary ancestry period becomes inadequate to meet the oxygen demand of the substance sinew . In other parole , angina occurs as a solution of imbalance between the warmheartedness ’s need and supply of oxygen . This unbalance result from an growth in need ( e.g. during physical effort , exercise etc ) without a relative step-up in supply of oxygen due to obstruction or atherosclerosis of the coronary arterial blood vessel .
Classification and Types of Angina
Causes and Risk Factors of Angina
The main cause of angina by far is coronary artery disease . Coronary arterial blood vessel are creditworthy for supplying oxygenize blood to heart muscle . Disease of these arteries lead to development of cholesterin deposits know as cholesterin plaques in arterial blood vessel wall . Accumulation of these inure cholesterol plaques leads to narrowing of coronary arteries . This condition is cognise as arteriosclerosis . If narrowing continues to increase more than 50 % , the coronary arteries will not be able-bodied to issue tolerable oxygenated origin to heart muscles and will not be able to meet increase oxygen requirement during physical activities such as exercising or at times of stress . This deficiency of oxygenated blood provision to heart muscles stimulate angina orchest pain . hardening of the arteries is exacerbated by smoke , gamy blood line pressure , rarified cholesterol , and diabetes .
One of the less common reason of angina is coronary arterial blood vessel spasms . The wall of arteries contain muscle fibre and contractions of these muscle fiber leads to spasm or constriction of arteries ensue in diminish blood supply and as a resultant role angina . Angina due to vasospasm is termed as Variant Angina or Prinzmetal ’s angina pectoris . These spasms can take place in normal arteries as well as those arteries move by coronary-artery disease . Coronary arterial blood vessel spasm can also occur due to usage of certain drug such as cocaine .
There are some cause of breast pain , which are not due to deficiency of atomic number 8 to pump muscle but due to other medical conditions and should be differentiated from angina pectoris . These are :
Risk Factors of Angina
Signs and Symptoms of Angina
Angina presents itself more as a chest discomfort , rather than frank pain , which is line as press , heaviness , parsimoniousness , squeezing , burning , or choking sensation . This irritation is unremarkably retrosternal in locating and refer to back , neck opening surface area , jaw , and shoulders . Angina is unremarkably precipitate by physical exertion , emotional stress and is relieved with rest and/or medicinal drug . Sometimes along with angina , the patient may also experience symptom like indigestion , pyrosis , weakness , hidrosis , sickness , cramping , shortness of breath , and pallor . A variant shape of angina pectoris is Prinzmetal ’s angina , which hap in patients with normal coronary arteries . It is think to be get by arterial spasms .
Tests to Diagnose Angina
Tests like CT scan calcium scoring are very dependable in discover minuscule amount of calcium in the brass of coronary arteries . In the absence seizure of atherosclerotic coronary artery disease CT scan come up negative . Ultrafast CT scanning is useful in evaluating breast pain in younger patients ( serviceman under 40 and cleaning lady under 50 year old ) . Other tests like utilisation treadmill run , magnetic resonance imaging ( MRI ) , electrocardiogram ( ECG , EKG ) , coronary angiogram , focus echocardiography , emphasis atomic number 81 , cardiac catheterisation , Tl scintigram or sestamibi scintigram etc . are also done to diagnose angina .
Treatment for Angina
The independent aim of treatment is succour of symptom , slowing the advance of disease and minify future anginous instalment andheart blast . intervention for angina pectoris admit residue , medication like nitroglycerin which is put under the patient ’s knife . Nitroglycerin is a virile vasodilator , which helps in dilatation of the arteries thereby increasing the oxygen supply to heart muscles and exempt angina pectoris .
If patient role go along to have angina despite necessitate medication then count on the rigourousness and fix of angina and coronary artery disease , surgical procedures like balloon angioplasty ( percutaneous transluminal coronary angioplasty or PTCA with or without stents ) or coronary arterial blood vessel electrical shunt graft surgery ( CABG ) to increase coronary artery blood flow can be done .
Identifying and treating endangerment factors is also important in handling and bar of angina pectoris . Patients involve to get prove for exalted cholesterin and other fat in the blood , diabetes and hypertension ( high blood pressure sensation ) regularly . Other than this , they should be encouraged to block smoke , follow a sizeable diet and work out government and keep their weighting under control .
