Everything you should know about "Angina Pectoris".

Everything you should know about "Angina Pectoris".

  • Angina pectoris or Angina is a clinical condition characterized by acute severe chest pain (substernal: below sternum) which is referred at left shoulder usually associated with breathlessness, profuse sweating, and nausea.
  • Its body's alarm telling you that heart is not working properly.
  • However, most of the times epigastric pains are mistaken as angina by many patients which may be caused due to hyperacidity: heartburn they call it.
  • Chest pains lasting few seconds are not usually Angina.
  • The condition is found mentioned in "Sushrut Samhita" of Indian medicine System "Ayurveda" and was termed as "Hridayshoola" (Severe Heart Pain).

Signs & Symptoms of Angina:

  • Well, "Angina" is itself a symptom and remember it's not a disease, in fact, its just a clinical condition by which your body is telling that there is a problem with the functioning of the heart.
  • Following things may signal you about angina.
  1. Pain in center of the chest.
  2. Fullness or feeling of pressure in the chest.
  3. Feeling of heaviness in chest.
  4. Pain may be referred at left shoulder and hand as shown in above image.
  5. Breathlessness.
  6. Nausea.
  7. Profuse sweating.
  8. Pale skin.
  9. Anxiety.
  10. Rapid and irregular heartbeats.

Causes of Angina:

  • The basic cause of angina is "Gap between oxygen demand by heart muscle and supply of oxygen they are getting".
  • Because lack of oxygen heart cells undergo necrosis and start dying signaling an acute pain we call it as angina.
  • Various causes which lead to above condition or angina are as follows.
  1. Atherosclerosis.
  2. Coronary artery spasm.
  3. Injury to the coronary artery.
  4. Cocaine and Cigarette smoking.
  5. Emotional stress.
  6. Physical exercise.
  7. Breathing of air with poor oxygen content.
  8. A clot in the coronary artery.
  9. High Blood Pressure.
  10. Diabetes.
  11. Aging.
  12. Family History.
  13. Obesity.
  14. High blood cholesterol levels.
  15. Smoking.
  16. Gender: Male. ( Ladies thanks to "Estrogen" the beauty hormone.)

Types of Angina:

A) Stable Angina:

  • Also called as "Effort Angina" and represent classical angina.
  • Usual causes include physical and mental stress, heavy meals, 
  • Responds well to sublingual GTN (Glyceryl Tri Nitrate).

B) Unstable Angina.

  • Its a form of "Acute Coronary Syndrome" and is defined as angina that changes or worsens.
  • It occurs at rest (minimal exertion) and usually lasts for more than 10 minutes.
  • It is usually severe and occurs with crescendo pattern i.e. increasing duration.
  • The usual cause is chronic atherosclerosis and platelet aggregation.
  • A study has shown that 64% cases occur during 22.00 to 8.00 when patients are at rest. 

C) Cardiac Syndrome X:

  • Also called as "microvascular angina" and is difficult to diagnose, characterized by typical angina chest pain.
  • The primary cause is unknown, factors involved are endothelial dysfunction and reduced blood flow due to spasm causing ischemic cardiac conditions.

Treatment for Angina:

  1. Vasodilators and other Antianginal Drugs.
  2. Lifestyle improvement.
  3. Cessation of smoking and drinking.
  4. Gentle and sustained exercise is the best thing for the anginal patient, however, intense physical workout must be avoided.
  5. Identification and treatment of precipitating factors like atherosclerosis, hypertension etc.
  6. Surgical procedures like "balloon angioplasty" and "coronary bypass surgery."



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