Angina, commonly known as chest pain, is a discomfort or pain that arises when the heart muscle doesn’t receive an adequate blood supply. This pain may not be confined to the chest alone and could manifest as pressure in the chest, jaw, or arm.
Angina typically occurs due to the narrowing of coronary arteries, the blood vessels supplying blood to the heart, caused by atherosclerosis (plaque buildup) or a spasm of these arteries.
Variant angina may be slightly more frequent at night but can occur at any time of the day, typically lasting a few minutes before subsiding.
Angina typically manifests as chest pain or pressure, often radiating to the neck, jaw, or arm. However, some individuals may experience angina as shortness of breath, upper belly pain, indigestion, light-headedness, extreme weakness or fatigue, or a general sense of discomfort.
In the case of women, symptoms of angina might be accompanied by additional indicators beyond chest pain or pressure.
When to Seek Medical Attention: It’s crucial to be aware of your typical angina symptoms to recognize when to seek medical assistance. Don’t hesitate to call 911 if your angina becomes more severe, more frequent, or lasts longer than usual.
Seek immediate medical attention or call your healthcare professional if you experience any of the following:
Prompt action in these situations is essential for appropriate evaluation and intervention.
Chest pain can arise from various causes, ranging from benign to serious. Distinguishing angina from other sources of chest pain can be challenging. When evaluating chest pain, your healthcare professional will conduct a thorough history and physical examination. They will inquire about the characteristics of the chest pain, including its location, accompanying symptoms, timing, duration, and aggravating or alleviating factors.
An electrocardiogram (ECG) may be performed to assess the heart’s rate and rhythm, identifying signs of prior heart attacks or reduced blood flow to the heart muscle, known as ischemia. This test also helps determine the appropriate type of stress test.
If coronary artery disease is suspected, a stress test, either with or without imaging, may be recommended. During a stress test, the heart is challenged to assess whether blood supply to the heart muscle meets the demands of increased activity. This test can reveal signs of reduced blood flow or identify areas of the heart muscle with insufficient blood supply. Some imaging stress tests use ultrasound to capture images of the heart muscle before and after exercise, revealing compromised heart muscle movement indicative of restricted blood flow.
Additional tests, such as coronary calcium scoring and coronary computed tomography, can detect atherosclerosis or narrowing of the coronary arteries. In cases where blood flow assessment is crucial, a stress cardiac MRI might be employed.
If a heart attack is a concern, blood work may be conducted, and immediate referral to the emergency department may be recommended. Early and accurate diagnosis is vital for appropriate intervention and management.
Effectively managing stable angina involves adopting a healthy lifestyle, including staying physically active, abstaining from smoking, and adopting a nutritious diet. Medications are often prescribed to control risk factors and alleviate symptoms. Your healthcare professional will work with you to determine the most suitable combination of medications and treatments.
Cardiac Rehabilitation: Cardiac rehab is a 12-week program that includes supervised exercise, heart-healthy eating guidance, stress management, and smoking cessation counseling. An intensive cardiac rehab option with extended sessions may provide even better outcomes.
Enhanced External Counterpulsation Therapy (EECP): EECP therapy may be recommended if angina persists despite standard treatments. It involves inflatable cuffs placed on the calves, thighs, and buttocks, enhancing blood flow to the heart. EECP may stimulate the formation of small blood vessels, creating a natural bypass around blocked arteries and improving exercise duration while reducing angina.
To prevent angina related to atherosclerosis, it’s crucial to reduce risk factors for coronary artery disease. Medications and lifestyle changes play key roles in this prevention.
Medications to Lower Heart Risk Factors:
Preventing Angina Through Lifestyle Changes:
Combining medications with these lifestyle changes forms a comprehensive approach to preventing angina and reducing the risk of cardiovascular events.