What is angina pectoris?
When there is not enough blood supply to the heart muscle, a pain or discomfort is felt in the chest, this is angina pectoris. The heart muscle needs oxygen, therefore this lack of the substance produces serious health problems. Angina pectoris manifests itself as a pressure or pain that squeezes the chest, sometimes similar to indigestion. But there may also be pain in other areas of the body:
- Arms
- Neck
- Jaw
- Back
The onset of angina pectoris is a symptom of coronary artery disease, one of the most common cardiovascular diseases. There are three different types of angina pectoris.
- Stable angina: appears when the heart muscle works harder than normal. This type of angina has a regular pattern and is treated with rest and medication.
- Unstable angina: this type of angina can be considered a sign that in a short time the person could suffer a heart attack. It is the most dangerous of all because it does not follow a definite pattern and can occur without any physical exertion.
- Variable angina: this is the least frequent angina. It appears when the patient is resting.
Between 2% and 5% of patients die in the first month, while 5-15% end up having a myocardial infarction.
Prognosis of the disease (if severe, no, etc.)
Before starting to talk about the prognosis of angina pectoris, we must differentiate between those corresponding to stable angina and unstable angina.
The prognosis of stable angina pectoris will depend on the functioning of the ventricles (the lower chambers of the heart) and also depends on the extent of the lesions caused by lack of blood supply. Some risk factors may include:
- Coronary anatomy
- Severity of ischemia
- Poor left ventricular function
- Presence of arrhythmias
As for unstable angina, this is based on the inability to prevent its progression. Between 2% and 5% of patients die in the first month, while 5-15% end up suffering a myocardial infarction. With all these circumstances, the patient should have continuous check-ups from the time of admission to the emergency room.
Symptoms of angina pectoris
The symptoms of angina pectoris can be listed as follows:
- Chest pain and a feeling of severe and suffocating pressure: It usually occurs on many occasions in the area behind the sternum and sometimes extends to the left arm or right arm.
- On the other hand, chest pain can last between 2 and 15 minutes. While at other times you may experience a feeling of heaviness or tightness in the chest area that does not become a great pain.
- Feeling of anxiety or death in brief moments.
- Profuse sweating hyperhidrosis
- Paleness
- Medical tests for angina pectoris
Your health care provider may perform several tests to diagnose angina pectoris. The first of these is an electrocardiogram (ECG), a non-imaging stress test, or a blood test that can help in making an accurate and correct diagnosis. To complete this procedure, the following tests may be performed:
- A chest X-ray
- Chest CT scan
- Coronary CT angiography
- Cardiac MRI
- Coronary angiography
- Echocardiogram
- An imaging stress test
What are the causes of angina pectoris?
Angina pectoris is preceded by a situation of physical or emotional excitement, sometimes it can occur after a large meal or driving a car during peak traffic hours. Another cause is the performance of physical exercise at low temperatures, in this case there are patients who experience a feeling of relief when moving from a cold to a hot area. In the case where the arteries of the heart are affected and cannot regulate themselves to the blood demand needed by the heart muscle, the nerves of the heart transmit messages in the form of pain, as an urgent warning, to the brain. The pain usually does not last more than 20 minutes, since the brain gets confused and feels that the nerve messages are coming from the arms, neck or jaw. However, there are other risk factors that can be controlled and can also contribute to the formation of atherosclerosis plaques:
- Smoking
- Obesity
- Diabetes
- Hypertension
- Increased cholesterol
Can it be prevented?
It is important to remember that angina pectoris occurs when a coronary obstruction originates, which in most cases is due to a genetic antecedent on which the patient cannot act. However, as mentioned above, there are risk factors that condition the onset of the disease. If the patient acts against these risk factors, the disease could progress more slowly and the symptoms would be reduced. These are the changes that a patient can change if he wants to reduce the probability of suffering angina pectoris:
- Quit smoking
- Doing moderate-intensity sports on a regular basis
- Maintain adequate blood pressure, cholesterol and glucose levels.
- Avoiding obesity and following a healthy diet with a healthy lifestyle.
Treatments for angina pectoris
Among all the existing treatments to treat angina pectoris, these are the most effective and useful according to professionals.
- Nitroglycerin: consists of dilating the coronary arteries and with this the pain is usually reduced in just a few minutes. The treatment is to place a pill under the tongue or use a spray. Side effects may include headache.
- Calcium antagonists or calcium channel blockers: the mission of this treatment is to prevent calcium from entering the heart cells. By doing this, the tendency of the coronary arteries to narrow decreases, and the heart will therefore make less effort and require less oxygen.
- Beta-blockers: this treatment blocks the effect that adrenaline produces in the organism, that is to say, it will reduce its effect on the heart. With this, the heart muscle will have a slower and less powerful beat, consequently it will need less oxygen and blood pressure will be reduced.
- Surgery: In cases in which unstable angina or stable angina resists the effect of medication, the coronary vessel blockage can be corrected, either by performing a by-pass or by coronary angioplasty.
Which specialist treats it?
The cardiologist is the specialist in charge of treating this type of pathology. Before diagnosing angina pectoris, the professional may ask some questions such as these:
- When did you begin to feel the symptoms?
- Is it pain? discomfort? do you feel pressure? pressure in any area? is it strong? do you notice a pinch?
- Where do you feel the pain? Does it appear in a specific spot or is it general?
- Does the pain extend to the neck and extremities? How and when did the pain begin? Was there a specific situation that caused the pain? Does it begin progressively and increase, or does it begin suddenly?
How long does it last?
- What makes it worse? Physical exercise? The way you breathe? Body movements?
- What makes it less severe? Does rest help? Deep breathing? Sitting?
- Do you have other symptoms along with the pain, such as nausea or dizziness?
- Do you have difficulty swallowing?
- Do you often have heartburn (heartburn may resemble the feeling of angina)?