Angina pectoris is the clinical manifestation of chest pain or tightness. The cause is the deficit of blood supply in the coronary arteries, in most cases caused by cholesterol plaque. Medical advances in cardiology make it possible to detect such obstructions, and even to clear them. However, if the obstruction is very serious, surgery or coronary bypass surgery will be necessary.
Causes of chest pain
The pain of angina pectoris usually occurs at times of exertion or stress. It is caused by a lack of blood supply, which provides the oxygen and nutrients necessary for the heart to contract effectively. Basically, the heart is a muscular engine whose functioning depends on the supply of its fuel, which arrives through the “pipes” (coronary arteries). Therefore, any narrowing, generated in most cases by a cholesterol plaque in the wall of the coronary arteries, can reduce the flow to the heart muscle. At that moment the patient notices a tightness or pain in the chest, which is what defines angina.
Symptoms and diagnosis of angina pectoris pain
A patient with angina pectoris will generally present with chest pain or tightness, most often in the center or left side, but which may extend to the neck, arms, even the back or jaw.
Diagnosis is based primarily on the patient’s clinical history. Cardiologists also have tests to diagnose the presence or absence of narrowing or coronary lesions that cause or may cause angina pectoris. The most commonly used is the treadmill stress test where, simultaneously with exercise, we determine the electrocardiographic tracing, blood pressure and clinical behavior of the patient.
More recently we have available a radiological test that can perform an anatomical reconstruction of the coronary arteries by means of CT (Computed Axial Tomography). However, if any of these tests arouse suspicion of coronary obstruction, cardiac catheterization is unavoidable.
Treatment of angina pectoris When is surgery necessary?
Cardiac catheterization is the only way to directly access and visualize the coronary arteries. Currently they are accessed by puncturing a peripheral artery in the arm or groin and advancing very fine catheters to the coronary arteries. With radiological visualization with radio-opaque contrast, we can examine the coronary arteries in real time.
We can also clean the obstructed arteries by inflating balloons that reduce the mass of cholesterol blocking the artery or by placing tubular meshes that contain and compress the coronary obstruction (coronary angioplasty). However, if the coronary obstructions revealed by catheterization are very numerous or extensive, the patient is a better candidate for coronary surgery or coronary bypass.
Healthy lifestyle minimizes angina risk
Both treatment modalities, coronary angioplasty or bypass surgery can be definitive if no new coronary lesions are generated. To achieve this, it is essential to lead a healthy life with physical exercise and control the risk factors that generate cholesterol deposits in our arteries, arterial hypertension, diabetes, smoking and high blood cholesterol levels.