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Angina

Introduction

  • Angina, or angina pectoris, is chest pain or discomfort that occurs when the heart muscle doesn't get enough oxygen-rich blood.

  • It is a symptom of underlying coronary artery disease (CAD).

Picture representation of angina
Picture representation of angina

Types

1. Stable Angina:

  • Occurrence: Predictably with physical exertion or emotional stress.

  • Relief: Rest or nitroglycerin.

2. Unstable Angina:

  • Occurrence: Unpredictably, may occur at rest.

  • Severity: More severe and prolonged; indicates a higher risk of heart attack.

3. Variant (Prinzmetal's) Angina:

  • Cause: Spasm in the coronary arteries.

  • Occurrence: Often at rest, usually at night or early morning.

Etiology

  • Atherosclerosis: Plaque buildup in coronary arteries.

  • Coronary Artery Spasm: Temporary tightening of the muscles within the artery walls.

Pathogenesis of Angina

Mechanism of Angina
Mechanism of Angina

1. Reduced Blood Flow:

  • Narrowing of coronary arteries due to atherosclerosis limits blood flow to heart muscle.

2. Oxygen Demand:

  • When oxygen demand exceeds supply during exertion or stress, it causes chest pain (angina).

Signs and Symptoms

  1. Chest Pain: Described as pressure, squeezing, or heaviness.

  2. Radiating Pain: Pain may spread to the shoulders, arms, neck, jaw, or back.

  3. Shortness of Breath: Difficulty breathing due to reduced oxygen supply.

  4. Other Symptoms: Nausea, fatigue, sweating, dizziness.

Management and Treatment

1. Lifestyle Changes:

  • Healthy diet

  • Regular exercise

  • Smoking cessation

  • Stress management

2. Medications:

  1. Nitrates: Nitroglycerin to relieve pain.

  2. Beta-blockers: Reduce heart workload.

  3. Calcium Channel Blockers: Improve blood flow.

  4. Statins: Lower cholesterol.

  5. Antiplatelet Agents: Aspirin to prevent blood clots.

  6. ACE Inhibitors: Lower blood pressure and reduce heart strain.

3. Medical Procedures:

  • Angioplasty and Stenting: Open narrowed arteries.

  • Coronary Artery Bypass Grafting (CABG): Create new paths for blood flow around blocked arteries.


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