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).
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
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
Chest Pain: Described as pressure, squeezing, or heaviness.
Radiating Pain: Pain may spread to the shoulders, arms, neck, jaw, or back.
Shortness of Breath: Difficulty breathing due to reduced oxygen supply.
Other Symptoms: Nausea, fatigue, sweating, dizziness.
Management and Treatment
1) Lifestyle Changes
Healthy diet
Regular exercise
Smoking cessation
Stress management
2) Medications
Nitrates: Nitroglycerin to relieve pain.
Beta-blockers: Reduce heart workload.
Calcium Channel Blockers: Improve blood flow.
Statins: Lower cholesterol.
Antiplatelet Agents: Aspirin to prevent blood clots.
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.
