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.