by The Welthi Bureau 18th March, 2019
Angina is experienced as pain in the centre of the chest, just beneath the breastbone. This pain can be felt under the jaw or on the left shoulder in some people. This usually occurs after exertion, like walking a few hundred meters, swimming, cycling, etc. A few people experience it as heaviness in the chest - like something heavy is on the chest. Some people only feel short of breath, with a lot of sweating. There are lots of reasons you get pain in the chest. It can be as simple as acidity, in which case the pain subsides within a few minutes of taking an antacid, and sometimes this pain may signify something more dangerous than indigestion. Angina is the chest pain that is caused due to reduced blood flow to the muscles of the heart. This pain mimics that of acidity/gastroesophageal reflux disease; therefore, tends to be ignored. Angina could be a warning sign of an underlying Cardiovascular Disease.
The discomfort/chest pain that occurs in Angina is due to diminished oxygen supply to the heart, which subsequently affects the strength of the heart muscles. There is reduced blood supply which leads to pain. Classically, patients complain of tightness or a constricting band around the chest. This pain may also be referred to the shoulder, arms, and sometimes the jaw. Pain is usually triggered by stress/exertion, and subsides within a few minutes of rest. Other symptoms of angina attack are a general feeling of sickness/nausea, breathlessness, pain in belly region, and a sudden feeling of tiredness.
This blockage of blood vessels and resultant reduction in blood and oxygen supply to the heart may be caused by Coronary Artery Disease (CAD). In CAD, the gradual build-up of plaque (fatty material) results in narrowing of the artery. Blockage of the coronary artery is more common in men than in women. Sometimes blockage may occur in the small arteries that branch out from the coronary arteries, and this condition, known as Microvascular disease (MVD), tends to affect young people.
The main variants of Angina are as follows:
Stable Angina - refers to chest pain that may occur during physical activity like walking for a few hundred meters, which subsides after taking rest.
Unstable Angina - that occurs suddenly and worsens over time. Unstable Angina may also occur at rest or during sleep, sometimes without any previous trigger or cause.
Prinzmetal Angina or Coronary Artery Spasm is a temporary discomfort or pain that occurs due to constriction of one or more coronary arteries, which may intermittently block blood supply to the heart muscles. The sudden spasms may vary in intensity, minor to severe, and in extreme cases may completely block blood supply to the heart, resulting in sudden death.
As previously mentioned, in Microvascular Angina (also called Cardiac Syndrome X), coronary arteries appear normal on investigation. Therefore, it is important to consider blockages in the tributaries/branches, which may go unnoticed and cause symptoms or even death of the individual.
The line of treatment in cases of Angina is as follows:
• Be aware of the different presentations of the condition.Diagnosis can be made after doing ECG, 2D Echocardiography and stress test. Consult your Cardiologist.
• Reach your nearest hospital/ doctor as soon as possible, in case of an attack.
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