Angina is a pain or discomfort in the chest that occurs when the heart does not receive enough blood supply. This is due to a partial blockage of the coronary arteries. If the obstruction is extended only a few minutes and then the patient recovers, there is talk of angina.
This condition can be caused when the heart is forced to work harder and the body is unable to increase blood flow to the organ.
Angina is very common. In men it usually occurs after age 30, and women later.
The cause, in most cases, is atherosclerosis. Angina usually is preceded by a physical or emotional arousal; occasionally it can be triggered to make a hearty meal or drive a car during the hours of heavy traffic.
Another cause may be exercising in a cold environment, in which case there are patients who experience almost immediately when going from a cold to a warm relief.
When the arteries of the heart (coronary arteries) are affected and cannot adjust to increased demand for blood, nerves transmit painful heart urgent messages to the brain notice. This pain, usually not exceed 20 minutes, because the brain, confusion, feeling impulses from nearby locations such as the arms, neck or jaw.
On the other hand, there are a number of modifiable risk factors that may favor the formation of atherosclerotic plaques:
The main manifestations of angina are:
Chest pain and feeling of acute and suffocating oppression usually behind the breastbone and sometimes extended to the left arm and sometimes to the right. Chest pain usually lasts 1-2 minutes and 10-15 minutes (sometimes a feeling of heaviness or tightness in the chest that does not become pain is perceived).
- Feeling of anxiety or impending death
- Profuse sweating (hyperhidrosis)
Angina is triggered due to coronary blockage that in many cases a genetic predisposition on which the patient can not influence should be.
However, there are certain other risk factors influencing the onset of the disease. If the patient is involved in these, the disease may progress more slowly and the symptoms reduced.
The changes that must carry the patient are:
- Give up smoking.
- Perform moderate physical activities constantly.
- Maintain adequate numbers of blood pressure, cholesterol and glucose.
- Avoid obesity.
- Follow a healthy diet and maintain a healthy lifestyle.
- Changes your lifestyle can help reduce the symptoms of angina and prevent arteries become blocked.
Considering the circumstances in which angina pain (such as indicating broadly the mechanism that causes it), have proposed different classifications appears. The Spanish Society of Cardiology distinguishes three types of angina:
Angina of effort
Caused by physical activity or other situations involving an increased need for oxygen in the heart. It is brief and disappears when you stop exercising or administration of nitroglycerin. In turn, it is classified as early, if the vehicle is less than one month; progressive, if it has worsened during the last month in frequency, intensity, duration or level of effort that appears; stable, if their characteristics and the patient’s functional capacity have not been modified in the last month.
Angina at rest
It occurs spontaneously, without apparent relation to changes in oxygen consumption in the heart. Its duration is variable and sometimes the episodes are very long and look like a heart attack.
Mixed or unstable angina
One in which coexist effort angina and rest, without a clear predominance of one or the other. Both the initial angina, such as progressive effort and the rest remain unpredictable forms of evolution and prognosis is variable, so also grouped under the name of unstable angina.
Treatment differs considerably from that of stable angina. This always occurs when performing the same level of exercise and duration of crises is similar. Unstable angina may be the warning of an impending heart attack and needs special treatment.
The history of unstable angina is frequent attacks of angina not linked to physical activity. Sometimes it is perceived differently, no fixed pattern, and extends to the upper abdomen, which causes attributed to indigestion.
As the clinical manifestations can be varied, is the doctor, with the help of electrocardiograms and laboratory analysis, who has to make a conclusive diagnosis.
The diagnosis of angina begins with clinical suspicion after suffering pain and concludes with performing certain tests to help rule out other cardiovascular diseases such as an electrocardiogram.
The main tests performed by doctors are:
Stress test: Also called stress test. This test is most often used to determine the diagnosis and information on the prognosis of the disease.
In the test the patient perform physical exercise on a treadmill or a stationary bicycle while the doctor evaluates whether there is pain while doing the activity and what is the electrical response of the subject (if there are changes in the electrocardiogram).
Coronary arteriography: It is done through a catheter and dye is injected. It is the standard method for diagnosing coronary strictures and often performed to correct the narrowness of the arteries (dilation and stent implantation) in cases with poor prognosis.
Among the most effective treatments and recommended are:
Nitroglycerin dilates the coronary arteries and the pain usually returns in minutes. Placing a pill it is taken under the tongue or in spray. You can get a headache as a side effect.
Calcium channel blockers or calcium channel: Seals out calcium in heart cells. This reduces the tendency of the coronary arteries to constrict and the effort made by the heart, so that their needs oxygen also decrease.
Beta-blockers act by blocking many effects of adrenaline in the body, particularly the stimulating effect on the heart. The result is that the heart beats more slowly and with less force, and therefore needs less oxygen. Also lower blood pressure.
Surgery: In case of unstable angina or stable resists treatment with medication angina, you can get correct the blockage of the coronary vessels, either by bypass (bypass) or, in some cases, by coronary angioplasty.