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Angina
Medical Questions » Angina
| Name: Angina |
| Also known as: Angina Pectoris; Ischaemic Heart Disease |
| Pain caused by an inadequate blood supply (ischaemia) to part of the heart muscle. |
Causes of Angina
Due to a narrowing of one or more of the three small arteries that supply blood to the heart muscle. This narrowing may be due to hardening of the arteries, or a spasm of the artery caused by another disease, smoking, excitement, heavy meals or stress. Angina may lead to a heart attack, or a heart attack may cause angina, but they are two different problems. In a heart attack, part of the heart muscle dies. |
Symptoms of Angina
A pressure-like, squeezing pain or tightness in the chest, usually central, that starts suddenly, often during exercise, and settles with rest, but may occur at almost any time and may extend into the left arm, neck, upper abdomen and back. It is uncommon during sleep. |
Tests for Angina
Diagnosis may be difficult as the pain has usually subsided when the patient sees a doctor, and all blood tests and electrocardiographs (ECG) may be normal. Sometimes a stress ECG must be performed under strict medical supervision to recreate the pain and observe the abnormal ECG pattern. Coronary angiography is a type of X-ray that can detect narrowed arteries around the heart. A more sophisticated test involves injecting radioisotopes into the bloodstream, and measuring their uptake by the heart muscle. |
Treatment for Angina
Prevention involves tablets or skin patches (eg. nitrates, beta-blockers or calcium channel blockers) that are used regularly to keep the arteries as widely dilated as possible. Smokers must stop smoking. Treatment of an acute attack involves immediately resting, and spraying glycerol trinitrate under the tongue, or placing a tablet containing nitroglycerin, nifedipine or a similar drug under the tongue to dilate the heart arteries and relieve the attack. If a narrowed artery can be found it can be bypassed by a coronary artery bypass graft (CABG) operation. Balloon angiography is a technique that involves passing a tiny deflated balloon through the arteries in the leg or arm, into the heart, and then into the small narrowed arteries around the heart, then inflating it to enlarge the narrowed artery. Sometimes a stent (tube shaped metal grid) is left behind to ensure that the artery does not close down again.
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Complications of Angina of its treatment
About 5% of all patients with angina will have a heart attack each year, and half of these will die from that heart attack. Heart failure can gradually affect those remaining, reducing their mobility and eventually leading to premature death. High blood pressure, diabetes and an irregular heart beat are unfavorable findings and will also lead to an early death. |
Likely Outcome of Angina
Most people with angina can have their symptoms prevented and relieved by medication. Many patients with narrowed arteries can be successfully treated by surgery. |
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