Angina
Pectoris
What is Angina
• Angina is chest pain or discomfort that occurs if an area of
your heart muscle does not get enough oxygen-rich blood.It is
a common symptom of coronary heart disease, which limits or
cuts off blood flow to the heart.
• Angina is typically the result of obstruction or spasm of the
arteries that supply blood to the heart muscle.Blood carries
oxygen, which the heart muscle needs to survive. When the
heart muscle isn't getting enough oxygen, it causes a
condition called ischemia.
• The main mechanism of coronary artery obstruction is
atherosclerosis as part of coronary artery diseaseOther causes
of angina include abnormal heart rhythms, heart failure and,
Type of Angina
There are many types of angina. The most prominent ones
are:
1. Stable Angina
Also known as 'effort angina', this refers to the classic type
of angina related to myocardial ischemia.
It usually happens during activity (exertion) and goes away
with rest or angina medication. For example, pain that
comes on when you're walking uphill or in the cold weather
maybe angina.
Stable angina pain is predictable and usually similar to
previous episodes of chest pain. The chest pain typically
lasts a short time, perhaps five minutes or less.
2. Unstable Angina
Unstable angina is unpredictable and occurs at rest. Or the
angina pain is worsening and occurs with less physical effort. It's
typically severe and lasts longer than stable angina, maybe 20
minutes or longer.
The pain doesn't go away with rest or the usual angina
medications. If the blood flow doesn't improve, the heart is
starved of oxygen and a heart attack occurs. Unstable angina is
dangerous and requires emergency treatment.
3. Variant Angina / Prinzmetal Angina
Variant angina, also called Prinzmetal angina, isn't due to
coronary artery disease. It's caused by a spasm in the heart's
arteries that temporarily reduces blood flow.
Severe chest pain is the main symptom of variant angina. It most
often occurs in cycles, typically at rest and overnight. The pain
4. Microvascular Angina
Previously known as cardiac syndrome X, is angina with signs
associated with decreased blood flow to heart tissue but with
normal coronary arteries.
The primary cause of microvascular angina is unknown, but
factors apparently involved are endothelial dysfunction and
reduced flow (perhaps due to spasm) in the tiny "resistance"
blood vessels of the heart
Since microvascular angina is not characterized by major
arterial blockages, it is harder to recognize and
diagnose.Microvascular angina was previously considered a
rather benign condition, but more recent data has changed
this attitude.
Studies, including the Women's Ischemia Syndrome Evaluation
(WISE), suggest that microvascular angina is part of the
What cause Angina
Risk Factor
The following things may increase the risk of angina:
• Increasing age. Angina is most common in adults age 60 and
older.
• Family history of heart disease. Tell your health care
provider if your mother, father or any siblings have or had heart
disease or a heart attack.
• Tobacco use. Smoking, chewing tobacco and long-term
exposure to secondhand smoke can damage the lining of the
arteries, allowing deposits of cholesterol to collect and block blood
flow.
• Diabetes. Diabetes increases the risk of coronary artery disease,
which leads to angina and heart attacks by speeding up
atherosclerosis and increasing cholesterol levels.
• High cholesterol or triglycerides. Too much bad cholesterol
— low-density lipoprotein (LDL) — in the blood can cause arteries to
narrow. A high LDL increases the risk of angina and heart attacks. A
high level of triglycerides in the blood also is unhealthy.
• Not enough exercise. An inactive lifestyle contributes to high
cholesterol, high blood pressure, type 2 diabetes and obesity. Talk to
your health care provider about the type and amount of exercise
that's best for you.
• Obesity. Obesity is a risk factor for heart disease, which can
cause angina. Being overweight makes the heart work harder to
supply blood to the body.
• Emotional stress. Too much stress and anger can raise blood
pressure. Surges of hormones produced during stress can narrow
the arteries and worsen angina.
• Medications. Drugs that tighten blood vessels, such as
some migraine drugs, may trigger Prinzmetal's angina.
• Cold temperatures. Exposure to cold temperatures can
trigger Prinzmetal angina
• Drug misuse. Cocaine and other stimulants can cause
blood vessel spasms and trigger angina.
• High blood pressure. Over time, high blood pressure
damages arteries by accelerating hardening of the arteries.
• Other health conditions. Chronic kidney disease,
peripheral artery disease, metabolic syndrome or a history
of stroke increases the risk of angina.
Sign and Symptoms
These are the most common symptoms of angina:
• A pressing, squeezing, or crushing pain, usually in the chest
under your breastbone
• Pain may also occur in your upper back, both arms, neck, or
ear lobes
• Pain radiating in your arms, shoulders, jaw, neck, or back
• Shortness of breath
• Weakness and fatigue
• Feeling faint and sweating
• Nausea and vomitting
• Symptoms of angina can be different for women and men.
Instead of chest pain, or in addition to it, women may feel pain
in the neck, jaw, throat, abdomen, or back.
• Sometimes this pain is not recognized as a symptom of a heart
condition. As a result, treatment for women can be delayed.
• It can be difficult to tell the difference between symptoms of
angina and of heart attack. Call 999 if you feel chest
discomfort that does not go away with rest or medicine.
• Angina can also lead to a heart attack and other complications
that can be life-threatening.
• The symptoms of angina pectoris may look like other medical
conditions or problems. Always see your healthcare provider
for a diagnosis.
Diagnosis
Complication of Angina
1. Heart attack
• Most cases of angina are caused by fatty deposits (plaques) building up on the
inside walls of the blood vessels leading to the heart.There's a small chance one
of the plaques will break away, causing a blood clot to form. The blood clot can
then block the supply of oxygen-rich blood to the muscles of the heart, causing
extensive damage to the heart muscles and triggering a heart attack.
2. Stroke
• If you have fatty plaques clogging up the arteries to your heart, you may also
have plaques clogging up the main blood vessel that supplies your brain with
blood (the carotid artery).If one of the plaques ruptures, it could cause a blood
clot to develop, blocking the supply of blood to your brain and triggering a stroke.
3. Stress, anxiety and depression
• Living with a condition such as angina can cause feelings of stress andanxiety in
some people, which can lead to symptoms of depression.
Treatment for Angina
• The goals of angina treatment are to reduce the
frequency and severity of the symptoms and to
lower the risk of a heart attack and death.
• Options for angina treatment include:
Lifestyle changes
Medications
Medical procedure/surgery
The End
&
Thank
You
