A Tutorial To Angina
Angina pectoris, or simply angina, is a chronic pain or discomfort in the chest area
. This comes about when some section of the heart does not collect adequate blood. It is one of the typical signs of coronary heart disease (CHD), when vessels that bring blood to the
heart become narrowed and blocked because of to atherosclerosis
Angina frequently seems like a pressing or squeezing pain, felt in the chest under the breast bone, but at times advancing up to the shoulders, arms, neck, jaws, or back.
Angina is commonly brought on by exertion. It happens when the heart's need for oxygen spikes outside of the oxygen available from the blood nourishing the heart. Physical exertion is the most frequent influence for angina. Other stimulates can be psychological fatigue, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.
But the truth is, angina is distinct from a heart attack. Angina pain means that some of the heart muscle in not getting an adequate amount of blood temporarily, such as during exercise, when the heart has to work harder. The pain does NOT mean that the heart muscle is enduring irreparable, long-term damage. Attacks of angina rarely bring about permanent damage to heart muscle. It is normally relieved within a few minutes by resting or by taking prescribed angina medicine.
In comparison, a heart attack occurs when the blood flow to a part of the heart is suddenly and completely cut off. This leads to permanent damage to the heart muscle. Generally, the chest pain is more severe, lasts longer, and does not go away with rest or with medicine that was formerly potent. It may be accompanied by indigestion, nausea, weakness, and sweating. Then again, the signs of a heart attack are wide-ranging and may be substantially milder.
When a person has a repeating but constant pattern of angina, it does not mean that a heart attack is about to happen. Angina implies that there is underpinning coronary heart disease. Patients with angina are at an elevated risk of heart attack in comparison with those who have no signs of cardiovascular disease, but the episode of angina is not a signal that a heart attack is about to take place. On the other hand, when the pattern of angina changes--if episodes become more numerous, last a bit longer, or occur without exercise--the chance of heart attack in pursuing days or weeks is much bigger.
A person who has angina need to uncover the pattern of his or her angina--what causes an angina attack, what it feels like, how long episodes usually last, and whether medication minimizes the attack. If the pattern changes greatly or if the symptoms are those of a heart attack, one should get medical help immediately, perhaps best done by searching for an assessment at a nearby hospital emergency room.
Take note, however, that not all chest pain is angina, or associated to the heart. If the pain lasts less that 30 seconds or if it goes away during a deep breath, after drinking a glass of water, or by just changing position, it almost surely is NOT angina and should not cause headache. But continuous pain, unrelieved by rest and accompanied by other signs may signal a heart attack.
Usually the doctor can identify angina by observing the symptoms and how they arise. Still one or more diagnostic tests may be necessary to exclude angina or to ascertain the severity of the underlying coronary disease. These include the electrocardiogram
(ECG) at rest, the stress test, and x- rays of the coronary arteries (coronary "arteriogram" or "angiogram").
The ECG records electrical impulses of the heart. These may show that the heart muscle is not receiving as much oxygen as it should have ("ischemia"); they may also indicate abnormalities in heart rhythm or some of the other probable unnatural features of the heart. To record the ECG, a technician positions a number of small contacts on the patient's arms, legs, and across the chest to hook up them to an ECG machine.
For many patients with angina, the ECG at rest is normal. This is not unusual because the symptoms of angina appear during stress. Therefore, the performance of the heart may be tested under stress, usually exercise. In the most basic stress test, the ECG is obtained before, during, and after exercise to look for stress related abnormalities. Blood pressure is also calculated during the stress test and symptoms are observed.
A more sophisticated stress test calls for picturing the blood flow pattern in the heart muscle in the course of peak exercise and after rest. A tiny amount of a radioisotope, usually thallium, is shot into a vein at peak exercise and is taken up by normal heart muscle. A radioactivity detector and computer record the pattern of radioactivity distribution to numerous parts of the heart muscle. Regional distinctions in radioisotope concentration and in the rates at which the radioisotopes disappear are measures of unequal blood flow due to coronary artery narrowing, or due to breakdown of uptake in scarred heart muscle.
The most precise way to determine the presence and severeness of coronary disease is a coronary angiogram, an x-ray of the coronary artery. A long thin versatile tube (a "catheter") is threaded into an artery in the groin or forearm and advanced through the arterial system into one of the two major coronary arteries. A fluid that blocks x-rays (a "contrast medium" or "dye") is injected. X-rays of its distribution show the coronary arteries and their narrowing.
by: Mariecarz David
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