subject: A Fast Guide on Angina [print this page] Angina pectoris, or simply angina, is a recurring pain or discomfort in the chest region. This occurs when some portion of the heart does not get a sufficient amount of blood. It is one of the general signs or symptoms of coronary heart disease (CHD), when vessels that carry blood to the heart become narrowed and impeded owing to atherosclerosis
Angina generally feels like a pressing or squeezing pain, felt in the chest under the breast bone, but from time to time stretching up to the shoulders, arms, neck, jaws, or back.
Angina is typically precipitated by exertion. It crops up when the heart's need for oxygen multiplies outside of the oxygen obtainable from the blood nourishing the heart. Physical exertion is the most typical prompt for angina. Other triggers can be emotional worry, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.
Yet, angina is distinct from a heart attack. Angina pain means that some of the heart muscle in not getting a sufficient 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 struggling with irreversible, long term injury. Attacks of angina don't often contribute to long-lasting damage to heart muscle. It is commonly relieved within a few minutes by resting or by taking prescribed angina medicine.
On the flip side, a heart attack develops when the blood flow to a part of the heart is immediately and completely cut off. This leads to permanent damage to the heart muscle. Usually, the chest pain is more severe, lasts longer, and does not go away with rest or with medicine that was formerly helpful. It may be complemented by indigestion, nausea, weakness, and sweating. Nonetheless, the signs of a heart attack are numerous and may be significantly milder.
When a person has a repeating but firm pattern of angina, it does not mean that a heart attack is about to take place. Angina indicates that there is underlying coronary heart disease. Patients with angina are at an amplified risk of heart attack n comparison with those who have no symptoms of cardiovascular disease, but the episode of angina is not a signal that a heart attack is about to transpire. In contrast, when the pattern of angina changes--if episodes become more common, last a bit longer, or happen without exercise--the possibility of heart attack in pursuing days or weeks is much bigger.
A person who has angina ought 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 alleviates the attack. If the pattern changes dramatically or if the symptoms are those of a heart attack, one should get medical help as soon as possible, perhaps best done by searching for an analysis at a neighborhood hospital emergency room.
Take note, however, that not all chest pain is angina, or associated to the heart. If the pain lasts fewer that 30 seconds or if it goes away during a deep breath, after drinking a glass of water, or by merely changing position, it nearly surely is NOT angina and should not cause dilemma. But prolonged pain, unrelieved by rest and accompanied by other signs or symptoms may indicate a heart attack.
Typically the doctor can identify angina by observing the indicators and how they pop up. Nonetheless one or more diagnostic tests may be necessary to leave out angina or to establish the severeness 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 obtaining as much oxygen as it demands ("ischemia"); they may also show abnormalities in heart rhythm or some of the other likely abnormal features of the heart. To record the ECG, a technician positions a number of tiny contacts on the patient's arms, legs, and across the chest to link them to an ECG machine.
For many patients with angina, the ECG at rest is regular. This is not surprising because the symptoms of angina happen during anxiety. Therefore, the performance of the heart may be tested under stress, normally exercise. In the easiest stress test, the ECG is obtained before, during, and after exercise to look for stress related abnormalities. Blood pressure is also measured during the stress test and symptoms are observed.
A more complicated stress examination involves picturing the blood flow pattern in the heart muscle while in 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 various parts of the heart muscle. Local differences in radioisotope concentration and in the rates at which the radioisotopes vanish are measures of imbalanced blood flow due to coronary artery narrowing, or due to inability of uptake in scarred heart muscle.
The most exact way to evaluate the existence and intensity of coronary disease is a coronary angiogram, an x-ray of the coronary artery. A long thin flexible 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.
