subject: A Handy Guide To Angina [print this page] Angina pectoris, or simply angina, is a recurring pain or painful sensation in the chest region. This arises when some section of the heart does not receive an adequate amount of blood. It is one of the well-known signals of coronary heart disease (CHD), when vessels that carry blood to the heart become narrowed and impeded because of to atherosclerosis
Angina often seems like a pressing or squeezing pain, felt in the chest under the breast bone, but sometimes advancing up to the shoulders, arms, neck, jaws, or back.
Angina is generally precipitated by exertion. It arises when the heart's need for oxygen goes up outside of the oxygen obtainable from the blood nourishing the heart. Physical exertion is the most prevalent prompt for angina. Other reasons can be emotional concerns, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.
But, angina is different 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 suffering irreversible, permanent injury. Attacks of angina don't often cause long-lasting damage to heart muscle. It is generally relieved within a few minutes by resting or by taking prescribed angina medicine.
In comparison, a heart attack takes place when the blood flow to a part of the heart is suddenly and permanently cut off. This brings about 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 earlier highly effective. It may be complemented by indigestion, nausea, weakness, and sweating. Then again, the symptoms of a heart attack are diverse and may be considerably milder.
When a person has a repeating but consistent pattern of angina, it does not mean that a heart attack is about to happen. Angina means that there is underpinning coronary heart disease. Patients with angina are at an accelerated risk of heart attack in contrast 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 happen. In contrast, when the pattern of angina changes--if episodes become more common, last for a longer time, or take place without exercise--the threat of heart attack in pursuing days or weeks is much bigger.
A person who has angina must comprehend the pattern of his or her angina--what causes an angina attack, what it feels like, how long episodes usually last, and whether medication reduces the attack. If the pattern changes greatly or if the symptoms are those of a heart attack, one should get medical help asap, perhaps best done by searching for an analysis at a nearby hospital emergency room.
Take note, however, that not all chest pain is angina, or related 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 practically definitely is NOT angina and should not cause worry. But extended pain, unrelieved by rest and followed by other discomforts may indicate a heart attack.
Normally the doctor can establish angina by noting the indicators and how they appear. Then again one or more diagnostic tests may be necessary to exclude angina or to identify 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 monitors electrical impulses of the heart. These may indicate that the heart muscle is not receiving as much oxygen as it needs ("ischemia"); they may also indicate problems in heart rhythm or some of the other possible unnatural 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 typical. This is not astonishing because the symptoms of angina take place during stress. Therefore, the functioning of the heart may be screened under stress, usually exercise. In the most straightforward stress test, the ECG is taken 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 complex stress test calls for 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 injected into a vein at peak exercise and is consumed up by normal heart muscle. A radioactivity detector and computer record the pattern of radioactivity distribution to numerous parts of the heart muscle. Regional variations in radioisotope concentration and in the rates at which the radioisotopes disappear are measures of imbalanced blood flow due to coronary artery narrowing, or due to failure of uptake in scarred heart muscle.
The most exact way to assess the occurrence and severity of coronary disease is a coronary angiogram, an x-ray of the coronary artery. A long slim 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.
