Angina: Symptoms, Causes, Treatment & Diagnosis

Written By: Dr. Brajesh Mittal

Dr. Brajesh Mittal is an interventional cardiology specialist in Dubai. He has completed his MD from the University of Rajasthan in India, and has earned fellowship of several international bodies, including the American College of Cardiology, European Society of Cardiology, SCAI, Cardiology Society of India, Indian Society of Cardiology, and the Gulf Heart Association.

Updated On:December 07, 2023

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What is Angina?

Angina is a sort of chest pain that can be brought on by a heart that receives less blood. A symptom of coronary artery disease is angina. Angina may feel like a heavy weight on the chest. If you have any new discomfort that might be angina, as well as any pain that returns but is eased by treatment, you should see a doctor.

Causes of Angina

Angina results from myocardial ischemia, which is a reduced blood supply to your heart. Your heart's ability to get enough blood can be hampered by a number of coronary artery issues. A few of these include

  • Angina most frequently results from coronary artery disease (CAD). The coronary arteries, which carry blood to your heart, become blocked when plaque (a fatty, waxy substance) accumulates there. Your heart's blood supply is decreased as a result of these arteries narrowing or hardening (atherosclerosis).
  • Women are more likely than men to have coronary microvascular disease. Your coronary arteries' branching little blood vessels suffer damage to their walls. These blood vessels require specialized testing, which is not available at all medical facilities because it cannot be observed during standard CAD testing.
  • Coronary artery spasm: Your coronary arteries frequently contract (tighten) before opening. Your heart's blood flow may briefly be hampered by these spams. Coronary artery disease is not a requirement to experience coronary spasms. It's possible that this can't be identified with standard CAD testing, and that it needs specialized testing that not all hospitals offer.

Symptoms of Angina

Angina symptoms include chest pain and discomfort. The chest discomfort or pain could feel like:

  • Burning
  • Fullness
  • Pressure
  • Squeezing

You can feel pain in your arms, neck, jaw, shoulder, or back.

Other signs of angina include:

  • Dizziness
  • Fatigue
  • Nausea
  • Breathing challenges
  • Sweating

Intensity, duration, and kind of angina can vary. It's possible for new or different symptoms to be a sign of unstable angina, a more dangerous form of angina, or a heart attack. If you encounter any new or escalating angina symptoms, you should consult a doctor straight away so they can determine if you have stable or unstable angina.

When to see a doctor for Angina?

It's crucial to consult your doctor if chest discomfort is a new symptom for you in order to identify the cause and receive the right treatments. If you have stable angina and it worsens or changes, you should visit a doctor soon. Contact emergency medical services, or if there is no other way to get there, drive yourself to the hospital if discomfort persists for more than a few minutes

Angina Risk Factors

The following factors may increase the risk of angina:

  • Age. Angina is more common in those 60 years of age and older.
  • You are more likely to have angina if you have a family history of heart disease. Inform your healthcare provider if your mother, father, or any of your siblings have ever experienced heart disease or a heart attack.
  • Tobacco use. Smoking, chewing tobacco, and extended exposure to secondhand smoke can damage the lining of the arteries, allowing cholesterol deposits to accumulate and restrict blood flow.
  • Diabetes. The risk of coronary artery disease, which results in angina and heart attacks, rises due to diabetes's acceleration of atherosclerosis and elevation of cholesterol levels.
  • Obesity. Angina can be brought on by heart disease, which is at risk due to obesity. The heart has to work harder to pump blood throughout the body when a person is overweight.
  • Psychological strain. Blood pressure can be increased by excessive stress and anger. Stress-related hormone surges can cause artery narrowing and exacerbate angina.
  • Medications. Certain types of anginas may be brought on by blood vessel-tightening medications, such as some migraine medications.
  • Misuse of drugs. Cocaine and other stimulants can lead to angina and cause blood vessel spasms.
  • Chilly conditions. Cold exposure has the potential to cause Prinzmetal angina, a type of angina.
  • A high blood pressure level. Chronically high blood pressure gradually damages the arteries by encouraging arterial hardening.
  • Excessive levels of cholesterol or triglycerides. Atherosclerosis may develop if blood LDL levels are too high. A person's risk of angina and heart attacks rises with high LDL levels.
  • Other medical problems. Metabolic syndrome, chronic renal illness, peripheral artery disease, and a history of stroke are all risk factors for angina.
  • Inadequate exercise. A sedentary lifestyle has been linked to obesity, type 2 diabetes, high blood pressure, and high cholesterol. You should talk to your doctor about the optimum type and amount of exercise for you.

 Angina Complications

Angina can make daily tasks uncomfortable or difficult to do. However, the most dangerous and life-threatening complication of angina is having a heart attack.

Angina Diagnosis

Your doctor will conduct a physical examination and inquire about your symptoms and family history to determine whether you have angina. The following test may be conducted to diagnose angina:

  • Electrocardiogram (ECG or EKG)
  • Chest X-ray
  • Blood test
  • Stress test
  • Echocardiogram
  • Nuclear stress test
  • Cardiac computerized tomography (CT)
  • Cardiac magnetic resonance imaging (MRI)
  • Coronary angiography

Angina Treatment

Your doctor or cardiologist will take care of the underlying heart condition that's causing your angina. Enhancing blood flow to your heart and reducing your risk of problems are the two main objectives of treatment. In order to better understand your disease and choose the most appropriate therapies, your provider will examine you physically and run various tests.

Typical forms of treatment include:

  • To reduce your risk of blood clots, anticoagulants or antiplatelet medications
  • Medication for high blood pressure
  • Cholesterol-lowering medication
  • Prescription drugs to treat angina
  • Modifications in way of life
  • CABG, or coronary artery bypass grafting
  • Coronary angioplasty and stenting or percutaneous coronary intervention (PCI)

Angina Prevention

By leading a heart-healthy lifestyle, you can aid in the prevention of angina. To improve heart health, follow these recommendations:

  • Avoid using any tobacco products or smoking. Additionally, stay away from secondhand smoke.
  • Consume heart-healthy foods. Reduce your consumption of sugar, salt, trans fat, and saturated fat.
  • Learn new stress-reduction techniques. Try yoga, meditation, or chatting with a friend or counselor.
  • Maintain a healthy weight. Ask your healthcare professional what you should aim for and for suggestions on how to get there.
  • Control coronary artery disease risk factors. These include diabetes, high blood sugar, high cholesterol, and excessive triglycerides.
  • Aim to work out for at least 150 minutes per week, or 2.5 hours. Take walks or engage in other enjoyable activities.
  • Take the meds that your cardiologist has recommended. Numerous of these drugs have been proven to lessen or get rid of your angina symptoms.

 References

Balla, C., Pavasini, R., & Ferrari, R. (2018). Treatment of angina: where are we?. Cardiology140(1), 52-67.

Bhatt, A. B., & Stone, P. H. (2006). Current strategies for the prevention of angina in patients with stable coronary artery disease. Current opinion in cardiology21(5), 492-502.

Ford, T. J., & Berry, C. (2020). Angina: contemporary diagnosis and management. Heart106(5), 387-398.

Kreatsoulas, C., Shannon, H. S., Giacomini, M., Velianou, J. L., & Anand, S. S. (2013). Reconstructing angina: cardiac symptoms are the same in women and men. JAMA internal medicine173(9), 829-833.

Mayou, R. (1973). The patient with angina; symptoms and disability. Postgraduate Medical Journal49(570), 250.

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