What is Angina?
Angina is a recurring pain or discomfort in the chest that occurs when a part of the heart does not receive enough blood. The result of this oxygen demand exceeding available supply produces chest pain. Angina is not a disease, but a symptom of coronary artery disease and atherosclerosis, or hardening of the arteries. About 3 million people seek treatment for angina every year.
The full name “angina pectoris” means chest pain, but its symptoms vary. The classic description is “weight on the chest,” a pressure or heaviness. However, some people experience a feeling like indigestion, sweating, or shortness of breath. Angina can also be felt in the back, shoulders, neck, arms or jaws. Also, angina must be distinguished from other chest pains caused by digestive problems, rib and muscle pains, or lung diseases. The diagnosis is made on the basis of a good description from the patient, laboratory testing, and cardiac testing.
What tests diagnose Angina?
- ECG- an electrocardiogram measures the electrical activity that occurs as the heart is beating. It can be normal or may serve as evidence of prior cardiac injury. Some people are not aware of having a past heart attack, but the ECG can provide evidence of a past event.
- X-rays- these are performed to assess heart size and also to check the lungs, ribs, and stomach for other causes of chest pain.
- Blood tests– a cholesterol profile measures cholesterol and fat in the blood. When lipid levels are elevated, they increase the likelihood of atherosclerosis. Also, glucose is measured to screen for diabetes, a major risk factor for heart disease.
- Exercise ECG with or without thallium is the best test to confirm the diagnosis of angina. The ECG is monitored continuously while the patient walks on a treadmill. If angina exists, the ECG can record characteristic changes. If thallium (a radioactive tracer used in minute amounts) is injected, pictures of the heart are taken and the exact area of the heart that has reduced blood supply can be identified.
- Angiography, also called cardiac catheterization, is the direct visualization of the coronary arteries. A catheter is inserted into a major artery usually in the groin and is manipulated into the heart’s vessels to inject the dye. This is performed using X-ray guidance. Blockages can be identified, and their extent can be documented for further intervention (balloon angioplasty, stenting, or bypass).
- High blood pressure
- Cigarette smoking
- High blood cholesterol levels
- Excessive weight
- Physical over-exertion
- Emotional upsets
- Excessive alcoholic intake
The medical treatment of angina includes lifestyle modification and medications. Risk reduction entails smoking cessation, weight loss, exercise, and a low fat, low cholesterol diet. Medications increase the blood flow and reduce the oxygen demand of the heart. They include nitrates, calcium channel blockers, and beta blockers.
If drugs fail to relieve angina, doctors may recommend surgery, angioplasty or coronary artery bypass surgery. Coronary artery bypass surgery is an operation in which a blood vessel is grafted onto the blocked artery to bypass the blocked section so that blood can get to the heart. An artery from inside the chest or long vein from the leg may be used.
The diagnosis of angina does not mean that you can no longer have a full and active life. With the proper treatment and making lifestyle changes, you can live a long and healthy life.