If you experience chest pain yourself or see someone with chest pain, the first thing that strikes the mind is heart attack. Yes, chest pain is not something you can easily ignore so, it needs to be understood that chest pain may be caused by various problems, including problems in esophagus, lungs, ribs, muscles or nerves. Angina is one of the perpetrators of chest pain, which can be caused by reduced flow of blood to the heart muscles. Read on to know about the symptoms and possible treatments for Angina.
As learnt, chest pain may not be related to heart attack (in all cases), but you should know that it can be a possible cause. Some conditions (of chest pain) can be fetal, while some may not, so if you have unexplained chest pain, you need to see a doctor to evaluate the cause.
What is Angina?
Angina for our understanding is discomfort in the chest area or chest pain which occurs when the area of the heart muscles does not get enough oxygen-rich blood. A patient in Angina feels pressure and/or squeezing in the chest, with pain (in few cases) extending up to the shoulders, arms, back, neck and even the jaws.
Basically, Angina is not a disease in itself, but it is a symptom of an underlying heart problem – for better understanding a symptom of coronary heart disease (CHD). Coronary heart disease is one of the most common type of heart disease in adults, which may occur due to the build-up of a waxy substance called Plaque in the inside of the coronary arteries – coronary arteries carry oxygen rich blood to the heart muscles.
Due to the accumulation of plaque (Plak) on the inner walls of the coronary arteries checks the flow of the oxygen rich blood to the heart muscles. This reduction in the flow of blood to the heart muscles causes discomfort or severe chest pain.
If this plaque goes unchecked for a while (i.e. if the chest pain arising from Angina is taken lightly), the plaque build-up can lead to blood clots in the arteries, which can partially or completely block the flow of blood to the heart, leading to heart attack.
In addition to this, Angina is also linked with symptoms of coronary micro-vascular disease (MVD), which is a kind of heart disease that affects the smallest coronary arteries leading to the heart. According to various clinical studies, coronary micro-vascular disease is more likely to affect women than men, but the good thing about micro-vascular disease is that plaque does not create blockages in the arteries like it does in CMD, thus it isn’t as severe a heart disease.
Types of Angina
Having understood what Angina is and the possible locations where Angina can affect, it becomes important to learn about the different types of Angina and their affects accordingly. Basically there are four types of Angina, they need to be understood separately because each of them have different symptoms and require different types of treatments. The four types of Angina are listed below:
- Stable Angina
The most common type of Angina is Stable Angina, which occurs when the heart is compelled to (due to various reasons) to work harder than usual. The occurrence of Stable Angina is a kind of set pattern – a set pattern for how it occurs, the pain and severity. Stable Angina often subsides (the pain is relived) after rest for few minutes or after taking medicines. Stable Angina isn’t heart attack but it a symptom that one could be following soon.
- Unstable Angina
Unlike stable angina, Unstable Angina doesn’t follow a set pattern – it can occur more often and prove to be more severe. Unstable Angina can occur without exertion and may not subside with rest or medicine. Unstable Angina is very dangerous and it can be a signal that heart attack may happen soon.
- Micro-vascular Angina
Micro-vascular Angina can be the most severe form of Angina. The pain and discomfort in the chest may last long and it may not be cured with Angina medication and rest.
- Variant Angina
Variant (Prinz metal's) Angina is rare; it is triggered by spasm in the coronary artery. This type of angina can occur when you are resting (usually at night or in the early morning) and can cause severe pain but it can be cured with medication.
Symptoms of Angina
- Feeling of pain or discomfort in the chest is one of the most common symptoms of angina. The chest pain can feel tight, dull or heavy and it needs to be evaluated by the doctor.
- The chest pain caused by angina can spread from the chest to the other parts of the body and may rise to the shoulders, left arm, neck, jaw and back.
- Other notable symptoms of angina can include breathlessness, dizziness, belching and restlessness.
- Feeling sick and unusual tired can also be some early symptoms of angina.
Treatment of Angina
Treatment of Angina primarily includes change in lifestyle and medication. Lifestyle changes and medicines are probably the only forms of treatment required if angina symptoms are mild. However patients may need cardiac rehabilitation and other forms of treatments if medication doesn’t work. Limiting exertion, eating lighter food and limiting stress can be some lifestyle changes patients can adopt. Most commonly used medicines for angina treatment are nitrates, which relax and widen blood vessels allowing for free flowing of the blood.
If lifestyle changes and medicines cannot treat angina, the doctors may have to treat the patient with medical procedures like angioplasty and coronary artery bypass grafting. The main purpose of both kinds of treatment is to reduce chest pain and lower risk of heart attack.
The author is a privately practicing cardiac doctor with years of experience in providing patients with consultancy on treatment of various kinds of symptoms of chest pain. The author has carried out numerous medical procedures for treatment of patients with angina.