Angina Pain

Last reviewed by Dr.Mary on August 7th, 2018.

Angina pain is a kind of discomfort or chest pain caused by the reduction of blood flow to the heart muscle. It is a symptom of coronary artery disease which occurs when muscle of the heart does not get enough blood that is oxygen-rich. It is this lack of blood flow that causes angina.


Angina Pain Location

Angina is typically described as a squeezing, heaviness, pressure, tightness or pain in the middle or the left side of the chest. Many individuals have stated that angina feels like someone is standing on the chest.

Angina can often be hard to distinguish from other kinds of chest pain for instance pain or discomfort of indigestion.

Angina Pain Symptoms

Angina symptoms consist of:

  • Chest discomfort or pain
  • Pain in the neck, arms, jaw, back or shoulder associated with pain in the chest
  • Fatigue
  • Nausea
  • Breathing shortness
  • Anxiety
  • Dizziness
  • Sweating

The discomfort or chest pain that is frequent with angina is often defined as fullness, pressure, and pain or squeezing in the middle of the chest. Some individuals with angina describe it as if the chest is being squeezed by a vise or feels like a weight that is heavy has been put on the chest.

The duration, type as well as the severity of angina may vary. It is significant to distinguish if this is changing or new chest pain. Different or new symptoms can be a signal of a more perilous angina – unstable angina – or a heart attack.

Stable angina characteristics

  • Triggers when exercising or climbing stairs or any activity when the heart must work harder
  • Can be predicted since this pain is normally similar to prior chest pain
  • Lasts only a short period of time, 5 minutes or even less
  • Goes away sooner when the individual rests or uses medication for angina
  • Often resembles indigestion
  • May spread to the back, arms or other parts of the of the body
  • May also be brought on by emotional or mental stress

Unstable angina characteristics – medical emergency!

  • Happens even while resting
  • Unexpected
  • Change in the usual form of angina
  • Lasts longer and is more serious than angina that is stable, perhaps as long as ½ hour.
  • Might not end with medication for angina or with rest
  • Can be a signal or indication of a heart attack

Prinzmetal’s or variant angina characteristic

  • Normally occurs when individual is at rest
  • Often severe
  • Can be comforted by medication for angina

Women with angina – A woman’s symptoms of angina may be unlike the symptoms that are classic for angina. For instance, a woman can have pain in the chest that resembles pulsating, sharp or stabbing type of pain in the chest instead of the characteristic vise-like pressure. Also women are likely to have symptoms such as shortening of breath, nausea or pain in the abdomen. These variances can lead to postponements in pursuing treatment.

Angina Pain Causes

The cause of angina is blood flow reduction to the muscle of the heart. Blood transports oxygen, which the muscle of the heart needs to persist. When the muscle of the heart is not getting sufficient oxygen, it triggers a condition referred to as ischemia.

The more frequent cause of blood flow that is reduced to the muscle of the heart is coronary artery disease or CAD. The heart or coronary arteries may become narrow because of fatty deposits called plaques. This is referred to as atherosclerosis.

Angina that is stable

Angina that is stable normally brought on by physical exertion. When the individual climb stairs, walks or exercises, the heart wants more blood, but it is harder for this muscle to get the amount of blood when the arteries are narrowed. In addition to physical activity, other factors such as emotional stress, heavy meals, cold temperatures as well as smoking also may cause the arteries to narrow and cause angina.

Angina that is unstable

If plaque or fatty deposits in a blood vessel ruptures or forms a blood clot, it may quickly block or reduce the flowing of blood thru a narrowed artery, suddenly as well as severely lessen the flow of blood to the muscle of the heart. Unstable angina gets worse and is not relieved by rest or the usual angina medications. If the flow of blood does not improve, the muscle of the heart that is deprived of oxygen dies – a heart attack. Unstable angina is dangerous as well as needs emergency treatment.

Angina that is variant

This angina is caused by a spasm in a coronary artery where the artery will momentarily narrow. This narrowing also reduces the flow of blood to the heart, causing chest pain. Variant angina is rare and accounts for only about 2% of cases of angina.

Angina Pain Treatment

There are lots of options for the treatment of angina including:

  • Medications
  • Lifestyle changes
  • Coronary bypass surgery
  • Angioplasty and stenting

If the angina is very minor, modification of lifestyle can be all that is needed. Even if the angina is serious, these lifestyle changes may still help.

Lifestyle changes consist of:

  • No smoking. Also avoid smoke that is secondhand
  • If overweight, consider weight loss choices
  • Diabetics need to have the diabetes well controlled
  • With exercise, pace yourself as well as take breaks to rest
  • Evade meals that are large
  • Avoid stress and look for things that help you relax
  • Eat healthy by limiting saturated fats, consuming plenty of whole grains as well as fruits and vegetables

Medications

When changes in lifestyle by itself do not help angina, the individual could need to take drugs. These consist of:

Aspirin

Aspirin lessens the capability of the blood to clot, helping it to be much easier for the flow of blood thru heart arteries that are narrowed. Stopping blood clots also can reduce the risk of heart attack.

Nitrates

Nitrates widen and relax the blood vessels allowing additional blood flow to the muscle of the heart. The more common type of nitrate is nitroglycerin tablets that are put under the tongue.

Beta blockers

These work thru blocking the hormone epinephrine, identified as adrenaline. This makes the heart beat slower and with less force and reduces the blood pressure. The also helps blood vessels improve blood flow by relaxing and opening up.

Statins

These are medications used to help lower blood cholesterol.

Calcium channel blockers

These widen and relax the blood vessels thru affecting the cells of the muscle in the walls of the arteries. This increases the flow of blood to the heart.

“Angiotensin-converting enzyme” or ACE inhibitors

These drugs help relax blood vessels.

Medical procedures and surgery

Angioplasty with stenting

During this procedure, a small balloon is put in the narrowed artery. After inflating the balloon the artery is widened and a very small wire coiled mesh – stent – is normally inserted in order to open and keep open the artery.

Coronary arteries bypass surgery

This surgery involves an artery or vein from another area of the body being used to bypass or evade a heart artery that is narrowed or blocked. This will increase blood flow to the heart and eliminate or reduce angina.

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