Angina is chest pain caused by reduced blood flow to the heart, as a result of coronary heart disease. When plaque forms on the inner walls of the coronary arteries, blood flow is slowed. As this plaque builds, the heart must work harder to ensure blood flow. This buildup of plaque, known as atherosclerosis, causes the heart to gradually become oxygen-starved, producing pain in the surrounding tissue. Angina may feel like pressure or a squeezing pain in the chest and is often associated with a range of other symptoms, including shortness of breath, dizziness sweating, nausea, and fatigue.
Types of Angina
There are several different types of angina that vary based on severity and duration of symptoms.
Stable Angina
The most common form of angina, symptoms of stable angina occur on a regular basis and are predictable after certain activities. In most cases of stable angina, symptoms occur after physical exertion and usually last less than five minutes.
Unstable Angina
Unstable angina is a more serious form of angina. Symptoms are more severe and unpredictable and appear to get worse over the duration of the episode. Symptoms of unstable angina tend to be more frequent and can occur at any time. Previously stable angina may become unstable, possibly signaling a heart attack.
Variant Angina
Also known as Prinzmetal's angina, variant angina is a relatively rare subtype of angina similar to unstable angina except that it occurs in cycles. It is caused by a spasm in the smooth muscle of the coronary arteries and not necessarily by atherosclerosis.
Chest pain may be a sign of a serious condition and should always be checked by a doctor.
Diagnosis of Angina
Angina is diagnosed through a physical examination and a review of symptoms. Blood tests may be performed as well as the following diagnostic tests:
- Electrocardiogram
- Nuclear stress test
- Echocardiogram
- Cardiac MRI or CT scan
A coronary angiography may also be performed to diagnose angina. This test uses X-ray imaging to examine the inside of the heart's blood vessels.
Treatment of Angina
Treatment for angina may include simple lifestyle modifications such as quitting smoking, losing weight, controlling stress and managing any underlying medical conditions, such as diabetes. In addition to lifestyle changes, treatment may include the following medication:
- Nitrates
- Aspirin
- Anti-clotting drugs
- Beta blockers
- Statins
- Calcium channel blockers
In severe cases, surgery may be recommended to treat angina. Surgical procedures such as angioplasty, stenting and coronary artery bypass surgery may be performed to open arteries and improve blood flow to the heart.
