Dominic Stone
Angina is a symptom of heart disease and a warning sign of a heart attack. It is characterised by chest pain or discomfort due to the heart muscle not receiving enough oxygen-rich blood. Angina can be stable or unstable. While stable angina is usually triggered by physical exertion or emotional stress, unstable angina can occur anytime and may signify a heart attack. Unstable angina may not improve with rest or medication and can be life-threatening.
| Characteristics | Values |
|---|---|
| Definition | Chest pain or discomfort due to the heart muscle not getting enough oxygen-rich blood |
| Types | Stable angina (angina pectoris), unstable angina, vasospastic angina, microvascular angina, variant angina pectoris, Coronary microvascular disease |
| Symptoms | Pain, pressure, or squeezing in the chest that may spread to other parts of the upper body, shortness of breath, fatigue, sweating, nausea, lightheadedness |
| Risk Factors | Coronary artery disease, ethnicity, family history of heart disease, high cholesterol, other cardiovascular conditions |
| Diagnosis | Electrocardiogram (ECG), Cardiac MRI, Coronary CT scan, Coronary angiogram, blood tests, stress test |
| Treatment | Medication (e.g. nitroglycerin, glyceryl trinitrate), lifestyle changes, Surgery (e.g. coronary angioplasty, coronary artery bypass) |
| Prevention | Avoid triggers such as stress, cold temperatures, large meals, exertion, physical exercise |
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What You'll Learn
Angina is a symptom of coronary heart disease
Angina is not a disease in itself. Instead, it is a symptom and a warning sign of heart disease. It is characterised by chest pain or discomfort due to the heart muscle not receiving enough oxygen-rich blood. This usually occurs when the coronary arteries, which supply blood to the heart, become narrowed or blocked. This condition is called ischemia.
Angina is most often a symptom of coronary heart disease (CHD), which is a narrowing of the blood vessels that supply blood and oxygen to the heart. This results in reduced blood flow to the heart, causing the noticeable pain associated with angina. The pain may feel like pressure or squeezing in the chest, and it may spread to other parts of the upper body, such as the arms, neck, or jaw. In some cases, angina can feel like indigestion or an upset stomach, and some people may experience shortness of breath, weakness, or fatigue without feeling any pain.
The most common type of angina is stable angina (angina pectoris), which is caused by coronary artery disease (CAD). CAD occurs when plaque, a fatty, waxy substance, builds up in the coronary arteries, causing them to narrow or harden (atherosclerosis). This reduces blood flow to the heart, leading to the symptoms of angina. Other causes of angina include coronary microvascular disease, which damages the walls of tiny blood vessels branching from the coronary arteries, and coronary artery spasm, where the coronary arteries repeatedly constrict and then open up, temporarily restricting blood flow.
It is important to note that angina can be a warning sign of a heart attack. If you experience severe or unexpected chest pain, it is crucial to seek immediate medical care. Additionally, maintaining a healthy lifestyle, including managing risk factors such as high blood pressure, cigarette smoking, high blood cholesterol levels, lack of exercise, excess weight, and an unhealthy diet, can help delay or prevent angina and reduce the risk of associated complications.
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Angina is a warning sign of a heart attack
Angina is chest pain or discomfort due to oxygen-rich blood not reaching the heart. It is a symptom of heart disease, usually coronary heart disease, and can be a warning sign of a heart attack. While angina does not cause permanent damage to the heart, it is important to seek medical attention if you are experiencing it.
There are several types of angina, with stable angina (angina pectoris) being the most common. It is caused by coronary artery disease, which occurs when plaque, a fatty, waxy substance, builds up in the coronary arteries, reducing blood flow to the heart. Angina can also be a symptom of coronary microvascular disease, which damages the walls of tiny blood vessels branching from the coronary arteries and is more common in women.
The discomfort associated with angina typically begins behind the breastbone and may spread to other parts of the upper body, including the neck, jaw, shoulders, arms, back, or abdomen. It can feel like pressure, squeezing, or tightness in the chest, and some people compare it to indigestion. In some cases, angina may present as shortness of breath, fatigue, or nausea instead of chest pain.
While angina itself does not cause permanent damage to the heart muscle, it is a warning sign that something is wrong and can be a precursor to a heart attack. A heart attack occurs when there is a prolonged reduction in blood flow to the heart, resulting in the death of heart muscle cells. Therefore, it is crucial to seek immediate medical attention if you experience severe or unexpected chest pain, as it could indicate a heart attack.
Stable angina can usually be managed with rest and medication, and learning one's triggers can help prevent and control symptoms. However, if stable angina suddenly becomes worse, or if rest and medication do not alleviate the pain, it may be a sign of a heart attack, and emergency medical care should be sought.
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Angina is caused by coronary artery disease
Angina is not a disease in itself, but a symptom and a warning sign of heart disease. It is caused by coronary artery disease (CAD), which occurs when plaque (a fatty, waxy substance) builds up in the coronary arteries that supply blood to the heart. This build-up causes the arteries to narrow or harden (a process known as atherosclerosis), reducing blood flow to the heart muscle. This reduced blood flow results in the chest pain associated with angina.
The most common type of angina is stable angina (angina pectoris), which is typically caused by CAD. It is important to note that angina is a symptom of a heart problem, usually coronary heart disease, and can be a warning sign of a heart attack. Therefore, anyone experiencing unexpected or severe chest pain should seek immediate medical attention.
There are several risk factors that can increase the likelihood of developing angina due to CAD. These include high blood pressure, cigarette smoking, high blood cholesterol levels, lack of exercise, excess weight, and a diet high in saturated fat. Age, sex, race, medical conditions, family history, genetics, environment, occupation, and lifestyle can also play a role in increasing the risk of angina.
Treating and managing angina involve addressing these risk factors. This includes taking prescribed medications as directed, such as nitroglycerin, which is commonly used to treat angina. Additionally, lifestyle modifications such as healthy eating, weight loss, exercise, and smoking cessation are crucial in managing angina and reducing the risk of associated cardiovascular conditions.
While angina is a symptom of CAD, it is important to note that not all cases of CAD will present with angina. Some people may have coronary artery spasms, which can cause temporary restrictions in blood flow to the heart, resulting in angina-like symptoms. These spasms can occur regardless of whether an individual has CAD, and they may require special testing for diagnosis.
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Angina can be treated with medication
Angina is chest pain or discomfort due to oxygen-rich blood not reaching the heart muscle. It is not a disease in itself but a symptom and warning sign of heart disease. Angina can be treated with medication, rest, and other procedures.
Stable angina (angina pectoris) is the most common type of angina and is caused by coronary artery disease. It can be treated with rest and medication to improve quality of life. If you are experiencing severe or unexpected angina, seek immediate medical care as it may signal a heart attack.
Medications that can be used to treat angina include calcium channel blockers, antiplatelet medicines, anticoagulant medicines, and statins. Calcium channel blockers can help prevent heart attacks, strokes, or other cardiovascular events. They may cause side effects such as headaches, drowsiness, upset stomach, and ankle swelling. Antiplatelet medicines like aspirin or clopidogrel prevent blood clots from forming. Anticoagulant medicines, or blood thinners, also reduce the chance of blood clots and future complications. Statins stop plaque from forming and can slow down coronary heart disease.
Ranolazine is another medication that can be used to prevent angina symptoms from occurring as often. It can also increase the amount of physical activity one can do without triggering angina. If other treatments are ineffective, morphine may be prescribed to relieve pain and relax the muscles in the blood vessels.
In addition to medication, angina can be treated with procedures such as coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), also known as coronary angioplasty. CABG can improve blood flow to the heart and prevent heart attacks. PCI can open narrowed or blocked blood vessels supplying blood to the heart.
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Angina can be treated with surgery
Angina is chest pain or discomfort due to the heart muscle not receiving enough oxygen-rich blood. It is not a disease in itself, but a symptom and warning sign of heart disease, usually coronary heart disease. Angina can feel like pressure or squeezing in the chest, and this discomfort may spread to other parts of the body, including the arms, neck, jaw, abdomen, or back. In some cases, angina feels like indigestion or an upset stomach, and some people experience shortness of breath or fatigue without feeling any pain.
Stable angina (angina pectoris) is the most common type and is caused by coronary artery disease (CAD). This occurs when plaque, a fatty, waxy substance, builds up in the coronary arteries, narrowing or blocking them, and reducing blood flow to the heart. Angina can be treated with rest and medication to improve quality of life and reduce the frequency of pain.
In some cases, surgery may be required to treat angina. This is particularly relevant for those at risk of heart disease or CAD. Surgical procedures for angina include percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). These procedures can help to improve blood flow to the heart and reduce the risk of a heart attack.
It is important to note that any chest pain should be evaluated by a healthcare professional to determine the underlying cause and the appropriate treatment plan. Pre-operative evaluation is crucial to assess the patient's current medical status, provide clinical risk profiling, and plan the management of cardiac illness during the peri-operative period. This is especially important for patients with ischaemic heart disease, as they are at an increased risk of myocardial ischaemia and other complications during non-cardiac surgical procedures.
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Frequently asked questions
Angina is chest pain or discomfort due to the heart muscle not getting enough oxygen-rich blood. It can feel like pressure or squeezing in the chest and may spread to other body parts like the shoulders, arms, neck, jaw, abdomen, or back. It is usually a symptom of coronary heart disease.
Angina itself is not known to cause damage to the heart muscle. However, it is a symptom and a warning sign of heart disease, which can lead to a higher risk of having a heart attack or stroke if left untreated. Therefore, it is important to seek medical attention and make healthy lifestyle changes to reduce this risk.
Angina can be treated and managed through medications, lifestyle changes, and, in some cases, surgery. Medications such as nitroglycerin or glyceryl trinitrate (GTN) are commonly prescribed to widen blood vessels and increase blood flow to the heart. Lifestyle changes may include avoiding triggers like stress, cold temperatures, or large meals. In severe cases, surgery may be recommended to increase blood flow to the heart.
The major risk factors for angina include having underlying heart disease, particularly coronary heart disease or coronary artery disease (CAD). Other risk factors include ethnicity, with certain ethnic groups such as Aboriginal and/or Torres Strait Islander Peoples having an increased risk of coronary heart disease. Additionally, those who have had heart procedures, such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), are also at higher risk.
