Angina is not a disease but usually a symptom of a lurking Coronary Heart Disease (CHD) and typically describes the excruciating and tightening pain and discomfort in the chest around the heart muscles when they do not receive enough oxygenated blood.
- Pain and discomfort which usually starts behind the breastbone, arms, shoulders, neck, jaw, throat or the back
- Heart burn and Indigestion-like pain in the abdomen
- Pressure, squeezing, burning, or tightness in the chest
- Nausea (feeling sick to your stomach)
- Fatigue and weakness
- Shortness of breath and sweating
- Light-headedness, dizziness and confusion
Stable angina is usually brought on by exertion and stops with rest. It is usually predictable, short and goes away with angina medication.
Unstable angina on the other hand is a medical emergency which can occur at rest also, is unusual in pattern, comes on suddenly, more severe, may not disappear with angina medicines and may evolve into a heart attack.
- Those with Coronary Heart Disease (CHD) and Coronary Microvascular Disease (MVD)
- Unhealthy cholesterol levels
- Hypertension or High blood pressure
- Insulin resistance or Diabetes
- Weight issues - Overweight/Obese
- Metabolic syndrome
- Lack of physical activity
- Unhealthy diet
- Increasing age - 45 years and above for men and 55 years and above for women
Angina must be diagnosed by the following investigations:
- Electrocardiogram (ECG or EKG).
- Treadmill or Stress test.
- Nuclear stress test.
- Chest X-ray.
- Blood tests for certain heart enzymes.
- Coronary angiography.
- Cardiac Computerized Tomography (CT) scan.
Prevention is the best treatment for angina. Though a lot depends upon the cause and include behavior modification like lifelong control of blood pressure levels, cholesterol and diabetes management, no smoking, exercise, medication like aspirin or angioplasty and coronary artery bypass surgery.
Lifestyle changes need to include stopping smoking, weight management, stress reduction, balanced diet and physical activity after clearance with the doctor.
Medical management includes treatment with nitrates, aspirin, clot preventing drugs, beta blockers, statins or calcium channel blockers.
In some cases, procedures, such as angioplasty, stenting and coronary artery bypass surgery, also are used to treat angina.