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Angina: Treatment, symptoms, advice and help

About angina

Angina is described as chest discomfort or chest pain occurring as a result of insufficient flow of blood to the heart. It is a significant symptom of heart disease like ischemic heart disease (IHD) or coronary artery disease (CAD). The coronary arteries are responsible for supplying oxygenated blood to the heart. Deposition of a fatty substance called plaque in the coronary artery causes narrowing of its lumen, resulting in reduced blood flow to the heart.

Angina: Incidence, age and sex

Angina is seen mainly in individuals above the age of 50 years but younger adults may also be affected. It has a higher predilection for men as compared to women.

Signs and symptoms of angina: Diagnosis

Angina is a clinical symptom and not a disease. Individuals having angina commonly experience chest discomfort or chest pain. Some individuals may describe it as tightness or choking sensation in chest. Angina pain may also spread to the jaw, the left shoulder and the left arm. The pain is usually felt during periods of physical exertion and improves at rest. Persistence of pain at rest may indicate a fairly advanced heart disease which needs immediate medical attention. Chest pain may be associated with nausea, perspiration, cold hands and feet and breathlessness. Any recent increase in intensity and grade of angina is serious and requires consultation with a cardiologist without any delay.

Causes and prevention of angina

Angina may be seen as a result of underlying ischemic heart disease (IHD) or coronary artery disease (CAD). Several risk factors may cause this heart problem. These risk factors include obesity, high cholesterol in blood, sedentary life style, emotional stress, smoking, high blood pressure, diabetes and family history of heart disease.

Ischemic heart disease (IHD) may be prevented by lifestyle modifications like regular physical activity, smoking cessation and reducing emotional stress level. Dietary modifications like low fat and low salt diet with increased consumption of fruits and vegetables are advisable. Rarely, diseases of heart valves or heart muscles may also result in angina.

Angina: Complications

Angina may be a sign of impending myocardial infarction or heart attack which may occur due to complete blockage of coronary artery. Sudden cardiac death may ensue in rare cases.

Angina: Treatment

An electrocardiogram (ECG) is the first investigation that is advised but a normal ECG does not necessarily rule out heart disease. Special tests like exercise stress ECG, stress echocardiography and stress radionuclide scan may be needed to establish the diagnosis. Anti-anginal medications like nitrates, beta blockers or calcium channel blockers are usually prescribed. Low dose aspirin is important in prevention of any major cardiac event. Control of high blood pressure, diabetes and cholesterol with appropriate dietary and pharmaceutical measures is of paramount importance in treatment of angina.