Angina pectoris or angina

But there is a disorder of the breast marked with strong and peculiar symptoms, considerable for the kind of danger belonging to it  …… The seat of it, and sense of strangling, and anxiety with which is attended, may make it not improperly be called angina pectoris. William Heberden (1768)


Angina pectoris is a recurring pain or discomfort in the chest that happens when some part of the heart does not receive enough blood. It is a common symptom of coronary heart disease, which occurs when vessels that carry blood to the heart become narrowed and blocked due to atherosclerosis. Angina feels like a pressing or squeezing pain, usuallyin the chest under the breast bone, but sometimes in the shoulders, arms, neck, jaws, or back. It is usually precipitated by exertion and it is relieved within a few minutes by resting or by taking prescribed angina medicine such as nitro-glycerine. Physical exertion is the most common trigger for angina. Other triggers can be emotional stress, extreme cold or heat, heavy meals, and cigarette smoking. The pain does not means that the heart muscle is suffering irreversible, permanent damage.


Stable and unstable angina

Angina is classified as stable when recurs in a regular or characteristic pattern. The level of activity or stress that provokes the angina is somewhat predictable, and the pattern changes only slowly. The established stable pattern of angina may change sharply or angina may first appear as a very severe episode or as frequently recurring bouts of angina. Angina may also appear at rest. In these forms angina is referred to as unstable angina


How is angina diagnosed?

Usually it is diagnosed by noting the symptoms, how they arise, and according to drug sensibility such as nitroglycerin. However, one or more diagnostic tests may be needed to exclude angina or to establish the severity of the underlying coronary disease. These include the electrocardiogram (ECG) at rest, the ECG, echo, and radioisotope stress test and coronary angiogram.  For many patients with angina the ECG at rest is normal. This is not surprising because the symptoms of angina occur during stress.


What’s the difference between angina and heart attack?

A heart attack occurs when the blood flow to a part of the heart is suddenly and permanently cut off. This causes permanent damage to the heart muscle. Typically, the cast pain is more severe, lasts longer, and does not go away with rest or with medicine that was previous effective. It my be accompanied by indigestion, nausea, weakness, an sweating. However, the symptoms ah a heart attack are varied and may be considerably milder.


Not every chest pain is angina

Beside your heart, chest pain can also come from your lungs, your oesophagus and stomach, and the muscles and bones that make up your rib cage. Angina will usually last from several minutes to about half an hour. Pain that lasts only a few seconds or is constant for several days is less likely to be due to angina. Angina pain should not change with position or movement, so pain that gets better or worse when you sit up, move your arms, or take a deep breath is also less likely to be angina. And feelings of chest or stomach discomfort are probably not angina. Knowing what your angina is usually like and recognizing how to distinguish it from other types of chest discomfort can help you to live a more normal life without constantly worrying about every little twinge of discomfort you experience. On the other hand, if you are ever not sure if you are having an angina attack, or even a heart attack (where the pain lasts longer and is often more intense), it is better to play it safe and call your doctor or go to a hospital emergency room immediately.


In angina get emergency medical assistance if your pain:

q       Comes on with less activity

q       Happens more often

q       Lasts longer

q       Isn’t helped by your usual medication

q       Happens at a time that is unusual for you

q       Awakens you from sleep

q       Seems more widespread or much more severe

Feels different in other ways

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