Angina pectoris is the result of myocardial ischemia caused by an imbalance between myocardial blood supply and oxygen demand.
An episode of angina is not a heart attack. Having angina means you have an increased risk of having a heart attack.
- A heart attack is when the blood supply to part of the heart is cut off and that part of the muscle dies (infarction).
- Angina can be a helpful warning sign if it makes the patient seek timely medical help and avoid a heart attack.
- Prolonged or unchecked angina can lead to a heart attack or increase the risk of having a heart rhythm abnormality. Either of those could lead to sudden death.
People who are at risk of angina are:
- Men above 55 years old,
- Women above 65 years old,
- Obese or overweight,
- Cigarette smokers,
- Having high blood pressure,
- Having high cholesterol levels,
- Physically inactive,
- Having kidney disease,
- Having diabetes mellitus, and
- Having family history of premature cardiovascular disease (men who suffer from heart disease below the age of 55 or women who suffer from the same disease below 65 year old).
Generally, angina pectoris is recognized in two types:
- Stable angina is found more often in people. The symptoms of this type occur regularly and are predictable. Usually, people with this type suffer from the chest discomfort during exercise and stress, or after consuming heavy meals. Generally, the symptoms last not more than five minutes and improve when the patient rests or takes medications such as nitroglycerin, amlodipine besylate, or ranolazine.
- Unstable angina is found less often but more serious than the first type. Unlike the stable one, the occurrence of unstable angina cannot be predicted. The symptoms of this type also tend to be more severe. Unstable angina usually creates more pain and occurs longer and more frequent. Usual medication or resting cannot improve the symptoms. While unstable angina differs from heart attack, it is often noted as the precursor to heart attack.
Your doctor or nurse will examine you and measure your blood pressure. Tests that may be done include:
- Coronary angiography
- Coronary risk profile (special blood tests)
- ECG
- Exercise tolerance test (stress test or treadmill test)
- Nuclear medicine (thallium) stress test
- Stress echocardiogram
Your doctor may give you one or more medicines to help prevent you from having angina.
- ACE inhibitors to lower blood pressure and protect your heart
- Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
- Calcium channel blockers to relax arteries, lower blood pressure, and reduce strain on the heart
- Nitrates to help prevent angina
- Ranolazine (Ranexa) to treat chronic angina
Reference :
http://www.ncbi.nlm.nih.gov
