Angina

Angina (心絞痛) is a term used to describe chest pain or discomfort that occurs, most commonly, when your heart muscle doesn't get enough oxygen-rich blood. It can feel like pressure or squeezing in your chest and may also be felt in the shoulders, arms, neck, jaw, or back. Angina is a symptom of coronary artery disease (CAD), the most common type of heart disease. This article will provide insight into what angina is, its characterisation, and how it can be treated effectively. 

What is Angina? 

Angina, also known as angina pectoris, is primarily caused by reduced blood flow to and oxygenation of the heart muscle. This reduction often results from narrowing or blockage of one or more of the coronary arteries due to atherosclerosis (buildup of plaque). Angina is typically triggered by physical exertion or emotional stress and is usually temporary. However, it is a consequential symptom that the heart is not receiving enough blood and oxygen, which could indicate a higher risk of a heart attack. 

Angina Characteristics 

Recognising the characteristics of angina is crucial for prompt treatment and effective management. Common symptoms include: 

• Chest Pain or Discomfort: Often described as pressure, squeezing, fullness, heaviness or stabbing pain in the center of the chest. 
• Pain in Surrounding Areas: Pain may spread to the arms, shoulders, neck, jaw, upper abdomen or back. 
• Shortness of Breath: This may accompany or occur before chest pain. 
• Nausea, Fatigue, or Dizziness: These symptoms can sometimes occur with angina. 

It is essential to differentiate between stable angina, which follows a predictable pattern and occurs during exertion or stress, and unstable angina, which is more random, can be more intense, and occur at rest. Unstable angina requires immediate medical attention as it indicates a higher risk of a heart attack. 

How to Treat Angina? 

Treatment for angina focuses on determining the main underlying cause (e.g. blockage, arrhythmia,  vessel spasm, non-cardiac causes),  reducing pain, rest, and lowering the risk of heart attacks. Common treatments include: 

• Medications: 

Nitrates (like nitroglycerin) help to widen the blood vessels and improve blood flow to the heart muscle. 

Beta-blockers and calcium channel blockers reduce the heart's workload and help prevent episodes of angina. 

Antiplatelet drugs (such as aspirin, clopidogrel, prasugrel and ticlopidine) can prevent blood clotting, which is a contributing factor in heart attacks. 

Lipid-lowering drugs (such as the “statins” simvastatin, atorvastatin, rosuvastatin) to control and lower the build-up of cholesterol and plaques in the coronary arteries. 

• Lifestyle Changes: 

Quitting smoking, eating a heart-healthy diet, maintaining a healthy weight, and exercising regularly can significantly reduce the frequency and severity of angina episodes. 

Managing stress through techniques like meditation or yoga can also be beneficial. 

• Procedures: In severe cases, procedures like angioplasty and stenting or coronary artery bypass surgery may be recommended to restore proper blood flow to the heart. 

What to Do When You Have Angina? 

If you experience angina: 

• Stop and Rest: Sit or lie down at the first sign of symptoms. If you're outdoors, find a safe place to rest. 
• Take Your Angina Medication: If prescribed, use your nitroglycerin spray or tablets as directed. 
• Monitor Symptoms: If the pain does not improve within a few minutes, or if symptoms worsen, seek emergency medical help immediately. 
• Follow Up with Your Doctor: Regular consultations with your healthcare provider are essential. They can help you keep track of your angina episodes and adjust your treatment plan as needed, providing you with the support you need to manage your condition effectively.   

Angina is a serious health condition that signals an underlying heart disease. Recognising the symptoms and understanding how to manage the condition can significantly reduce the risk of developing more severe complications, such as a heart attack. Regular consultations with healthcare providers, adherence to treatment protocols, and lifestyle adjustments are crucial steps in effectively managing angina and improving overall heart health. Whether through medications, lifestyle changes, or more invasive procedures, treatment options are available to help those suffering from angina lead healthier, more comfortable lives.