Angina

Angina Pectoris ("Angina") 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.

Causes
Angina episodes occur when the heart’s need for oxygen increases beyond the oxygen available from the blood nourishing the heart. Common triggers include physical exertion, emotional stress, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.

An episode of angina does not mean that a heart attack is about to happen, but could be a sign of underlying coronary heart disease.

Symptoms
Angina feels like a pressing or squeezing pain, usually in the chest under the breast bone, but sometimes in the shoulders, arms, neck, jaws, or back. Angina episodes usually take place after physical exertion and is relieved within a few minutes by resting or by taking prescribed angina medicine.

Diagnosis
Usually the doctor can diagnose angina by noting the symptoms and how they arise. 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), the stress test, and x- rays of the coronary arteries (coronary "arteriogram" or"angiogram").

Treatment
A person who has angina should learn the pattern of his or her angina -- what causes an angina attack, what it feels like, how long episodes last, and whether medication relieves the attack. If the pattern changes sharply or if the symptoms are those of a heart attack, one should get medical help immediately, perhaps best done by seeking an evaluation at a nearby hospital emergency room.

The underlying coronary artery disease that causes angina should be attacked by controlling existing "risk factors" such as high blood pressure, cigarette smoking, high blood cholesterol levels, and excess weight. Taking these steps reduces the likelihood that coronary artery disease will lead to a heart attack.

Doctors may recommend surgery or angioplasty if drugs fail to ease angina or if the risk of heart attack is high. Coronary artery bypass surgery is an operation in which a blood vessel is grafted onto the blocked artery to bypass the blocked or diseased section so that blood can get to the heart muscle. An artery from inside the chest or long vein from the leg may be used.

Balloon angioplasty involves inserting a catheter with a tiny balloon at the end into a forearm or groin artery. The balloon is inflated briefly to open the vessel in places where the artery is narrowed.

Last Updated: December 03, 2007