Angina

Angina pectoris is chest pain due to ischemia (a lack of blood and hence oxygen supply) to the heart muscle, generally due to obstruction or spasm of the coronary arteries (the heart's blood vessels). Coronary artery disease, the main cause of angina, is due to atherosclerosis of the cardiac arteries. The term derives from the Greek ankhon ("strangling") and the Latin pectus ("chest"), and can therefore be translated as "a strangling feeling in the chest".

Symptoms

Most patients with angina complain of chest discomfort rather than actual pain, the discomfort is usually described as a pressure, heaviness, squeezing, burning, or choking sensation. Anginal pain may be localized primarily in the epigastrium (upper central abdomen), back, neck, jaw, or shoulders. Typical locations for radiation of pain are arms, shoulders, and neck. Angina typically is precipitated by exertion or emotional stress, and exacerbated by having a full stomach or cold temperatures (the "4 Es": exertion, emotion, eating and extreme temperature). Pain may be accompanied by sweating and nausea in some cases. It usually lasts for about 1-5 minutes, and is relieved by rest or specific anti-angina medication. Chest pain lasting only a few seconds is normally not angina.

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An attack of angina pectoris usually comes on with a sudden seizure of pain, felt at first over the region of the heart, but radiating through the chest in various directions, and frequently extending down the left arm. A feeling of constriction and of suffocation accompanies the pain, although there is seldom actual difficulty in breathing. When the attack comes on, as it often does, in the course of some bodily exertion, the sufferer is at once brought to rest, and during the continuance of the paroxysm experiences the most intense agony. The countenance becomes pale, the surface of the body cold, the pulse feeble, and death appears to be imminent, when suddenly the attack subsides and complete relief is obtained. The duration of a paroxysm rarely exceeds two or three minutes, but it may last for a longer period. (If it lasts more than a few minutes longer than it normally does, this means medical attention is needed immediately and a call for help should be made.) The attacks are apt to recur on slight exertion, and even in aggravated cases without any such exciting cause.

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Major risk factors for angina include family history of premature heart disease, cigarette smoking, diabetes, high cholesterol, and high blood pressure.

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Factors associated with reducing the risk of angina include education of patients about the benefits of stopping smoking, cholesterol-lowering (low saturated fats) diet, physical activity, moderate alcohol intake (1-2 drinks per day), and periodic screening for diabetes and high blood pressure.

Related Topics:
Diabetes - Blood pressure

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