Understanding Angina Pectoris: Symptoms, Causes, and Treatments
Cardiovascular diseases are known for their insidious nature, especially because they do not always manifest themselves in time. What can happen instead is that sudden symptoms occur, including chest pain also defined angina pectoris.
The pressure and painful sensation in the chest, but also in the neck, jaw, and left arm must be a cause for alarm, to the point of having to call emergency services.
What is angina pectoris
It is a pain, therefore it is a symptom, which occurs when the heart does not receive the oxygen transported by the blood flow. Angina pectoris indicates that something is wrong and may imply the presence of a heart condition. Angina can be:
Stable, i.e. when the pain is caused, for example, by a session of intense physical activity and can be treated with rest and adequate medicines; This type of angina comes on suddenly, without any known trigger factors and the symptoms persist even if a period of rest is observed. By virtue of these considerations, unstable angina pectoris represents a medical emergency since the heart is not functioning properly and the patient is at risk of having a stroke or heart attack.
What are the symptoms of angina pectoris
Angina pectoris can manifest itself with mild, barely perceptible and annoying symptoms, or with stronger signs that include:
- chest pressure or pain
- profuse sweating
- nausea/vomiting
- feeling of fatigue
- fast breathing
- pain similar to that of indigestion
The pain often spreads to other parts of the body, including the shoulders, jaw, neck, back, left arm. In the case of stable angina, symptoms may last for a few minutes and then improve with some rest; otherwise, if unstable angina occurs, the signs continue for a long time and may not respond to treatments used for stable angina.
What are the causes of angina pectoris
Causing angina is one reduction in blood flow to the heart. This event can occur when there are some problems with the coronary arteries – blood vessels responsible for transporting blood to the heart – to the point of reducing or preventing the arrival of blood to the heart muscle.
There are several factors that can lead to this in the course of a man’s life to atherosclerosis, a process in which fat deposits, over time, accumulate along the arteries, thus reducing their internal lumen and resulting in a reduction in blood supply. If the heart requires a modest amount of blood at rest, when it makes an effort the demand increases exponentially. It goes without saying that if the coronary arteries are narrower due to atherosclerosis, the blood will have difficulty reaching the heart, giving rise to the manifestation of angina.
What are the risk factors for angina pectoris
Anything that in a certain sense requires a significant effort on the part of the heart (therefore more blood) and which causes narrowing of the arteries can cause angina pectoris. Consequently, among the main risk factors for this symptom are:
- the age. In old age, the possibility of experiencing angina pectoris increases due to the gradual formation of plaques along the sides of the arteries
- the presence of conditions such as diabetes, hypertension (high blood pressure) family history
- all situations that can cause stress
- overweight
- poor physical activity
- excess alcohol
- smoking, because it damages the arterial walls
- an unregulated diet, mostly based on refined fats and sugars
- high levels of cholesterol in the blood, in particular LDL (bad) cholesterol composed mostly of fats and only part of proteins
- metabolic syndrome
As we have seen, some of these factors (for example, age and familiarity) cannot be changed, but efforts can be made to reduce others. Eating well, exercising, keeping your diet under control are just some of the useful strategies to reduce the risk of developing angina pectoris.
Diagnosis of angina pectoris
In the presence of chest pain, the doctor starts with a clinical evaluation which involves measuring weight and blood pressure. To reach a diagnosis, the story of the patient’s history is of great importance, therefore if the symptoms appeared following physical effort, for how long and with what intensity they manifested themselves, what are the daily habits (nutrition, smoking, alcohol), if there are cases diagnosed with cardiovascular diseases in the family.
To understand whether atherosclerosis may be the cause of angina, the doctor may prescribe routine tests such as:
- urinalysis, useful for evaluating kidney function
- blood tests to detect cholesterol and blood sugar levels
If your GP suspects angina, he or she may prescribe a specialist visit to a cardiologist. The essential tests for the actual diagnosis of angina are:
- the electrocardiogram (ECG). It records the electrical activity of the heart and is useful for detecting any damage to the heart muscle and arrhythmias
- the stress electrocardiogram. In this case, the patient walks on a platform or on an exercise bike, therefore while performing physical effort, and in the meantime the functioning capacity of the heart is monitored. This type of exam is essential to evaluate the severity of the disease and to understand what levels of exercise are suitable for the patient
- coronary angiography. It is performed to evaluate the severity of coronary lesions when considering the possibility of an operation, such as coronary artery bypass grafting
If the symptoms are severe and the unstable form of angina is suspected, the patient should be monitored closely. This translates into hospital admission where various tests are performed such as blood tests and those to understand the presence of possible damage to the heart muscle. This all happens in a short time because, as we have seen, this form of angina can lead to even serious complications that must be avoided.
What are the complications of angina pectoris
Among the most relevant complications of angina pectoris are:
- stroke
- heart attack
- Depression
- anxiety
The last two conditions are mostly linked to the chronicity of angina pectoris. If you often feel empty or down, consider a personalized path with a mental health professional. In addition to drugs to manage anxiety and depression, cognitive-behavioral therapy can represent a valid help in dealing with the chronicity of angina pectoris with greater serenity.
What are the treatments for angina pectoris
Angina pectoris is treated depending on the underlying cause. The goals are: to reduce the risk of developing complications and to improve blood flow to the heart. Once you have received the diagnosis, your doctor may suggest that you undertake therapy that includes taking medications including:
- those to keep blood pressure at bay
- anticoagulants, to reduce the risk of blood clotting, and consequently the risk of heart attack and stroke
- specific ones to take in case of angina (nitroglycerin)
- those to help reduce high cholesterol levels
- beta-blockers, which make the heart beat slower, thus preventing angina from developing following effort
Pharmacological therapy, which may involve taking more than one medicine, must then be associated with improvements/changes in lifestyle, especially linked to nutrition and physical activity.
When medications have not returned the desired results, surgery is considered. The main ones are:
- coronary angioplasty, in which a small catheter with a balloon at its end is inserted and guided to the narrowed coronary artery. Here, the balloon is inflated to widen the lumen of the artery and the surgeon proceeds by inserting one stent to keep it open
- coronary bypass, in which channels are created from scratch to allow blood to flow from the aortas to the coronary arteries. The ducts used can be taken from the internal wall of the chest or from the legs
How to prevent angina pectoris
Cardiovascular diseases, in most cases, develop as a result of an irregular lifestyle that has been going on for a long time. By intervening on them, it is possible reduce the possibilities that they manifest themselves. Here’s what to do:
- avoid smoking or take a gradual path to quitting
- reduce your weight, if there is excess weight
- follow an adequate and personalized food plan (especially if pathologies are present), in which ample space is given to fruit, cereals, vegetables, and legumes. Fatty foods, fried foods, condiments and sauces and ready-to-eat foods should be avoided or reduced to a minimum
- limit alcohol consumption
- take the medications indicated by your doctor
- do physical activity or commit to moving every day
- reduce situations that can develop stress and anxiety
When to contact your doctor
There are cases in which angina pectoris occurs following a previous diagnosis. The first thing to do is take the medications prescribed by your doctor and wait a few minutes; if the symptoms persist or become intense, it is best not to wait, but to call for help immediately.
If you have been diagnosed with angina pectoris, it is important to take note of any symptoms that usually appear and if these present differently or are different, it is advisable to call your doctor and explain the situation. Contact your doctor whenever you have concerns about the medications you are taking and the possible presence of side effects, as well as if you are not comfortable with the treatment plan you are following.
In conclusion, angina pectoris is a symptom (more or less intense) that could be a sign of a significant condition affecting the heart. For this reason, if you experience chest pain or signs like those described above, it is always a good idea to consult your doctor and consider the tests to follow. Otherwise, if the symptoms are significant, it is advisable to go to the emergency room as soon as possible.
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