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Angina : Causes - Symptoms- Diagnosis -Treatment

 What is Angina?

Angina is a type of chest pain that is caused by reduced blood flow to the heart. It is typically the result of coronary heart disease, which is the narrowing of the coronary arteries. When these arteries become constricted, it can reduce oxygenated blood from reaching the heart, causing the pain associated with angina. It is important to recognize the symptoms of angina, as it can be an indication of serious underlying health issues.

Angina is chest pain that is experienced when the heart is not receiving enough oxygen. It is often caused by a restriction of the arteries in the heart, which limits the amount of blood flow and oxygen to the organ. Angina can occur spontaneously or can be triggered by physical exertion or stress. The pain associated with angina can vary in severity and may include a feeling of pressure, tightness, or heaviness in the chest.

What is Angina?

  1. Circulatory system

    1. Heart

    2. Arteries

    3. Veins

    4. Capillaries

 Medical terms

  • Angina is a medical condition that is caused by a lack of oxygen-rich blood to the heart muscle. It commonly occurs when the heart muscle needs more blood than its regular supply of oxygen-rich blood can provide. In this condition, the patient experiences chest pain or tightness, fatigue, shortness of breath, and/or other symptoms. It is important to be aware of the condition so that proper treatment can be sought out.

Types Angina

There are distinct types of angina. The kind relies upon the cause and whether or not rest or medicinal drug relieve signs.

  • Stable angina. Stable angina is the most common shape of angina. It commonly occurs during activity (exertion) and goes away with relaxation or angina remedy. For example, pain that comes on when you're strolling uphill or inside the bloodless weather may be angina.

  • Stable angina ache is predictable and commonly similar to preceding episodes of chest pain. The chest pain typically lasts a quick time, possibly 5 minutes or much less.

  • Unstable angina (a clinical emergency). Unstable angina is unpredictable and happens at rest. Or the angina ache is worsening and happens with much less bodily attempt. It's generally excessive and lasts longer than solid angina, maybe 20 mins or longer. The ache would not leave with rest or the same old angina medicines. If the blood flow with the flow does not improve, the coronary heart is starved of oxygen and a coronary heart assault occurs. Unstable angina is risky and requires emergency remedy.

  • Variant angina (Prinzmetal angina). Variant angina, additionally known as Prinzmetal angina, is not due to coronary artery disorder. It's resulting from a spasm in the heart's arteries that temporarily reduces blood float. Severe chest pain is the principal symptom of variant angina. It most customarily occurs in cycles, commonly at rest and in a single day. The pain can be relieved by way of angina medicine.

  • Refractory angina. Angina episodes are common notwithstanding an aggregate of medicines and way of life adjustments.

Symptoms Angina

Most human beings with angina describe having chest ache or pressure. Or they describe a squeezing sensation or a tightness of their chest. Some human beings say it feels like indigestion. Others say it’s hard to explain angina with words.

The soreness generally starts behind your breastbone. Sometimes, you can no longer be capable of finding precisely where the ache is coming from.

Pain/soreness you feel in your chest might also unfold to other parts of your higher frame. These encompass your neck, jaw, shoulders, fingers, back or stomach.

Angina symptoms include chest pain and soreness. The chest ache or discomfort may also sense like:

  • Burning

  • Fullness

  • Pressure

  • Squeezing

Other signs and symptoms of angina encompass:

  • Dizziness

  • Fatigue

  • Nausea

  • Shortness of breath

  • Sweating

When to look a physician

If your chest pain lasts longer than a few minutes and doesn't leave whilst you rest or take your angina medicinal drugs, it is able to be a sign you're having a heart attack. Call 911 or emergency scientific help. Only force yourself to the hospital if there is no different transportation choice.


If chest discomfort is a new symptom for you, it's essential to peer your fitness care company to determine the cause and to get proper treatment. If you've been recognized with solid angina and it gets worse or modifications, seek clinical help straight away.

Causes Angina

Angina is due to reduced blood flow to the coronary heart muscle. Blood consists of oxygen, which the heart muscle desires to live to tell the tale. When the coronary heart muscle isn't getting enough oxygen, it causes a condition called ischemia.

The maximum not unusual purpose of reduced blood waft to the heart muscle is coronary artery ailment (CAD). The heart (coronary) arteries can turn out to be narrowed by way of fatty deposits called plaques. This is referred to as atherosclerosis.

If plaques in a blood vessel rupture or a blood clot bureaucracy, it can quickly block or reduce go with the flow via a narrowed artery. This can abruptly and seriously lower blood waft to the coronary heart muscle.

During instances of low oxygen call for — while resting, for instance — the coronary heart muscle might also nonetheless be capable of paintings on the reduced quantity of blood float without triggering angina symptoms. But whilst the call for oxygen is going up, consisting of when exercise, angina can result.

These include:

  • Coronary artery disease (CAD): This is the most not unusual cause of angina. It occurs while plaque (a fatty, waxy substance) builds up on your coronary arteries, which deliver blood to your heart. These arteries slim or harden (atherosclerosis), reducing blood flow in your coronary heart.

  • Coronary microvascular disease: This condition is more common among ladies and people assigned girls at birth (AFAB) as compared with guys and those assigned male at delivery (AMAB). It damages the walls of tiny blood vessels that branch from your coronary arteries. These blood vessels aren’t seen on usual checking out for CAD and require unique trying out that’s now not to be had at all medical centers.

  • Coronary artery spasm: Your coronary arteries time and again constrict (tighten) then open up. These spasms briefly restrict blood glide in your heart. You could have coronary spasms without having coronary artery sickness. This may not be diagnosed with habitual trying out for CAD and may require special checking out that’s now not available in any respect medical centers.

Risk Angina

There are many threat factors for angina. Some elements increase your risk of heart issues that at once cause angina, like coronary artery sickness. Other factors limit how an awful lot of oxygen-wealthy blood can reach your heart.

The following matters may additionally growth the danger of angina:

  • Increasing age. Angina is most common in adults aged 60 and older.

  • Family history of heart disease. Tell your health care company in case your mom, father or any siblings have or had heart sickness or a coronary heart assault.

  • Tobacco use. Smoking, chewing tobacco and long-term exposure to secondhand smoke can damage the lining of the arteries, allowing deposits of cholesterol to acquire and block blood flow with the flow.

  • Diabetes. Diabetes increases the threat of coronary artery disease, which ends up in angina and coronary heart assaults via dashing up atherosclerosis and increasing levels of cholesterol.

  • High blood pressure. Over time, excessive blood pressure damages arteries through accelerating hardening of the arteries.

  • High cholesterol or triglycerides. Too much awful ldl cholesterol — low-density lipoprotein (LDL) — within the blood can cause arteries to narrow. A high LDL will increase the threat of angina and coronary heart assaults. An excessive stage of triglycerides within the blood is also unhealthy.

  • Other health conditions. Chronic kidney ailment, peripheral artery sickness, metabolic syndrome or a record of stroke increases the chance of angina.

  • Not enough exercise. An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes and weight problems. Talk to your health care company about the type and quantity of exercise. It truly is excellent for you.

  • Obesity. Obesity is a threat element for heart ailment that could cause angina. Being overweight makes the heart work more difficult to deliver blood to the body.

  • Emotional stress. Too much pressure and anger can enhance blood strain. Surges of hormones produced all through stress can narrow the arteries and get worse angina.

  • Medications. Drugs that tighten blood vessels, which include a few migraine tablets, may additionally cause Prinzmetal's angina.

  • Drug misuse. Cocaine and different stimulants can cause blood vessel spasms and cause angina.

  • Cold temperatures. Exposure to bloodless temperatures can cause Prinzmetal angina.

Complications Angina

The chest pain that takes place with angina could make performing some sports, consisting of taking walks, uncomfortable. However, the most dangerous difficulty is a heart attack.

Warning signs and symptoms of a heart attack consist of:

  • Pressure, fullness or a squeezing pain within the middle of the chest that lasts for greater than a couple of minutes

  • Pain extending past the chest to the shoulder, arm, returned, or maybe to the tooth and jaw

  • Fainting

  • Impending feel of doom

  • Increasing episodes of chest ache

  • Nausea and vomiting

  • Continued pain within the top belly area (abdomen)

  • Shortness of breath

  • Sweating

Prevention Angina

You can help save your angina by following the equal life-style changes that are used to treat angina. These consist of:

  • Not smoking.

  • Eating a healthful food plan.

  • Avoiding or restricting alcohol.

  • Exercising regularly.

  • Maintaining a healthy weight.

  • Managing different health situations related to heart disease.

  • Reducing strain.

  • Getting encouraged vaccines to keep away from heart complications.

How is angina different from a heart attack?

  • Angina is a symptom of reduced blood flow to the heart, while a heart attack is caused by complete blockage of a coronary artery. Angina typically presents itself as a feeling of tightness or pressure in the chest, but it is not accompanied by the damage done to the heart muscle tissue that a heart attack causes. Angina can be triggered by physical or emotional stress and will usually resolve itself with rest. In contrast, a heart attack is a medical emergency and requires immediate medical attention.

  • Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle. It is often mistaken for a heart attack, but the two are different. Angina is a sign of an underlying heart problem, usually coronary artery disease, while a heart attack is caused when one of the arteries that supplies blood to the heart muscle is blocked. Symptoms of angina include chest tightness, pressure, or pain, and pain that may spread to the neck, jaw, arms, shoulders, and back.

Diagnosis Angina

To diagnose angina, your health care company will do a physical examination and ask questions about your signs. You'll additionally be requested approximately any danger factors, together with whether or not you've got a circle of relatives records of heart disorder.


Tests used to diagnose and confirm angina include

  • Electrocardiogram (ECG or EKG). This brief and painless take a look at measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and occasionally the arms and legs. Wires join the electrodes to a pc, which shows the test outcomes. An ECG can show if the coronary heart is beating too speedy, too slow or under no circumstances. Your health care provider can also search for patterns inside the coronary heart rhythm to see if blood waft thru the heart has been slowed or interrupted.

  • Chest X-ray. A chest X-ray shows the condition of the heart and lungs. A chest X-ray may be carried out to decide if different conditions are inflicting chest ache signs and symptoms and to peer if the heart is enlarged.

  • Blood assessments. Certain coronary heart enzymes enter the bloodstream when the heart muscle is damaged, together with from a coronary heart assault. A cardiac enzyme blood check can help stumble on those substances.

  • Stress check. Sometimes angina is less complicated to diagnose when the coronary heart is operating more difficult. A pressure test usually includes strolling on a treadmill or riding a stationary motorbike at the same time as the coronary heart is monitored. Other exams can be finished at the same time as stress . Take a look at. If you cannot exercise, you'll be given drugs that mimic the impact of exercising at the coronary heart.

  • Echocardiogram. An echocardiogram uses sound waves to create images of the coronary heart in motion. These pix can show how blood flows through the heart. An echocardiogram may be accomplished throughout a stress test.

  • Nuclear strain take a look at. A nuclear stress check helps measure blood flow to the coronary heart muscle at relaxation and during stress. It is just like a routine stress test, but during a nuclear stress test, a radioactive tracer is injected into the bloodstream. A special scanner suggests how the tracer moves thru the coronary heart arteries. Areas that have very little quantities of the tracer advocate negative blood flow.

  • Cardiac automatic tomography (CT). For this check, you generally lie on a desk inside a doughnut old-fashioned device. An X-ray tube inside the gadget rotates around the frame and collects images of the heart and chest. A cardiac CT experiment can show if the coronary heart is enlarged or if any heart's arteries are narrowed.

  • Cardiac magnetic resonance imaging (MRI). This check uses magnetic fields and radio waves to create targeted snap shots of the coronary heart. You usually lie on a table inside an extended, tubelike device that produces exact pics of the coronary heart's shape and blood vessels.

  • Coronary angiography. Coronary angiography makes use of X-ray imaging to look at the inside of the heart's blood vessels. It's a part of a general institution of techniques known as cardiac catheterization.

  • A fitness care company threads a thin tube (catheter) through a blood vessel within the arm or groin to an artery inside the heart and injects dye through the catheter. The dye makes the heart arteries display up greater actually on an X-ray. Your fitness care issuer might name this kind of X-ray an angiogram.

Treatment Angina

Your healthcare issuer will treat the underlying coronary heart hassle that’s causing your angina. The dreams of treatment are to enhance blood go with the flow for your coronary heart and lower your threat of complications. Your provider will give you a physical examination and carry out checking out to analyze extra approximately your circumstance and determine the first-rate treatments.

Options for angina remedy encompass:

  • Lifestyle changes

  • Medications

  • Angioplasty and stenting

  • Open-heart surgical treatment (coronary skip surgical operation)

The desires of angina remedy are to reduce the frequency and severity of the symptoms and to lower the hazard of a coronary heart attack and loss of life.


You will want instantaneous treatment if you have volatile angina or angina ache. It's distinctive from what you normally have.


If the way of life changes — which include consuming wholesome and exercising — do not enhance coronary heart fitness and relieve angina ache, medicinal drugs may be needed. Medications to deal with angina can also encompass:

  • Nitrates. Nitrates are frequently used to deal with angina. Nitrates relax and widen the blood vessels so extra blood flows to the coronary heart. The most common form of nitrate used to deal with angina is nitroglycerin. The nitroglycerin tablet is located under the tongue. Your fitness care issuer would possibly advocate taking a nitrate earlier than activities that typically cause angina (together with exercise) or on a long-term preventive basis.

  • Aspirin. Aspirin reduces blood clotting, making it less complicated for blood to glide via narrowed coronary heart arteries. Preventing blood clots can lessen the risk of a coronary heart attack. Don't start taking aspirin each day without talking to your health care company first.

  • Clot-stopping tablets. Certain medications which include clopidogrel (Plavix), prasugrel (Effient) and ticagrelor (Brilinta) make blood platelets less likely to paste together, so blood doesn't clot. One of those medications may be encouraged in case you can not take aspirin.

  • Beta blockers. Beta blockers reason the heart to beat more slowly and with less force, which lowers blood strain. These drugs also relax blood vessels, which improves blood waft.

  • Statins. Statins are capsules used to lower blood cholesterol. High ldl cholesterol is a threat to coronary heart disease and angina. Statins block a substance that the body needs to make cholesterol. They assist in saving you blockages within the blood vessels.

  • Calcium channel blockers. Calcium channel blockers, additionally known as calcium antagonists, relax and widen blood vessels to enhance blood drift.

  • Other blood pressure medications. Other drugs to lower blood strain consist of angiotensin-changing enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). If you've got high blood stress, diabetes, signs of coronary heart failure or chronic kidney disorder, your health care issuer may additionally prescribe one of these forms of medications.

  • Ranolazine (Ranexa). This medication can be prescribed for chronic solid angina that doesn't get higher with other medications. It can be used on my own or with different angina medicinal drugs, such as calcium channel blockers, beta blockers or nitroglycerin.


Sometimes, a non drug alternative referred to as more suitable external counterpulsation (EECP) can be recommended to boom blood glide to the coronary heart. With EECP, blood pressure-type cuffs are located across the calves, thighs and pelvis. EECP requires a couple of remedy sessions. EECP might also help reduce signs and symptoms in human beings with frequent, out of control angina (refractory angina).

Surgery and methods

If way of life changes, medicines or different cures do not reduce angina pain, a catheter system or open-coronary heart surgical treatment can be needed.

Surgeries and methods used to deal with angina and coronary artery disease consist of:

  • Angioplasty with stenting. During an angioplasty — additionally known as a percutaneous coronary intervention (PCI) — a tiny balloon is inserted into the narrowed artery. The balloon is inflated to widen the artery, after which a small wire mesh coil (stent) is commonly inserted to maintain the artery open.

  • Angioplasty with stenting improves blood waft within the coronary heart, decreasing or doing away with angina. Angioplasty with stenting can be an awesome treatment choice for those with risky angina or if way of life modifications and medications do not successfully deal with chronic, solid angina.

  • Open-coronary heart surgical procedure (coronary artery bypass surgery). During coronary artery skip surgery, a vein or artery from somewhere else inside the body is used to pass a blocked or narrowed heart artery. Bypass surgical treatment increases blood flow to the coronary heart. It's a treatment alternative for both unstable angina and stable angina that has no longer spoken back to other remedies.

Lifestyle and domestic remedies

Heart disorder is often the cause of angina. Making lifestyle adjustments to maintain the coronary heart wholesome is an vital part of angina remedy. Try those strategies:

  • Don't smoke and avoid publicity to secondhand smoke. If you want help quitting, communicate with your fitness care company about smoking cessation remedies.

  • Exercise and control weight. As a popular goal, intention to get at least 30 minutes of mild bodily hobby each day. If you are overweight, communicate with your fitness care company about safe weight loss options. Ask your fitness care company what weight is first-rate for you.

  • Eat a healthy weight loss plan low in salt and saturated and trans fats and wealthy in complete grains, end result and veggies.

  • Manage other health situations. Diabetes, high blood pressure and excessive blood ldl cholesterol can lead to angina.

  • Practice stress relief. Getting greater workout, training mindfulness and connecting with others in aid agencies are a few methods to lessen emotional stress.

  • Avoid or restrict alcohol. If you choose to drink alcohol, achieve this carefully. For wholesome adults, which means up to 1 drink an afternoon for ladies and up to 2 beverages an afternoon for guys.

Preparing in your appointment

If you have got sudden chest pain (risky angina), name 911 or your local emergency variety immediately.

If you have a sturdy circle of relatives with a history of heart sickness, make an appointment with your healthcare provider.

Appointments can be brief, and there's often lots to talk about. So it's a very good concept to take steps to prepare for your appointment. Here's some information that will help you get geared up and what to expect out of your health care company.

What you could do

  • Be aware about any pre-appointment restrictions. When you make the appointment, ask if there may be something you want to do in advance, along with restricting your food plan. For example, you may need to keep away from ingesting or drinking for a time period for a ldl cholesterol blood test.

  • Write down any signs you're having, together with any which could seem unrelated to angina.

  • Write down key private information, which includes any circle of relatives, history of angina, chest pain, heart disorder, stroke, high blood pressure or diabetes, and any foremost stresses or latest life adjustments.

  • Make a listing of all medicines, nutrients or supplements you're taking, and the dosages.

  • Take a member of the family or friend alongside, if viable. Sometimes it could be difficult to not forget all of the data furnished to you throughout an appointment. Someone who accompanies you can keep in mind some thing that you ignored or forgot.

  • Be prepared to discuss your weight-reduction plan and exercising habits. If you don't already observe a food regimen or exercising recurring, speak to your fitness care company about any challenges you may face in getting started.

  • Write down questions to ask your fitness care provider.

Your time with your fitness care issuer is restricted, so preparing a list of questions will assist you in making the maximum amount of time collectively. For angina, a few fundamental inquiries to ask your health care company encompass:

  • What's the maximum probable reason for my chest ache signs and symptoms?

  • What varieties of checks will I want? How do I want to prepare for these assessments?

  • What treatments do you propose and why?

  • What's the safest type and amount of bodily interest for me?

  • I have other health situations. How can I nicely control these conditions collectively?

  • How frequently do I want to follow up with you approximately my angina?

  • Are there any brochures or other published substances that I can take home with me?

  • What websites do you advise traveling?

Don't hesitate to invite every other question that you may have at some stage in your appointment.

What to assume from your health practitioner

Your fitness care issuer is likely to invite you some questions. Being equipped to answer them might also save time to move over any data you need to spend extra time on. Your fitness care provider might also ask:

  • When did you first begin having signs and symptoms?

  • How might you describe the chest ache?

  • Where is the pain placed?

  • Does the ache spread to other parts of the body, such as the neck and hands?

  • How and when did the pain start?

  • Did something unique seem to trigger the chest pain?

  • Does the ache start gradually or unexpectedly?

  • How lengthy does the ache remain?

  • What makes the chest ache worse?

  • What makes the experience better?

  • Do you have different symptoms with the ache, along with nausea or dizziness?

  • Do you have a hassle swallowing?

Do you have a history of heartburn? (Heartburn can mimic the sensation of angina.)

What you can do in the meantime

It's by no means too early to make healthful lifestyle changes. Try these steps:

  • Quit smoking.

  • Eat wholesome meals.

  • Get more exercise.

General summary

  1. Angina is a type of chest pain caused by reduced blood flow to the heart. It is usually caused by a buildup of plaque in the arteries which can restrict blood flow and cause the pain. Angina is not a heart attack, however, as it is typically not due to an obstruction of the artery and only affects part of the heart muscle. Angina can usually be managed with medications and lifestyle changes, whereas a heart attack needs to be treated immediately with medical intervention.

  2. Angina is a type of chest pain caused by reduced blood flow to the heart muscle due to blockage of the coronary arteries. It is a sign that a person is at risk of a heart attack. Unlike a heart attack, angina pain does not cause permanent damage to the heart muscle, and it can be relieved with rest and medications. Angina pain is usually felt in the chest, but it can also spread to the neck, jaw, back, and arms.

  3. Angina is a symptom of heart disease and is not the same as a heart attack. Angina occurs when there is decreased blood flow to the heart muscle. This decreased blood flow can be caused by narrowed arteries due to plaque buildup, or spasms in the coronary arteries. A heart attack, on the other hand, occurs when there is a complete blockage of one of the arteries causing severe damage or death to the heart muscle.

Angina : Causes - Symptoms- Diagnosis -Treatment

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