Angina (patient information)

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What is Angina?

Angina is chest pain or discomfort that occurs when your heart muscle does not get enough blood. It may feel like pressure or a squeezing pain in your chest. You may also feel pain in your shoulders, arms, neck, jaw or back. Sometimes it may feel like indigestion.

Not as a disease, Angina is one of symptoms of coronary artery disease (CAD), the most common type of heart disease. CAD happens when a fatty substance called [plaque] builds up in the arteries that supply blood to the heart, reducing blood flow. Thus, people cannot get enough oxygen-rich blood and Angina occurs.

What are symptom of Angina?

Angina itself is the most important syptom of coronary artery disease. It is the signal of myocardium ischemia. There are other symptoms accopanying with angina as following,

• Chest pain: It always focus on precordial region or behind sternum. Not all chest pain is related to coronary artery disease. You need to discriminate from lung problems and digestive diseases. Go to see your doctor to obtain more information.
• Feeling of chest pressure: Some people feel chest pressure just like a huge stone on your chest or like a rope stringing your chest.
• Feeling of indigestion: [Poor appetite], [nausea] or [vomitting] may occur in part patient.
• Pain in shoulders,arms,jaw or back: It is always accompanying with chest pain or discomfort.

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell his/her doctor so that problems can be diagnosed and treated as early as possible.

Who is at risk of Angina?

Studies have found a number of factors that may induce Angina. The risk factors of coronary artery disease are as the same as Angina. It concludes bad lifestyle and cardiovascular diseases risk factors. Some you can change and some you cannot change.

Risk Factors You Can Change

• Cigarette smoking: Cigarette somking has a close relationship with many cardiovascular diseases. Smokers' risk of developing coronary heart disease is 2–4 times than that of nonsmokers. Besides, it is also a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease; smokers have about twice the risk of nonsmokers. Furthermore, cigarette smoking acts with other risk factors to greatly increase the hazard for coronary heart disease. People who smoke seem to have a higher risk of death from coronary heart diseases (and possibly stroke) but these risk isn't as great as cigarette nonsmokers'.
• High blood cholesterol: As blood [cholesterol] rises, so does risk of coronary heart disease. A person's cholesterol level is greatly affected by diet.
• Stress: Clinical researches demonstrate that stress may be a contributing factor for coronary artery disease. People under stress may overeat, start smoking or smoke more than they otherwise would. These behavior may increase the risk of incidence of cardiovascular diseases.
• Weight: Overweight and fat, especially body mass index(BMI) higher than 28 are risk factor for Angina. Controlling weight is an available way to decrease the incident of Angina.
• High blood pressure: Patients with Hypertension seem to have a higher risk to develope coronary artery disease. This is because that Hypertension decrease the reserve of coronary arteries.
• Diabetes mellitus: Like Hypertension, patients with Diabetes mellitus seem to have a higher risk to develope coronary artery disease. Because Diabetes mellituS damage both coronary arteries and [myocardial capillary vessels].
• Drinking too much alcohol: Data has demonstrated too much alcohol damage your arteries and myocardium.

Risk Factors That You Cannot Change

• Age: People being older than 65 years or more have more probobility to develope to coronary artery disease than younger.
• Gender: Male is an independent risk factor to develope to coronary artery disease than female. Post-menopause women also have greater probobility than younger women.
• Heredity: Person with a family history of cardiovascular diseases is more likely to develope to coronary artery disease than people without family history.
• Race: African Americans are at a higher risk than other races.

Diagnosis

Some health problems may cause the similar symptoms with Angina. So people with any of those symptoms should go to see the doctor to be diagnosed and treated as early as possible.

Tests used to Determine the Cause of Angina

• Several blood tests: Blood tests such as CK-MB Test and Troponins Test can be done by your doctor to determine whether or not your heart is damaged.
• Coronary angiography: This is an imaging test that involves the injection of a special dye into your coronary arteries so that visible images can be seen on x rays to show the inside of your coronary arteries and to determine whether or not there is any obstruction of blood flow.
• Electrocardiogram: This is a painless and basic procedure in which a healthcare professional will measure the electrical activity of your heart to find whether there are any heart abnormalities or irregular heart beats.
• Echocardiogram: This is a painless test to identify whether some areas of your heart are not contracting normally.
• Stress testing: The test is done when you are exercising. This makes it easier for doctors to diagnosis heart disease.

When to seek urgent medical care?

People with cardiovascular diseases family history or bad life-style should go to the doctor to follow-up. When one has the following symptoms, he/she need to seek urgent medical care:

• Persistent and severe chest pain
• Sudden drop in blood pressure
• Shortness of breathe
• Angina or chest pain accompanying with sweating or nausea or discomfort in shoulders,arms,jaws,neck or abdomen

These symptoms suggest that the person need to go to hospital to verify whether there are acute coronary syndrome(ACS) or not.

Treatment options

People with Angina have many treatment options. The options are drugs, percataneous coronary intervention(PCI), coronary artery bypass grafting（CABG） and a combination of these methods. The choice of treatment depends mainly on symptoms and the [stenosis] degree of coronary arteries. Your doctor can describe your treatment choices, the expected results of each, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

• Life-style changes: This is the basis of treatment. Controlling your weight and waistline, giving up smoking and alcohol, doing some exercises every week, avoiding stress may be helpful.
• Drugs: Taking the drugs under doctor's direction. Beta-blockers, calcium-channel blockers, aspirin, nitrates, statins and angiotensin-converting enzyme inhibitors(ACEI) are general medicines.
• Percataneous coronary intervention(PCI) and coronary artery bypass grafting（CABG）: These are surgeries to expand coronary arteries or to place stents in coronary arteries or to improve blood supply to coronary arteries.

Diseases with similar symptoms

Other health problems may also cause similar symptoms. Go to see your doctor to verify your diseases as early as possible.

• Shortness of breathe: This is needed to discriminate from respiratory system diseases such as pneumonitis, pulmonary tuberculosis, etc.
• Indigestion: This symptom should be discriminated from digestive system diseases such as gastritis,stomach ulcer,etc.
• Pain in shoulders, arms, jaw or back: Your doctor may discriminate from scapulohumeral periarthritis, teeth diseases and etc.

Sources

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