Angina

Introduction to Angina:

• Angina, or anginal pectoris, is chest pain or discomfort that occurs when the heart muscle doesn’t get enough oxygen-rich blood.
• It is a symptom of underlying coronary artery disease (CAD).

Types

1. Stable Angina:

   • Occurrence: Predictably with physical exertion or emotional stress.
   • Relief: Rest or nitroglycerin.

2. Unstable Angina:

   • Occurrence: Unpredictably, may occur at rest.
   • Severity: More severe and prolonged; indicates a higher risk of heart attack.

3. Variant (Prinzmetal’s) Angina:

   • Cause: Spasm in the coronary arteries.
   • Occurrence: Often at rest, usually at night or early morning.

Etiology

• Atherosclerosis: Plaque buildup in coronary arteries.
• Coronary Artery Spasm: Temporary tightening of the muscles within the artery walls.

Pathogenesis of Angina

1. Reduced Blood Flow:

   • Narrowing of coronary arteries due to atherosclerosis limits blood flow to heart muscle.

2. Oxygen Demand:

   • When oxygen demand exceeds supply during exertion or stress, it causes chest pain (angina).

Signs and Symptoms

• Chest Pain: Described as pressure, squeezing, or heaviness.
• Radiating Pain: Pain may spread to the shoulders, arms, neck, jaw, or back.
• Shortness of Breath: Difficulty breathing due to reduced oxygen supply.
• Other Symptoms: Nausea, fatigue, sweating, dizziness.

Management and Treatment

1. Lifestyle Changes

   • Healthy Diet
   • Regular Exercise
   • Smoking Cessation
   • Stress Management

2. Medications

   • Nitrates: Nitroglycerin to relieve pain.
   • Beta-Blockers: Reduce the heart’s workload.
   • Calcium Channel Blockers: Improve blood flow.
   • Statins: Lower cholesterol levels.
   • Antiplatelet Agents: Aspirin to prevent blood clots.
   • ACE Inhibitors: Lower blood pressure and reduce heart strain.

3. Medical Procedures

   • Angioplasty and Stenting: Opens narrowed arteries.
   • Coronary Artery Bypass Grafting (CABG): Creates new pathways for blood flow around blocked arteries.

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