Angina Pectoris: What are the Symptoms, Causes, and Treatment?

Angina pectoris is a symptom of a coronary artery disease which causes chest pain due to less blood flow to the heart muscle. Angina pectoris is also known as angina, and this problem can be a recurring issue or a sudden acute issue. Angina pectoris can be defined as pressure, stiffness, tightness or pain experienced in the chest. It is a common health problem, but many times it becomes difficult to differentiate from other types of chest pain or uneasiness caused by indigestion. Therefore, if a person is experiencing unexplained chest pain then it is advisable to consult a doctor.

Some of the signs and symptoms of angina pectoris are

• Uneasiness or pain in chest
• Pain in the neck, jaw, arms, shoulder and back along with pain in chest
• Nausea
• Tiredness
• Fainting or lightheadedness
• Difficulty in breathing
• Irregular heart beats
• Sweating
• Anxiety or nervousness

Stable angina is a very common type of angina, and it occurs with exertion and goes away when sufficient rest is taken. The severity and the duration of the pain can vary. If a person is experiencing chest pain as a new or different symptom, then he or she must immediately visit the doctor as it can be due to unstable angina, heart attack or some other serious problem. Also if the symptoms of stable angina do not reduce with time or get worse, then one must seek immediate medical attention.

The difference between stable and unstable angina pectoris

Stable angina pectoris

• It occurs when the heart works harder, for example while exercising or climbing stairs.
• This pain can be easily identified.
• It lasts for a short period of time, which may be five minutes or less.
• It goes away with rest or by taking medication for angina. 

Unstable angina pectoris (a condition which needs emergency medical assistance)

• It can occur anytime even while resting.
• It is different from the usual type of angina.
• It is more severe and will last for a longer duration that can prolong to around 30 minutes. 
• It will not reduce with rest or any angina medication. 
• It can also indicate a heart attack. 

If a person experiences pain or pressure in the chest which lasts for more than a couple of minutes and does not reduce by resting or taking medicines for angina, then meet the doctor immediately. This kind of pain may be because the person is having a heart attack.

Causes of angina pectoris

• Stable angina pectoris usually occurs with physical exertion like exercising, climbing stairs or walking.  When a person exerts excessively the heart requires more blood, but this becomes difficult when the arteries are narrowed. Apart from physical activity, there are other factors that can narrow the arteries which are emotional stress, extreme cold temperature, heavy food and smoking.

• If fat-containing deposits known as plaques in the blood vessels get damaged, a blood clot is formed and this can block or reduce the flow of blood through a narrow artery to the heart muscles causing unstable angina pectoris. And even when blood clots block the heart muscles completely or partly it can cause unstable angina. These situations need immediate medical assistance because if the symptoms of unstable angina get worst and there is no improvement in the flow of blood to the heart muscles the heart will be deprived of oxygen it needs. This can cause a heart attack and therefore be very fatal even causing death.

• When a spasm is developed in the coronary artery, it causes the artery to narrow temporarily and is called variant angina. This reduces the flow of blood to the heart muscles which causes pain in the chest. This condition can be developed even when the person is resting and is many times a severe medical condition which has to be treated with medication.

Risk factors of angina pectoris

There are risk factors that can increase the chance of developing angina pectoris. They include:

• Smoking, chewing tobacco or exposure to secondhand smoke can affect the interior walls of the arteries which cause cholesterol to get deposited and block the blood flow.
• Diabetes is a health condition that increases the chances of coronary artery diseases.
• High blood pressure damages the arteries which affect the flow of blood to the heart muscles.
• High blood cholesterol can cause blockage and narrow the arteries including the arteries that supply blood to the heart.
• Any coronary heart disease or heart attack in the past increases the chance of angina pectoris.
• Men above 45 years old and women above 55 years old are more prone to developing this disease. 
• Lack of physical exercise can cause high blood pressure, high cholesterol, type 2 diabetes and obesity which increase the chance of developing any heart diseases or angina pectoris. 
• Stress also increases the chances of heart attacks and angina pectoris. The hormones produced when a person is under tremendous stress can narrow the arteries and even worsen the symptoms of angina pectoris.

Complications of angina pectoris

The chest pain that is a common symptom of angina pectoris can make certain normal activities difficult, even walking. But the biggest complication associated with angina pectoris is a heart attack. Some of the signs of heart attacks are given below:

• Feeling pressure or squeezing pain in the center of the chest which lasts for more than a couple of minutes
• Pain which extends to the arm, shoulder, back and even to the jaw
• Difficulty in breathing
• Sweating profusely
• Fainting
• Nausea

Treatments for angina pectoris

There are different options available for treating angina pectoris, and they depend on the severity and type of angina the person is suffering from. The objective of the treatment is to reduce the reoccurrence, the severity of the symptoms and the risk of a heart attack.

Change in lifestyle

If a person has mild symptoms of stable angina, then certain lifestyle changes can be sufficient. These include:

• Quit smoking and exposure to second-hand smoke
• Reduce weight if a person is overweight by discussing a weight loss plan with a doctor
• If diabetic, then control diabetes and maintain a healthy diet and exercise regularly
• Reduce over exertion by taking rest breaks
• Avoid eating heavy meals
• Control stress and anger
• Eat healthy foods such as fruits and vegetables. Eat less foods with saturated fat. 
• Workout regularly

Medications

If a person gets no relief by making the necessary lifestyle changes, then he or she must consult a doctor and start taking medications that will help improve the blood flow and reduce chances of blockages in the arteries. Some of the medications are as follows:

• Nitrates – They help in widening the blood vessels, and the most common type of nitrate used to cure angina pectoris is nitroglycerin tablets which are placed under the tongue.
• Aspirin – This reduces the blood clots. allowing smooth flow of blood and reducing the risk of heart attack.
• Clot-preventing medicines – This prevents blood clots by lowering the chances of the blood platelets sticking together. 
• Beta blockers – This allows the blood vessels to calm down and open up to improve the flow of blood. 
• Statins – This is useful to reduce blood cholesterol.
• Calcium channel blockers – This is beneficial in relaxing and widening the blood vessels which improves blood flow.

Apart from lifestyle changes and medication, the other options available for treating angina pectoris are medical procedures and surgeries which include angioplasty, stenting and coronary artery bypass surgery.