Living with Angina Pectoris
If you suffer regularly from the pains of angina, you are not alone. According to the American Heart Association, approximately 9,100,000 people in the United States also suffer from angina pectoris. Nearly 500,000 new cases will be diagnosed each year.1
Simply put, angina (pronounced an-jahy-nuh) is the symptom commonly known as chest pain. Angina can occur for different reasons, many of which are related to heart disease.
There are two classifications for angina pectoris: Stable angina and unstable angina. Stable angina is the most common type of angina and tends to occur on a frequent basis. Stable angina is often predictable and occurs with physical activity, such as walking or climbing stairs. Stable angina tends to go away with rest or medication (nitroglycerin).
Unstable angina, on the other hand, is not as common but can be a more serious condition. Unstable angina causes severe, gripping chest pain that is often less predictable. This type of angina can occur with no physical activity (at rest). If you suspect that you may have unstable angina contact your doctor or even the hospital immediately. This could be a sign of a serious heart condition and could lead to a heart attack or stroke.
What Causes Angina?
The causes for angina are often heart related. One of the most common causes of angina is Coronary Artery Disease (CAD). Coronary Artery Disease is a condition in which the arteries that supply oxygen rich blood to your heart build up plaque over time. This progressive condition is known as atherosclerosis (pronounced ath-uh-roh-skluh-roh-sis).
Progression of Atherosclerosis
click to enlarge
Atherosclerosis is the leading cause of Coronary Artery Disease. As plaque accumulates over time, the arteries begin to narrow. Eventually, these blockages sreduce blood flow to the heart muscle, a condition known as ischemia. Ischemia simply means there is not enough oxygen supplied to the heart to keep up with the needs of this hard working muscle. The body may react to this reduced blood flow by causing angina or even a heart attack.
What does Angina typically feel like?
When people describe angina, they often use terms like "constricting," "suffocating," "crushing," "tightness," or "squeezing" in their chests. Sometimes this pain may also radiate to your shoulders, arms, neck, jaw, or back. Other severe symptoms may include: weakness, heavy sweating, nausea, indigestion, cramping, or shortness of breath.
It is important to remember that many people do not display any symptoms at all. This is known as "silent" ischemia. Often times, CAD is not diagnosed until a heart attack or heart failure occurs. Heart attacks occur when, overtime, an area of the heart muscle is unable to receive oxygen rich blood. This causes permanent damage to the heart muscle. A heart attack is serious should be treated immediately.
How Long Does Angina last?
Angina attacks tend to begin gradually and reach the maximum intensity within a few minutes, and then it dissipates. The pain usually lasts from 1 to 15 minutes. Non-anginal chest pain typically lasts less than 5 seconds or may last more than 20-30 minutes (unless experiencing a heart attack).2 These non-coronary causes of chest pain may cause sharp, stabbing or burning sensations that tend to come and go within a few seconds.
When does Angina Occur?
The pains of angina can come and go at any time. Many people say they experience discomfort during rest, when walking or climbing stairs, after a heavy meal, or under conditions of extreme stress or cold weather. If you experience chest pain or discomfort with daily activities or when you are resting, contact your doctor immediately. This could be a sign of a serious condition.
What treatments are available for Angina?
The treatments for angina can vary. It is first necessary to determine what is causing the angina. If it is a heart condition, such as Coronary Artery Disease, physicians often prescribe pharmacological agents, perform bypass surgery (CABG), angioplasty or stenting when necessary and appropriate. ECP therapy is often prescribed for those unable or unwilling to undergo surgical intervention. Physicians commonly suggest lifestyle changes such as exercise, stress reduction, or diet modifications to help fight heart disease.
References
1 "Heart Attack and Angina Statistics." American Heart Association. 15 Oct 2008.Heart Attack and Angina Statistics
2 Rutherford, John D., M.D., Eugene Braunwald, M.D. and Peter Cohn, M.D. "Chronic Ischemic Heart Disease." Ed. Braunwald, Eugene, M.D. Heart Disease – A Textbook of Cardiovascular Medicine. Philadelphia: W.B. Saunders Company, 1988. 1316-1318.