Angina Pectoris

Manila Bulletin, September 6, 2011 | Go to article overview

Angina Pectoris


MANILA, Philippines - ANGINA Pectoris is not a disease in its own right. It is the name for pain that occurs when the muscular wall of the heart becomes temporarily short of oxygen. Normally, the coronary arteries that supply blood to the heart can cope with an increased demand, but this ability is restricted if you have coronary artery disease.

If you have a condition that restricts the supply of oxygen to your heart, the supply may be adequate for some activities but become inadequate if there is an increased demand for oxygen, as occurs when you exercise, when subjected to extremes of temperature, or become highly emotional. When the oxygen requirement falls, the pain usually disappears.

What are the symptoms?

The main symptom of angina is pain in the center of your chest. The pain can spread to your throat and upper jaw, your back, and your arms (almost always the left one). Angina is a dull, heavy, constricting or pressure-like pain that characteristically appears when you are active and fades when you stop activity and rest. Additional symptoms that often accompany the pain of an attack of angina include difficulty breathing, sweating, nausea, and dizziness.

Angina is a common condition. In men it usually occurs after age 30 and it is nearly always caused by coronary artery disease. Angina tends to begin later in life for women except among women over 35 who smoke and also use oral contraceptive pills. The risk of coronary artery disease also increases after a woman goes through menopause.

What are the risks?

Since angina is a symptom rather than a disease, the risks are basically those of the condition that causes it. The heart may become so deprived of oxygen that there is a risk of heart attack - "myocardial infarction" (MI). This refers to the formation of infarcts (area of local tissue death or decay) in the myocardium (heart muscle).

The angina may occur more readily as time goes by, and it may last longer. You may find that you have to become less and less active to avoid the pain.

What should be done?

If you think you are having attacks of angina, see your physician. Accurate diagnosis is essential. The chest discomfort could be related to other problems such as spasm of the esophagus (food pipe) and may not be angina at all.

With accurate diagnosis, your physician can prescribe medications to help relieve the discomfort and determine what treatment might be necessary. Consult your physician at once if the pain of angina lasts longer than 5 minutes after you stop exercising, if your attacks of chest pain are increasing rapidly in frequency, length, or severity, or if the angina comes on at rest and without emotional or physical stress. These are all signs that the condition may be worsening.

Your physician may order a blood test for hyperthyroidism; anemia or some other possible cause contributing to chest pain. You may need a separate blood test to determine the level of cholesterol, or fats, in your blood. You may also need to have blood and urine tests to determine if you have diabetes, since diabetics are particularly susceptible to coronary artery disease.

Tests that may also be required in order to obtain an accurate diagnosis include a chest x-ray, an electro-cardiogram (ECG), an exercise stress test and a coronary angiogram. …

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