Limbic 365Angina, also known as angina pectoris, is a type of chest pain that occurs when the heart muscle doesn’t receive enough oxygen-rich blood. It is usually caused by narrowed or blocked coronary arteries, which can restrict blood flow to the heart.
Case: A 60-year-old male presents with a history of chest pain, tightness, and discomfort that radiates to the neck and left arm. The pain usually occurs during physical activity or emotional stress and is relieved by rest or medication. He has a medical history of hypertension, hyperlipidemia, and smoking. The patient also reports occasional shortness of breath and fatigue.
Pathophysiology
Angina is usually caused by atherosclerosis, a buildup of plaque in the coronary arteries that supply blood to the heart. The plaque can cause the arteries to narrow, reducing blood flow to the heart muscle. When the heart muscle doesn’t receive enough oxygen-rich blood, it can lead to chest pain or discomfort.
Signs and Symptoms
The most common symptom of angina is chest pain or discomfort, which is often described as a pressure or tightness in the chest. The pain may also be felt in the neck, jaw, shoulders, back, or arms. Other symptoms may include shortness of breath, sweating, nausea, dizziness, or fatigue.
Investigations
The diagnosis of angina is usually made based on the patient’s symptoms and medical history. Additional tests may be ordered to confirm the diagnosis or to assess the severity of the condition. These tests may include an electrocardiogram (ECG), a stress test, a chest X-ray, or coronary angiography.
Treatment
The treatment of angina aims to relieve symptoms, prevent complications, and reduce the risk of heart attack or other cardiovascular events. Treatment options may include lifestyle changes, medications, or invasive procedures such as angioplasty or bypass surgery. Lifestyle changes may include quitting smoking, losing weight, exercising regularly, and eating a healthy diet. Medications may include nitroglycerin, beta-blockers, calcium channel blockers, or antiplatelet agents.
Advice (Dos and Don’ts)
To manage angina, it is important to follow some dos and don’ts. The following are some tips to manage angina:
Dos:
- Take medications as prescribed by the healthcare provider.
- Follow a healthy diet that is low in saturated fat and cholesterol.
- Exercise regularly as recommended by the healthcare provider.
- Quit smoking if you smoke.
- Manage stress through relaxation techniques such as meditation or yoga.
Don’ts:
- Don’t ignore chest pain or discomfort. Seek immediate medical attention if you experience chest pain or other symptoms.
- Don’t eat large meals or heavy meals before exercise.
- Don’t exercise in extreme temperatures or weather conditions.
- Don’t overexert yourself during physical activity.
- Don’t consume alcohol in excess.
Reference:
- American Heart Association. (2021). Angina (Chest Pain). Retrieved from https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain
- Mayo Clinic. (2021). Angina. Retrieved from https://www.mayoclinic.org/diseases-conditions/angina/symptoms-causes/syc-20369373
- National Heart, Lung, and Blood Institute. (2021). Angina. Retrieved from https://www.nhlbi.nih.gov/health-topics/angina
- American College of Cardiology. (2021). Angina. Retrieved from https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/About-ACC/Accreditation/BPA/ACC-Resources-for-BPA/Angina_BPA_Resource_2016.pdf
- European Society of Cardiology. (2019). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Retrieved from https://academic.oup.com/eurheartj/article/41/3/407/5556844
- The Joint Commission. (2016). Comprehensive accreditation manual for hospitals: The official handbook. Retrieved from https://www.jointcommission.org/-/media/tjc/documents/standards/comprehensive-accreditation-manuals/camh-2017-tracer-activity-guide.ashx
