Angina, commonly refer to pain or heaviness in chest on exertion or emotional upset, Chest discomfort is produced by in sufficient supply of oxygen to heart muscles Similar situation can arise in brain leading to brain etc. But when we talk about angina it means lack of blood supply to heart muscles. Angina is common and serious problem and these patients may suffer from heart attack any time.
Incidence of coronary artery diseases is in increasing and how affecting the relatively younger people in the country. Angina pain maybe of various types severity and due to different causes.
STABLE ANGINA: This is most common form of angina Patient feel heaviness in the chest which is induced by physical exertion or mental or emotional problems. They may have feeling of squeezing, crushing gripping bank like feeling in the chest. The pain may radiate to neck and throat in to Jaws and or down arms to wrist. Usually pains don’t reach to the fingers It may also be felt in mid upper part to abdomen or on both side of lower chest on side.
Attacks are more likely to occur during work, exercise especially if indulge after meals, in cold weather with high winds, at high altitude
Arguments, exciting good or bad news, watching TV waiting in traffic jams for long segina attacks can also cause angina attacks can occur when lying or a sleeping an exciting or horrible dream etc. Pain is relieved by rest or by antianginal drugs like glycerol trinitrate(sorbitrate). ECG is normal in these patients in bemiain stationary or worsen with decreased capacity.
UNSTABLE ANGINA: When angina attacks are more frequent prolonged with relief, these attacks can occur at rest. Their ECG shows abnormal changes these patients are at high risk to suffer from heart attacks. They enquire immediate hospitalization and prompt treatment.
VARIANT ANGINA (PRINZ - METAL ANGINA) it is rare from of angina. They get angina attacks can occur at any time during work dun to mental emotional tensions or even at rest ECG. Become abnormal during attacks. Pain may or may not be relieved by anti angina drugs these may also suffer from other diseases of arteries in other part of body like Raynaud's disease in hand or and migraine headache.
Usually angina occur due to narrowing of coronary arteries which supply oxygen and nutrients to heart muscles because of deposition of coronary arteries. This process is called as atherosclerosis. The coronary arteries become narrow and less elastic so blood supply to heart muscles decrease and blood flow can't increase during increased need during Physical work, exercise, emotional and tension leading to angina pain. Effort necessary for attacks depends upon the extant and severity of atherosclerosis, change in coronary arteries can be deleted by angiography or/ and Thallium scanning.
ANGLNA WITH NORMAL CORONARY ARTHRIES: Some time angina attacks occur even when these arteries are normal. This condition can occur due to inflame emotion of coronary arteries (coronary arteritis) coronary stenosis, small vessel disease, formation of thrombi or emboli coronary arteries enlargement ( hypertrophy ) of ventricles.
SILENT ANGINA: These patients suffer from angina attacks but don't have typical chest pain The attack can occur usually in morning. They may have feeling of uneasiness weakness dizziness etc. during attacks during attacks ECG become abnormal. Thallium scanning shows reduced perfusion to cardiac muscles. Silent angina is more
WHY ANGINA ATTACKS OCCURS: Heart muscles contract at regular pace throughout the life nutrients. This is supplied by coronary arteries and is branches. The needs for nutrients and oxygen increases during work exercise, emotional tension as heart has to contract rapidly and more force fully. When blood flow can 't meet the requirement of heart muscles, them situation is called as "Ischemia" Muscle contracting under deficit of oxygen produces chemicals like Adenosina, lactic acid etc which causes pain, thus angina attack.
The blood supply to heart muscled can decrease due to atherosclerosis, which make blood vessels narrow and less elastic. Blood flow to heart muscles can also decrease if a blood clot partially block the coronary arteries leading to angina. If blood supply is totally cut off due to total block of coronary arteritis the area of heart muscle dead and this situation is called as heart attacks or Myocardial Infarction (MI) In some patients the angina spasm of coronary arteries due to known or unknown causes (variant angina )
Angina are more likely to occur in obese, heavy smoking, woman consuming oral contraceptive pills, person leading sedentary life live a life full of tension, thyroid diseases havells. To some stent angina is hereditary disease. If one or both parents are suffering from angina, then their offspring are at high risk to suffer from angina.
ASSESSMENT OF ANGINA PATIENTS: Angina is serous disease, these patients should have a full medical checkup to confirm whether they are really suffering from angina or not and to know the severity of angina and its cause. Blood test for hemoglobin, lipid profile glucose be done ECG and TMT (stress test) should be done to know its severity. Thallium scanning is most severity. Thallium scanning is most specific test for diagnosis of angina and its severity. If the test is normal then person is not suffering from angina and chest pain suffering from angina and chest pain may be because of other cause.
By TMT, severity of disease and patients work capaCITY CAN BE assessed. By stress echo cardiography ischemic are in left ventricle can be located, Lastly patients may require angiography to know the sites severity of narrowed or blocked arteries.
MANAGEMENT: Angina is related to life style. These patients have to change their life style, avoid risk factors and so that disease progression can be retarded and if possible reverted.
They should control weight. If overweight or obese, they should decrease it by dieing and exercise, Give up the smoking and tobacco consumption.
If they have abnormal lipid profile like increased total cholesterol LDL - cholesterol decreased HDL - cholesterol, them they should control ' it by changing the died, Curtailing fats especially saturated fats and cholesterol consumption. If needed they should take treatment (stains ). They should eat plenty of vegetables and fruits and whole grain such is cereals legumes.
Incidence of coronary artery diseases is in increasing and how affecting the relatively younger people in the country. Angina pain maybe of various types severity and due to different causes.
STABLE ANGINA: This is most common form of angina Patient feel heaviness in the chest which is induced by physical exertion or mental or emotional problems. They may have feeling of squeezing, crushing gripping bank like feeling in the chest. The pain may radiate to neck and throat in to Jaws and or down arms to wrist. Usually pains don’t reach to the fingers It may also be felt in mid upper part to abdomen or on both side of lower chest on side.
Attacks are more likely to occur during work, exercise especially if indulge after meals, in cold weather with high winds, at high altitude
Arguments, exciting good or bad news, watching TV waiting in traffic jams for long segina attacks can also cause angina attacks can occur when lying or a sleeping an exciting or horrible dream etc. Pain is relieved by rest or by antianginal drugs like glycerol trinitrate(sorbitrate). ECG is normal in these patients in bemiain stationary or worsen with decreased capacity.
UNSTABLE ANGINA: When angina attacks are more frequent prolonged with relief, these attacks can occur at rest. Their ECG shows abnormal changes these patients are at high risk to suffer from heart attacks. They enquire immediate hospitalization and prompt treatment.
VARIANT ANGINA (PRINZ - METAL ANGINA) it is rare from of angina. They get angina attacks can occur at any time during work dun to mental emotional tensions or even at rest ECG. Become abnormal during attacks. Pain may or may not be relieved by anti angina drugs these may also suffer from other diseases of arteries in other part of body like Raynaud's disease in hand or and migraine headache.
Usually angina occur due to narrowing of coronary arteries which supply oxygen and nutrients to heart muscles because of deposition of coronary arteries. This process is called as atherosclerosis. The coronary arteries become narrow and less elastic so blood supply to heart muscles decrease and blood flow can't increase during increased need during Physical work, exercise, emotional and tension leading to angina pain. Effort necessary for attacks depends upon the extant and severity of atherosclerosis, change in coronary arteries can be deleted by angiography or/ and Thallium scanning.
ANGLNA WITH NORMAL CORONARY ARTHRIES: Some time angina attacks occur even when these arteries are normal. This condition can occur due to inflame emotion of coronary arteries (coronary arteritis) coronary stenosis, small vessel disease, formation of thrombi or emboli coronary arteries enlargement ( hypertrophy ) of ventricles.
SILENT ANGINA: These patients suffer from angina attacks but don't have typical chest pain The attack can occur usually in morning. They may have feeling of uneasiness weakness dizziness etc. during attacks during attacks ECG become abnormal. Thallium scanning shows reduced perfusion to cardiac muscles. Silent angina is more
WHY ANGINA ATTACKS OCCURS: Heart muscles contract at regular pace throughout the life nutrients. This is supplied by coronary arteries and is branches. The needs for nutrients and oxygen increases during work exercise, emotional tension as heart has to contract rapidly and more force fully. When blood flow can 't meet the requirement of heart muscles, them situation is called as "Ischemia" Muscle contracting under deficit of oxygen produces chemicals like Adenosina, lactic acid etc which causes pain, thus angina attack.
The blood supply to heart muscled can decrease due to atherosclerosis, which make blood vessels narrow and less elastic. Blood flow to heart muscles can also decrease if a blood clot partially block the coronary arteries leading to angina. If blood supply is totally cut off due to total block of coronary arteritis the area of heart muscle dead and this situation is called as heart attacks or Myocardial Infarction (MI) In some patients the angina spasm of coronary arteries due to known or unknown causes (variant angina )
Angina are more likely to occur in obese, heavy smoking, woman consuming oral contraceptive pills, person leading sedentary life live a life full of tension, thyroid diseases havells. To some stent angina is hereditary disease. If one or both parents are suffering from angina, then their offspring are at high risk to suffer from angina.
ASSESSMENT OF ANGINA PATIENTS: Angina is serous disease, these patients should have a full medical checkup to confirm whether they are really suffering from angina or not and to know the severity of angina and its cause. Blood test for hemoglobin, lipid profile glucose be done ECG and TMT (stress test) should be done to know its severity. Thallium scanning is most severity. Thallium scanning is most specific test for diagnosis of angina and its severity. If the test is normal then person is not suffering from angina and chest pain suffering from angina and chest pain may be because of other cause.
By TMT, severity of disease and patients work capaCITY CAN BE assessed. By stress echo cardiography ischemic are in left ventricle can be located, Lastly patients may require angiography to know the sites severity of narrowed or blocked arteries.
MANAGEMENT: Angina is related to life style. These patients have to change their life style, avoid risk factors and so that disease progression can be retarded and if possible reverted.
They should control weight. If overweight or obese, they should decrease it by dieing and exercise, Give up the smoking and tobacco consumption.
If they have abnormal lipid profile like increased total cholesterol LDL - cholesterol decreased HDL - cholesterol, them they should control ' it by changing the died, Curtailing fats especially saturated fats and cholesterol consumption. If needed they should take treatment (stains ). They should eat plenty of vegetables and fruits and whole grain such is cereals legumes.
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