ABSTRACT

Angina is a consultant cardiologist explains angina, a syndrome caused by a restriction in the

supply of oxygen-rich blood to the heart. He explains the risks, symptoms and treatment, and
who is most likely to develop angina. There are two main types of angina are stable angina
and unstable angina.
1. Stable angina
If you have stable angina, your symptoms will usually develop gradually over time and
follow a set pattern. For example, you may only experience symptoms when climbing stairs
or if you are under a lot of stress. The symptoms of stable angina usually only last for a few
minutes and can be improved by taking medication called glyceryl trinitrate.
Stable angina is not life-threatening on its own. However, it is a serious warning sign that you
have an increased risk of experiencing more serious conditions, such as a heart
attack or stroke.
2. Unstable angina
In cases of unstable angina, the symptoms develop rapidly, can persist even at rest and can
last up to 30 minutes. The symptoms of unstable angina may also be resistant to treatment
with glyceryl trinitrate. You may experience symptoms of unstable angina after previously
having symptoms of stable angina. However, unstable angina can also occur in people who
do not have a previous history of stable angina. Unstable angina should be regarded as a
medical emergency because it is a sign that the function of your heart has suddenly and
rapidly deteriorated, increasing your risk of having a heart attack or stroke. Unstable angina
can be treated with medication and surgery.
 Treating Angina
There are three main goals in treating angina. They are:
1. to relieve the symptoms during an angina attack
2. to reduce the number of angina attacks that a person has
3. to prevent the restricted blood supply to the heart becoming more severe because this
could trigger a heart attack or stroke
Who is affected by angina?
Angina is a common condition among older adults.
It England it is estimated that 1 in every 12 men and 1 in every 30 women between 55 and 64
years of age have angina. This figure rises to 1 in every 7 men and 1 in every 12 women who
are over 65 years of age. Angina is thought to be more common in men than women because
in the past more men smoked and smoking is a significant risk factor.
Complications of angina
A major concern for people with angina is that their atherosclerosis will continue to get
worse. This can lead to the blood supply to their heart becoming blocked, which could trigger
a heart attack. Similarly, a blockage of the blood supply to the heart could trigger a stroke. It
is important to emphasise that you can considerably reduce your risk of developing
complications by making a series of lifestyle changes. For example, if you are obese and you
smoke, and you successfully quit smoking and achieve a healthy weight, your risk factor will
be significantly reduced.

Causes of Angina
Like all of the body’s organs and tissues, your heart needs a constant supply of oxygen-rich
blood to function normally. Blood is supplied to the heart by two large blood vessels that are
known as the left and right coronary arteries. Stable angina is most commonly caused when
the coronary arteries become narrow and hardened (atherosclerosis), which restricts the blood
flow to the muscles of the heart. Stable angina is essentially a supply and demand problem.
When you are at rest, the muscles of your heart only need a relatively small supply of blood,
so you will not experience any symptoms. However, when you exercise or feel stressed, your
heart muscles have to work harder and the demand for blood increases. Due to the narrowed
coronary arteries, the required amount of blood is unable to reach the heart in time, which
means that the demand for blood outstrips the supply, triggering the symptoms of angina.
Anything that causes the coronary arteries to narrow is a risk factor for both stable and
unstable angina. For example: high blood pressure, a diet that is high in fat and cholesterol, a
lack of exercise, drinking too much , alcohol , type 1 diabetes and type 2 diabetes, age, family
history
Surgery
Surgery is usually recommended if your angina symptoms fail to respond to medication.
However you will probably need to continue taking some medication after having surgery.
There are two main types of surgery that can be used to treat angina are :
coronary artery bypass graft - where a section of blood vessel is taken from another part of
the body and used to re-route the flow of blood passed a blocked or narrow section of artery
percutaneous coronary intervention (also known as a coronary angioplasty) - where a
narrowed section of artery is widened using a tiny tube called a stent
Heart attack
The leading cause of angina is when the blood supply to the heart becomes clogged up by
fatty deposits called plaques. In cases of stable angina, there is a small chance that one of the
plaques will burst open, causing a blood clot to form. The blood clot can then block the
supply of oxygen-rich blood to the muscles of the heart, causing extensive damage to the
heart muscles and triggering a heart attack. The risk of having a heart attack depends on a
number of factors, such as age, blood pressure and the extent of the blockage. Symptoms of a
heart attack include:
- chest pain - the pain is usually in the centre of your chest and can feel like a sensation
of pressure, tightness or squeezing
- pain in other parts of your body - it can feel as if the pain is travelling from your chest
to your arms (usually the left arm is affected but it can affect both arms), jaw, neck,
back and abdomen
- shortness of breath
- nausea
- an overwhelming sense of anxiety (similar to having a panic attack)
-
The main symptoms of a stroke can be remembered using the word FAST which stands
for Face-Arms-Speech-Time.
Face - the face may have dropped on one side, the person may not be able to smile or their
mouth or eye may have drooped
Arms - the person with suspected stroke may not be able to lift one or both arms and keep
them there because of arm weakness or numbness
Speech - the person’s speech may be slurred or garbled or they may not be able to talk at all
despite appearing to be awake
Time - you should dial 999 immediately if you see any of these signs or symptoms
A stroke can be treated using medication to dissolve the blood clot and surgery to unblock the
carotid artery.
Depression
Living with a condition such as angina can cause feelings of stress and anxiety in some
people, which can lead to symptoms of depression. You may be feeling depressed if during
the last month:
- you have often felt down, depressed or hopeless
- you have little interest or pleasure in doing things
It is important that you speak to your GP if you think that you have depression. Depression
does not only affect your mental health, it can also have an adverse affect on your physical
health as well. Treatments for depression include antidepressant medications and a type of
talking therapy called cognitive behavioural therapy (CBT).
Preventing angina

1. Lifestyle changes
The best way to achieve these goals is to eat a healthy, balanced diet, try to keep your
blood pressure at a healthy level and avoid smoking. This will lower your blood
pressure, reduce your cholesterol levels and strengthen your heart, which are three of
the most effective ways of preventing angina and reducing the risk of a heart attack
and stroke.
2. Diet
Eating an unhealthy diet that is high in fat will make your atherosclerosis worse and
increase your risk of developing a heart attack or stroke. Continuing to eat high fat
foods will cause more fatty plaques to build-up in your arteries. This is because fatty
foods contain cholesterol. There are two main types of cholesterol:
3. low-density lipoprotein (LDL) - is mostly made up of fat plus a small amount of
protein; this type of cholesterol can block your arteries so it is often referred to as ‘bad
cholesterol’
4. high-density lipoprotein (HDL) - is mostly made up of protein plus a small amount
of fat; this type of cholesterol can reduce a blockage in your arteries so it is often
referred to as ‘good cholesterol’
 References

Article-angina pectories –definition-risk factors-types of angina-preventing-surgery.

www.healthcarecenter.com
Angina pectories factors-all/about/angina pectories.humancare.com. Michael, 2002