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Angina Overview

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Angina Overview

Angina, also known as angina pectoris  chest pain, pressure, or squeezing, discomfort occurs due to decreased blood oxygen to heart muscle  as a result of obstruction or spasm of the coronary arteries.

Angina is classified into three categories

  • Stable angina
    • Stable angina occurs when the heart is working harder than usual, for instance, during exercise. It is predicted to happen over months or even years. Rest or medication relieves symptoms.
  • Unstable angina : Unstable angina is acute coronary syndrome where changes are worsen.
    • It is not on regular patter. It is very uncommon and has the alarm for future heart attack.
    • It has at least one of these three features:
      1. It occurs at rest (or with minimal exertion), usually lasting more than 10 minutes
      2. It is severe and of new onset (i.e., within the prior 4–6 weeks)
      3. It occurs with a crescendo pattern (i.e., distinctly more severe, prolonged, or frequent than before).
  • Cardiac syndrome X or microvascular angina
    • It is very rare and can even occur in the rest or relaxed mood without any underlying coronary artery disease.  It is characterized by normal angina like chest pain, in the context of normal epicardial coronary arteries on angiography where decreased blood oxygen to heart muscle  as a result of obstruction or spasm of the coronary arteries. It is relieved by medicine.

Causes 

It occur due to anemia, abnormal heart rhythms and heart failure, its main cause is coronary artery disease, an atherosclerotic (arteries become too narrow) process affecting the arteries increasingly difficult for oxygen-rich blood to reach the heart muscle.

Plaque is build up in condition arteries are damaged (Plaque if formed due to activities like smoking and high levels of fat or sugar in the blood)

Risk factors associated with Angina are

  • Above the age of 45
  • Smoking
  • Diabetes mellitus
  • Hypertension
  • kidney diseases
  • Obesity
  • Physical inactivity
  • Stress
  • family history of premature cardiovascular disease.
  • medications like excess thyroid replacement etc.,
  • Polycythemia etc.,l

Signs and symptoms

  • Signs and symptoms are mainly seen chest region where one can feel squeezing, pressure, heaviness, tightening burning or aching across the chest, usually starting behind the breastbone.
  • And some more symptoms can also seen like
    • Indigestion
    • heartburn
    • weakness
    • Sweating
    • nausea
    • cramping
    • shortness of breath

Diagnosis

  • Diagnosis can be done with physical examination, symptoms, risk factors and family medical history.
  • Some tests are done to diagnosis angina ara
    • Electrocardiogram
    • stress test
    • chest X-ray
    • Coronary angiography
    • Blood tests

Treatment

  • The most specific medicine to treat angina is nitroglycerin. Nitrates prevent or reduce the intensity of angina attacks by relaxing and widening blood vessels.
  • Other medicines may be used such as:
    • beta blockers
    • calcium channel blockers
    • ACE (angiotensin-covering enzyme) inhibitors
    • oral anti-platelet medicines
    • anticoagulants
  • All the medicines are design to lower blood pressure and cholesterol levels as they which slows down the heart rate.

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