What Causes Angina? A Comprehensive Guide

Angina, also known as angina pectoris, is a common symptom of underlying heart disease characterized by angina pain or discomfort. It occurs when the heart muscle does not receive enough oxygen-rich blood, typically due to reducing blood flow through the coronary arteries. This condition can range from mild discomfort to severe chest pain and is often a warning sign of more serious heart conditions such as coronary artery disease or acute coronary syndromes.

At Avicenna Cardiology, we specialize in diagnosing and treating angina to help patients manage symptoms effectively and prevent complications. This guide will explore what causes angina, its risk factors, symptoms, diagnosis, and treatment options to help you take control of your heart health.

Understanding Angina

Definition and Symptoms

Angina, also known as angina pectoris, is a type of chest pain or discomfort caused by reduced blood flow to the heart muscle. This condition occurs when the heart muscle does not receive enough oxygen-rich blood, leading to ischemia. Angina is often a symptom of underlying heart problems, such as coronary artery disease (CAD) or coronary heart disease (CHD).

The symptoms of angina can vary from person to person, but common ones include:

• Chest pain or discomfort that feels like pressure, tightness, or squeezing
• Pain or discomfort in the arms, neck, jaw, back, or stomach
• Shortness of breath
• Lightheadedness or dizziness
• Fatigue
• Nausea or vomiting

It’s important to recognize that angina can be a warning sign of a heart attack. If you experience severe or unexpected chest pain, seek medical attention immediately.

What Causes Angina?

Angina is primarily caused by an imbalance between the heart’s oxygen demand and the supply of oxygen-rich blood. The most common cause is coronary artery disease, which results from plaque buildup (a fatty substance) in the arteries, leading to a narrowed artery and restricted blood flow to the heart.

Angina pain is a symptom of underlying heart conditions and can be triggered by various factors.

Other causes include:

• vasospastic angina (also called prinzmetal angina), which involves spasms in the coronary arteries that temporarily block blood flow
• microvascular angina, which results from dysfunction in the small blood vessels that supply blood to the heart
• aortic stenosis, a condition that narrows the aortic valve and restricts blood flow
• severe hypertension (high blood pressure), which increases the heart’s workload and leads to insufficient oxygen supply
• pulmonary embolism, a blood clot blocking lung arteries, affecting oxygenation of blood reaching the heart

Types of Angina: Stable Angina and Others

Understanding the different types of angina is crucial for proper diagnosis and treatment. The main types include:

1. stable angina (also known as stable ischemic heart disease)
   • Predictable pattern triggered by physical exertion or emotional stress
   • Improves with rest or angina medicine such as nitrates
   • Commonly caused by a narrowed artery due to coronary heart disease
   • Symptoms: chest discomfort, squeezing pain in the shoulders, arms, neck, or jaw
2. unstable angina
   • Occurs suddenly, even at rest, and is considered a medical emergency
   • May lead to a heart attack if left untreated
   • Requires immediate emergency medical treatment
3. variant angina (prinzmetal angina)
   • Caused by coronary artery spasms, often occurring at rest or during nighttime
   • Can be triggered by emotional stress, smoking, or cold temperatures
   • Treated with calcium channel blockers to relax the blood vessels
4. microvascular angina
   • Involves the smaller coronary arteries that fail to supply enough blood
   • More common in women and associated with cardiac syndrome X

Symptoms of Angina

The symptoms of angina may vary from person to person but commonly include:

• chest pain or discomfort, a squeezing, pressure-like feeling in the chest
• pain radiating to shoulders, arms, neck, jaw, often mistaken for a panic attack
• shortness of breath, especially during physical activity
• nausea or dizziness
• fatigue, feeling unusually tired after minimal exertion

It’s important to remember that not all chest pain is related to angina; conditions like musculoskeletal pain or gastroesophageal reflux can mimic angina symptoms.

When to seek medical attention:
If you experience continued pain that does not improve with rest or medications, it may indicate a serious condition like a heart attack, requiring immediate evaluation by a healthcare provider.

Risk Factors for Coronary Artery Disease and Angina

Several risk factors for angina increase the likelihood of developing the condition. These can be classified into modifiable and non-modifiable factors:

Non-modifiable risk factors:

• increasing age, as the risk of developing angina rises with age
• family history, which increases the likelihood of heart disease if close relatives are affected
• gender, with men at higher risk at a younger age, while women’s risk increases after menopause

Modifiable risk factors:

• high blood pressure, which increases strain on the heart and contributes to artery narrowing
• high cholesterol, which promotes plaque formation, reducing blood flow to your heart
• diabetes, which affects the blood vessels and increases heart disease risk
• smoking, which damages blood vessels and lowers oxygen levels in the blood
• sedentary lifestyle, which leads to poor heart health
• unhealthy diet, a diet high in saturated fats and sugars contributes to artery plaque
• emotional stress, which can trigger angina episodes and increase blood pressure

Complications of Untreated Angina

Diagnosing Angina

To diagnose angina, your healthcare provider at Avicenna Cardiology may recommend several tests, including:

1. physical exam and medical history to evaluate risk factors and discuss symptoms such as chest pain caused by exertion
2. blood tests to assess cholesterol levels, markers of heart damage, and overall heart health
3. exercise stress test to measure the heart’s response to physical exertion while monitoring blood flow
4. electrocardiogram (ECG) to record the electrical activity of the heart and detect ischemia
5. coronary angioplasty (diagnostic procedure) to visualize blockages in the coronary arteries

Tests and Procedures

If left untreated, angina can lead to serious complications that can significantly impact your health. Some of the potential complications include:

• Heart Attack: Reduced blood flow to the heart muscle can cause a heart attack, leading to permanent damage to the heart muscle.
• Cardiac Arrhythmias: Angina can increase the risk of abnormal heart rhythms, which can be life-threatening.
• Heart Failure: Untreated angina can lead to heart failure, a condition where the heart is unable to pump enough blood to meet the body’s needs.

To diagnose angina and assess the severity of the condition, your doctor may perform several tests and procedures, including:

• Electrocardiogram (ECG or EKG): This test measures the electrical activity of the heart to detect any abnormalities.
• Stress Test: This test evaluates the heart’s ability to function during physical activity, helping to identify issues with blood flow.
• Coronary Angiogram: Using X-rays and dye, this test visualizes the coronary arteries to identify any blockages or narrowing.
• Heart Scan: Imaging technology is used to visualize the heart and its blood vessels, providing detailed information about the heart’s structure and function.

How to Treat Angina

angina treatment aims to relieve symptoms, prevent progression, and reduce the risk of complications such as heart attacks. Treatment options include:

1. Medications (Angina Medicine):

• nitrates help widen blood vessels to improve blood flow
• beta-blockers reduce heart rate and workload
• calcium channel blockers prevent vasospastic angina by relaxing arteries
• antiplatelet drugs reduce clot formation risk

2. Lifestyle Changes:

• Adopting a heart-healthy lifestyle with regular exercise and a healthy diet
• Managing stress and avoiding triggers of anginal symptoms

3. Medical Procedures:

• coronary angioplasty, a procedure to open narrowed arteries and restore blood flow
• coronary artery bypass surgery (CABG), which redirects blood flow around blocked arteries

Living with Angina

Monitoring and Managing Symptoms

Living with angina requires careful monitoring and proactive management of symptoms to prevent complications. Here are some essential tips to help you manage your angina effectively:

• Take Your Medications as Prescribed: Your doctor may prescribe medications such as nitroglycerin or beta-blockers to help manage your angina symptoms. It’s crucial to take these medications exactly as directed.
• Make Lifestyle Changes: Adopting a heart-healthy lifestyle can significantly improve your condition. Quit smoking, engage in regular physical activity, and follow a balanced diet rich in fruits, vegetables, and whole grains.
• Monitor Your Symptoms: Keep a detailed record of your angina symptoms, noting when they occur, how long they last, and what triggers them. This information can help your doctor adjust your treatment plan as needed.
• Seek Medical Attention: If your symptoms worsen or change, seek medical attention immediately. Prompt treatment can prevent serious complications such as a heart attack.

By understanding angina, its symptoms, and potential complications, you can take proactive steps to manage your condition and maintain your heart health.

Preventing Angina

To prevent angina, consider these strategies:

• maintain healthy blood pressure through diet and exercise
• quit smoking to protect your heart and improve oxygen supply
• monitor cholesterol levels and take prescribed medications
• exercise regularly with guidance from a healthcare provider

Conclusion

Angina is a serious but manageable condition when detected early and treated appropriately. If you experience symptoms such as chest pain, discomfort, or other signs of reduced blood flow to your heart, it’s essential to seek medical attention.

At Avicenna Cardiology, our team of specialists provides expert care in diagnosing, treating, and helping patients manage angina effectively. If you’re concerned about your heart health, schedule an appointment today by visiting Avicenna Cardiology.

Frequently Asked Questions (FAQ) About Angina