Angina

Angina, or angina pectoris, is a recurring discomfort. It’s usually located near the center of the chest.
 
The discomfort occurs most often during exercise or emotional stress. That’s when the heart rate and blood pressure increase, and the heart muscle needs more oxygen. The pain or discomfort occurs when the blood supply to part of the heart muscle doesn’t meet the heart’s needs (oxygen and nutrients).
 
Anginal pain or discomfort is usually brief, lasting just a few minutes. The pain is often accompanied by feelings of anxiety. People describe it as a heaviness, tightness, oppressive pain, burning, pressure or squeezing. Usually it’s located behind the breastbone. Sometimes it spreads to the arms, neck or jaws. It may also cause a numbness in the shoulders, arms or wrists.
 
Causes
Angina is caused by atherosclerosis. This is the narrowing of the coronary arteries caused by deposits of fatty substances such as cholesterol. It usually starts early in life. Everyone has it to some degree by middle age.
 
Risk Factors

•	Family history (parents, siblings) of heart disease
•	Overweight
•	Smoking
•	High stress
•	Type A personality
•	High fat diet (high cholesterol test results)

 
Diagnosis
Usually your doctor can accurately diagnose angina from your description of symptoms:
 

•	Face may be pale or livid
•	Forehead may become sweaty
•	May experience shortness of breath
•	Pulse may become rapid
•	Blood pressure may elevate
•	Eating may have no affect or may cause pain to intensify
•	Pain diminishes when lying flat and resting comfortably

 
But, your doctor may recommend an exercise test or thallium stress test. These techniques allow doctors to diagnose patients who are suffering from angina, but are not exhibiting the symptoms.
 
Treatment
Nitroglycerin usually works well to relieve chest discomfort from angina. Also prescribed are beta blocking calcium blocking drugs. Beta blockers reduce your heart’s work during exercise by slowing the heart rate and lowering blood pressure. Calcium blockers reduce the blood pressure — and sometimes the heart rate — during exercise. They also relax and widen the arteries to the heart muscle like nitrogylcerin does.
 
If you keep having frequent or disabling angine despite using medications, or if your coronary artieries are badly blocked, you may need surgery. Your doctor may advise coronary artery bypass on one or more of your arteries. In this operation, a vein (taken from the leg or chest) is grafted onto the blocked artery, bypassing the blocked area. For a small percentage of people, another procedure, coronary angioplasty, may be advised. It's a technique in which the blockage is a coronary artery is dilated (stretched open) using an inflatible baloon on the tip of a heart catheter.

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