Angina

Angina is a heart condition that is caused when the blood supply to the muscles of the heart is restricted. 
 
It usually occurs when the arteries that supply the heart become hardened and narrowed.
 
The main symptom of angina is a dull, heavy or tight pain in the chest that can sometimes spread to the left arm, neck, jaw or back. The pain is usually triggered by physical activity or stress and usually only lasts for a few minutes.
The onset of this type of chest pain is often referred to as an angina attack.
 
Types of angina
The 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
 
A number of medications can be used to try to achieve these goals. Surgery may be recommended if a person's symptoms do not respond to other forms of treatment. 
 
There are two types of surgical techniques that are used to treat angina. They are:
 
(1) 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 past a blocked or narrow section of artery
 
(2) Percutaneous Coronary Intervention (also known as a coronary angioplasty) - where a narrowed section of artery is widened using a tiny tube called a stent
 
What causes angina?
Most cases of angina are caused by atherosclerosis, which is a condition where the arteries become hardened and narrowed due to a build-up of fatty substances that are known as plaques. 
 
This can restrict the blood supply to the heart and trigger the symptoms of angina.
 
Risk factors for atherosclerosis include:
 - Advanced Age
 - Smoking
 - Obesity
 - A High-fat Diet
 - Conditions that affect the normal flow of blood, 
such as atherosclerosis, are known as cardiovascular diseases (CVD).
 
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.
 
Outlook
Each year it is estimated that just,1 in every 100 people with stable angina will have a fatal heart attack or stroke.
 
However, it is thought that as many as 1 in 40 people may experience a non-fatal heart attack or stroke, both of which can have a considerable impact on a person's quality of life.
 
Depending on a number of possible risk factors, the outlook for people with unstable angina can vary considerably. 
 
These risk factors include:
(1) Your Age
(2) Whether you have a history of Heart Disease
(3) Whether you have high-blood pressure (Hypertension)
(4) Whether you have a long-term condition, such as Type 2 Diabetes.