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Chest Pain or AnginaChest pain can have a number of different causes however angina pectoris can be one of the most common type of heart attack symptoms. Angina is a latin word meaning pain or tightness, and angina pectoris in turn is the latin for pain or tightness in the chest. However the word angina alone is usually used to describe the pain in the chest related to coronary artery disease.
Symptoms of anginaAngina pectoris is commonly used to describe the type of chest pain involved with heart attack symptoms related to coronary artery disease. The pain is commonly described as a crushing, heaviness or tightening sensation in the chest. It may travel into the arms or neck, or less commonly into the abdomen. Although there are other causes of this type of pain (i.e. heartburn, pneumothorax, pleurisy etc), it is often very difficult to distinguish them and professional medical advice should be sought out from your local GP or physician.
Angina pectoris is divided into 2 categories known as stable or unstable angina. These are related to whether the angina is triggered by exercise or physical
activity (stable angina), or occur at rest (unstable angina). Unstable angina is the more serious of the two types as this indicates that the degree of
ischemia to the heart is greater because it does not need an increased blood supply, yet still exhibits symptoms of ischemia. Whereas in stable angina the
heart is working harder during exercise, and this may trigger some ischemia due to an insufficient supply to match the heart muscles demands.
Investigations for anginaInvestigations for angina involve identifying whether the cause of the chest pain is due to the heart or something else. The most common investigation performed on someone suffering from chest pain would be an electrocardiogram (ECG or EKG). This helps to identify any ischemia (lack of blood supply) occuring to the heart muscle. A chest x-ray is also routinely performed on people with pain in the chest as this can help to rule out some types of lung disease. Blood tests may also be performed to help diagnose a heart attack or pulmonary embolism.
An exercise stress test or other types of cardiac studies may also be carried while the heart is under stress (i.e while functioning at an increased workload)
to identify whether the angina is stable or unstable.
Treatment of anginaTreatment for angina pectoris is similar to that of other heart attack symptoms. It is focused around helping to reduce the blockage of the coronary vessels supplying the affected heart muscle. A coronary angiogram is sometimes performed to identify the severity of the coronary artery blockage, and if severe enough it may attempt to be unblocked with the use of angioplasty. Medications can also be used to dilate the coronary vessels and thus reduce the blockage. These include glyceryl trinitrates (GTN), isosorbide mononitrate (ISMN) and calcium channel blockers (nifedipine, amlodipine etc).
Other medications are used to reduce the risk of clotting in the blood, these include aspirin and clopidogrel. Statins are also common first line medications that
reduce the cholesterol level in the blood, and thereby reduce the risk of cholesterol accumulations on the vessel walls (atheromas), these include simvastatin and
atorvastatin amongst many others.
Prognosis of anginaThe prognosis of angina pectoris is variable depending on its severity. Many people who have angina are at significant risk of experiencing significant heart disease. Those who suffer from unstable angina are in turn more likely to have a heart attack than those who have stable angina.
It is important to commence treatment as soon as possible if you think you may be experiencing angina and to reduce your risk factors for coronary artery disease.
Please see your GP or physician as soon as possible if you suspect this.
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