Angina, also known as angina pectoris, is pain or discomfort in the chest. This is typically a symptom of coronary artery disease, also called coronary artery disease. The pain can arise suddenly (acute) or occur in intermittent and recurrent phases (in this case the problem is chronic). Angina is caused by reduced blood flow to the heart muscle which can lead to cardiac ischaemia; usually, it is the result of a cholesterol build-up that hardens and blocks the arteries of the heart. It has several symptoms, in addition to the well-known chest pain, and it is important to learn to recognize it in order to know if it is worth contacting the doctor.
Steps
Part 1 of 3: Recognizing the Signs of Angina
Step 1. Look for localized pain behind the breastbone
The main symptom of angina is chest pain or discomfort that usually occurs in this area. It is often described as pressure, squeezing, tightness and heaviness.
- This suffering also causes difficulty in breathing. Chest tightness is often compared to pressure from an elephant sitting on the chest.
- Some also consider it similar to the pain of indigestion.
Step 2. Notice if the pain is radiating to other parts of the body
It can start from the chest and reach the arms, shoulders, jaw or neck. It can also manifest as primary pain in areas other than the chest, such as those just mentioned or even in the back.
Women are statistically more likely to develop primary angina pain in other areas than the chest or to suffer from excruciating chest discomfort, far more intense than the sense of constriction or heaviness
Step 3. Recognize associated symptoms
Angina pectoris is caused by myocardial ischemia due to a reduction in blood flow to the heart, which in this way can no longer receive enough oxygen. As a result, the patient is likely to have several types of symptoms in addition to the classic pain. Generally speaking, women are more likely to experience these additional signs, sometimes even without experiencing typical chest pain. These symptoms are:
- Sense of exhaustion
- Nausea
- Vertigo / fainting
- Sweating
- Shortness of breath
- Sense of constriction in the chest
Step 4. Measure the duration of the pain
When you start to feel chest pain that you might associate with angina, you need to get to rest right away and stop any activity that may be causing unwanted stress on the heart. Once you sit and rest, the pain should begin to subside within a short time - about five minutes - if you are experiencing what is called "stable angina," the most common form of this disorder.
A variant is unstable angina, which occurs when the pain is most intense and can last up to thirty minutes. In this case, it is a medical emergency and you need to go to the emergency room right away, to make sure it does not develop into a heart attack
Step 5. Check for typical patterns in the origins of pain
Stable angina is considered stable because the causes and severity are usually constant and predictable - sometimes when the heart is put under too much strain. This means that pain can arise constantly after physical activity, when climbing stairs, when you are particularly stressed and so on.
- If you are used to monitoring the symptoms of stable angina and you find that the pain, its cause, duration, or any other symptom is particularly unusual and different from normal, you should seek immediate medical attention, as the disorder may become unstable and indicate a heart attack.
- Prinzmetal's angina (also called variant angina) is another form of the disorder, but it is associated with heart spasms that interfere with blood flow. This type of angina could cause concern because it also deviates from predictable patterns. However, there are medications that help manage the heart spasms underlying this problem. Symptoms of this variant are often severe and occur at rest, and can therefore be confused with unstable angina. See your doctor right away to get an appropriate diagnosis.
Part 2 of 3: Know when to go to the emergency room
Step 1. Call 911 if you have never suffered from angina in the past
If you have never experienced pain associated with this disorder before and have never been diagnosed with any heart problems, you should call the ambulance at the first episode. Symptoms could indicate a heart attack, so you don't have to wait for them to go away on their own. If these are signs of coronary artery disease, your doctor will discuss possible treatments with you and how to manage future episodes of angina.
Step 2. Call for help if the attack is different from the stable angina attacks you have experienced so far
If you have been diagnosed with coronary artery disease and are familiar with typical pain triggers, you need to seek immediate medical attention when symptoms are different than usual. In this case it could mean that there is a heart attack in progress. Symptoms can differ in different ways, for example:
- They are more serious
- Symptoms last for more than 20 minutes
- They occur at rest
- They occur when you do less activity than usual
- New symptoms develop, such as nausea, shortness of breath, or cold sweats
- Symptoms do not subside despite taking medications such as nitroglycerin
Step 3. Call 911 if stable angina is unresponsive to medication
Nitroglycerin is often prescribed to patients suffering from coronary artery disease, because it is able to dilate the arteries, helping to restore blood flow adequately. You must call an ambulance if the pain does not go away when you are at rest and if it is not reduced by taking nitroglycerin.
Directions for use regarding this tablet or spray drug typically recommend resting when taking one dose every five minutes (up to three doses), while symptoms persist. Take the medicine according to the instructions given to you and contact your doctor if you do not notice any improvement
Part 3 of 3: Recognizing the Risk Factors
Step 1. Age is a risk factor
The chances of suffering from angina increase over the years. In particular, they increase in men over 45 and in women over 55. In general, the development of the disease in women occurs on average 10 years later than in men. A natural drop in estrogen during postmenopause can be a factor that increases the risk of angina and heart attacks.
Step 2. Take gender into consideration
Angina is the more frequent symptom of coronary artery disease in women than in men. Reduced estrogen levels in postmenopausal women play an important role in the development of coronary microvascular disorders - and therefore microvascular angina. Up to 50% of women who have angina suffer from coronary microvascular disease. Coronary heart disease is the leading cause of death in both sexes.
Estrogen protects women from heart attacks. However, after menopause their levels drop significantly and the risk of suffering from angina increases dramatically in patients in this age group. Women who have had an early menopause, either from natural causes or from a hysterectomy (surgical removal of the uterus), are twice as likely to develop angina than their peers who are still menstruating
Step 3. Check your family history
Family history of early heart disease increases the risk of suffering from angina and other heart ailments. If you have a father or brother who was diagnosed with these conditions before the age of 55 - or a mother or sister who became ill before the age of 65 - the risk of suffering from them too is much higher.
If you have a first-degree relative who has been diagnosed with early heart disease, the risk of angina and other heart conditions can increase by as much as 33%. This percentage can be as high as 50% if you have two or more first-degree relatives who are sick
Step 4. Pay attention to smoking
This habit increases the risk of angina and heart problems due to several mechanisms. Smoking accelerates the development of atherosclerosis (storage of fat and cholesterol in the arteries) by up to 50%. The carbon monoxide present in cigarette smoke replaces oxygen in the blood, leading to a shortage of this precious gas in the cells of the heart (cardiac ischemia). In turn, cardiac ischemia can lead to angina and heart attack. Smoking also reduces stamina during exercise, causing the individual to decrease time spent on physical activity, another factor associated with the development of angina.
Step 5. Consider if you are diabetic
Diabetes is a modifiable risk factor for heart disease and therefore also for angina. The blood of diabetics has a viscosity (density) higher than normal; as a result, the heart has to work harder to pump blood. Diabetics also have thicker atrial walls of the heart, which increases the likelihood of obstruction.
Step 6. Measure your blood pressure
In the case of high blood pressure (hypertension), the arteries can harden and thicken. When hypertension is chronic and persistent, damage is created to the walls of the arteries, which thus become more susceptible to atherosclerosis (arterial plaques).
If you are under 60, it is referred to as hypertension when your blood pressure is 140/90 mmHg or higher or when it reaches these levels on more than one occasion. If, on the other hand, you are over 60, it is defined as hypertension when the pressure is 150/90 mmHg or higher on several occasions
Step 7. Try to lower your cholesterol
Hypercholesterolemia (high cholesterol) contributes to the formation of plaques on the atrial walls of the heart (atherosclerosis). Experts recommend adults over 20 years of age to have a full lipoprotein profile check every four to six years to check for angina and other heart conditions.
- This is a blood test that measures total cholesterol, high density lipoprotein (HDL), also known as "good" cholesterol, LDL ("bad") cholesterol and triglycerides.
- Both high levels of LDL and low levels of HDL can lead to atherosclerosis.
Step 8. Don't neglect the weight
Obesity (a body mass index of 30 or more) increases the incidence of other risk factors, as it is a disease linked to hypertension, high cholesterol and the development of diabetes. In fact, this set of associated symptoms is called metabolic syndrome and includes:
- Hyperinsulinemia (fasting blood glucose level above 100 mg / dl);
- Abdominal obesity (waist circumference greater than 100 cm in men and greater than 90 cm in women);
- Reduction in HDL cholesterol levels (less than 40 mg / dl in men and 50 mg / dl in women);
- Hypertriglyceridemia (triglycerides greater than 150 mg / dl);
- Hypertension.
Step 9. Consider the use of oral contraceptives as a risk factor for developing the disease
If you take oral contraceptives, you may be at a higher risk of angina due to the increased risk of coronary heart disease. Check with your doctor to find out if the contraceptive drug you are taking might increase your risk factor and to consider different options.
Step 10. Find out if you have high levels of certain substances in your blood
Your doctor may order blood tests to determine if you have high levels of homocysteine, C-reactive protein, ferritin, interleukin-6, and lipoprotein A. All of these can increase the risk of coronary artery disease and angina if the values are out of the ordinary.. You could have your doctor prescribe these types of tests and then discuss with him how to lower the risk factors in case the values are abnormal.
Step 11. Assess your stress levels
An anxious state leads the heart to work harder, beat faster and harder. People with chronic stress are more likely to develop heart ailments.
Warnings
- If you experience chest pain, see your doctor right away.
- Although this article offers information related to angina, it should not be considered medical advice. Contact your doctor right away if you experience any symptoms associated with the disorder.
- Exposure to cold weather can narrow the lumen of blood vessels, including coronary arteries. This factor can therefore also be a cause of angina.
