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| What is it? |
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| Chest pain arising from the heart, usually under the sternum (breastbone), due to an inadequate supply of oxygen to the heart muscle. |
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| Causes |
| * The commonest cause is coronary-artery disease with partial blockage caused by a cholesterol plaque or atherosclerosis. Less common is spasm of arteries that supply blood to the heart. |
| * Anemia. |
| * Overactive thyroid gland. |
| * Rhythm abnormalities causing very rapid heartbeat. |
| * Heart-valve disease. |
|
| Signs and Symptoms |
| * Tightness, squeezing, pressure or mild ache in the chest. Typically this occurs during exertion, emotional stress, or after a heavy meal, lasts 1 to 10 minutes, and is relieved by nitroglycerine spray or tablets under the tongue. |
| * Sudden breathing difficulty (sometimes). |
| * Frequent chest pain similar to indigestion. |
| * A choking feeling in the throat. |
| * Chest pain that may radiate to the jaw, teeth or earlobes. |
| * Heaviness, numbness, tingling or ache in the arm, shoulder, elbow or hand usually on the left side. |
| * Pain between the shoulder blades. |
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| Risk Factors |
| * Smoking, obesity, diabetes mellitus. |
| * High blood pressure, high blood-cholesterol levels. |
| * Excess intake of fat or salt, some medications and caffeine. |
| * Sedentary lifestyle, fatigue, overwork or stress. |
| * Family history of coronary-artery disease. |
| * Exposure to cold and wind. |
|
| Prevention |
| * Obtain medical treatment for underlying causes or risks. |
| * Stop smoking. |
| * Eat a diet that is low in fat and low in salt. Lose weight if you are overweight. |
| * Avoid the stressful physical or emotional factors that trigger angina attacks. |
| * Exercise regularly after consulting doctor. |
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| Prognosis |
| Minor angina can be relieved with rest and use of nitroglycerin and other drugs. Other treatment may be necessary to correct underlying diseases. |
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| Diagnosis and Treatment | |
| *Electrocardiogram, exercise treadmill (Stress test), stress echocardiography, stress Thallium and cardiac catheterisation may be performed. |
| General Measures |
| * Follow up with family doctor is essential. |
| * Medications as prescribed by your doctor. |
| * If medications cannot control the angina, other treatment possibilities include balloon angioplasty to open blocked coronary arteries or surgery to bypass severely blocked coronary arteries. |
| * Follow suggestions under Prevention. |
| * Avoid situations that increase the heart's workload, such as anger, temperature extremes, high altitude (except in commercial airline flights), or sudden bursts of activity. |
| Medication |
| * Nitroglycerin relieves acute symptoms of angina, but it does not affect symptoms of other disorders. It can work within seconds to relieve pain. Always keep it with you for immediate use. |
| Short-acting nitroglycerin treatment can be repeated at 5 minute intervals. When 3 successive doses fail to relieve chest pain, seek urgent medical attention.
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| * Other drugs for coronary disease, such as aspirin, long-acting nitroglycerin preparations, beta-blockers or calcium antagonists may be prescribed. If they are, it is important to follow the prescribed drug regimen. |
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| Activity |
| * Learn to adjust activities to minimize attacks. |
| * Don't use angina as an excuse not to exercise. A regular moderate exercise routine (determined by the doctor) can help to control symptoms. |
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| Diet |
| Low fat, low salt diet is recommended. |
| Weight loss if overweight. |
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| Possible Complications |
| * Heart attack. |
| * Congestive heart failure. |
| * Potentially fatal arrhythmais. |
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