Angina: Causes, Signs and Symptoms and Classification

Angina: Causes, Signs and Symptoms and Classification

Blocked Coronary Artery




Angina is a chest pain which often spreads to shoulders, arms, or neck and is due to inadequate supply of blood to cardiac muscles.

It is also called as Angina Pectoris. Angina word is derived from a Latin word "Angere"- to strangle and pectus- chest, meaning strangling feeling in the chest.

It is one of the most prominent feature of most of the heart diseases, specially Myocardial infraction.


Causes and Risk factors:

  • Age- elderly above 45 yrs
  • Obesity
  • Sedentary life
  •  Smoking
  • Dyslipidemia
  • Hypertension
  • Diabetes mellitus
  • Stress
  • Family history of cardiovascular disease

Etiopathogenesis

Angina results due to restricted blood supply to cardiac muscles which affects the oxygen supply to heart. The Ischemia of Myocardium may be due to-
  1. Stenosis, spasm of occlusion of coronary arteries.
  2. Atherosclerosis is the main commonest cause
  3. Vasospasm
  4. Embolism
  5. Anemia
  6. Chronic smoking

Signs and Symptoms

  • Feeling of pain, discomfort, tightness, dullness or heaviness in chest.
  • The pain may originate from left side of chest or retrosternal and can radiate to left arm, shoulder, neck, jaw or back.
  • Symptoms are precipitated by physical exertion or mental stress and may get relieved after taking rest.
  • It is also precipitated after heavy meals and in cold weather.
  • Chest pain is often associated with dyspnoea, nausea, gastritis, epigastric discomfort.

Classification

Angina is classified into 2 types-
  1. Stable angina
  2. Unstable angina

Stable angina-

This is classical type of angina resulting from myocardial ischemia induced by physical activity or emotional stress. Therefore it is also termed as "Effort Angina". The symptoms of chest pain and discomfort arises after physical exertion on exercise like running. walking etc. and is relieved after taking rest or medication. It is also precipitated after taking heavy meals or emotional stress.

Unstable angina-

This type of angina can occur at any time, it usually occurs at rest or after minimum exertion and last for more than 10 minutes. The pain is severe, prolonged and frequent. It is unpredictable and not relieved by the measures used to relieve stable angina. Unstable angina results due to  reduction of blood flow of coronary artery due to platelet aggregation, coronary spasm or thrombosis. It can result in acute myocardial ischemia.
Other types include-

  • Micro vascular Angina-

also called as Cardiac syndrome X is also characterized by chest pain. It is more common in women and is due to endothelial dysfunction and reduced blood flow in small blood vessels, major arteries are not involved.

  • Prinzmetal’s Angina- 

This type of angina occurs due to spasm of arteries and is common in young women. Coronary arteries are normal with no atherosclerosis.

  • Coital Angina-

Also called as angina d’amour originates after sexual intercourse and is seen in patients with severe coronary artery disease.

Investigations:

  1. ECG
  2. Treadmill test
  3. Echocardiography
  4. CAG coronary angiogram
  5. CT scan
  6. Blood test to study enzyme, blood sugar, blood cholesterol, lipid profile etc.
  7. Chest X-Ray
  8. Nuclear stress test

 

Location: Indonesia

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