Angina

Chest pain due to Heart Disease is called Angina. Angina is usually described as a tightness or crushing sensation in the central chest, often spreading to the jaw or left arm. It may be accompanied by sweating or nausea together with a general sense of lack of well-being and a sense of foreboding.

Angina is caused by blockages within the coronary arteries which supply blood, and therefore oxygen to the heart . In this state, when exercise places a demand for more oxygen to the heart muscle, the coronary blood flow just can’t keep up.

Typical angina is brought on by exertion – and goes away with rest.

The diagnosis is confirmed with an Exercise Stress Test – where heart function is monitored by ECG during a walking test on a treadmill.

Cardiac Dynamics -Angina

A Typical Angina

Perhaps there is no such thing as typical when it comes to angina. Exertion may induce unexplained fatigue, shortness of breath, or just feeling light-headed.

Atypical angina occurs more frequently with age – such that an urgent ECG is recommended in assessing any sudden symptom change occurring in a person over 75 years of age.

Diabetic persons often have minimal symptoms yet can show dramatic changes on an ECG during a treadmill test.

Females may differ slightly in their angina symptoms but more commonly the condition is overlooked in the belief that women are less prone to heart disease than men. They are not. It is simply the age of onset is later in women.
Any symptom that comes on with stress or exertion and is relieved by rest should be regarded as angina until proved otherwise. It warrants prompt investigation.

Unstable Angina

New, onset Angina may constitute a medical emergency. The implication is that a new blockage has occurred, and needs prompt evaluation in an emergency department. It is similar to a heart attack, and is known these days as Acute Coronary Syndrome (ACS)

Acute Coronary Syndrome

When angina symptoms persist for longer than 20 minutes, there is a high risk of on-going injury to the heart muscle. In an injured state, the heart muscle becomes prone to irregular rhythm such as ventricular fibrillation, resulting in cardiac arrest. Hence, emergency department evaluation, with the facility of a cardiac catheter laboratory is required, for urgent coronary angiography, and the placement of a stent. The advent of such facilities has revolutionised the outcome for ACS patients, who nowadays leave hospital effectively unscathed, to return to a normal life.