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Chest Pain Due To Angina And Other Causes
What is angina?
What causes angina?
Why is it important to establish the diagnosis of angina?
How is angina diagnosed?
What are other causes of chest pain?
How does the doctor make a diagnosis in patients with chest pain?
What are the treatment options for angina patients?
What's new in the evaluation of angina?
Angina At A Glance
Chest pain is a common
symptom which can be caused by many different conditions. Some
causes of chest pain require prompt medical attention, such as
angina, heart attack, or tearing of the aorta. Other causes of chest
pain can be evaluated electively, such as spasm of the esophagus,
gallbladder attack, or inflammation of the chest wall. Therefore, an
accurate diagnosis is important in providing proper treatment to
patients with chest pain. The diagnosis and treatment of angina is
discussed below, as well as the diagnosis of other causes of chest
pain that can mimic angina.
What is angina?
Angina (angina pectoris - Latin for squeezing of the chest) is the
chest discomfort that occurs when the blood oxygen supply to an area
of the heart muscle does not meet the demand. In most cases, the
lack of blood supply is due to a narrowing of the coronary arteries
as a result of arteriosclerosis (see below). Angina is usually felt
as a squeezing, pressure, heaviness, tightening, or aching across
the chest, particularly behind the breastbone. This pain often
radiates to the neck, jaw, arms, back, or even the teeth. Patients
may also complain of indigestion, heartburn, weakness, sweating,
nausea, cramping, and shortness of breath.
Angina usually occurs
during exertion, severe emotional stress, or after a heavy meal.
During these periods, the heart muscle demands more blood oxygen
than the narrowed coronary arteries can deliver. Angina typically
lasts from 1 to 15 minutes and is relieved by rest or by placing a
nitroglycerin tablet under the tongue.
Nitroglycerin relaxes the blood vessels and lowers blood pressure.
Both resting and nitroglycerin decrease the heart muscles demand for
oxygen, thus relieving angina.
What causes angina?
The most common cause of angina is coronary artery disease. A less
common cause of angina is spasm of the coronary arteries. Coronary
arteries supply oxygenated blood to the heart muscle. Coronary
artery disease develops as cholesterol is deposited in the artery
wall, causing the formation of a hard, thick substance called
cholesterol plaque. The accumulation of cholesterol plaque over time
causes narrowing of the coronary arteries, a process called
arteriosclerosis. Arteriosclerosis can be accelerated by smoking,
high blood pressure, elevated cholesterol, and diabetes.
When
coronary arteries become narrowed by more than 50% to 70%, they can
no longer meet the increased blood oxygen demand by the heart muscle
during exercise or stress. Lack of oxygen to the heart muscle causes
chest pain (angina). For further information on cholesterol, please
read the
Cholesterol article. The walls
of the arteries are surrounded by muscle fibers. Rapid contraction
of these muscle fibers causes a sudden narrowing (spasm) of the
arteries.
A spasm of the coronary arteries reduces blood to the
heart muscle and causes angina. Angina as a result of a coronary
artery spasm is called "variant" angina or Prinzmetal angina.
Prinzmetal angina typically occurs at rest, usually in the early
morning hours. Spasms can occur in normal coronary arteries as well
as in those already narrowed by arteriosclerosis.
Why is
it important to establish the diagnosis of angina?
Angina is usually a warning sign of the presence of significant
coronary artery disease. Patients with angina are at risk of
developing a heart attack (myocardial infarction). A heart attack is
the death of heart muscle precipitated by the complete blockage of a
diseased coronary artery by a blood clot. For further information,
please read the
Heart Attack article.
During angina, the lack of
oxygen (ischemia) to the heart muscle is temporary and reversible.
The lack of oxygen to the heart muscle resolves and the chest pain
disappears when the patient rests. The muscle damage in a heart
attack is permanent. The dead muscle turns into scar tissue with
healing. A scarred heart cannot pump blood as efficiently as a
normal heart, and can lead to heart failure.
Up to 25% of patients with
significant coronary artery disease have no symptoms at all, even
though they clearly lack adequate blood and oxygen supply to the
heart muscle. These patients have "silent" angina. They have the
same risk of heart attack as those with symptoms of angina. Click
here for more information on angina.
Please note there are
more links to
MedicineNet.com listed below:
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Calcium Channel Blockers - Establishes the medication
Calcium Channel Blockers, which are drugs used for
treating high blood pressure, angina, and abnormal heart
rhythms like atrial fibrillation.
Source:MedicineNet
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verapamil, Calan, Verelan, Verelan PM, Isoptin, Covera-HS
- Clarifies the medication verapamil (Calan, Verelan,
Verelan PM, Isoptin, Covera-HS), a drug used for the
treatment and prevention of angina resulting from coronary
artery spasm as well as from exertion.
Source:MedicineNet
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Coronary Angiogram - Information on coronary angiogram
procedure by MedicineNet.com
Source:MedicineNet
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Read 189 more Angina related articles ...
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