Types of Angina: How to treat it and how to diagnose it?
Angina, also named as Angina Pectoris is a form of severe chest pain caused by decreased blood flow to the heart muscle, usually as a result of coronary artery disease. Its a warning sign that your heart isn’t receiving enough oxygen-rich blood. A person having Angina attack may feel like pressure, squeezing or pain in the chest.
Now, let’s discuss the types of angina, treatment and diagnostic tests.
Stable Angina: This is the most frequent type. The pain occurs with exertion. It happens with exercise or a stress response and usually goes away with rest or medical therapy.
Unstable Angina: More serious and not predictable, even at rest and does not relieve with rest or medical therapy. Unstable angina is considered a medical emergency because it tends to progress rapidly to a myocardial infarction.
Microvascular Angina: This involves the very tiny arteries in your heart and can occur even at rest. This type of angina may be more relentless and painful as compared to stable angina.
Variant (Prinzmetal’s) Angina: This is a rare form, occurring as a blockage or spasm of coronary artery, usually seen between midnight and early morning. It can cause chest pain, leading to visit emergency rooms often precipitated by stress, cold, or medications.
Symptoms:
Symptoms include severe and sudden chest pain radiating to jaw, neck, back and arms. In some patients pain also radiate in epigastrium region (upper central abdomen).
Some patients feel chest discomfort istead of pain that may be reported as a pressure, squeezing, heartburn, or sensation of choking, nausea, vomiting.
Acute Dyspnea (shortness / difficulty of breathe)
In some cases high blood pressure and heart rate is noticed
Acute coronary syndrome
Sweating, Dizziness
Feeling Exhaust etc
Risk factors
Some common risk factors include
Smoking
Obesity (BMI ≥ 30 kg/m2)
Diseases like Diabetes (type 1 & 2), Hypertension & Dyslipidemia
Lifestyle, family history etc
Diagnosis
Electrocardiogram (ECG or EKG)
Troponin test
Echocardiogram:
Nuclear Stress Test
Coronary Angiogram
Treatment of Angina
Lifestyle changes It includes regular exercise, healthy food, quitting smoking etc
Surgical procedures; In some cases, procedures like angioplasty or coronary artery bypass grafting (CABG) need to be performed to improve blood flow to the heart.
Medication;Four types of medicines are used in the treatment of Angina either alone or in combination
Organic Nitrates; By vasodilation these drugs reduce the demand of myocardial oxygen and workload of heart. Main drugs belong to this group are Nitroglycerine, Sodium nitroprusside, Isosorbide mononitrate, Isosorbide dinitrate etc. Nitroglycerine is often prescribed to relieve acute angina attacks. It’s usually taken as a sublingual tablet (under the tongue) or spray. The typical dose is 0.3 to 0.6 mg as needed, but no more than 3 doses in 15 minutes.
Beta Adrenergic blockers : These drugs helps to reduce the heart rate & heart muscles contraction and oxygen demand. Most common drugs include Propranolol, Atenolol, Metoprolol etc The dosage can vary however initial dose for metoprolol is 25-50 mg daily, which may be adjusted based on the patient’s response and tolerance.
Calcium channel blockers : These help relax and dilate blood vessels, improving blood flow to the heart. these drugs protect cardiac tissue by inhibiting the entering of calcium in coronary vessels. Most common drugs include Amlodipine, Nifedipine etc The typical dose for amlodipine is 5-10 mg daily.
Sodium Channel Blocker Ranolazine belonging to this class is used to treat chronic angina. The typical dose is 500 mg twice daily, but it can be adjusted based on the patient’s needs.
Antiplatelet drugs: These medications prevent the formation of blood clot. Asprin (Acetyl salicylic acid) is the most commonly used
Statins: These drugs are used to lower blood cholesterol levels. Atorvastatin, Rosuvastatin and Simvastatin are most commonly used statins.
Self Care and Awareness
A patient of angina must be aware of following things to improve his health
Regular exercises, like walking or aerobics for atleast half an hour daily.
studies reveal that Quiting smoking will significantly improve health & angina.
Weight management by adopting a healthy diet plan
Manage stress by practicing relaxation techniques regularly like yoga ,deep breathing and meditation.
Treat other health conditions like Diabetes, Hypertension, Insomnia etc
It’s crucial to follow doctor’s prescription and guidance when taking medications, as they will tailor the dose to your specific condition and needs. If you have any concerns or experience side effects, be sure to consult your healthcare provider.
Frequently Asked Questions