Angina pectoris is a common heart condition and can be a stressful experience. It causes fear and anxiety, and if you are not treated correctly, it can lead to death. Fortunately, there are a variety of treatment options available to alleviate symptoms and avoid hospitalization. Here are a few things to keep in mind about angina pectoris.
Stable angina
Stable angina pectoris is a form of coronary artery disease, a condition in which the blood vessels that supply the heart are blocked. It typically manifests as angina, a pain experienced during physical activity. The prevalence of coronary artery disease is increasing, particularly in low and middle-income countries. The underlying cause of stable angina is an imbalance between the supply of blood and demand for oxygen. The condition is characterized by pain during physical exertion and can be relieved by rest. In addition, patients can be given medication such as nitrates to control the pain.
Stable angina pectoris episodes tend to occur during physical activity, particularly during the morning hours. While these episodes are usually not severe, they are very common and generally follow the same pattern. The most common causes are emotional stress and physical activity. Other triggers may include exposure to extreme temperatures or smoking.
Prinzmetal’s variant angina
Prinzmetal’s variant angina is a type of ischemic chest pain that is associated with transient ST-segment elevation on an electrocardiogram. Symptoms of this syndrome often respond to nitroglycerin therapy. Its pathophysiology is unclear, but a common hypothesis suggests it is caused by coronary artery spasm. It has a benign prognosis and is an infrequent cause of coronary heart disease.
Variant angina occurs almost exclusively at rest and is not precipitated by emotional or physical stress. Electrocardiograms show elevated S-T segments in patients with this disorder, which indicates that the cause is coronary artery spasm. In recent years, arteriographic studies have blurred the distinction between this angina type and other types of angina. In fact, Selwyn and Braunwald regard this angina type as a peculiar form of unstable angina.
Nocturnal angina
Nocturnal angina pectoris is a type of chest pain that occurs during the night. This condition is different from stable angina pectoris, which occurs during the daytime but is associated with stress and activity. In stable angina, episodes are triggered by consistent or similar amounts of activity or stress. In nocturnal angina, however, the heart must work more to provide oxygen, resulting in an elevated ventricular volume. Patients suffering from this type of angina should elevate the head of the bed to relieve the pain.
The best way to treat nocturnal angina pectoris is with a calcium channel blocker or a beta-blocker. In addition, you should try to get adequate rest. In addition to this, it is important to avoid a heavy diet during the night.
Microvascular angina
Researchers have found that coronary microvascular dysfunction can result in a worse prognosis for patients with microvascular angina pectoris than normal patients. They report findings in J Am Heart Assoc. These findings may help identify patients at higher risk for cardiovascular mortality. The clinical significance of these findings is yet to be determined.
In general, the symptoms of microvascular angina (MVA) are similar to those of ischemic chest pain. However, there are important differences between the two. Although the pain may be similar, the artery walls are often normal. Similarly, patients with MVA may have a normal ECG.
Although the diagnosis of microvascular angina has not been fully established, it has been associated with an increased risk of death and major adverse cardiovascular events. Despite these risks, there are no clear guidelines for its management.
Treatment
Medical management of angina pectoris involves two key objectives: the prevention of future myocardial infarctions and death, and the symptomatic reduction of angina. Anti-ischaemic and vasculoprotective medicines are used to reduce symptoms. Revascularisation is performed when pharmacological therapies fail. Recent trials have shown that calcium antagonists and revascularisation can significantly improve symptom control and prognosis.
There are various reasons for the development of angina. It can be due to inadequate coronary perfusion, reduced stroke volume, or frequent premature beats. Cardiovascular abnormalities such as tachyarrhythmia and bradyarrhythmia can also cause angina.
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