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Angina Pectoris

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By definition, angina pectorisis the term used in medicine for chest pain or chest discomfort and it is caused by the coronary heart disease. Angina pectoris is also the major symptom of ischemic heart disease.

Physiologically, the condition it is caused by insufficient blood flow in the heart and to insufficient oxygen supply to the heart muscle-the myocardium, condition caused by the narrowing or blockage of one or more of the coronary blood vessels that supply the myocardium.

In rare cases angina can occur in patients with valvular heart disease, with enlarged heart due to ischemic heart disease called hypertrophic cardiomyopathy or in patients with uncontrolled hypertension.

Typical angina is characterizedby chest pain, chest pressure, chest discomfort, a sensation of fullness, or of squeezing in the chest’s center. Moreover the discomfort may also radiate toward the jaw, neck, shoulder, or even back and arms.

Acid reflux also known as heartburn and various types of lung infections or inflammations can also produce similar symptoms.

Angina may occur in situations of physical pressure, when the heart needs an extra blood supply. An angina attack can be triggered by physical effort, exercises for example running to catch the bus but also by intense emotions or by thermal discomfort. In the case of patients withcoronary artery spasm, angina may occur while they are resting.

Angina is a sign of ischemic heart disease, and must be a warning about the risk of myocardial infraction, cardiac arrest and sudden death.

When we talk about angina, we must take into consideration its forms, first of all, stable angina – patients that experience stable or chronic angina, experience usually predictable episodes of chest pain and chest discomfort.They are triggered by physical or emotional stress and they disappear after rest orthe use of nitroglycerin.

Secondly, unstable angina- manifested as unexpected chest pain that can occur without notable physical stress.In this case chest discomfort can be actually more severe and even more prolonged than in a typical episode of angina. It can be the case of the first angina attack. The cause of unstable angina is commonly known to be the reduced blood flow to the myocardium due to the narrowing of the coronary arteries, caused by cholesterol buildups, condition known as atherosclerosis. A blood clot can partially block an artery or abnormally constricted it causing either inflammation, either infection or secondary complications that can also lead to episodes of unstable angina.

A particularly form of unstable angina is the so-called Prinzmetal’s angina; that is caused by a transient coronary artery spasm and it doesn’t follow emotional or physical stress and always happens when the patient is at rest. The angina attack is characterized by extreme pain and usually occurs between midnight and 8 a.m.

People who experience angina episodes should see their physician for an evaluation because they are at increased risk of stroke –acute myocardial infraction, severe cardiac arrhythmias – ventricular tachycardia and fibrillation and cardiac arrest followed by sudden death.

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