Angina pectoris - causes, Symptoms, Treatment

What is Angina Pectoris?

Angina pectoris is the medical term for pain or discomfort in the chest due to an inadequate supply of oxygen-rich blood to the heart. It is often described as a pressure, squeezing, or aching sensation in the chest which can then radiate to the back, neck, arms, shoulders, teeth, or jaw. Angina is not a disease in itself but a symptom related to an underlying problem of the heart, which is usually coronary artery disease.

Types of Angina Pectoris

Understanding the different types of angina pectoris is important for the identification of its symptoms and timely treatment.

Stable Angina: It is controlled with the help of lifestyle measures and medication, and therefore, control of the amount of physical activity and managing stress are necessary for the patient.

Unstable Angina: Is an acute condition that requires immediate treatment in order to prevent damage to the heart.

Variant Angina: Responsive to vasodilators, such as nitrate or calcium channel blockers.

Microvascular Angina: It can be much trickier to diagnose because of the location of the problem in the smaller blood vessels, and the assessment must, therefore, cover the entire complexity of symptoms and medical history.

Risk Factors of Angina Pectoris

Several risk factors cause angina pectoris, that are:

• Coronary Artery Disease: This is the most common cause of angina, generally where the arteries become narrowed or blocked.

• Hypertension: Over time, high blood pressure can damage the arteries, thereby increasing the risk of angina.

• High Cholesterol: It prevents proper blood flow in the arteries due to plaque build-up.

• Smoking: Smoking causes harm to the blood vessels and reduces the oxygen delivery to the heart.

• Diabetes: The risk of developing the disease of coronary artery increases.

• Sedentary Lifestyle: Laziness at work causes no exercise, and subsequently obesity and heart disease

• Obesity: Increased body weight is a strain on the heart.

Symptoms of Angina Pectoris

Recognition of symptoms of angina pectoris is an important step to ensure medical intervention at the right time. Some common symptoms include:

• Chest Pain or Discomfort: It is usually felt to squeeze or pressure.

• Diffuse Pain: Pain may spread to the shoulders, neck, arms, back, teeth, or jaw.

• Shortness of breath: This can be an isolated finding or be present in conjunction with chest pain.

• Nausea: Some people can experience nausea and abdominal pain.

• Fatigue: Some individuals, especially females, may experience unusual levels of tiredness that may indicate angina.

Diagnosis of Angina Pectoris

Diagnosis of angina pectoris includes the following;

Medical history: Provides an overall appreciation of signs and symptoms and risk factors

Electrocardiogram (ECG): Measures activities of the heart .It detects anomalies and monitors heart performance.

Stress Testing: Tests how the heart performs under physical stress

Imaging Tests: Echocardiograms, or coronary angiography, to check blood flow through the coronary arteries.

Treatment for Angina Pectoris

Angina pectoris treatment is directed towards the relief of symptoms and improvement in heart function. General treatment options are:

Lifestyle changes: Dietary, exercise, and weight loss counselling to promote a healthy lifestyle.

Medications: Nitrates, beta-blockers, calcium channel blockers, and antiplatelet medications to improve blood flow and also reduce chest pain.

Surgical Therapy: Angioplasty, CABG, or other interventions are required in more severe cases to open blood vessels.

Tips & Tricks for Exams

Here are some tips and tricks to prepare for the topic of Angina Pectoris:

Study Aids

Be familiar with diagrams of the anatomy of the heart and of the effect of angina pectoris. Study more on causes, symptoms, types of angina pectoris, stable, unstable and variant.

Utilize the flowcharts in mapping diagnosis and treatment options.

Mnemonics

Make mnemonics of characteristic features of angina pectoris. For instance, "CHESS" may be an acronym for Chest pain, Heart muscle, Exertion, Stability (stable angina), and Symptoms.

Practice Diagrams

Draw neat diagrams of the heart to show blood flow and areas affected by angina. Add examples to the several types of angina and their characteristics, which are questions commonly asked in any examination.

Exam Weightage

The table below indicates the weightage and types of questions asked about angina pectoris in different exams:

Angina Pectoris NEET MCQs

Q1. Heaviness with severe chest pain which may disappear with rest indicates

1. Angina pectoris

2. Atherosclerosis

3. Arteriosclerosis

4. Hyperthyroidism

Correct answer: 1) Angina pectoris

Explanation:

Angina pectoris, a condition frequently known as angina, is a manifestation of cardiac distress that arises when the myocardium is deprived of an adequate supply of oxygenated blood. Typically, this condition is indicative of a more profound issue, namely coronary artery disease (CAD).

Causes:
The primary etiological factor for angina pectoris is the diminished perfusion of the heart muscle secondary to atherosclerosis, a condition characterized by the gradual buildup of plaque within the coronary arteries, leading to their narrowing.
Another significant cause is an augmentation in the heart's oxygen requirements, which may surpass the limited supply provided under the constraints of impaired blood flow. This increased demand is often triggered by activities such as exercise or exposure to stressful situations.

Hence, the correct answer is option 1) Angina pectoris

Q2. Blood pressure in the pulmonary artery is:

1. same as that in the aorta.

2. more than that in the carotid.

3. more than that in the pulmonary vein.

4. less than that in the venae cavae.

Correct answer: 3) more than that in the pulmonary vein.

Explanation:

The openings of the right and the left ventricles into the pulmonary artery and the aorta respectively are provided with the semilunar valves.

The valves in the heart allow the flow of blood only in one direction, i.e., from the atria to the ventricles and from the ventricles to the pulmonary artery or aorta. These valves prevent any backward flow.

Hence, the correct answer is Option (3) more than that in the pulmonary vein.

Q3. Most probable cause of heart attack is

1. Vasomotion

2. Systolic pressure 120 mmHg

3. Arteriosclerosis

4. High level of HDL

Correct answer: 3) Arteriosclerosis

Explanation:

Myocardial infarction is also referred to as a heart attack It results from the expiration of a part of the heart muscle following the stopping of blood supply. The symptoms of myocardial infarction include chest pain or discomfort (angina), shortness of breath, nausea, sweating, and pain radiating to the arm, jaw, or back. If left undiagnosed, can lead to major complications like heart failure and even death.

Hence, the correct answer is option 3) Arteriosclerosis.

Also Read:

• MCQ Practice on Disorders of the Circulatory System

• Components of Blood

• Disorders of the Circulatory System

FAQs on Angina Pectoris

What do you mean by angina pectoris?

Angina pectoris is a chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. It is usually caused by coronary artery disease, where fatty deposits (atherosclerosis) narrow the arteries supplying the heart. The pain is often triggered by physical exertion, emotional stress, or heavy meals and usually subsides with rest or medication. Angina itself is not a disease but a symptom of underlying heart problems.

What are the types of angina pectoris?

The main types of angina are:

• Stable angina: Predictable chest pain during exertion or stress, relieved by rest or nitroglycerin.

• Unstable angina: Unexpected chest pain at rest, more severe and dangerous, requiring immediate medical attention.

• Variant angina: Caused by spasms in coronary arteries, often occurring at rest, usually at night.

• Microvascular angina: Chest pain due to poor function of small coronary blood vessels, common in women.

What are the symptoms of angina pectoris?

The symptoms of angina pectoris include chest pain, pressure, heaviness, or tightness often described as a squeezing sensation. The pain may radiate to the left arm, neck, jaw, shoulder, or back. Other associated symptoms are shortness of breath, sweating, dizziness, nausea, and fatigue. Stable angina symptoms appear during exertion, while unstable angina can occur even at rest and may last longer.

How is angina pectoris treated?

Treatment of angina pectoris involves lifestyle changes, medications, and sometimes surgical interventions. Common medications include nitrates (nitroglycerin) to relieve chest pain, beta-blockers and calcium channel blockers to reduce heart workload, and antiplatelet drugs (aspirin) to prevent clots. Severe cases may require angioplasty with stent placement or coronary artery bypass surgery. Lifestyle modifications like a healthy diet, exercise, quitting smoking, and stress management are crucial for long-term management.

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