HERZ

Symptoms, causes and treatments of angina pectoris

It can happen that a person may experience severe chest pain when over- exerting themselves. One of the probabilities is that this person suffers from angina pectoris, also known as angina. This is a disease of varying degrees of concern, especially as it can be very harmful to the person.

What is angina?

Angina is a disease that manifests itself by a strong bar-like pain in the chest. In some cases, the pain can spread to the back, shoulder, left arm or even the lower jaw. It is often the result of heart pain due to a lack of oxygen. There are generally two types of angina pectoris, depending on the circumstances in which it occurs. It can be stable or unstable depending on whether it is caused by stress or not.

Stable angina

Stress angina or stable angina occurs as a result of physical activity. When this type of angina appears, the activity in question must be stopped immediately. The pain must disappear quickly, or give way under the effect of a molecule called trinitrine. These cases usually occur due to a narrowing of a coronary artery that carries blood to the heart muscle. This narrowing will result in a drop in oxygen levels, which will not be able to get the necessary inflow of oxygen.

Unstable angina

Unstable angina pectoris occurs when the person is at rest. It is more serious because it can be a sign of a myocardial infarction. Unstable angina corresponds to a rupture of atheromatous plaque, which is an accumulation of cells loaded with bad cholesterol. When it breaks off, the cluster may block the lumen of the artery and form a blood clot. It can then lead to a heart attack, a prolonged attack requiring rapid treatment.

Risk factors

The risk factors forangina pectoris are similar to those for other cardiovascular diseases. They include a person's age and family history. Similarly, certain conditions may present a risk factor for angina such as:{xtypo_list}

• High blood pressure
• Diabetes
• A high cholesterol level
• Being overweight
• A sedentary lifestyle
• Excessive consumption of alcohol and tobacco/{xtypo_list}

Symptoms of angina

The pain a person feels is often in the sternum. It can be the result of intense exertion such as brisk walking for example. It can also occur at rest or when a person feels a strong emotion. Severe stress can lead to angina pectoris, for example. In rare cases, the pain may be in the jaw, shoulders or stomach. It can also affect the left lower limbs. However, the disease may be silent in certain categories of people. This is the case for the elderly or those suffering from diabetes. These people usually only experience digestive signs such as nausea and fatigue.

Diagnosis and means of treatment

Diagnosis of angina

The diagnosis of angina pectoris is based on an electrocardiogram if there is no history of infarction. The doctor may also subject the individual to a stress test to stress the heart. This physical test is much more revealing. Ultrasound or scintigraphy can be useful to observe the narrowing of the coronary artery. In case of doubt, the doctor will favour coronary angiography. This is an invasive examination which first involves drawing a catheter up into the heart artery. The injection of a product will then follow, allowing the extent of the narrowing to be revealed precisely. Once the diagnosis of angina is confirmed, treatment must be started immediately to avoid degeneration.

Means of treatment

The basic treatment of stable angina pectoris is divided into five parts, which can be summarised under the acronym "BASIC".

Beta blockers

The prescription of beta-blockers slows down the heart. The aim is to minimise its need for oxygen.

Platelet anti-aggregant

The use of these anti-aggregants helps to fluidify the blood and therefore facilitate its circulation. This is the case with aspirin, for example.

Statins

The third part consists of the use of statins, which are molecules whose role is to combat bad cholesterols. These then prevent the formation of atheromatous plaques.

Conversion enzyme inhibitors

These inhibitors aim to lower the tension.

Correction of risk factors

The aim is to avoid as far as possible all the factors that can contribute to the development of any cardiovascular disease. Indeed, certain behaviours favour certain types of diseases, including angina pectoris. This is the case with tobacco and alcohol. While avoiding these factors, it is important to practise sport regularly and eat a healthy and balanced diet. The aim is to control cholesterol levels. Similarly, to treat and prevent angina at the same time, it is essential to cure all forms of underlying pathologies. These may be hypertension, diabetes or any other condition. Since certain risk factors cannot be changed, such as age, the key is to maintain a healthy lifestyle.