The term “angina” comes from the Greek word “ankhone”, which means “a strangling sensation”, and the Latin word “pectoris” refers to the chest. Although various factors play a role in the pathogenesis of angina, it is usually a clinical hallmark of myocardial ischaemia and the outcome of CAD (Coronary Artery Diseases).
In ancient India, the condition was known as “hritshoola” and was first described by Sushruta (6th century BC). Dr William Heberden, a British physician, published the first clinical description of angina pectoris in 1768. During the next decade, Heberden saw nearly four times as many such patients, and many other English medical writers documented cases of angina.
If you are looking to know what angina is and how it is diagnosed, let’s discuss it more.
What Is Angina Pectoris?
Angina Pectoris is the medical term used to describe chest pain or discomfort caused by coronary heart disease. It occurs when the heart muscle does not receive enough blood and oxygen. This happens when one or more of the heart’s arteries become restricted or blocked, a condition is known as ‘ischemia’.
Angina causes discomfort in the centre of the chest, such as pressure, fullness, squeezing, or pain. Even though angina is very common, it can be difficult to distinguish it from other types of chest pain, such as indigestion discomfort. Furthermore, some people do not experience pain but have other symptoms such as shortness of breath or weariness. Although angina pectoris is not similar to a heart attack, it does indicate a higher risk of suffering one.
Types of Angina Pectoris
Let’s look at the types of angina and how they differ from one another:
1. Stable Angina
When a person has stable angina, they have brief bouts of discomfort, a squeezing sensation, pressure, or tightness in the chest. Moreover, the person may experience pain episodes that are triggered by physical activity or stress. Episodes are usually brief and eventually vanish. Although stable angina is temporary chest pain, it can gradually lead to acute coronary syndrome.
2. Unstable Angina
Unstable angina, also known as an acute coronary syndrome, is characterised by sudden chest discomfort that arises while you are resting. The discomfort becomes more frequent and severe. The most common reason is decreased blood flow to the heart muscle due to fatty buildups (atherosclerosis) in the coronary arteries. Unstable angina can lead to a heart attack, heart failure, or arrhythmias if left untreated.
3. Microvascular Angina
Microvascular angina is a disorder caused by problems with the heart’s tiniest arteries, which go undiagnosed. This disorder is also known as cardiac syndrome X or non-obstructive coronary artery disease (NOCAD). The symptoms of microvascular angina, which include chest pain, can vary greatly from one patient to the next. For many patients, predicting when the pain will strike is difficult; it can strike at any time, even at rest, during exercise, or during periods of stress.
4. Vasospastic or Variant Angina
Variant angina is a kind of angina that is unusual and can be a severe form of chest pain. Variant angina, unlike other types of angina, happens when you are at rest and not exerting yourself. This usually happens in the early morning or middle of the night. Variant angina is also called ‘Prinzmetal’ (or Prinzmetal’s), angina inversa, and vasospastic angina. This type of angina is rare, accounting for around 2 out of every 100 occurrences of angina, and it frequently affects individuals who are younger than those who suffer from other types of angina.
Symptoms of Angina Pectoris
To fully understand what angina pectoris is, it is essential to know about its symptoms. The following are some of the most common symptoms of angina:
- Chest pain and discomfort, such as a squeezing, pressing or crushing pain, usually under the breastbone
- Pain in the arms, jaw, neck, shoulders, or back
- Shortness of breath
- Fatigue or tiredness
- Nausea, upset stomach, or vomiting
- Dizziness
- Sweating
Take note of the pattern of your symptoms, including what causes the chest discomfort, how it feels, how long it lasts, and whether or not medicine helps. Seek medical help right away if your angina symptoms become more severe, occur when you’re resting, or become unpredictable.
Causes of Angina Pectoris
Another important aspect to grasp Angina Pectoris is understanding the causes behind it. As mentioned before, Angina Pectoris can be a symptom of coronary artery disease. This happens when the arteries that deliver blood to your heart contract and get clogged. There can be a variety of factors behind it:
- Blood clot
- Atherosclerosis (hardening of arteries)
- Plaque in an artery
- Coronary artery spasm
- Reduced pumping of the heart muscle
- A thickened or enlarged heart
- Swelling of a heart sac
- Poor blood flow due to a narrowed heart valve
How is Angina Pectoris diagnosed?
If your doctor suspects you have angina or that your angina is linked to a major cardiac problem, he/she may suggest the following tests and procedures:
- ECG: The electrocardiogram (ECG) is a test that records the electrical activity of the heart and is used to diagnose heart disorders such as arrhythmias or to reveal ischemia (lack of oxygen and blood) in the heart.
- Cardiac catheterisation: In this method, a wire is passed through your coronary arteries. Then a contrast dye is injected into the arteries. X-ray pictures are obtained to see if certain arteries are narrowed, blocked, or have other issues.
- Blood test: These tests can detect specific enzymes, such as troponin, that escape into the bloodstream after a heart attack or severe angina. Elevated cholesterol, LDL, and triglycerides (that can put you at a higher risk for coronary artery disease and, as a result, angina) can be detected by blood testing.
- Stress test: This heart-monitoring test is designed to assess how well the heart performs during physical activity. Typically, during a stress test, you will be asked to engage in physical activity, such as walking on a treadmill. During the exercise session, an ECG is taken. Your doctor examines the ECG to see if your heart rate is normal and if any abnormalities indicate decreased blood supply to your heart.
Some other tests that can be prescribed are:
- Chest X-ray
- Computed Tomography (CT) of chest
- MRI (Magnetic Resonance Imagining)
- Coronary angiography
- Echocardiogram
Conclusion
Angina makes you more likely to have a heart attack. It is, however, a treatable condition. Take it as a warning sign and make healthy lifestyle decisions. Talk to other people who have it. That could assist you in learning how to feel better. Hope this guide has helped you understand what angina is and how it can be diagnosed.