Angina Pectoris
Are there different types of angina pectoris? Learn about the various symptoms, causes, and the most effective treatments.
Symptoms and Causes
Angina pectoris is a symptom indicating insufficient blood flow to the heart muscle due to a temporary, partial, or complete blockage of one or more coronary arteries. As a result, the myocardium stops receiving blood supply for a few minutes. The main characteristic of this condition is that both blood flow and heart function recover quickly.
Angina pectoris is an oppressive chest pain that may radiate to the left arm and/or jaw and may be accompanied by other symptoms such as sweating, nausea, and dizziness.
Depending on the causes that trigger it or how it responds to treatment, there are different types of angina pectoris:
- Stable angina: This is the most common type. It occurs when the heart is working harder than usual, such as during physical activity or in response to emotional stress, which is why it is also known as exertional angina. The pain is short-lived and usually subsides with rest or appropriate medication.
- Unstable angina: Also known as resting angina, this type manifests even when the heart is beating at a normal rate. It appears suddenly and lasts longer than stable angina, often persisting for more than twenty minutes without improvement from rest or standard medication. To prevent a heart attack, urgent hospital treatment is required.
- Variant angina: Also called Prinzmetal’s angina, named after the cardiologist who first described it, this is the least common type. It is caused by a spasm in the muscle of the arterial wall rather than a blockage due to coronary artery disease.
- Refractory angina: This type presents as chronic pain that does not respond to standard treatments, requiring innovative therapeutic approaches.
Although angina pectoris and heart attacks are sometimes confused, there are clear differences between them. The main distinction is that angina does not cause the death of heart cells, whereas a heart attack leads to irreversible cell death. For this reason, most people affected by angina pectoris do not experience a reduced life expectancy.
Symptoms
The symptoms of angina pectoris are easily recognizable. The most common include:
- Oppressive chest pain that may radiate to the shoulders, back, or jaw.
- Nausea.
- Dizziness.
- Fatigue.
- Shortness of breath.
Sometimes, women present different symptoms, which should be recognized to avoid a delayed diagnosis. The most frequent include:
- Sharp chest pain without pressure.
- Discomfort in the back, neck, and teeth.
- Nausea.
- Abdominal pain.
- Shortness of breath.
Causes
Except for Prinzmetal’s angina, the main cause of angina pectoris is the obstruction of the blood vessels supplying the heart. This blockage is usually due to atherosclerosis, a condition in which the coronary arteries accumulate fatty plaques inside them.
Risk Factors
The main risk factors for developing angina pectoris include:
- Age: It is more common in individuals over 60 years old.
- Family history.
- Smoking.
- High cholesterol.
- High blood pressure.
- Diabetes.
- Obesity.
Complications
In most cases, individuals can lead a normal life despite experiencing angina pectoris. However, there is a higher risk of suffering a heart attack, especially if medical recommendations are not followed.
Prevention
Angina pectoris can be prevented by adopting certain habits, such as:
- Engaging in moderate exercise regularly.
- Maintaining a healthy diet.
- Avoiding alcohol and tobacco consumption.
- Managing weight, cholesterol levels, and blood pressure.
- Properly controlling blood sugar (glucose) levels in diabetics.
- Reducing stress.
Which Doctor Treats Angina Pectoris?
Angina pectoris is treated by cardiologists, internists, and cardiovascular surgeons. Additionally, doctors in the cardiovascular risk unit and specialists in the smoking cessation unit participate in prevention and follow-up care.
Diagnosis
To diagnose angina pectoris, doctors often use various tests. The most common include:
- Physical examination and medical history assessment.
- Electrocardiogram to evaluate the severity of ischemia and detect any previous abnormalities.
- Stress test (exercise electrocardiogram) to assess how the heart responds to increased heart rate.
- Stress echocardiogram (similar to the stress test but combined with an echocardiogram at rest and during exercise).
Treatment
In most cases, the treatment for angina pectoris focuses on making lifestyle changes that promote heart health. These recommendations are the same as those used to prevent the condition. Additionally, to reduce the risk of a heart attack, the following treatments may be used:
- Medications to dilate or widen blood vessels or prevent blood clot formation.
- Drugs to lower cholesterol or control blood pressure.
- Angioplasty to place stents and widen the arteries.
