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| {{Infobox medical condition (new) | | |
| | name = Angina | | {{Infobox medical condition |
| | pronounce = {{IPAc-en|æ|n|ˈ|dʒ|aɪ|n|ə|,_|ˈ|æ|n|dʒ|ɪ|n|ə}} {{respell|ann|JY|nə|,_|AN|jin|ə}}<ref>{{cite web|title=The definition of angina|url=http://www.dictionary.com/browse/angina?s=t}}</ref> | | | name = Angina |
| | synonyms = Angina pectoris
| | | image = <!-- Image removed --> |
| | image = File:Angina pectoris.png
| | | caption = <!-- Image caption removed --> |
| | caption = Diagram of discomfort caused by coronary artery disease.<br> Pressure, fullness, squeezing or pain in the center of the chest. <br>Can also feel discomfort in the neck, jaw, shoulders, back or arms. | |
| | field = [[Cardiology]] | | | field = [[Cardiology]] |
| | symptoms = | | | symptoms = [[Chest pain]], [[shortness of breath]], [[sweating]], [[nausea]] |
| | complications = | | | complications = [[Heart attack]], [[heart failure]] |
| | onset = | | | onset = [[Middle age]] |
| | duration = | | | duration = [[Minutes]] to [[hours]] |
| | causes = | | | causes = [[Coronary artery disease]], [[anemia]], [[arrhythmia]] |
| | risks = | | | risks = [[Smoking]], [[high blood pressure]], [[diabetes]], [[high cholesterol]] |
| | diagnosis = | | | diagnosis = [[Electrocardiogram]], [[stress test]], [[coronary angiography]] |
| | differential =
| | | treatment = [[Lifestyle changes]], [[medications]], [[surgery]] |
| | prevention =
| | | medication = [[Nitrates]], [[beta blockers]], [[calcium channel blockers]] |
| | treatment = | | | frequency = Common |
| | medication = | |
| | prognosis =
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| | frequency = | |
| | deaths =
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| }} | | }} |
| '''Angina pectoris''' is [[chest pain]] due to [[ischemia]] (a lack of blood and hence [[oxygen]] supply) of the [[myocardium|heart muscle]], generally due to obstruction or spasm of the [[coronary artery|coronary arteries]] (the heart's blood vessels). [[Coronary artery disease]], the main cause of angina, is due to [[atherosclerosis]] of the cardiac arteries. The term derives from the [[Greek language|Greek]] ''ankhon'' ("strangling") and the [[Latin]] ''pectus'' ("chest"), and can therefore be translated as "a strangling feeling in the chest".
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| Worsening ("crescendo") angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of ''unstable angina'' (usually grouped with similar conditions as the [[acute coronary syndrome]]). As these may herald [[myocardial infarction]] (a heart attack), they require urgent medical attention and are generally treated as a presumed heart attack.
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| ==Symptoms==
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| Most patients with angina complain of chest discomfort rather than actual pain, the discomfort is usually described as a pressure, heaviness, squeezing, burning, or choking sensation. Anginal pain may be localized primarily in the epigastrium (upper central abdomen), back, neck, jaw, or shoulders. Typical locations for radiation of pain are arms, shoulders, and neck. Angina typically is precipitated by exertion or emotional stress, and exacerbated by having a full stomach or cold temperatures. Pain may be accompanied by sweating and nausea in some cases. It usually lasts for about 1 to 5 minutes, and is relieved by rest or specific anti-angina medication. Chest pain lasting only a few seconds is normally not angina.
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| Some experience "autonomic symptoms" (related to increased activity of the [[autonomic nervous system]]) such as [[nausea]], [[vomiting]] and [[pallor]].
| | '''Angina''', also known as '''angina pectoris''', is a type of [[chest pain]] caused by reduced blood flow to the [[heart muscle]]. It is a symptom of [[coronary artery disease]]. |
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| <youtube>
| | == Signs and Symptoms == |
| title='''{{PAGENAME}}'''
| | Angina is typically described as a feeling of pressure, heaviness, or tightness in the chest. It may also be felt in the [[shoulders]], [[arms]], [[neck]], [[jaw]], or [[back]]. Other symptoms can include [[shortness of breath]], [[sweating]], [[nausea]], and [[dizziness]]. |
| movie_url=http://www.youtube.com/v/4SeAswTIWrs
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| embed_source_url=http://www.youtube.com/v/4SeAswTIWrs
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| Major risk factors for angina include [[family history (medicine)|family history]] of premature heart disease, [[tobacco smoking|cigarette smoking]], [[diabetes]], [[high cholesterol]], and [[hypertension|high blood pressure]].
| | == Causes == |
| | The most common cause of angina is [[coronary artery disease]], which occurs when the [[coronary arteries]] become narrowed or blocked by [[atherosclerosis]]. Other causes can include [[anemia]], [[arrhythmia]], and [[heart valve disease]]. |
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| A variant form of angina ([[Prinzmetal's angina]]) occurs in patients with normal coronary arteries or insignificant atherosclerosis. It is thought to be caused by spasms of the artery. It occurs more in younger women.
| | == Risk Factors == |
| | Risk factors for angina include [[smoking]], [[high blood pressure]], [[diabetes]], [[high cholesterol]], [[obesity]], [[sedentary lifestyle]], and [[family history]] of heart disease. |
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| ==Diagnosis== | | == Diagnosis == |
| In patients with occasional angina who are not having chest pain, an [[electrocardiogram]] (ECG) is typically normal, unless there have been other cardiac problems in the past. During pain, depression or elevation of the [[Electrocardiogram#T wave|ST segment]] may be observed. To elicit these changes, an [[Cardiac stress test|exercise ECG test]] ("treadmill test") may be performed, during which the patient exercises to the point that the pain occurs; if the ECG changes are documented, the test is considered diagnostic for angina. Other alternatives include a [[Cardiac stress test|thallium scintigram]] (in patients that cannot exert enough for the purposes of the treadmill tests, e.g., due to [[asthma]] or [[arthritis]]).
| | Diagnosis of angina typically involves a [[medical history]] and [[physical examination]], followed by tests such as an [[electrocardiogram]] (ECG), [[stress test]], and [[coronary angiography]]. |
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| In patients in whom noninvasive testing is diagnostic, a [[coronary angiogram]] is typically performed to identify the nature of the coronary lesion, and whether this would be a candidate for [[angioplasty]], [[coronary artery bypass graft]] (CABG) or other treatments.
| | == Treatment == |
| | Treatment for angina includes [[lifestyle changes]] such as [[diet]] and [[exercise]], [[medications]] like [[nitrates]], [[beta blockers]], and [[calcium channel blockers]], and [[surgical procedures]] such as [[angioplasty]] and [[coronary artery bypass grafting]] (CABG). |
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| ==Pathophysiology== | | == Prevention == |
| Increases in heart rate result in increased oxygen demand by the heart. The heart has a limited ability to increase its oxygen intake during episodes of increased demand. Therefore, an increase in oxygen demand by the heart (eg, during exercise) has to be met by a proportional increase in blood flow to the heart.
| | Preventive measures include maintaining a [[healthy lifestyle]], managing [[risk factors]] like [[hypertension]] and [[diabetes]], and taking prescribed [[medications]] to prevent the progression of [[coronary artery disease]]. |
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| Myocardial ischemia can result from:
| | == See Also == |
| # a reduction of blood flow to the heart caused by the stenosis or spasm of the heart's arteries
| | * [[Coronary artery disease]] |
| # resistance of the blood vessels
| | * [[Heart attack]] |
| # reduced oxygen-carrying capacity of the blood.
| | * [[Cardiology]] |
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| [[Atherosclerosis]] is the most common cause of [[stenosis]] (narrowing of the blood vessels) of the heart's arteries and, hence, angina pectoris. Some people with chest pain have normal or minimal narrowing of heart arteries; in these patients, vasospasm is a more likely cause for the pain, sometimes in the context of [[Prinzmetal angina]] and [[syndrome X]].
| | == References == |
| | {{Reflist}} |
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| Myocardial ischemia also can be the result of factors affecting blood composition, such as reduced oxygen-carrying capacity of [[blood]], as seen with severe [[anemia]] (low number of red blood cells), or long-term [[tobacco smoking|smoking]].
| | == External Links == |
| | * [https://www.wikimd.com/wiki/Angina Angina on WikiMD] |
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| ==Epidemiology==
| | [[Category:Cardiology]] |
| Roughly 6.3 million Americans are estimated to experience angina. Angina is more often the presenting symptom of coronary artery disease in women than in men. The prevalence of angina rises with an increase in age. Similar figures apply in the remainder of the Western world. All forms of coronary heart disease are much less-common in the [[Third World]], as its risk factors are much more-common in Western and Westernized countries; it could therefore be termed a [[Diseases of affluence|disease of affluence]]. The increase of [[tobacco smoking|smoking]], [[obesity]] and other risk factors has already led to an increase in angina and related diseases in countries such as [[China]].
| | [[Category:Medical conditions]] |
| | | [[Category:Symptoms]] |
| ==Treatment==
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| The main goals of treatment in angina pectoris are relief of symptoms, slowing progression of the disease, and reduction of future events, especially [[myocardial infarction|heart attacks]]. An [[aspirin]] (75 mg to 100 mg) per day has been shown to be beneficial for all patients with stable angina that have no problems with its use. [[Beta-blocker]]s and [[nitroglycerin]] medication are used for symptomatic relief of angina and prevention of ischemic events, and [[calcium channel blocker]]s (such as [[nifedipine]]). [[Isosorbide mononitrate]] and [[nicorandil]] are vasodilators commonly used in chronic stable angina.
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| Identifying and treating risk factors of coronary heart disease is a priority in patients with angina. This means testing for [[hypercholesterolemia|elevated cholesterol]], [[diabetes mellitus|diabetes]], [[hypertension]] (high blood pressure), [[smoking cessation|stopping smoking]] and [[weight loss|losing weight]].
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| ==See also==
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| *[[Ludwig's angina]]
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| *[[Prinzmetal's angina]]
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| {{Medical condition classification and resources
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| | DiseasesDB = 8695
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| | ICD10 = {{ICD10|I|20||i|20}}
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| | ICD9 = {{ICD9|413}}
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| | ICDO =
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| | OMIM =
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| | MedlinePlus = 000198
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| | MedlinePlus_mult = {{MedlinePlus2|000201}}
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| | eMedicineSubj = med
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| | eMedicineTopic = 133
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| | MeshID = D000787
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| }}
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| {{stub}}
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| {{Cardiovascular system symptoms and signs}}
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| {{Heart diseases}}
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| {{DEFAULTSORT:Angina Pectoris}}
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| [[Category:Acute pain]] | |
| [[Category:Ischemic heart diseases]] | |
| Angina
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|
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| Synonyms
|
N/A
|
| Pronounce
|
N/A
|
| Specialty
|
N/A
|
| Symptoms
|
Chest pain, shortness of breath, sweating, nausea
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| Complications
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Heart attack, heart failure
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| Onset
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Middle age
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| Duration
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Minutes to hours
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| Types
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N/A
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| Causes
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Coronary artery disease, anemia, arrhythmia
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| Risks
|
Smoking, high blood pressure, diabetes, high cholesterol
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| Diagnosis
|
Electrocardiogram, stress test, coronary angiography
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| Differential diagnosis
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N/A
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| Prevention
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N/A
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| Treatment
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Lifestyle changes, medications, surgery
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| Medication
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Nitrates, beta blockers, calcium channel blockers
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| Prognosis
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N/A
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| Frequency
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Common
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| Deaths
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N/A
|
Angina, also known as angina pectoris, is a type of chest pain caused by reduced blood flow to the heart muscle. It is a symptom of coronary artery disease.
Signs and Symptoms
Angina is typically described as a feeling of pressure, heaviness, or tightness in the chest. It may also be felt in the shoulders, arms, neck, jaw, or back. Other symptoms can include shortness of breath, sweating, nausea, and dizziness.
Causes
The most common cause of angina is coronary artery disease, which occurs when the coronary arteries become narrowed or blocked by atherosclerosis. Other causes can include anemia, arrhythmia, and heart valve disease.
Risk Factors
Risk factors for angina include smoking, high blood pressure, diabetes, high cholesterol, obesity, sedentary lifestyle, and family history of heart disease.
Diagnosis
Diagnosis of angina typically involves a medical history and physical examination, followed by tests such as an electrocardiogram (ECG), stress test, and coronary angiography.
Treatment
Treatment for angina includes lifestyle changes such as diet and exercise, medications like nitrates, beta blockers, and calcium channel blockers, and surgical procedures such as angioplasty and coronary artery bypass grafting (CABG).
Prevention
Preventive measures include maintaining a healthy lifestyle, managing risk factors like hypertension and diabetes, and taking prescribed medications to prevent the progression of coronary artery disease.
See Also
References
<references group="" responsive="1"></references>
External Links
