What is angina pectoris?

Angina pectoris is a generally painful and / or oppressive, acute, gradual discomfort usually appearing in the center of the chest, although it can extend to the left arm, both, back, or area under the sternum. Although it is a serious illness, with proper treatment and a heart-healthy lifestyle can be controlled.

Ischemic heart disease is a heart disease that is due to the existence of 'myocardial ischemia', that is, insufficient or no oxygenated blood supply to a zone of the heart muscle (myocardium).

Ischemic heart disease manifests itself in two ways: as angina pectoris or acute myocardial infarction. Its most frequent cause is coronary atherosclerosis, the appearance of cholesterol plaques and other substances (atherosclerosis plaques atheromas) in the inner wall, in the lumen of the coronary arteries.

The cardiac muscle (heart wall or myocardium) receives oxygenated blood through the coronary arteries and atherosclerotic plaques, when they grow excessively, narrow the lumen of the artery, making it difficult for oxygenated blood through it and causing myocardial ischemia .

Myocardial ischemia causes pain or discomfort in the center of the chest. This pain known as 'angina pectoris'. It may be stable or unstable if there is a partial or total acute obstruction due to the sudden association of a clot in the atherosclerotic plaque. An acute myocardial infarction may occur if the obstruction of this clot is prolonged over time.

Among the risk factors that can trigger ischemic heart disease are tobacco addiction, high blood pressure , diabetes , obesity , high cholesterol levels, lack of physical activity and family history.

Symptomatology of angina pectoris

The main symptom of stable angina is a discomfort in the center of the chest, in the area of ​​the neck, which can radiate towards the throat, arms, back and jaw. The feeling is of tightness, weight, tightness, burning or swelling. It lasts between five and twenty minutes and appears when doing physical exercise or with strong emotions, yielding with the rest.

In unstable angina pectoris, the discomfort has the same characteristics, but appears to be at rest and calm, lasts more than 20 minutes and the episodes are becoming more intense and frequent.

In acute myocardial infarction, the discomfort continues to have the same characteristics, but persists after half an hour and does not subside with sublingual nitroglycerin intake.

Causes and Prevention of Angina

Although in some people they have a genetic predisposition, it is the people with multiple cardiovascular risk factors who usually suffer from it. These are smoking , sedentary lifestyle , obesity , diabetes , high blood pressure and high cholesterol. Other factors that may favor angina are the stress to which the patient is subjected or the states of depression.

If modifiable cardiovascular risk factors - hypertension, diabetes, etc. - are controlled by a healthy diet, physical exercise, medication, and keeping stress at bay, the onset of the disease and its complications can be considerably prevented or delayed.

Treatment of angina

First, cardiovascular risk factors must be monitored and their blood pressure checked periodically.

All patients should take acetylsalicylic acid or another antiplatelet agent without hypersensitivity or intolerance, a statin (to lower cholesterol), and one or more medications to reduce episodes of angina (beta blocker, nitrate, or other alternatives). The metabolism of cholesterol and lipids and that of glucose should be monitored.

Nitroglycerin tablets should always be used to chew and deposit one under the tongue in case of angina. In severe cases, implantation of one or more coronary stents or coronary artery bypass surgery may be used.

An adequate prescription of the exercise that the patient should and can do is important, as well as adequate prevention. For more information on angina pectoris, consult a specialist in cardiology.