Angina – symptoms, causes and its associated risk factors

Angina has been haunting a significant population of the world these days. The disease has existed from old times, but our modern lifestyle has accelerated the development of angina. It happens all over the world with almost equal mortality rates without a cure.

Causes of angina

Angina is a severe chest pain that is due to incomplete blockage of blood vessels that supply the heart. This blockage is due to cholesterol deposits upon the walls of these blood vessels. The pain of Angina is sudden in onset and has terrible outcomes. A person should be taken to the nearby hospital immediately.

Angina pain usually occurs again in people having raised cholesterol levels. The levels of cholesterol depend upon intake of foods that have high cholesterol content. This cholesterol forms plaques on the walls of blood vessels. When the plaque is smaller, it can cause Angina but if it becomes large enough to impede the blood flow to a heart muscle completely, a heart attack occurs. This is the reason it is crucial to stop the progression of plaque size once you have Angina.

Symptoms of Angina

Chest Pain: A severe chest pain that does not go away by taking any pain killer. It is usually central. It is constant in severity and is not disappearing any sooner. The pain is agonizing, and the person feels helpless. [1,2,4]

Chest Tightness: Many people complaint of something grasping their chest. They have a feeling of chest tightness. You can feel that someone is squeezing your heart from inside. The person will place hands on the chest in effort to comfort the pain. [2]

Pain in the shoulder: Pain of angina can also be felt in the left shoulder tip. It can radiate to the whole left arm. People also complain of neck pain. Most of the times pain is also referred to the jaw. This is due to the nerves supplying these body parts are connected. [3]

Breathlessness: People who are having angina pain experience breathlessness. They are unable to feel relieved even if they take deep breaths. When this happens, the person must be taken to hospital where he will be given oxygen to ease his symptoms. Breathlessness is a serious symptom and may lead to a cardiorespiratory arrest. [4]

Sweating: Sweating happens when a person is experiencing angina pain. It occurs even when you are sitting or sleeping comfortably because it is not associated with exercise. These are cold sweats that are profuse. The sweating will stop only after the pain.

Dizziness: Angina occurs due to blockage of an artery supplying the heart muscle. The heart’s function may be compromised and blood supply to brain decreases. This leads to a feeling of dizziness. [5]

Nausea: Nausea can start in case of angina pain. Many people complain of nausea that is a feeling of sickness and discomfort. [5]

Vomiting: It may occur due to nausea. Vomiting can continue or stop after one episode. It can cause dehydration if occurs again and again.

Fatigue: You may feel tired after an angina pain. This is due to your sickness and the function of heart that is compromised. [6]

Occurs During Exercise: The pain usually occurs after you had a strenuous exercise or you were climbing stairs. It is because heart needs more blood when it is working harder as in exercise or various diseases. Because the blood vessel is incompletely blocked, it supplied the blood needed to your heart when the body is at rest. As the heart starts working harder, the blood supply becomes insufficient, and you develop the pain. [7]

Anxiety: You feel anxious when the heart is not supplying blood and because of the pain that is excruciating. This may further worsen the pain because stress directly affects the heart to pump more forcefully. You must ease your anxiety and someone else if he is affected by chest pain. [8]

Fear of Death: Most of the people are aware of their disease or they know the symptoms of heart attack. This may make them afraid of getting a heart attack and die. Every chest pain is not a heart attack.

Pallor: Many people with angina pain appear pale than usual because the heart is not pumping enough blood into the body tissues. This may reverse in a few minutes.

Sudden Death: Sometimes, angina may lead to heart attack or a cardiorespiratory arrest; if Cardiopulmonary resuscitation is not done, a person may not recover, and death may occur. [9]

References:

[1] American Heart Association, Inc. Angina pectoris (stable angina). 2015. Retrieved from www.heart.org/en/health-topics/heart-attack/angina-chest-pain/angina-pectoris-stable-angina

[2] Aydin F, Aksit E, Yildirim OT, et al. Chest pain score: a novel and practical approach to angina pectoris. A diagnostic accuracy study. Sao Paulo Medical Journal. 2019;37(1).

[3] Kreatsoulas C, Crea-Arsenio M, Shannon HS, et al. Interpreting angina: symptoms along a gender continuum. Open Heart. 2016;3(1):e000376.

[4] Barnett LA, Prior JA, Kadam UT, Jordan KP. Chest pain and shortness of breath in cardiovascular disease: a prospective cohort study in UK primary care. BMJ Open. 2017;7:e015857.

[5] Newman-Toker DE, Dy FJ, Stanton VA, et al. How often is dizziness from primary cardiovascular disease true vertigo? A systematic review. Journal of General Internal Medicine. 2008;23(12):2087–94.

[6] Kimble LP, Dunbar SB, Weintraub WS, et al. Symptom clusters and health-related quality of life in patients with chronic stable angina. Journal of Advanced Nursing. 2011;67(5):1000–11.

[7] Anderson L, Dewhirst AM, He J, et al. Exercise‐based cardiac rehabilitation for patients with stable angina. Cochrane Database of Systematic Reviews. 2017;2017(9):CD012786.

[8] Katerndahl DA. Chest pain and its importance in patients with panic disorder: An updated literature review. The Primary Care Companion to The Journal of Clinical Psychiatry. 2008;10(5):376–83.

[9] Mehta D, Curwin J, Gomes JA, Fuster V. Sudden death in coronary artery disease: Acute ischemia versus myocardial substrate. Circulation. 1997;96(9):3215-23.