What Is Angina And What Is The


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What Is Angina? And What Is The Cure? Essay, Research Paper

What is Angina? And What Is The Cure?

Angina refers to the pain arising from lack of adequate blood supply to the

heart muscle. Typically, it is a crushing pain behind the breastbone in the

center of the chest, brought on by exertion and relieved by rest. It may at

times radiate to or arise in the left arm, neck, jaw, left chest, or back. It

is frequently accompanied by sweating, palpitations of the heart, and generally

lasts a matter of minutes. Similar pain syndromes may be caused by other

diseases, including esophagitis, gall bladder disease, ulcers, and others.

Diagnosis of angina begins with the recognition of the consistent symptoms.

Often an exercise test with radioactive thallium is performed if the diagnosis

is in question, and sometimes even a cardiac catheterization is done if the

outcome is felt necessary to make management decisions. This is a complex area

which requires careful judgment by physician and patient.

Angina is a manifestation of coronary artery disease, the same disease

leading to heart attacks. Coronary artery diseas refers to those syndromes

caused by blockage to the flow of blood in those arteries supplying the heart

muscle itself, i.e., the coronary arteries.

Like any other organ, the heart requires a steady flow of oxygen and nutrients

to provide energy for rmovement, and to maintain the delicate balance of

chemicals which allow for the careful electrical rhythm control of the heart

beat. Unlike some other organs, the heart can survive only a matter of minutes

without these nutrients, and the rest of the body can survive only minutes

without the heart–thus the critical nature of these syndromes.

Causes of blockage range from congenital tissue strands within or over the

arteries to spasms of the muscular coat of the arteries themselves. By far the

most common cause, however, is the deposition of plaques of cholesterol,

platelets and other substances within the arterial walls. Sometimes the buildup

is very gradual, but in other cases the buildup is suddenly increased as a chunk

of matter breaks off and suddenly blocks the already narrowed opening.

Certain factors seem to favor the buildup of these plaques. A strong family

history of heart attacks is a definite risk factor, reflecting some metabolic

derangement in either cholesterol handling or some other factor. Being male,

for reasons probably related to the protective effects of some female hormones,

is also a relative risk. Cigarette smoking and high blood pressure are definite

risks, both reversible in most cases. Risk also increases with age. Elevated

blood cholesterol levels (both total and low density types) are risks, whereas

the high density cholesterol level is a risk only if it is reduced. Possible,

but less well-defined factors include certain intense and hostile or time-

pressured personality types (so-called type A), inactive lifestyle, and high

cholesterol diets.

Medications are increasingly effective for symptom control, as well as

prevention of complications. The oldest and most common agents are the nitrates,

derivatives of nitroglycerine. They include nitroglycerine, isosorbide, and

similar agents. Newer forms include long acting oral agents, plus skin patches

which release a small amount through the skin into the bloodstream over a full

day. They act by reducing the burden of blood returning to the heart from the

veins and also by dilating the coronary arteries themselves. Nitrates are

highly effective for relief and prevention of angina, and sometimes for limiting

the size of a heart attack. Used both for treatment of symptoms as well as

prevention of anticipated symptoms, nitrates are considered by many to be the

mainstay of medical therapy for angina.

The second group of drugs are called “beta blockers” for their ability to

block the activity of the beta receptors of the nervous system. These receptors

cause actions such as blood pressure elevation, rapid heart rate, and forceful

heart contractions. When these actions are reduced, the heart needs less blood,

and thus angina may be reduced.

The newest group of drugs for angina is called the calcium channel blockers.

Calcium channels refer to the areas of the membranes of heart and other cells

where calcium flows in and out, reacting with other chemicals to modulate the

force and rate of contractions. In the heart, they can reduce the force and

rate of contractions and electrical excitability, thereby having a calming

effect on the heart. Although their final place in heart disease remains to be

seen, they promise to play an increasingly important role.

When medications are unsuccessful, or if there is concern about an impending

or potential heart attack, coronary bypass surgery is highly successful in

reducing symptoms. Whether or not it prolongs survival is questionable for most


Angina which is new or somehow different from previous episodes in any way is

termed unstable angina, is a medical emergency, and requires urgent attention.

Research is active, and careful medical follow-up is important.mergency, and

requires urgent attention. Research is active, and careful medical follow-up is



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