Types of Angina:

1. Stable Angina: This is the most common type and typically occurs with physical exertion, emotional stress, or after eating. The pain usually goes away with rest or medication (such as nitroglycerin). Stable angina is predictable and occurs in a pattern that can be managed with treatment.

2. Unstable Angina: This type is more serious and can happen unexpectedly, even at rest, and can last longer. Unstable angina is a medical emergency, as it may signal a heart attack is imminent or already occurring. It’s not relieved by rest or medication and requires immediate medical attention.

3. Prinzmetal’s Angina (Variant Angina): This is a rare form of angina caused by a spasm in a coronary artery, leading to temporary reduced blood flow to the heart. It often occurs at rest and can happen unpredictably, though it’s usually short-lived. It can be triggered by factors like cold weather, stress, or certain medications.

Symptoms:

• Chest Pain or Discomfort: Often described as pressure, squeezing, or a feeling of fullness in the chest. It may radiate to the arms, shoulders, neck, jaw, back, or abdomen.
• Shortness of Breath: A feeling of breathlessness may occur during an angina episode.
• Nausea or Dizziness: Some people may feel lightheaded or nauseous.
• Sweating: Excessive sweating may accompany chest pain.
• Fatigue: A feeling of extreme tiredness, even after minimal exertion, can occur.

Risk Factors:

• Coronary Artery Disease (CAD): The primary cause of angina, where the coronary arteries become narrowed or blocked.
• Age: Angina becomes more common with age, particularly in men over 45 and women over 55.
• High Blood Pressure: Increased pressure on the walls of the arteries can contribute to CAD and angina.
• High Cholesterol: Elevated cholesterol levels can promote plaque buildup in the arteries, leading to reduced blood flow to the heart.
• Smoking: Smoking accelerates the development of coronary artery disease and increases the risk of angina.
• Diabetes: High blood sugar levels can damage blood vessels and increase the risk of angina.
• Family History: A family history of heart disease or angina increases the risk.
• Obesity: Being overweight places extra strain on the heart, increasing the risk of angina and heart disease.
• Physical Inactivity: Lack of regular exercise can contribute to cardiovascular problems, including angina.

Causes:

• Atherosclerosis: The most common cause of angina, a condition where plaque builds up in the coronary arteries, restricting blood flow to the heart.
• Coronary Spasms: Sudden contractions of the coronary arteries can temporarily reduce blood flow to the heart muscle, leading to angina.
• Increased Heart Demand: Physical exertion, stress, or other factors that increase the heart’s need for oxygen can trigger angina if the heart’s blood supply is insufficient.

Diagnosis:

• Physical Exam: A doctor will perform a thorough physical examination and may listen to your heart and lungs.
• Electrocardiogram (ECG or EKG): A test that records the electrical activity of the heart and can help detect heart damage.
• Stress Test: Involves exercising on a treadmill or stationary bike while the heart’s activity is monitored. It helps determine how the heart responds to physical exertion.
• Angiogram (Cardiac Catheterization): A special dye is injected into the coronary arteries, and X-ray images are taken to assess any blockages.
• Blood Tests: Can help assess cholesterol levels, blood sugar, and other factors that may contribute to heart disease.

Treatment:

1. Lifestyle Changes:

   • Diet: A heart-healthy diet, low in saturated fat, cholesterol, and salt, can help manage angina.
   • Exercise: Regular physical activity strengthens the heart and can improve blood flow.
   • Weight Management: Maintaining a healthy weight can help reduce the strain on the heart.
   • Stress Management: Techniques like meditation, yoga, and relaxation exercises can help reduce stress, which can trigger angina.

2. Medications:

   • Nitroglycerin: Often used to relieve chest pain during an angina attack by relaxing the coronary arteries and improving blood flow to the heart.
   • Beta-blockers: Help reduce heart rate and blood pressure, easing the heart’s workload.
   • Calcium Channel Blockers: Relax the blood vessels and reduce the heart’s workload.
   • Aspirin: May be used to reduce the risk of blood clots and prevent heart attacks.
   • Statins: Medications to lower cholesterol levels, which can help prevent further plaque buildup in the arteries.
   • ACE Inhibitors: Help lower blood pressure and protect the heart.

3. Procedures:

   • Angioplasty and Stent Placement: A catheter with a balloon is inserted into a narrowed artery to open it up. A stent (a small mesh tube) is often inserted to keep the artery open.
   • Coronary Artery Bypass Surgery (CABG): In cases of severe coronary artery disease, surgery may be required to bypass blocked arteries and restore blood flow to the heart.