Angina: Right Arm Pain

Arm pain is very common. We use our arms a lot in our daily life which can cause pain. However, arm pain can also come from elsewhere in the body, which could be a sign of a more serious problem.

What can cause arm pain?

There are many reasons why you may have right arm pain. It could be a pain in the muscles or bones, like from a sprain, pulled or strained muscle, bursitis, or tendinitis which is often the case for right-handed people. Right arm pain might also be brought on by a problem with your joints or nerves, such as osteoarthritis in your elbow, a slipped disc, bone tumours (which can produce stabbing sensations that worsen at night), straining of the arm from overuse other potential causes of right arm pain.¹

Heart Problems are not Just Felt in the Left Arm

One of the most typical signs of a heart attack is a pain in the left arm. Nerves that come out of the heart and arm both send signals to the same brain cells. As a result, your brain can’t figure out where the pain is coming from. Common symptoms for this are chest pain or discomfort that persists, your chest may feel heavy, pressed, or under strain. Pain that travels down to your right arm can also be a sign of having heart problems.²

What is Angina?

Angina, often known as chest pain, is the most common symptom of ischemic heart disease, which is a leading cause of morbidity and death globally.  Angina is one of the symptoms of Acute Coronary Syndrome (ACS), and it’s divided into stable and unstable angina.  Stable angina is when symptoms only happen when there is a high level of activity or emotional stress. Unstable angina occurs while doing very little or resting and is much more unpredictable.³

Signs and symptoms

The main sign of angina is chest pain. Angina pain usually feels tight, dull, or heavy, and it can spread to your neck, arms, neck, jaw, or back. It starts when you work out or are stressed, and it goes away after a few minutes of rest. Sometimes there may be other symptoms, such as feeling sick or having difficulty breathing.⁴

Causes and risk factors

Angina results from a decrease in blood flow to the heart muscle. Oxygen is carried by the blood to the heart muscle, which is essential for its survival. When there is a lack of oxygen going to the heart, it causes a condition called ischemia. 

Coronary artery disease is the most common reason for reduced blood flow to the heart muscle. The fatty buildups known as plaques can cause the heart's coronary arteries to be narrow which causes atherosclerosis. The heart muscle could be able to operate on the lower volume of blood without inducing angina symptoms when there is little oxygen demand, such as when you are resting. However, angina can develop when the need for oxygen increases, such as during exercise.⁵

Risk Factors for angina include:⁵

• High blood pressure
• High Cholesterol
• Diabetes
• Smoking
• Obesity
• Lack of exercise
• Emotional Stress
• Family history
• Older age
• Health conditions (chronic kidney disease, peripheral artery disease etc)

Diagnosis

When you're getting a diagnosis for angina, your doctor may inquire about the symptoms you have had, what you were doing when the symptoms first appeared, your lifestyle (such as your food and if you smoke or drink), and the medical history of your family members because heart conditions sometimes run in families. They may also perform other tests to determine whether you have a cardiac condition, such as blood pressure checks, body mass index (BMI) calculations using your height, weight, and waist measurement, and blood tests to check your cholesterol (blood fats) level. They could suggest you go to the hospital for some testing if they suspect you have angina or another heart condition.⁶

There are a few tests that are used to figure out if someone has angina. An electrocardiogram (ECG) is a test to examine the electrical activity and rhythm of your heart. A coronary angiography scan is done after receiving a dye injection to make your heart and blood vessels bright. An exercise ECG is done on a treadmill,  exercise bike or while you're walking, as well as blood tests.⁶

Management and Treatment

Treatment of angina is aimed to control the symptoms and reduce the risk of further problems like a heart attack. If you have stable angina, which is the most common type, you will be prescribed medication to take when you experience an episode. This is called Glyceryl trinitrate, or GTN. This is available as a tablet or mouth spray.³

The main treatments used to stop angina pain are beta blockers and calcium channel blockers. Beta-blockers cause the heart to beat more slowly and less forcefully and calcium channel blockers relax the arteries, which ultimately leads to an increase in the amount of blood that is supplied to the heart muscle. If neither of these medications will work for you, you could be prescribed ivabradine, nicorandil, or ranolazine.³

You might also need to take other medications to lower the risk of angina and stroke. These include ACE inhibitors to lower blood pressure, a low dosage of aspirin to avoid blood clots and statins to lower cholesterol (blood fats).³

If the medications don't help with your condition, surgery might be advised by your doctor. 

The two main surgical procedures for treating angina are coronary artery bypass graft (CABG) and stent insertion. Coronary artery bypass graft (CABG) is when a blood vessel is harvested from another area of the body and used to redirect blood around a blocked or constricting artery. A stent insertion widens a constricted portion of an artery by inserting a small tube known as a stent into it. These two procedures are equally efficient and If surgery is suggested, you should discuss your options with your doctor.³

If you have unstable angina, which means that your symptoms are unpredictable, you'll need medication to keep your blood from clotting and lower your risk of a heart attack or stroke. You may be given a low-dose aspirin, clopidogrel, or an injection of a blood-thinning medication.³

Prevention

In order to effectively manage a condition, it is important to change your lifestyle, reduce the risk factors, and get medical treatment. Changes in your lifestyle like getting regular exercise, watching your weight, quitting smoking, reducing stress, and managing your blood pressure, cholesterol, and blood sugar can reduce the risk of getting angina.⁷

When to see a doctor

If your chest is in pain for more than a few minutes and doesn't go away when you relax or take your medication, it might be a sign that you're experiencing a heart attack. You should phone 911 or any other emergency services and seek medical help.⁵

Summary

Angina occurs when there is a decrease in the amount of blood that's flowing to the heart muscles. Although it normally isn't life-threatening, it is a symptom that might put you at risk of having a heart attack or stroke. However, angina may be managed with medication and healthy lifestyle modifications, which also lowers the likelihood of developing these more severe issues.