Causes of Angina

The cardiovascular system consists of the heart and blood vessels. Any abnormalities in the functioning of The cardiovascular system consists of the heart and blood vessels. Any abnormalities in the functioning of the heart are termed ‘cardiovascular disease’ or (CVD). Cardiovascular disease is one of the major causes of death and health problems today, and there are many different conditions associated with it. Some of these conditions develop into other diseases over time if left unnoticed. Angina, arrhythmia, and congenital heart disease are examples of a few conditions that affect the heart. In this article, we will focus on angina, which can be a serious problem that could lead to a heart attack. Therefore, it is important to understand this condition and take necessary precautions. This article will focus on the types and causes of angina, and how to prevent it. 

What is Angina

Angina, also called angina pectoris, creates a painful and squeezing sensation in the chest. 

The pain arises due to the tightening of the heart muscle. The heart muscle tightens as it requires more blood which is rich in oxygen than what is being supplied to it. When the heart does not receive enough of this oxygen-rich blood, the person suffers from angina. This condition is not quite a disease related to the heart but it can be a warning sign that our heart may not be as healthy as we think. This condition may reveal underlying heart problems.

Symptoms 

The feeling of sensation, pressure or tightening of the muscle may last for a few minutes. This condition may worsen with time, when participating in other activities such as exercising, or even when one is stressed.

Chest pain is a common symptom of angina, but not the only one. Other symptoms to be aware of include: 

Types of Angina

  1. Stable Angina
    This is the most common form of angina. This type may be triggered by heavy physical activity or stress. When you rest your body, this pain will subside. The pain that you might feel is not a heart attack, but might be a sign of it. If you can see a consistent pattern for 2-3 months, this may also progress to unstable angina. Some possible triggers of this type of angina include smoking, heavy meals, exposure to different temperatures, and emotional stress.
  2. Unstable Angina
    This type of angina may be triggered even when one is resting. You may have this type if It happens frequently, and this is an indication of a heart attack. The main cause for this type of angina is a blood clot in the artery. The blood clot can also partially dissolve later but forms again from time to time which blocks the artery. This type of pain can be long-lasting. Also, the pain from this type of angina is not relieved by medicine or rest, which is a way of distinguishing between stable and unstable angina. If you have any such symptoms you should consult a doctor immediately.
  3. Vasopastic or variant Angina
    This rare type of angina is also called Prinzmetal’s or Prinzmetal angina. It occurs when one is at rest or sleeping. This will feel extremely painful, resulting from the spasm in the coronary arteries that supply blood to the heart muscle. The main triggers for this type of angina include exposure to low temperatures, stress, smoking, substance use disorder, and medicines that narrow your blood vessels. Prinzmetal angina is usually severe but can be relieved with the proper medication.
  4. Microvascular
    This type of angina might be a symptom of coronary microvascular disease (MVD). It is caused by spasms that take place in the walls of small arterial blood vessels. These spasms lead to a decrease in blood flow to the heart and result in pain. The pain lasts longer than other types of angina (around 10 to 30 minutes). You can feel the pain when doing daily activities or when you’re stressed. This type of angina is more common in females as compared to males.

Causes

The main cause of angina is atherosclerosis. 

Condition as a whole

  • Atherosclerosis:

    When the arteries narrow or harden, this results in atherosclerosis. This disease is caused by the buildup of plaque, a fatty substance, building upon the walls of arteries. The plaque is made up of calcium, cholesterol, fat (LDL - low-density lipids) and other molecules. This fatty accumulation hinders the flow of blood to the heart muscle. When there is a decrease in blood flow, the heart has to function in an environment where it has less oxygen. This can also result in the formation of blood clots, which in turn increases the chances of a heart attack.

    This condition can lead to tissue infection in the legs, arms, and other parts of the body, as these plaques can break off and travel to various parts of the body and cause further problems. 

    The risk factors surrounding this disease can be categorized into modifiable and non-modifiable factors. 

    Modifiable factors can be controlled by making certain changes that lower the chance of getting heart disease. As the name suggests, non-modifiable factors cannot be controlled or reversed, and certain precautions must be taken to prevent the condition from worsening over time. Examples of these factors include:
  1. Modifiable factors:
    • Unhealthy diet - this is one of the most common risk factors that can lead to cardiovascular disease. An unhealthy diet significantly contributes to heart problems. One example to think of is cholesterol. People in different age groups have high cholesterol as a result of unhealthy eating habits. One should reduce the intake of processed food. In order to lower the risk of developing high cholesterol levels, one should maintain a balanced diet that includes fruits, vegetables, polyunsaturated fats, omega-3, and proteins. Also, alcohol consumption should be moderated. 
    • Lack of exercise - physical inactivity increases the chance of a person gaining unhealthy amounts of weight. This can also increase the chances of having high blood pressure. So if one starts exercising and being physically active they can reduce the risk of developing heart disease.
  2. Non-modifiable factors: Some examples of these factors include:
    • Increasing age - With the increasing age your body, especially the immune system weakens. A good diet and lifestyle keeps the body healthy at older age and can thus reduce the chances of developing cardiovascular disease.
    • Family history - This is also one of the factors that cannot be reversed but a healthy lifestyle can decrease the chances of suffering from any disease. 

Things To Do if You Have Angina

Angina might be a fresh discomfort that requires medical attention or a persistent ache that responds to treatment. Even though angina is very prevalent, it can be difficult to distinguish it from other types of chest pain, such as indigestion discomfort. If you're experiencing inexplicable chest pain, consult a doctor immediately. 

Your doctor will prescribe medication to alleviate your symptoms and improve the function of your heart. A change in lifestyle, on the other hand, can help prevent more fatty stuff called plaque from accumulating in your arteries and alleviate your angina symptoms. 

Following lifestyle changes can do a great deal to prevent or manage existing conditions of CVD.

  • Stop smoking. Smoking causes congested arteries, which can exacerbate angina symptoms. It's never too late to quit, and we can help you take modest steps in the right direction.  
  • Keep your blood pressure in check. If you need it, take your prescription, then check out our low-salt recipes. Choose low-saturated-fat products and replace bad snacks with more nutritious alternatives to maintain a healthy balanced diet. 
  • Reduce your cholesterol levels with your medicine and eat the proper fats according to our recommendations.

References

  1. Ada's Medical Knowledge Team (2017). Cardiovascular Disease Risk Factors «Ada. [online] Ada. Available at: https://ada.com/cardiovascular-disease-risk-factors/
  2. ‌Cleveland Clinic (n.d.). Angina (Chest Pain): Causes, Risk Factors, Diagnosis. [online] Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/21489-angina.
  3. Cleveland Clinic (n.d.). Coronary Spasm: Symptoms, Treatments. [online] Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/16900-coronary-spasm.
  4. ‌Watson, S. (2007). Angina. [online] WebMD. Available at: https://www.webmd.com/heart-disease/heart-disease-angina.
  5. American Heart Association (2015). Angina (Chest Pain). [online] www.heart.org. Available at: https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain.
  6. ‌Felman, A. (2019). Cardiovascular disease: Types, symptoms, prevention, and causes. [online] www.medicalnewstoday.com. Available at: https://www.medicalnewstoday.com/articles/257484#treatment.

Ankita Thakur

Postgraduate Degree, MSc. Biotechnology and Management, University of Glasgow
Experienced as a Healthcare Management Intern and Healthcare Writer.

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