Angina Pectoris 

Angina is due to an imbalance between the heart's oxygen supply and demand. Like all muscles, the heart muscle needs a steady supply of oxygenated blood to work. Oxygenated blood is supplied to the heart muscle by the coronary arteries. When the coronary arteries are narrowed or blocked by atherosclerosis, the heart muscle is unable to get enough blood, especially when blood demand increases (for example, during physical activity or stressful situations). An inadequate supply of oxygen is called myocardial ischemia, which is what causes angina's characteristic chest pain.

1.0Angina Pectoris Causes

1. Atherosclerosis:

• The most common reason.
• When plaque builds up in the coronary arteries, it narrows the lumen, slowing blood flow.

2. Coronary Artery Spasm:

• A temporary tightening of the muscle wall in a coronary artery that slows down blood flow.

3. Thrombosis:

• Anginal pain can happen when a blood clot forms inside a narrowed coronary artery.

4. Increased Oxygen Demand:

• When people with low coronary blood flow work out, are stressed, or are exposed to cold, their hearts need more oxygen, which can cause angina.

2.0Types of Angina Pectoris

Angina is typically classified into three main types based on its predictability and pattern.

• Stable Angina: The most common type. It is predictable and occurs as the heart is working too hard, as with exercise, heavy exertion, or emotional stress. The pain usually lasts a few minutes and resolves with rest or nitroglycerin. It has a consistent pattern related to the trigger and duration.
• Unstable Angina: This is a more severe and less predictable form of angina. It can happen even at rest and is not relieved by rest or medication. The pain is often more severe and longer-lasting. Unstable angina is a medical emergency as it can indicate a worsening of the underlying heart disease and is a precursor to a myocardial infarction (heart attack).
• Variant Angina (Prinzmetal's Angina): This is a rare phenomenon caused by a temporary spasm of the coronary arteries that constricts blood flow. The spasms may occur while resting, often in the early morning hours, and not due to exertion or activity. 

3.0Angina Pectoris Symptoms

The primary symptom of angina is chest pain or discomfort. However, the sensation can vary from person to person. It's often described as:

• A squeezing, pressure, heaviness, or tightness in the chest.
• A burning or aching sensation.
• The pain may radiate to other parts of the body, including the left arm, shoulder, back, neck, jaw, or even the teeth.
• Other symptoms may accompany the chest pain, such as:
• Shortness of breath
• Nausea
• Fatigue
• Dizziness
• Sweating

It's important to note that women and older adults may experience more subtle or "atypical" symptoms, such as indigestion-like discomfort or a general feeling of unease, rather than classic chest pain.

4.0Angina Pectoris Diagnosis

1. Electrocardiogram (ECG): Detects ischemic changes in heart rhythm.
2. Echocardiography: Assesses heart wall motion abnormalities.
3. Coronary Angiography: Visualises blockages in the coronary arteries.
4. Exercise Stress Test: Evaluates heart performance under physical stress.

5.0Angina Pectoris Treatment and Management

1. Medications:

• Nitrates (e.g., Nitroglycerin): Dilate the coronary arteries and relieve pain.
• Beta-blockers: Reduce heart rate and oxygen demand.
• Calcium Channel Blockers: Relax blood vessels and decrease workload.
• Antiplatelet Drugs (e.g., Aspirin): Prevent clot formation.

2. Lifestyle Modifications:

• Quit smoking, reduce stress, and maintain a healthy diet.
• Regular physical activity under medical supervision.

3. Surgical Procedures (for severe cases):

• Angioplasty: Opens blocked arteries using a stent.
• Coronary Artery Bypass Grafting (CABG): Creates alternate routes for blood flow.

6.0Angina Pectoris Prevention

• Keep your blood pressure, cholesterol, and blood sugar in the normal range.
• Stay on a heart-healthy eating pattern that includes fruits, vegetables, and whole grains.
• Do not smoke, and limit how much alcohol you consume.
• Manage stress levels with yoga, meditation, or relaxation techniques.