Angina pectoris is chest pain due to coronary heart disease. Sitting winds or angina pectoris occur when the heart muscle does not get enough blood supply, due to narrowing or blockage of the arteries in the heart.
Angina pectoris can happen anytime and to anyone. Pain due to angina pectoris is often misinterpreted as a symptom of other conditions, such as increased stomach acid and inflammation of the lungs.
Causes and Risk Factors for Angina Pectoris
Angina pectoris is most often caused by coronary heart disease. Coronary heart disease occurs due to the buildup of plaque in the arteries ( atherosclerosis ). Several factors that can increase the risk of developing coronary heart disease which can then cause angina are:
- Smoking habit
- History of high blood pressure or hypertension
- High levels of bad cholesterol (LDL) and triglycerides
- History of heart disease in the family
- Rarely exercise and not actively move
- Age over 45 years for men and over 55 years for women
Symptoms of Angina Pectoris
Angina pectoris is characterized by left chest pain that feels like being crushed, burning, stabbed or feels tight. This pain can radiate to the arms, shoulders, back, neck and jaw.
Other symptoms that can accompany chest pain include:
- Excessive sweating even though the weather is not hot
- Hard to breathe
Based on the characteristics of the symptoms, angina pectoris can be divided into:
Stable angina or stable angina often occurs when doing strenuous activities or when experiencing emotional stress. S table angina has a regular pattern and is of short duration, usually no more than 5 minutes.
Unstable angina is a more dangerous type of angina. This type of angina does not depend on the activities carried out, and can appear suddenly and continue even though the sufferer is resting.
Compared with stable angina , unstable angina lasts longer with more severe pain intensity.
The symptoms caused by this type of angina also do not disappear even if the patient has rested or taken medication. Unstable angina is generally a sign of a heart attack.
Unlike the two types of angina previously described, Prinzmetal's angina is caused by stiffness in the heart arteries. This condition causes the amount of blood flow to decrease temporarily.
Prinzmetal's angina is a rare type of angina. This type of angina usually occurs at rest, at night or in the morning. The intensity of the pain is quite severe, but usually subsides with the administration of drugs.
When to see a doctor
If this is the first time you experience pain and discomfort in your chest, consult your doctor immediately. Complaints of chest pain can lead to angina pectoris which is caused by heart disease.
You also need to see a doctor if the angina you are experiencing lasts a long time and does not improve after resting.
Because angina pectoris is often caused by coronary heart disease, it is advisable to check with your doctor if you have a history of hypertension , high cholesterol, and live an unhealthy lifestyle, such as:
- Often eat fatty foods
- Excessive consumption of alcoholic beverages
The sooner you are examined and treated by a doctor, the risk of more severe complications can be prevented.
Diagnosis of angina pectoris
To diagnose angina pectoris, the doctor will ask about the patient's complaints and at the same time ask whether the patient has risk factors for coronary heart disease. After that, the doctor will carry out a physical examination and several supporting tests for cardiac examination , such as:
- Electrocardiogram (EKG) , to check the electrical flow of the heart and detect disturbances in heart rhythm
- Cardiac echo , to find the location of heart muscle damage and areas of the heart that are not getting enough blood
- Treadmill EKG (stress test), which has the same purpose as an EKG, but is done while the patient is on the move
- Chest X-ray , to check the possibility of an enlarged heart
- Cardiac catheterization , to see narrowing of the heart arteries with the help of a catheter, special dye (contrast), and X-rays
- Heart scan with a CT scan or nuclear examination, to check for blocked heart vessels and parts of the heart that don't get blood flow
- Blood test, to detect the presence of cardiac enzymes, which levels in the blood can increase when the heart does not get enough blood supply.
Treatment of angina pectoris
Treatment of angina pectoris aims to reduce complaints and prevent heart attacks. The methods given may vary, depending on the conditions experienced by the patient, including:
Several types of drugs that can be given by doctors to relieve angina symptoms are:
- Blood thinners, such as aspirin, clopidogrel, or ticagrelor
- Nitrate class of blood vessel widening drugs , such as nitroglycerin and isosorbide dinitrate , to dilate and relax blood vessels, so that blood flow to the heart is better
- Beta-blockers , such as atenolol or bisoprolol, to slow the heart rate and relax blood vessels, thereby reducing the heart's workload
- Drugs to control diabetes, cholesterol, and hypertension which are risk factors for coronary heart disease
- Antianginal drugs, such as trimetazidine or ranolazine , to reduce and prevent the occurrence of chest pain
If angina pectoris does not subside after administering drugs, the doctor will recommend medical measures, such as:
- Installation of a heart ring, to widen a narrowed artery by placing a special wire (ring) that is shaped like a tube in the arteries of the heart
- Heart bypass surgery , by taking blood vessels from other parts of the body, to create new blood flow channels to replace narrowed blood flow channels
In addition to undergoing treatment, patients need to undergo treatment for various risk factors for coronary heart disease that cause angina, such as hypertension and diabetes.
Patients also need to make lifestyle changes to prevent these complaints from reappearing. Lifestyle changes that need to be made include regular exercise, adopting a healthy diet, quitting smoking, and getting enough rest.
Complications of angina pectoris
Angina pectoris is often caused by coronary heart disease. If the coronary arteries are getting narrower and totally blocked, a life-threatening heart attack will appear.
Therefore, angina pectoris needs to be checked since it is still in the form of early symptoms , or since the pain is still mild and can subside on its own with rest.
Prevention of angina pectoris
Angina pectoris can be prevented by adopting a healthy lifestyle. Efforts that can be implemented include:
- Quit smoking and limit consumption of alcoholic beverages
- Exercise regularly and maintain ideal body weight
- Improve your diet by eating foods low in fat and salt, fruits, vegetables, and whole grains.
- Avoid consuming foods high in saturated fat, such as sausages and fatty meats, butter, cheese and fast food
- Managing stress in a positive way, can be with yoga, meditation, or doing a fun hobby
- Check with your doctor regularly if you have hypertension, hypercholesterolemia or diabetes