If left untreated, angina leads to myocardial infarction. Symptoms may be atypical in women so do not alert immediately.
The risk of angina increases with age. It concerns more men over 50, especially smokers, suffering from diabetes, excess cholesterol, high blood pressure or obesity. If angina is not treated medically, it leads to myocardial infarction.
Definition: what is angina?
Angina, also called “angina pectoris”, is a damage to the coronary arteries of the heart which do not provide it with the necessary oxygen to function correctly. This lack of essential contribution is at the origin of a heart pain. It can lead to heart attack. We distinguish :
► stable angina (or stable angina or coronary artery disease) for which the characteristics do not change over time (same cause, same intensity, same duration). It occurs during exercise and disappears when it stops.
► and unstable angina, more serious. She corresponds to a more advanced stage with attacks occurring even at rest, often more frequent and longer. Electrocardiogram, ultrasound, scintigraphy and coronary angiography can confirm the diagnosis. This unstable angina pectoris is considered a threat of myocardial infarction (we speak of acute coronary syndrome) and requires emergency hospitalization in a unit cardiological.
What are the symptoms of angina?
In the early stages, a pain in the chest behind the sternum appears only during exercise, digestion or emotion, times when the heart requires more oxygen. The pain is called “anginous”, that is to say it corresponds to a vice-like tightness behind the sternum with some possible radiation in the arm or shoulder, sometimes accompanied by a cough. If coronary obstruction increases, symptoms may occur at rest; unstable angina may be a precursor to myocardial infarction.
In women?
The symptoms of an angina attack differ from one individual to another. Particularly in women, they can be “atypical” and result in respiratory and/or digestive symptoms in the foreground.
If left unchecked, angina leads to myocardial infarction.
What causes angina?
Angina is caused by a narrowing of the caliber of the arteries which will slow down the blood flow to the heart. The most common cause is atherosclerosis, that is to say the formation of atherosclerotic plaques inside the coronary arteries due to cardiovascular risk factors: tobacco, excess weight, sedentary lifestyle, high blood pressure, diabetes, hypercholesterolemia and family history. However, certain angina attacks can also be linked to coronary artery spasms which cause sufficient constriction to decrease blood flow in these vessels as in the case of Prinzmetal’s angina whose origin is unknown.
What is the life expectancy?
Without medical monitoring and hygienic-dietary measures,Angina leads to myocardial infarction. This risk is increased if it is “unstable” angina. In this case, hospitalization must be done urgently. To prevent angina attacks, it is necessary to counteract atherosclerosis (a phenomenon which blocks the arteries and deprives the heart of its good oxygenation). So :
- Reduce your weight if you are overweight (see your doctor)
- Eliminate tobacco
- Treat high blood pressure if present
- Correct your cholesterol level if it is too high – Stop smoking – Correct high blood pressure – Maintain cholesterol
“Thanks to different treatments (risk factor control, medication, bypass surgery, etc.), angina pain can disappear and a completely normal life – active or even sporty (but not just any sport or any way) –is possible“ inform her French Federation of Cardiology.
What tests should you do to find out?
The assessment of chest pain is carried out by the attending physician, in coordination with a cardiologist. Typical exams include:
- a blood test (hemogram, ionogram, blood sugar, lipid and renal balance);
- a resting electrocardiogram (ECG)carried out if possible during or just after a painful episode of angina;
- a resting transthoracic echocardiogram or MRI if ultrasound is not possible. It eliminates other causes of pain (valve abnormality, heart muscle disease, pericarditis, cracked aorta), analyzes the movements of the heart and calculates the ejection fraction of the left ventricle (search for heart failure ).
Sometimes a chest x-ray is prescribed if the doctor suspects a lung disease that could explain the symptoms (pneumonia for example). Specific examinations, called ischemia testsare carried out in a manner adapted to each case:
- a stress test : exercise ECG, exercise or stress echocardiography;
- a stress scintigraphy or MRI…
In case of emergency, a coronary angiography can be achieved. This examination may be necessary to directly identify coronary artery stenoses (shrinked areas).
Treatments for angina may initially be medicinalbut at advanced stages, angioplasty or coronary artery bypass grafting become essential. The treatment consists of the administration of nitrates (Lenitral or trinitrin). It is important to distinguish anginal pain from the pain encountered in cases of myocardial infarction which does not respond to the administration of trinitrin and which requires emergency treatment. In case of unstable angina, the basic treatment is known by the acronym BASIC : Beta blockers, Antiplatelet agents, Statins, Conversion enzyme inhibitors and Correction (diet, reduction of risk factors).