Angina pectoris, or chest tightness, is a heart condition that belongs to the coronary artery disease (CAD) group. Symptoms are often similar to those of heart attack. Angina should be immediately evaluated by a physician if suspected. Calling the emergency doctor or urgent medical help is therefore more than advisable.
What is angina pectoris?
Stabbing or tearing heart pain is described by most patients during a heart attack. The pain may radiate to the arms, neck, shoulder, upper abdomen, and back. Accompanying symptoms are usually: Shortness of breath, nausea, and anxiety (“fear of death”) accompanies. Angina pectoris is a serious condition that belongs to the group of conorary heart diseases. It is also translated as “chest tightness” and this makes it clear what it is. Symptoms that occur in the context of angina pectoris are called “pectanginal complaints”. To distinguish angina pectoris from the even more serious myocardial infarction, one must consider the time in which the symptoms occur, because the unpleasant symptoms of angina pectoris usually occur only for a short time, but in any case require rapid medical clarification.
Causes
The causes of angina pectoris are narrowed coronary arteries and resulting circulatory disorders of the vessels and, as a consequence, a reduced supply of oxygen to the heart muscle. This problem occurs frequently under physical and mental stress and almost always accompanies coronary heart disease. However, since not every case of coronary artery disease is accompanied by these symptoms, it is quite insidious, because it therefore often remains undetected for a long time and the earlier the causes are eliminated, the more favorable are the chances of recovery. Other causes may include: Hypertension, diabetes, arteriosclerosis, stress and smoking.
Symptoms, complaints and signs
The symptoms of angina pectoris can be very different. Frequently, the stabbing chest pain usually described does not occur at all. In many cases, patients complain only of discomfort localized behind the breastbone. Here, such symptoms as pressure, dull pain, burning or a feeling of heaviness are described. Frequently, there is shortness of breath and a feeling of chest constriction (see chest tightness). In many cases, the pain radiates to the back, neck, shoulders, or stomach. Sometimes even the jaw area can be affected by the pain. Thus, it is even possible that the origin of the pain is no longer realized if it dominates in the radiated area of the body. When the jaw is affected, very severe toothache can often be perceived as the only symptom. In this case, the patient will often see a dentist instead of a cardiologist. Angina pectoris may be stable or unstable. In the stable form, the symptoms always occur with the same intensity during certain stressful situations and subside when the patient rests. Unstable angina pectoris occurs even with low levels of exertion, becomes more severe with each attack, and lasts longer and longer. In addition, the pain often does not subside even at rest, and drug treatment with nitroglycerin often does not respond. Furthermore, the risk of heart attack is significantly increased in unstable angina pectoris.
Course
If angina is suspected, a physician should be called immediately to prevent permanent damage. If medical treatment is then initiated, the coronary arteries can be sustainably treated by modern medical therapy methods, so that the risk of a heart attack or other heart diseases can be reduced. Nevertheless, especially in the case of angina pectoris, the patient should become active himself. This means absolutely abstaining from smoking, alcohol and fatty food. In addition, the patient should start to exercise more or even do sports under medical supervision. Stress should also be avoided. If the patient also suffers from overweight, this should be treated by additional dietary measures. If coronary heart disease, which includes angina pectoris, is not treated, there is a high risk of dying from a heart attack.
Complications
If complications occur with angina pectoris, they should be clarified by a physician.As soon as a feeling of tightness or oppression in the chest becomes noticeable, breathing difficulties or cardiac rhythm disturbances occur, there is an acute danger to life. The sudden lack of oxygen can no longer guarantee blood supply to the heart muscle, and a heart attack is imminent. At times, the complications also manifest themselves as chest pain, numbness in the arms, dizziness and sweating. It is advisable to cure any form of angina. After the symptoms are over, the patient belongs to a risk group and should correct his lifestyle within the framework of therapy. If the symptom is protracted and the signs of an onset of the problem are ignored, the clinical picture can turn into a chronic permanent condition. Once the heart muscle has been weakened by angina pectoris, this affects the general quality of life and life expectancy. Furthermore, the chances of recovery are reduced. As a result, therapy-resistant angina pectoris or even unstable agina pectoris can develop, causing sudden circulatory problems even during periods of rest. Sick patients must therefore pay closer attention to their body’s warning signs to avoid extreme cases. In particular, people in midlife who are exposed to a high stress potential as well as elderly patients can succumb unexpectedly to a heart attack.
When should you see a doctor?
In the event of the onset of seizure-like chest pain, always call an emergency physician in the first instance. Affected individuals must be evaluated for the cause of the attack. Coronary sclerosis, heart defects, arrhythmias and other coronary causes must be identified and treated if necessary. Surrounding vessels may also play a role. In addition, angina may indicate or be a symptom of a heart attack. Patients with stable angina experience similar attacks of chest tightness with consistent pain in different situations. They can take care of themselves thanks to prescribed medications. If this does not help, an emergency physician should be called. Two other factors also determine whether an emergency physician should be called. First, it should be called if the seizure is different from previously experienced seizures. Under certain circumstances, it may be a heart attack. A doctor should also always be consulted if the attacks become more frequent, i.e. if they occur under less stress than usual. Unstable angina pectoris is a case for the doctor every time the affected person notices a single deterioration. Regular examinations of the heart and surrounding vessels are essential for all people who experience these attacks.
Treatment and therapy
Often underlying a heart attack is a narrowing of the coronary arteries known as arteriosclerosis. If such a narrowing is blocked by a blood clot, all subsequent heart muscle areas are no longer supplied with blood and oxygen. The heart muscle then dies within a few hours. Click to enlarge. Anyone who experiences penctanginous symptoms should seek medical treatment immediately in order to recognize and treat possible angina pectoris in time, because time is of the essence here. The best thing to do is to call the emergency medical services immediately. This will probably come with the emergency doctor, since the disease can be life-threatening. In any case, you should elevate your upper body and not take any more steps. It can happen that one must vomit or it even comes to a circulatory collapse. The first measures of the rescue service will be to supply high-dose oxygen through a nasal probe, to check the vital functions, i.e. breathing, pulse and blood pressure, and to insert one or more venous accesses (infusion needles) so that medication such as painkillers etc. can be administered quickly. If the angina pectoris symptoms persist until the ambulance arrives, it is probably a heart attack, which can lead to death if left untreated. This is the reason why this chest tightness should be taken very seriously and it is better to call the ambulance once more than once too little. Only on the basis of the applied and evaluated ECG, one can possibly determine whether it is “only” an angina pectoris or a heart attack.Even with an unremarkable EKG, a heart attack may be present, so people with heart conditions, no matter what type, always belong in the care of a doctor so they can be helped quickly.
Outlook and prognosis
In the worst case, angina can cause sudden cardiac death. This usually occurs without any particular symptoms and can thus lead to the death of the patient. Those affected suffer from severe chest pain and not infrequently shortness of breath. The shortness of breath can also lead to a panic attack, which is associated with a breakout of sweat. Furthermore, there is a strong lassitude and an oppressive feeling in the chest. It is not uncommon for patients to suffer from fear of death and severe abdominal pain. The patient’s resilience is reduced and there are difficulties in everyday life. Furthermore, paralysis or other sensory disturbances may also occur, which significantly reduce the quality of life. With this disease there is also no self-healing, so that the affected person is dependent on treatment by a doctor in any case. The treatment itself is carried out with the help of medication or by surgical intervention. In the case of a heart attack, treatment by an emergency physician is necessary so that the patient does not die. If necessary, life expectancy is limited by angina.
Prevention
The best prevention of angina is, of course, to prevent it from happening in the first place and to be examined in detail by a doctor on a regular basis. This is especially true if you are a so-called high-risk patient. This includes people who are overweight, have high blood pressure and high blood lipid levels; people who have a family history of heart disease and, of course, people who have had heart problems in the past. Even if the symptoms are mild, you should immediately see a specialist (cardiologist) or at least your family doctor, who can then decide whether consultation with a specialist is necessary. Angina pectoris does not only affect people who are obviously predestined for it, i.e. who are overweight or have elevated blood fat levels. People who are under a lot of physical or psychological stress also belong to the group of people at risk. It is not uncommon to see the image of the stressed manager trying to loosen his tie knot and gasping for air. Mental stress can also lead to the symptoms of angina pectoris. Underlying diseases need to be treated and those who are constantly under pressure to perform, in whatever form, need to shift down a gear and slow down a bit for the sake of their health, because you only have one heart and that heart is vital.
Aftercare
Once a chest tightness has been detected, there is no immunity to recurrence. Patients can predominantly prevent the likelihood of recurrence through self-designed aftercare. Preventive measures include a healthy diet, daily physical activity, and abstaining from addictive substances such as alcohol and cigarettes. Avoiding stress has also been shown to have a positive effect. Overweight patients urgently need to reduce their weight. If agina pectoris occurs again, patients should definitely consult a doctor. In a pronounced form, there is a threat to life. The electrocardiogram is an important examination to determine the presence of the disease. The physician measures the heart currents and uses them to determine the susceptibility to chest tightness. Even patients who have not previously complained of the typical symptoms should regularly take part in preventive measures offered by their health insurer. There is an entitlement to this from the age of 35. Risk factors are diagnosed during the health check-up. The doctor can provide meaningful information by measuring blood pressure and analyzing blood. Patients usually begin interval therapy after a single episode of the disease. This is intended to prevent complications and progression. It is important to stop the high blood pressure and the lipometabolic disorder. Medications are used regularly to optimize cardiac work.
Here’s what you can do yourself
For people suffering from angina pectoris – or other heart diseases – there are numerous places to go to help them cope with the disease. In so-called heart groups, patients can exchange information with each other and exercise together.Exercise is essential in the treatment of cardiovascular diseases. In addition, sharing experiences with other patients can reduce the fear of a heart attack. If this is not enough, therapy with a specialist or psychologist can be considered. Relaxation techniques can also help against anxiety. Specialists and psychologists have observed that patients who regularly practice techniques such as progressive muscle relaxation, autogenic training or yoga suffer less frequently from attacks of angina pectoris. For patients who are skeptical about relaxation techniques, so-called biofeedback is recommended as an introductory technique. Here, the patient imagines an image (for example, a pleasant landscape or situation) and concentrates entirely on it. In addition to regular exercise and relaxation, other factors play a role. The following are recommended: a low-fat, healthy diet, weight normalization in the case of obesity, and abstinence from nicotine. Regular medical check-ups can identify risk factors for angina pectoris (for example, arteriosclerosis). Patients with statutory health insurance can have a free check-up every two years from the age of 35. This is particularly recommended for diabetics and smokers, as well as patients with blood pressure problems. During an attack, it is important to remain calm. The patient should keep an upright posture and try to breathe calmly. In most cases, the pain passes within a few minutes. Sufferers carry a nitro spray or nitro capsules, which eliminate the symptoms. If this does not, and if the discomfort persists for more than fifteen minutes, the emergency services should be alerted.
