With the World Heart Day on September 25, Belhoul European Hospital’s Cardiologist Dr Mohammad Motaweh says that everyone need to be aware of the symptoms of angina and its difference to heart attack.
According to Dr Motaweh, angina, known as angina pectoris, is pain or discomfort felt in the chest originating in the heart due to deficient oxygen delivered to the heart muscle. Conversely, heart attack results from total obstruction of one or more of the coronary arteries leading to complete cut off of the blood supply to that part of the heart muscle supplied by the obstructed artery.
Angina occurs when the heart’s oxygen demands exceed the supply and usually happens under extreme conditions. The greatest risk is coronary atherosclerosis, which is stiffness of walls and narrowing of lumens or coronary arteries by deposition of cholesterol and inflammatory cells in the arterial walls. This process takes years or even decades to develop.
The main causes of atherosclerosis include hypertension, diabetes, high cholesterol, smoking, high homocysteine, family history, stress, physical inactivity, obesity, age and sex. Other heart diseases that may cause angina include valve diseases, cardiac rhythm disturbances and heart muscle disease or cardiomyopathies. Non-cardiac causes include hyperthyroidism and severe anemia.
Although symptoms of both angina and heart attacks are very similar, heart attacks are more extreme, lasting a lot longer and can be fatal if severe. Anginal attacks occur under extreme conditions whereas heart attacks usually occur whilst asleep.
“Symptoms of angina vary but generally involve mild discomfort in the central chest, burning sensation like indigestion, tightness, heaviness, cramping and a squeezing or sharp pain behind the breast bone,” Dr Motaweh said.
“Pain may also occur in areas such as shoulders and arms, neck, jaw, throat, upper back or upper abdomen. Others may have no pain but rather sweating, nausea, shortness of breath or suffocation.”
Dr Motaweh says pain may be triggered by intense emotions, a heavy meal, sexual intercourse or walking in very cold weather. Unlike heart attacks, pain from angina can be relieved by rest or having nitroglycerine tablet or spray under the tongue.
For those at risk of suffering from an anginal attack, Dr Motaweh suggests leading a more active life such as undertaking brisk walking, swimming or cycling. He also suggests avoiding stress, eating well, not smoking and controlling blood pressure.
According to Dr Motaweh, there are also certain medications which can assist angina sufferers like aspirin which inhibiting platelets to avoid clotting, nitrates act by dilating blood vessels and beta-blockers act by blocking the sites of action of adrenaline hormone. Calcium channel blockers both decrease the hearts demands of oxygen and increase blood flow vasodilatation of blood vessels.
