HEART PROBLEMS
Angina
Angina is generally described as a pain or severe tightness felt in the chest. Sometimes this pain can spread to the arms, neck, jaw and through to the back. There are various degrees of severity depending on the limitations it causes.
Angina usually presents as chest pain after exercise, exposure to cold weather, after a meal, or sometimes just walking to the shops. For a small minority of people, it can be triggered at rest or when they are sleeping.
Angina is caused by inadequate blood supply to a particular region in the heart. The coronary arteries which supply the heart with blood become narrowed in people with coronary artery disease. This process is called atherosclerosis and can take years to manifest. If the heart doesn’t get enough blood, this results in angina pain.
There are a multitude of risk factors for coronary heart disease. Risk factors for angina include diabetes, high blood cholesterol, smoking, high blood pressure, familial history, lack of physical exercise and being overweight. For some people, there may be multiple risk factors such as being overweight, hypertensive (high blood pressure) and smoking. For these subgroups of people, the risk of coronary heart disease is very high.
Angina is easily diagnosed by a cardiologist and treatment mainly takes the form of a nitrate which is sprayed under the tongue. This spray works by dilating the area that has become narrowed in the artery. Sometimes other medications are added to reduce the risk of angina pain. These include anti-hypertensives such as calcium channel blockers, Beta blockers, and potassium channel activators. Calcium channel blockers work by decreasing vascular smooth muscle cells such as those present in the coronary arteries. An example of a calcium channel blocker is Nifedipine. This results in dilation of the artery, therefore blood pressure drops. Beta blockers work differently by slowing the heart rate, increasing the amount of time the heart has to fill, and reducing the force of contraction that the heart has to undergo in order for it to eject blood into the aorta. The net result of this process is a reduction in the amount of oxygen required by the heart and a lower blood pressure. Examples of Beta blockers are Atenolol, Metoprolol, and Propranolol. Potassium channel activators have a similar effect to nitrates. They work by dilating both the arteries and veins, allowing blood to flow through the body more easily. This action reduces the amount of work the heart has to undertake in order to eject blood out in the aorta.
Angina is generally successfully treated with a combination of the above drugs to gain a good control over the symptoms. Patients are usually also given a small dose of daily aspirin.