Cardiovascular Diseases

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Angina

Description 

Angina occurs when the heart must do extra work but does not receive enough oxygen for its needs because a coronary artery is narrowed due to arteriosclerosis. angina may occur not only in the case of physical exertion but also during an episode of mental stress or the digestion of a large meal. Angina pain generally disappears quickly once the activity has stopped or with nitroglycerin.

Someone has stable angina when the angina pain occurs and can be reproduced during specific activities and remains of short duration.

Unstable angina , which is also called acute coronary syndrome, refers to prolonged pain that generally occurs when patients are at rest and that can be a sign of myocardial infarction (heart attack). These symptoms are described in the Acute Coronary Syndrome section.

Symptoms 
  • Pain, tightening, weight or discomfort in the middle of the chest
  • Pain that may radiate out to the arm, neck, jaw, shoulders or back
  • These symptoms may be associated with shortness of breath, nausea or vomiting, dizziness or loss of consciousness
Diagnosis 

After filling out a questionnaire and performing a medical exam, the doctor may prescribe different tests to confirm the diagnosis of angina , evaluate the severity of the problem, and determine the best treatment. These tests may include:

  • An electrocardiogram (ECG)
  • A stress test (on a treadmill) that may be combined with a nuclear medicine exam or an echocardiogram
  • The administration of an intravenous medication to trigger an angina episode combined with a nuclear medicine exam or an echocardiogram
  • Coronary angiography
Treatment 

Stable angina is generally treated with medication that decreases the heart's workload and dilates the arteries. A medication to reduce the risk of blood clots (aspirin or other) is also indicated along with medication to decrease the harmful impact of cholesterol on the artery wall.

If these measures are insufficient to control the condition or if tests demonstrate particularly severe damage, specialized intervention may be required, such as cardiac catheterization or surgery.

Living with the disease 

It is important for angina patients to work with their doctors on the risk factors listed above. Quitting smoking, reaching a healthy weight, eating a healthy diet and following an adapted exercise program are part of treatment, which also includes taking medication to treat high blood pressure or diabetes. These recommendations are applicable for people who want to avoid developing coronary atherosclerosis (primary prevention) and for people who have already been diagnosed with this condition (secondary prevention). For more information on preventing heart disease by working on your risk factors, refer to the section on Prevention.