Angina pectoris: Symptoms, Causes and Home Treatment
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In angina the patient feels a squeezing type of pain, a burning sensation, or a feeling of choking, tightness, pressure or heaviness in the chest. The patient may complain of 'gas' or indigestion. Angina may be precipitated by stress, extreme weather, excitement or exertion. Pain usually starts near the middle of the breastbone and may spread from there to the arm and shoulder (usually the left side), the neck and jaw. Arm pain may reach the fourth and fifth fingers. The area affected by pain tends to be the same in a patient, except sometimes when his condition is getting worse. The commonest cause is reduced blood supply to heart muscle due to atherosclerosis in the coronary arteries. At times the cause is coronary artery spasm, or an embolism or clot that travels to block a coronary artery, or a pre-existing abnormality in the heart or in body metabolism like severe anaemia. At times an arterial blockage may be 'silent' and cause no symptoms till a heart attack. In one type of angina pain tends to occur early in the morning and wakes up the patient. In unstable angina the pain episodes tend to worsen, occurring with less exertion than before and even at rest, and there is increased risk of an actual heart attack.
Note: Angina is relieved in a few minutes by resting promptly or using sublingual nitrates. If there is a family history of heart problems, high cholesterol or hypertension, particularly after 40 and at any age if there is a personal history, a practical step is to carry some sublingual nitrate tablets. Angina brought on by stress or a big meal may last longer, but not more than half an hour. Pain that is more severe or lasts longer could be an actual heart attack (myocardial infarction) and should be taken as a warning to hospitalize the person immediately. Angina is the heart's 'cry' of distress, as it is not getting enough blood supply for its needs.
Tests include ECG at rest, after monitored exercise ('stress test;' treadmill etc.) and during norq1al activities. Blood tests are done for diabetes, cholesterol etc. Imaging methods like echocardiography, CT scan, MRI, and angiography - where an injected contrast medium is used - help evaluate the condition and functions of the heart.
Home remedy for the treatment of Angina pectoris
Consult at the earliest in a first attack. Regular follow-up is advisable. It is important to correct the avoidable contributing factors mentioned earlier. Avoid over-exertion. A person who has had an anginal attack must always carry with him a few sublingual tablets. In angina, rest promptly. Place a sublingual tablet under the tongue: it acts as fast as an injection and works by dilating the heart's arteries. Repeat if necessary. (Note: If a nitrate tablet is not available, half a tablet - about 150 mg - of aspirin can be chewed.) If pain is not relieved within 30 minutes it could be a heart attack. Urgently hospitalize the person. Treatment includes drugs that dilate the coronary arteries, reduce the heart's workload and prevent clogging of the arteries. High cholesterol and BP are controlled by treatment. Drugs called statins effectively reduce cholesterol levels.
Lifestyle changes - including a healthy low-fat diet, giving up smoking and excess alcohol, and regulated exercise - are vital in reducing the risk of repeat attacks and their intensity. A low-fat predominantly vegetarian diet containing a variety of vegetables and fruits (and including soluble fibre sources like beans, peas and oats) is very helpful for reducing cholesterol; so are crushed garlic, dark-fleshed fish and isabgul. (See notes on nutrition and exercise)Low dose aspirin, usually 75 to 150 mg daily, is useful in preventing the aggregation of blood cells (called pl4telets) that Facilitates clot or thrombus formation in the arteries. Other drugs too can prevent platelet clumping. No more than two single pegs of alcoholic drink or preferably one wine glass of red wine a day is recommended by many doctors to help reduce artery blockage. Note: 1. Exceeding that quantity of drinks could be counterproductive and harmful. 2. Take aspirin or other medications only as advised by the doctor, especially in view of possible side effects like hyperacidity. 3. Follow lifestyle advice based by your doctor on your condition, particularly with regard to exercise.
Patients with unstable angina need full investigations and treatment, including if necessary operative steps to reduce the risk of a serious heart attack. Coronary bypass creates an alternate channel for blood to flow past the blocked part of an artery using a vein graft. In angiopl4sty a small balloon passed through a catheter is inflated to dilate the narrowed artery. Further, a tube-like stent may be placed inside to keep the artery open.
Drug-eluting stents, though expensive, are even better as they slowly release medications that can cut down the risk of re-narrowing or blockage.
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