Coronary artery disease refers to obstructed blood flow to the cardiac muscles due to atherosclerosis, which is the narrowing or blockage of arteries due to fat and other substances forming plaques within the lumen. Coronary artery disease results in reduced blood flow to the heart. This weakens the heart, and can eventually lead to heart failure.
Some of the Coronary Artery Disease Symptoms are:
Angina is a common symptom of coronary artery disease. Angina is a type of chest pain that may feel like chest tightness or heaviness. It may be associated with numbness or aching with or without a squeezing sensation. Angina may radiate to your arms, back, neck or shoulders, sometimes extending up to your stomach or fingertips.
Sometimes, angina is felt merely as a vague pressure or discomfort in your chest and is associated with shortness of breath. Ischemia can present without any symptoms and still have serious consequences such as heart failure or arrhythmia. This is known as “silent ischemia”.
Cause of Angina
Angina is the result of ischemia or a reduced supply of oxygen to the heart. This causes dysfunction of the heart and cramping of the cardiac muscles. Angina occurs when you are performing activities that put stress on the heart, such as exercise, physical activities, or even when you experience cold temperatures. These conditions require extra oxygen and hence cause symptoms of angina.
Stable and unstable angina:
Stable angina occurs during predictable situations such as during stress, or after exertion. Stable angina only lasts a few minutes and resolves after rest. Also known as ‘chronic stable angina’, it occurs at predictable times with identical episodes every time.
Unstable angina happens even when the person is at rest or minimal activity and when the heart is under no additional stress. Every episode may be worse than the previous and may be associated with excruciating pain. Unstable angina can even wake you from your sleep. This is suspected to be due to the rupture of an atherosclerotic plaque followed by the formation of a blood clot that causes sudden cessation of blood supply to one region of the heart.
Other types of angina:
Also referred to as variant angina or angina in versa, Prinzmetal’s angina is rare and is seen in younger patients when compared to other forms of angina.
This type of angina always occurs when the person is at rest, usually late at night or early morning. This occurs due to the spasm of one of the coronary arteries that supply blood to the heart and is known to be very painful. Triggers of Prinzmetal’s angina include exposure to cold weather, stress, smoking and the use of cocaine.
This occurs due to the spasm of the vessel walls of the smallest arteries of the heart. It differs from other types of angina as it lasts longer, sometimes for over half an hour. It is also associated with shortness of breath, sleep problems and lack of energy.
Maintaining an Angina Log:
If you experience anginas frequently or are a patient who has had a heart attack or heart surgery in the past and is on treatment, keeping an angina log is recommended.
- Enter the date and time of the attack/attacks
- The duration of your symptoms
- How it was relieved – with rest or a nitroglycerine tablet
- Whether there were any triggers for the symptoms, such as physical activity or stress
- The severity of the pain or discomfort on a scale of 1 to 4
Make sure you take this logbook with you for every doctor’s visit. The log helps your treating cardiologist keep track of your angina pattern and also decide the course of your treatment.
Other Symptoms of Coronary Artery Disease:
- Shortness of breath
- Palpitations or Rapid Heartbeat
Angina or Heart Attack – How would you know?
Angina mimics a heart attack as both conditions cause chest pain and other similar symptoms. If the chest pain changes in quality, or is not relieved within fifteen minutes or does not go away after taking a nitroglycerine tablet placed under the tongue (usually prescribed by the doctor if you suffer from angina frequently), chances are you may be having a heart attack. You should seek immediate medical attention. It is vital not to ignore these symptoms. The quicker you begin treatment for a heart attack, the better the chances of survival.
Other causes for Chest Pain:
Though angina or a heart attack is a common cause for chest pain, they are not the only cause. Other reasons include:
- Pulmonary embolism (blockage in an artery supplying the lung)
- Lung infection or pneumonia
- A panic attack
- Aortic stenosis or constriction in the aortic valve opening
- Aortic dissection – an acute life-threatening condition caused by rupture of the aorta
- Cardiomyopathy or dysfunction of the cardiac muscles
Dr. Uday B Khanolkar, Senior Consultant – Cardiology – Adult, Narayana Institute of Cardiac Sciences, Bommasandra