Angina Pectoris
Angina pectoris is a disease that occurs due to disruption of oxygen supply and blood flow to the heart muscle. The typical symptom of this disease is chest pain that can interfere with daily activities.
The blood supply to the heart muscle can be disrupted due to narrowing or blockage in the blood vessels. This disease can occur suddenly and can affect anyone.
However, there are several factors that can increase the risk of angina, starting from high cholesterol levels, having diabetes, having a history of hypertension, stress, being overweight or obese, and actively smoking. A history of heart disease, and rarely exercising can also increase the risk of angina.
Symptoms of Angina
Most people with angina describe chest pain or pressure. Most people also describe a squeezing or tightness sensation in the chest.
Meanwhile, a small number of others said the symptoms of angina felt like indigestion. However, the rest of the sufferers said it was difficult to describe angina symptoms specifically.
When angina occurs, here are a number of symptoms that sufferers can feel, including:
- Chest pain that can spread to the left arm, neck, jaw, and back.
- The chest feels like it is being squeezed or pressed by a heavy object.
- Hard to breathe.
- The body feels tired.
- Nauseous.
- Dizzy.
- Nervous.
- Excessive sweating.
- Faint.
Causes of Angina
In order to function properly, the heart needs enough oxygen-rich blood. Two large vessels, called the coronary arteries, supply blood to the heart.
The main cause of angina is narrowing or blockage of the coronary arteries. If you look at the triggers, there are three types of angina, namely:
1. Stable angina
Generally, this condition is triggered by physical activity, such as exercise. When exercising, the heart organ requires more oxygen supply from the bloodstream.
However, these needs will not be met if there is a blockage or narrowing of the coronary vessels. Stable angina attacks can also occur due to other things, such as smoking, stress, overeating, and cold air.
2. Unstable angina
This condition occurs due to fat deposits or blood clots that reduce or block blood flow to the heart.
Even though the sufferer has taken medication and rested, chest pain due to unstable angina will still persist.
If not treated properly, unstable angina attacks can develop into heart attacks.
3. Variant angina (Prinzmetal’s sitting angina)
In this condition, there is a temporary narrowing of the heart arteries due to spasm or stiffness of the blood vessels. This type of angina can even attack people who are resting. Because this variant of angina can occur at any time.
Temporary narrowing of the blood vessels causes the oxygen supply from the blood flow to the heart to decrease and chest pain occurs. Symptoms of this type of angina can be treated with medication.
Diagnosis of Angina
In addition to conducting a physical examination and asking about the history of symptoms experienced by the sufferer, there are several other examinations that doctors will generally perform, such as:
- Electrocardiogram (ECG). The use of an ECG or heart recording aims to see whether the patient’s blood flow is disturbed or decreased.
- Echocardiogram. This examination aims to assess the function of heart muscle contraction and heart valve function which can decrease if there is damage to the heart muscle, due to impaired blood flow or parts of the heart that do not receive enough blood flow.
- Exercise Tolerance Test ( Exercise Tolerance Test ). The main purpose of this examination is to measure the heart’s endurance during physical activity before angina symptoms arise.
- Cardiac scintigraphy. This examination aims to determine whether blood flow in the blood vessels is disturbed.
- Coronary angiography. This examination aims to determine whether the coronary blood vessels are blocked and how severe the blockage is.
- Blood test. This type of test aims to measure the level of cardiac enzymes in the blood to determine heart damage due to a heart attack.
- Chest X-ray (X-ray). This examination aims to see whether the symptoms experienced by the sufferer are due to conditions other than angina or to see if there is an enlarged heart.
- CT scan of the heart. This examination aims to determine how severe the narrowing of the heart vessels is, and whether there is an enlargement of the heart that is not very visible from the results of the chest X-ray.
Angina Treatment
Can angina pectoris be cured? The answer is that angina pectoris cannot be cured. But angina pectoris can be treated if the symptoms appear at any time.
The goal of angina treatment is to reduce the frequency and severity of symptoms and reduce the risk of heart attack and death.
The following are options for angina treatment including:
1. Sitting Wind First Aid
There are several ways you need to do immediately if you experience angina symptoms. First aid that you can do for yourself, including:
- Stop Activities and Take a Rest Immediately
If you experience chest pain during activity, immediately stop the activity and rest, such as sitting or lying down.
- Taking Medicines
If symptoms do not subside after resting, take a dose of angina medication. You are advised to sit or lie down before taking the medication, as the medication can make you dizzy. Take the smallest dose you usually take. For example, a full tablet, half or even a quarter of a tablet. Here’s how to use angina medication:
- Spray medication. Spray once under the tongue.
- Tablets. Place the medicine under the tongue, but do not swallow. When symptoms stop, spit out the remaining tablet.
- Wait Before Taking Additional Doses
Wait 5 minutes. If angina symptoms persist, take another dose, then wait another five minutes.
- Tell the Family
Tell your family or closest people about your condition so they can help.
- Contact the Nearest Hospital
If angina does not improve after 10 minutes of waiting or gets worse, immediately contact the nearest hospital for an ambulance and emergency medical treatment.
2. Lifestyle changes
Heart disease is a common cause of angina. Making lifestyle changes to maintain heart health is an important part of angina treatment.
Here are some efforts that can be made:
- Don’t smoke and avoid exposure to cigarette smoke. It is common knowledge that smoking is one of the habits that can increase many health problems.
- Exercise and manage your weight. As a general goal, aim for at least 30 minutes of moderate physical activity each day. If you are overweight, talk to your doctor about safe weight-loss options. Ask your doctor what weight is best for you.
- Change your diet. Eat healthy foods low in salt and saturated fat, and choose healthy foods such as whole grains, fruits, and vegetables.
- Manage other health conditions. Diabetes, high blood pressure, and high blood cholesterol can cause angina. Therefore, it is important for people with these conditions to manage and monitor their conditions.
- Practice stress relief. Exercising more, practicing mindfulness, and connecting with others in a support group are some ways to reduce emotional stress.
- Avoid or limit alcohol. If you choose to drink alcohol, drink in moderation.
3. Medical action
Medical treatment options for angina are divided into two options, namely the use of medication and surgical procedures.
Use of drugs
If lifestyle changes such as healthy eating and exercise don’t improve heart health and relieve angina pain, medications may be the answer.
Medications to treat angina may include:
- Nitrates. These drugs help relax and widen blood vessels so more blood can flow to the heart. The most common form of nitrate doctors prescribe for angina is nitroglycerin.
- Aspirin. This medication can reduce blood clotting, making it easier for blood to flow through narrowed heart arteries. Preventing blood clots can reduce the risk of heart attack.
- Clot-preventing medications. Certain medications, such as clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta), make blood platelets less likely to stick together, so your blood doesn’t clot.
- Beta-blockers. Beta-blockers cause the heart to beat more slowly and with less force, which lowers blood pressure.
Therapy
Sometimes, a non-drug option or Enhanced External Counterpulsation (EECP) may be recommended by your doctor to improve blood flow to the heart.
With EECP, your doctor will place a blood pressure-type cuff around your calf, thigh, and pelvis.
EECP requires several treatment sessions. EECP can help reduce symptoms in people with frequent, uncontrolled angina (refractory angina).
Operating procedure
There are a number of surgical procedures that your doctor may recommend to treat angina, including:
- Angioplasty surgery. This procedure involves placing a stent in the blood vessels of the heart. This procedure is the main procedure in treating coronary artery blockages.
- Bypass surgery. This procedure aims to divert blood flow so that it does not pass through blocked or damaged blood vessels by using blood vessels from other parts of the body.
Recommended Medicine for Angina Pectoris
There are various choices of angina medication with a doctor’s prescription that you can take, including:
- Concor 1.25 mg 10 Tablets. Antihypertensive drug containing bisoprolol fumarate 1.25 mg. This drug can help treat hypertension, angina, and chronic heart failure.
- Zendalat 10 mg 10 Tablets. Zendalat contains nifedipine 10 mg, which can help prevent certain types of chest pain, including angina. It works by relaxing blood vessels, allowing blood to flow more easily.
- Cardio Aspirin 100 mg 10 Tablets. Aspirin class drug that works as an analgesic, antipyretic, anti-inflammatory, and anti-platelet. How it works, prevents the platelet aggregation process in patients with myocardial infarction and unstable angina patients.
- Aspilets 80 mg 10 Chewable Tablets. These chewable tablets contain acetylsalicylic acid 80 mg, which is a non-steroidal analgesic compound. You can use this medicine to treat unstable angina, as well as temporary ischemic brain attacks.
- Cardicap 5 mg 10 Tablets. Antihypertensive drug Calcium Channel Blocker (CCB), which can be used as first-line treatment for hypertension, stable angina, and variant angina.
- Intervask 5 mg 10 Tablets. Contains amlodipine, a drug that works as an antihypertensive Calcium Channel Blocker (CCB). You can use this drug as a first-line treatment for variant angina and stable angina.
- Adalat Oros 30 mg 10 Tablets. Used to treat hypertension and angina. It contains nifedipine which works by relaxing the heart muscles and blood vessels so that blood flows easily and the heart load is reduced.
In addition to taking medication, angina sufferers also need to know how to provide first aid when experiencing it.
Prevention of Angina
Angina pectoris is a condition that you can prevent. There are several preventive measures you can take, including:
- Exercise regularly. If you want to know when is the right time to exercise.
- Eat heart-healthy foods.
- Avoid foods that are harmful to the heart.
- Maintain ideal body weight.
- Limit consumption of alcoholic beverages.
- Quit smoking.
Angina Complications
Chest pain that occurs with angina can make everyday activities uncomfortable. However, one of the most dangerous complications is a heart attack.
Warning signs and symptoms of a heart attack include:
- A feeling of pressure, fullness, or squeezing pain in the middle of the chest, lasting more than a few minutes.
- The pain spreads beyond the chest to the shoulders, arms, back, or even to the teeth and jaw.
- Faint.
- Anxiety.
- Increased episodes of chest pain.
- Nausea and vomiting.
- Continuous pain in the upper abdominal area.
- Hard to breathe.
- Sweating.