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The different faces of heart pain: What are the differences between stable and unstable angina?
Angina pectoris, also known as angina, is a type of chest pain or pressure caused by insufficient blood flow to the myocardium (heart muscle). This pain is often a symptom of coronary artery disease, in which insufficient blood flow is often caused by partial blockage or spasm of a coronary artery. The main cause of angina pectoris is usually arteriosclerosis. Although there is a correlation between the intensity of angina and the degree of myocardial oxygen deprivation, the relationship is not always direct. For example, some people may experience severe pain but not necessarily be at risk for a heart attack, while others may experience mild or no symptoms during a heart attack.
Symptoms of unstable angina include worsening chest pain, chest pain that comes suddenly while you are at rest, and chest pain that lasts for more than 15 minutes.
Stable angina
Stable angina pectoris, also known as "exertional angina pectoris", is a classic type of angina pectoris caused mainly by myocardial ischemia. Stable angina usually causes chest discomfort during certain activities (such as running or walking) and is usually relieved by resting or taking nitroglycerin. This pain is relatively short-lived and subsides within a few minutes of activity, only to reappear when activity begins again.
Unstable angina
Unstable angina is defined as sudden onset of chest pain, either at rest or with minimal physical activity, usually lasting more than 10 minutes. This type of angina requires emergency medical attention. Unlike stable angina, the pain of unstable angina is more severe and may occur unexpectedly at rest and occur more often and last longer than before.
Unstable angina is primarily due to a reduction in coronary blood flow and associated arterial embolism, which may be caused by the progression of atherosclerosis.
Microvascular angina
Microvascular angina, also known as cardiac syndrome X, is characterized by angina-like chest pain in the absence of major artery blockages shown on imaging of the heart arteries. This type of angina is more difficult to identify and diagnose because it does not involve a blockage. Women with microvascular angina often experience higher rates of angina attacks, which may be related to their physiological characteristics or internal and external environment.
Signs and symptoms
The pain people feel from angina is often described as a feeling of pressure, heaviness, or tightness in the chest. In addition to chest pain, angina pain may also feel in the upper abdomen, back, neck, jaw, or shoulders. The source of this pain sensation is related to the concept of neuralgia, as the visceral nerves to the heart share the same nerve source as other cutaneous nerves, causing a crossover of sensations.
The main triggers of angina include exercise, emotional stress, cold weather, and large meals.
Risk Factors for Angina
Major risk factors for angina include smoking, diabetes, high cholesterol, high blood pressure, a sedentary lifestyle, and a family history of premature heart disease. In addition to these factors, angina may be made worse by other medical problems such as gastroesophageal reflux disease and hyperthyroidism.
Diagnosing angina
Doctors suspect angina when patients report cramping chest pain, particularly during activity or under emotional stress. Results of an electrocardiogram (ECG) often aid in the diagnosis; ST segment elevation or depression may be observed during chest pain. To measure the heart's response, exercise testing is often used to determine if angina is present.
Treatment of angina pectoris
Treatment of angina focuses on reducing the heart's demand for oxygen so that the heart can function normally despite the lack of blood flow. Common medications include beta-adrenergic blockers, calcium channel blockers, and organic nitrates, which can help relieve symptoms and reduce the risk of a heart attack.
The management of angina is not static but needs to be adjusted based on the patient's condition and progress. When faced with heart health problems, can we clearly understand and identify the warning signals from our bodies and respond in a timely manner?
