Angina and a Heart Attack

Angina and a Heart Attack

Angina- Not a Heart Attack, Confirmation of Diagnosis

It is necessary to place an oxygen demand on the heart to stimulate the conditions which normally precede a heart attack. Using certain special studies, evidence of ischemia is noted. Conduction of further tests can also locate precisely the site of an arterial blockage.

Stress Electrocardiogram or Treadmill Test

The stress electrocardiogram stimulates those conditions which are prevalent preceding an angina attack. Early signs of ischaemia are detectable. The test is performed on a treadmill or bicycle.

Stress Echography

Ultrasound waves are directed at the chest. These waves bounce off the heart’s wall and valves.

An analysis of these rebounding waves helps us with the calculations of the size, shape and movement of the structures within the heart.

Two echoes are usually taken- one of the heart at rest and the other of the heart under stress e.g. after the patient exercises on a treadmill. A comparison between the two images helps detect areas of the heart not receiving enough blood.

The limitations of this test

The limitations of the ultrasound are that the resolution of the ultrasound is not high enough to see the arteries. We can only detect and highlight the big change in structures, e.g. that of the heart chamber and heart muscles.

Some people may be genetically more prone to heart disease than others. Still, there are plenty of ways to reduce your risk factors.

The comprehensive treatment of angina- for the prevention of heart attack includes eliminating or reducing the risk factors.

Stop Smoking: Smoking is known to contribute to coronary artery disease. Throw away your pack of cigarettes. It’s never too late to stop.

Lose Weight: Less weight in the body means less strain on your heart. Avoid fat and fatty products e.g. red meat, fried food, dairy products, sugar and sweet foods e.g. cakes pastries etc. Lower your cholesterol levels and other lipids in the body. This may help slow down the formation of fatty deposits and hardening of the arteries.

Exercise: Take guidance from your doctor for a fitness programme. A regular exercise programme will help you lose weight and improve your body fitness. You will feel good once you have adjusted to the exercise regime.

Reduce Your Stress: Take small breathers at work e.g. getting up for a glass of water or just stretching your legs after finishing a part of your job. Try stress busting exercises.

Meditation and Yoga: Meditation and yoga are other tools to relax your body. If you had a change in your angina pattern recently or your discomfort or pain is not relieved by medication and rest, consult your doctor.

Medical Treatment for Angina

Anti-anginal medication is prescribed to reduce your heart’s workload. The medication can be:-

Nitrates

Nitrate containing medications have been used for years and give prompt relief to the angina patient. Nitrates are small tablets which can be kept under the tongue, chewed or swallowed. They may also come in spray form.

Action: Nitrates ease the strain on the heart by reducing the blood pressure. Long acting nitrates include patches placed on the skin. These patches are available to help prevent angina attacks before they occur.

Beta Blockers

Site and Radiation of Cardiac Pain

Action: They act by directly reducing the heart’s demand for oxygen. They achieve this by slowing down the rate of heart and reducing the force of contraction of the heart muscles. The oxygen supply, which would be limited by blockages, remains adequate for the slower muscle contraction and a comparative resting heart. These are used for long-term angina patients.

Calcium Channel Blockers

They are used for the long-term angina treatment.

Action: They reduce the oxygen demand by slowing down the heart’s activity. This helps the narrowed coronary vessels to relax and widen. Thus the oxygen supply to the heart increases and at the same time the heart’s demand for oxygen decreases.