Angina Pectoris Angina Pectoris is a medical term for chest pain caused by a lack of blood flow to the heart muscle. Angina is almost always caused by a partial obstruction of the coronary arteries. Other less common causes of angina include abnormal heart rhythm, drug reactions and thyroid conditions. Angina Pectoris can take two different forms: typical and atypical. Typical angina gives a sensation of pressure or tightness in the center of the chest or to the left of the sternum, usually brought on by over-exertion or extreme emotions. It often radiates to the left shoulder down the inside of the left arm. Onset is gradual, building in intensity and decreases with rest. Atypical angina refers to any symptom that falls outside the norms for typical angina. Common manifestations of atypical angina are chest discomfort unrelated to over-exertion or discomfort not located in the chest. What is angina pectoris? Angina Pectoris is the most common symptom of coronary artery disease. The majority of patients with angina complain of chest pain, but can also include shortness of breath, fatigue, indigestion, faintness, pain in the arm or neck. What causes angina? Angina signals that a part of the heart muscle is not receiving an adequate supply of blood and oxygen. When narrowed or blocked arteries prevent or restrict blood flow, oxygen supply to portions of the heart may be insufficient. Increases in oxygen demand can occur during exercise, when you have a fever, during periods of hypoglycemia or after meals. This increased demand can trigger the onset of angina. How can angina be avoided? Doctors recommend controlling the risk factors that contribute to the underlying coronary artery disease, namely high blood pressure, diabetes, cigarette smoking, high blood cholesterol levels, and obesity. How is angina treated? Angina is usually controlled by medications that either increase the supply of oxygen to the heart muscle by dilating coronary vessels, or decrease demand for oxygen by slowing the heart rate or decreasing the intensity of contraction. In some patients, however, medication becomes insufficiently effective over time. What happens when medication fails to control angina? Angioplasty (bypass surgery) is usually recommended if medication fails to control angina or if the risk of heart attack is high. What is an angiogram? Angiograms are used to evaluate the condition of the coronary arteries and nourishment of the heart muscle. A dye which can be imaged by x-ray techniques is injected into the heart's blood vessels via a catheter is inflated alongside the obstructing plaque deposits, flattening them against the vessel wall to restore blood flow. What are coronary arteries? Surrounding the heart, these arteries provide the heart with a nourishing supply of blood. What is coronary artherosclerosis? Every year one million Americans develop atherosclerosis, partial or total blockage of arteries caused by deposits of plaque in and on the walls of the vessels. What is an electrocardiogram (EKG)? An electrocardiogram is a recording of the heart's electrical activity. It is detected by electrodes attached to the skin, and recorded in waves that are displayed graphically. The EKG provides information on heart rate, rhythm, and function. EKG may also indicate the presence of heart damage or inadequate blood and oxygen supply to the heart muscle, and abnormalities of heart structure. Peripheral Vascular Disease Symptoms The most common symptom of PVD is painful cramping in the leg or hip, particularly when walking. This occurs when there is insufficient blood flowing to the leg muscles during activity. The pain usually disappears with rest. Following are possible signs of PVD: • Leg or hip pain during walking • Numbness, tingling or weakness in the legs • Burning or aching pain in feet or toes when resting • Sore on leg or foot that won’t heal • Cold legs or feet • Color change in skin of legs or feet • Loss of hair on legs If you have ANY of the PVD symptoms or risk factors, seek medical assessment immediately. Who is at risk for PVD? Men are slightly more likely than women to have PVD. Those who are at highest risk are: • Over 50 • Smokers • Diabetic • Obesity Sedentary • High blood pressure • High cholesterol How is PVD treated? Based on an examination and risk factors, you may need to modify your diet, quit smoking and/or begin a regular exercise routine. If your symptoms are more advanced, you may require medical treatment such as: Angioplasty: A tiny balloon is inserted into a blood vessel through a tiny tube (catheter) and moved to the site of the blockage. The balloon is then inflated to open the artery. In some cases, a tiny metal cylinder (stent) is inserted in the artery to keep it open. Thrombolytic Therapy: If PVD is caused by a blood clot, thrombolytic drugs, sometimes referred to as “clot-busting” drugs, may be administered to dissolve the blood clot and restore blood flow. Thrombectomy: If PVD is caused by a blood clot, a tiny balloon may be inserted into the affected artery above the clot site. The balloon is inflated, then pulled back, removing the clot in the process. Bypass Graft: A healthy blood vessel from another part of the body or an artificial artery is used to create a detour around the blockage.