Angina is a heart disease associated with chest pain or discomfort that happens when the heart muscle does not receive enough blood rich in oxygen through the coronary arteries. The heart is a muscular organ that pumps blood through the vascular system supplying oxygen, glucose and other nutrients to the brain, lungs, kidneys and other organs and parts of the body, thus ensuring their proper function. Like other organs, the heart also requires blood to make about 250,000 beats daily. The blood enters the heart through two main arteries, called the coronary arteries: the right coronary artery and the left coronary artery.
Angina is a very common disease. According to statistics, over 3.2 million people in Ukraine suffer from angina.
STABLE ANGINA is the most common type that is normally characterized by symptoms occurring during physical exercise: running, climbing stairs, walking, lifting a weight. In these cases, the heart has to work harder to supply more blood, and thus more oxygen, to upper and lower extremities doing the exercise. The narrowing of coronary vessels in this disease causes imbalance between increased oxygen demand of the heart and insufficient blood supply. The pain usually lasts for a few minutes and goes away after rest. However, it may come back when you resume the exercise. It is very important that such pain attacks are absolutely identical, i.e. stereotypic. Normally, this type of angina is well controlled with medicines.
There are three different types of angina: stable angina, unstable angina and variant angina (Prinzmetal angina). Knowing the difference between these type is very important, as they have different symptoms and risk profiles and require different treatment.
The severance of stable angina is defined according to the Canadian Cardiovascular Society grading (abridged):
- Functional class I.Regular physical activity does not cause angina attacks. The pain occurs only with excessive or prolonged unusual exertion;
- Functional class II. Slight limitation of regular physical activity. The pain occurs on walking more than two hundred meters on the level or climbing more than one flight of stairs;
- Functional class III. Marked limitation of regular physical activity. Angina attacks occur on walking one to two hundred meters on the level, or climbing one flight of stairs;
- Functional class IV. Any physical activity can cause an angina attack. The pain behind the breastbone may occur at rest.
UNSTABLE ANGINA is less common but more dangerous than stable angina. It may develop as a separate disease or as a result of stable angina progression. The symptoms of unstable angina may occur after slight exercise (e.g., after walking just a few steps) or even when you are resting. Furthermore, angina is considered unstable when the symptoms appear during usual physical exercise which used not to be accompanied by these symptoms before, for example, when your angina attack normally starts after climbing two floors of stairs, but you suddenly feel chest pain already after reaching the first floor. This should be regarded as a sign of destabilization, in which case you should seek medical advice. This usually happens when one of the blood vessels has become so narrow that the blood supply of the heart muscle is critically low and you are at immediate risk of myocardial infarction. Therefore, if you feel a sudden chest pain at rest lasting for more than 15 minutes, you should call an ambulance.
VARIANT ANGINA (Prinzmetal angina) is a very rare type of angina. It usually comes on suddenly when you are at rest, at night or in pre-dawn hours, while you are sleeping. This is caused by spontaneous spasm of coronary arteries. You may need additional tests to diagnose this type of angina.VARIANT ANGINA (Prinzmetal angina) is a very rare type of angina. It usually comes on suddenly when you are at rest, at night or in pre-dawn hours, while you are sleeping. This is caused by spontaneous spasm of coronary arteries. You may need additional tests to diagnose this type of angina.
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