Types of Angina

Angina usually refers to angina pectoris. Angina pectoris signifies chest pain and discomfort triggered by the insufficient supply of oxygen rich blood to the heart muscles. Along with chest pain, pain may also be experienced in the shoulder, back, arms, neck and even in the jaw. The word angina pectoris is derived from the Greek words, ankhon, which means strangling and pectus, which means chest. So, it can be explained as a strangling sensation felt in the chest. Angina is actually not a disease, but usually a symptom of coronary artery disease (CAD). Coronary artery disease is generally caused by the deposition of fatty substances on the inner walls of the arteries. This makes the arteries narrow and stiff, which is known as arteriosclerosis. However, chest pain is not always an indication of angina, but can be caused by many other factors like pneumonia, pleuritis (inflammation of the lining of the lungs), pneumothorax (rupture of the alveoli of lungs), etc.

Types of Angina
Angina pectoris is usually classified into three types, stable, unstable and variant angina.

Stable Angina
Stable angina is the most prevalent type of angina, and is usually predictable as it exhibits a definite pattern. It is commonly induced by exercise or any other physical exertion like running or walking. The pain in the chest is generally relieved after resting for sometime. The pain usually lasts for 3 to 5 minutes, and medications help relieve the pain. The pain experienced in the chest may sometimes spread to other parts of the body such as arms, back and shoulders, etc. It can be responsible for increasing the risk of heart attacks.

Unstable Angina
Unlike stable angina, unstable angina is not triggered by physical activities. It is more severe than stable angina and can occur even while resting. The chest pain can last for 10 or 15 minutes and can't be cured by rest or medications. It does not follow a regular predictable pattern like stable angina, and can be an indication of an imminent heart attack.

Variant Angina
Variant angina is also known as Prinzmetal's angina. Variant angina can occur while you are resting or sleeping. This type of angina can be relieved by taking appropriate medicines. It occurs usually between midnight and morning.

Causes
The most common cause of angina pectoris is the coronary artery disease, which is caused by the deposition of fatty substances or cholesterol, on the inner lining of arteries. This deposition of cholesterol leads to the formation of a hard and thick substance known as cholesterol plaque, which makes the arteries narrow and stiff. This in turn, impedes the supply of oxygen rich blood to the heart and causes chest pain. During exercise or physical activities, the oxygen demand in the heart increases, and the narrow arteries can't supply enough oxygenated blood to meet this demand.

Another cause of angina, especially variant angina, is the coronary artery spasm. The arterial wall is surrounded by muscle fibers, the sudden contraction of which, narrows down the lumen of the arteries. This also results in reduction in the ability of arteries to supply adequate amount of oxygenated blood to the heart muscles.

Symptoms
The common symptoms of angina include chest pain and discomfort like tightness, squeezing and heaviness of the chest. Sometimes, chest pain or discomfort is also accompanied by other symptoms like pain in the upper abdomen, back and neck. Other than this, breathlessness, nausea and sweating may also be experienced.

Treatment
Treatment of angina aims at relieving the symptoms and stopping or slowing down the advancement of the disease, i.e. reducing the risk of a heart attack. The common medicines include, aspirin, beta blockers, nitroglycerine, calcium channel blockers, isosorbide mononitrate and nicorandil.

The people with diabetes, high blood pressure, and high cholesterol have a higher risk of suffering from angina. Besides, smoking can also be an important contributory factor. So, efficient supervision and regulation of these factors can be effective in preventing angina and thereby lowering the risk of a heart attack.