ANGINA

Angina is an important symptom of coronary artery disease. It occurs when the heart muscle does not receive enough blood and oxygen to meet its needs. The most common cause is narrowing or blockage of the coronary arteries due to atherosclerosis.

Angina may occur during physical activity, exercise, emotional stress or other situations that increase the heart's demand for oxygen. In many cases, symptoms improve with rest. However, new, worsening or unexpected chest pain may indicate an acute coronary syndrome and requires urgent medical evaluation.

SYMPTOMS OF ANGINA

Patients may experience one or more of the following symptoms:

• Chest pain, pressure or heaviness, usually in the center of the chest.
• A squeezing or tight sensation in the chest.
• Pain or discomfort that may spread to the arm, shoulder, back, neck or jaw.
• Shortness of breath.
• Sweating.
• Nausea or dizziness.
• Unusual tiredness or reduced exercise tolerance.

WHEN DOES ANGINA OCCUR?

Angina may occur during:

• Walking or climbing stairs.
• Physical exercise.
• Increased physical effort.
• Emotional stress or anxiety.
• Exposure to cold weather in some patients.

Stable angina typically improves when the patient stops the activity and rests.

HOW IS ANGINA DIAGNOSED?

Diagnosis is based on the patient's symptoms, medical history and cardiovascular risk factors. Depending on the clinical situation, the doctor may recommend:

• Electrocardiogram (ECG).
• Echocardiography (Echo).
• Exercise stress test.
• Coronary CT angiography (CCTA).
• Invasive coronary angiography and cardiac catheterization when indicated.

TREATMENT OF ANGINA

Treatment depends on the underlying cause, the severity of coronary artery narrowing and the patient's overall health.

Treatment may include:

• Lifestyle and dietary modifications.
• Smoking cessation.
• Control of blood pressure, diabetes and cholesterol.
• Appropriate medications based on the patient's condition.
• Coronary angioplasty when indicated.
• Balloon angioplasty and coronary stent implantation when appropriate.

UNSTABLE ANGINA

New chest pain, increasing frequency or severity of pain, pain occurring at rest, or pain lasting longer than usual may indicate a serious problem involving the coronary arteries.

Urgent medical assessment is particularly important when chest pain is associated with shortness of breath, sweating, nausea, dizziness or severe weakness.

ANGINA AND CARDIAC CATHETERIZATION

In some patients, coronary angiography by cardiac catheterization may be required to accurately determine the location and severity of coronary artery narrowing.

When a significant and treatable blockage is identified, balloon angioplasty and coronary stent implantation may be performed during the same catheterization procedure when appropriate.

SPECIALIZED CARDIAC EVALUATION

Not all chest pain is caused by the heart. However, symptoms that may indicate coronary artery disease should be evaluated appropriately, particularly in patients with cardiovascular risk factors.

Each patient is assessed individually to determine the appropriate diagnostic tests and treatment plan, whether medical therapy and follow-up or coronary intervention with angioplasty and stent placement is required.