Angina pectoris, << an JY nuh PEHK tuhr ihs, >> is chest discomfort or pain that occurs when the blood flow to the heart is limited. The word angina means to strangle, and angina pectoris feels like a pressing or squeezing sensation in the area of the breastbone. The pain may travel to the shoulders, especially the left shoulder, and down the arms. The pain is usually called simply angina.
An attack of angina can occur any time the heart works harder than usual and requires an additional supply of blood. For example, an attack may occur following physical exertion or during a time of emotional stress. Blood flowing through the coronary arteries carries oxygen to the heart. The coronary arteries can become narrowed by accumulations of fatty deposits, called plaque, and scar tissue. These conditions result in arteriosclerosis (hardening of the arteries), a disease that is the primary cause of angina pectoris. If the coronary arteries are narrowed, extra blood cannot reach the heart. Part of the heart muscle is temporarily deprived of oxygen carried by the blood, causing pain. Angina can also be caused by a spasm in the coronary artery.
Most people who experience angina are commonly middle-aged or older. Many are overweight, have high blood pressure, eat foods high in cholesterol, smoke cigarettes, and get little exercise. Resting and taking a medication called nitroglycerin can relieve most attacks of angina. Doctors may also prescribe drugs called beta-blockers and calcium channel blockers. These drugs help keep the heart from working harder under stress.
When medication can no longer control angina, other treatments are necessary. Physicians may perform a procedure called angioplasty to clear the narrowed arteries. Angioplasty involves threading a balloon-tipped catheter (slender tube) into the blocked artery. The balloon is then inflated, flattening the blockage against the artery wall. In severe cases of angina, narrowed coronary arteries may be by-passed by grafts of vessels taken from the leg or chest. Surgeons may use lasers to create channels in the heart muscle to increase blood flow. Scientists are also investigating ways to increase blood flow to the heart by stimulating _angiogenesis—_that is, the growth of new blood vessels.
See also Angiogenesis; Angioplasty; Calcium channel blocker; Heart (Coronary artery disease); Nitroglycerin (As a medication).
