Main types of angina, symptoms and how to treat

Angina, also known as angina pectoris, corresponds to the feeling of heaviness, pain or tightness in the chest that happens when there is a decrease in the flow of blood in the arteries that carry oxygen to the heart, which is known as cardiac ischemia.

Most of the time, cardiac ischemia is a consequence of atherosclerosis, which is characterized by the accumulation of fatty plaques in the coronary arteries, being more frequent in people with high blood pressure, high cholesterol or decompensated diabetes. See what are the top 5 causes of atherosclerosis.

Cardiac ischemia and, consequently, angina, are more common in people over 50 and should be treated quickly, as they are a great risk for the development of infarction, cardiac arrest and other cardiovascular diseases, such as arrhythmia, heart failure or Stroke, for example.

Main types of angina

There are different types of angina, which can vary according to the symptoms presented, the main ones being:

1. Stable angina

It is caused by a transient ischemia, that is, it arises when the person makes some effort or suffers some emotional stress, for example, with a partial and momentary decrease in blood flow. This type of angina is more common in people who already have some type of partial coronary atherosclerosis, which can get worse and even lead to a heart attack.

Main symptoms : Symptoms usually related to stable angina are tightness or burning sensation in the chest area, which lasts about 5 to 10 minutes, and which can radiate to the shoulder, arm or neck. Symptoms are usually triggered by effort or moments of great emotion, and improve with rest or with medications to dilate arteries and increase blood flow, such as Isordil.

How it is treated : In the case of stable angina, the cardiologist usually indicates rest and, in some cases, the use of vasodilator drugs, such as Dinitrate or Isosorbide Mononitrate (Isordil), to improve blood flow in the artery.

In addition, it is important to have healthy lifestyle habits to prevent angina from happening again and, for this, it is recommended that the person has control of pressure, cholesterol and blood glucose, in addition to it being important to have a diet low in salt, fat and sugar and practice physical activity on a regular basis.

2. Unstable angina

It is a more serious situation than stable angina, as it is caused by a greater interruption of oxygenation of the heart, due to a rupture and inflammation of the atherosclerosis plaque which causes more intense and constant symptoms, being considered a form of pre-infarction.

Main symptoms : The main symptoms of stable angina are pain, tightness or burning in the chest area that lasts more than 20 minutes, which also radiates to nearby locations and may be associated with other symptoms such as nausea, sweating and shortness of breath. When these symptoms appear, you should immediately go to the emergency room. Find out what chest pain can be.

How is the treatment : The initial treatment is done already in the emergency room, with remedies to prevent the worsening of symptoms, such as:

  • Medicines to improve blood flow , such as nitrate, such as Isordil, beta blockers, such as Metoprolol, or calcium channel blockers, such as Verapamil and Morphine, when the symptoms are very intense;
  • Medicines to reduce the formation of clots , with the use of antiplatelet agents, such as AAS and Clopidogrel or Prasugrel and Ticlopidine, and anticoagulants, such as Heparin.
  • Anti-hypertensive drugs of the ACE type, such as Captopril, or lipid-lowering agents for cholesterol control, such as Atorvastatin.

After the initial treatment, the cardiologist begins to investigate the level of coronary obstruction and cardiac impairment through tests such as echocardiography, cardiac scintigraphy and cardiac catheterization.

Just as in stable angina, in unstable angina it is also important to treat risk factors, such as pressure control, cholesterol, blood glucose, in addition to controlling food and practicing physical activities, attitudes that are fundamental to maintaining good coronary health and from heart.

3. Prinzmetal’s angina or variants

This type of angina has no clear cause and happens due to spasm of the coronary, in which there is interruption of blood flow even if the person does not have accumulation of fat in the artery or other types of narrowing.

Main symptoms : In the case of Prinzmetal’s angina, severe pain or tightness in the chest may be noticed, which occurs even at rest and gradually improves after a few minutes. It is also common to appear during sleep or early in the morning.

How is the treatment : The treatment for this type of angina is done with the guidance of a cardiologist and is usually done through the use of drugs such as nitrate or calcium channel blockers, such as Diltiazem and Verapamil, for example.

How the diagnosis is made

At the time of the crisis, the diagnosis of angina is made by the cardiologist through the evaluation of the signs and symptoms presented by the person, in addition to the evaluation of the results of some tests, such as electrocardiogram, chest X-ray and measurement of cardiac enzymes in the blood. In addition to these, other tests may be ordered to confirm the diagnosis, such as exercise testing, myocardial scintigraphy, echocardiography and cardiac catheterization.

Cardiac catheterization is a very important exam because, in addition to more accurately quantifying the obstruction of blood vessels and assessing the presence of changes in blood flow, it is able to treat the cause of the obstruction, through angioplasty, with implantation of a stent or the use of a balloon, to open the artery. Know what it is for and what are the risks of cardiac catheterization .

Is angina curable?

Angina can be cured in people who are able to treat cardiac ischemia according to the cardiologist’s recommendation. Many cases are well controlled with the use of medications prescribed by the cardiologist, while others that are more severe require catheterization or even heart revascularization surgery.

Some useful tips for properly treating angina include:

  • Take the drugs prescribed by the doctor;
  • Stop smoking;
  • Adopt a healthy diet;
  • Exercise regularly (under professional guidance);
  • Avoid overeating and alcoholic beverages;
  • Avoid salt and caffeine;
  • Keep pressure under control;
  • Avoid stress;
  • Avoid very hot or very cold temperatures, as they can also trigger an angina attack.

With these attitudes, in addition to treating angina, it is also possible to prevent the worsening or the appearance of new fatty plaques in the coronary arteries.

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