today's topic is angina pectoris angina pectoris is a chest pain due to an inadequate supply of oxygen to the heart muscle the pain is typically severe and crushing and it is characterized by a feeling of pressure and suffocation just behind the breastbone angina can accompany or be a precursor of a heart attack causes the most common cause is a blockage somewhere in the coronary arteries the arteries that supply blood to the heart arteries can narrow due to plaque deposits and angina may be especially prevalent during physical exertion due to the heart's increased demand for oxygen it may also occur if the coronary arteries are inflamed infected or injured a person is at higher risk of developing angina if they have diabetes high blood pressure high cholesterol a history of heart disease or a sedentary lifestyle other risk factors include smoking obesity age and stress stable angina is characterized by regular episodes of paint triggered by physical exercise or activity smoking eating large meals or extreme temperatures this occurs because the arteries have accumulated deposits narrowing the pathway for blood to move through unstable angina is characterized by sudden pain that doesn't go away on its own or respond to rest or medication this type is caused by a blood clot that blocks the blood vessel and it will cause a heart attack if the blockage isn't removed variant angina is caused by a spasm in a coronary artery causing it to temporarily narrow this is a specific form of unstable angina that can occur at any time no trigger if that causes it to happen science and symptoms the painful sensation that occurs during an episode of stable angina is often described as pressure or fullness in the center of the chest the pain can feel like a vise squeezing your chest or like a heavy weight resting on your chest this pain may spread from your chest to your neck arms and shoulders during an episode of stable angina you may also experience shortness of breath nausea fatigue dizziness profuse sweating anxiety diagnosis there are several tests your doctor may order to help confirm whether you have angina electrocardiogram ECG or EKG each beat of your heart is triggered by an electrical impulse generated from special cells in your heart an electrocardiogram records these electrical signals as they travel through your heart stress tests sometimes angina is easier to diagnose when your heart is working harder during a stress test you exercise by walking on a treadmill or pedaling a stationary bicycle while exercising your blood pressure is monitored and your ECG readings are watched echocardiogram an echocardiogram uses sound waves to produce images of the heart your doctor can use these images to identify and join up related problems including whether there are areas of your heart muscle that have been damaged by for blood flow nuclear stress test a nuclear stress test helps measure blood flow to your heart muscle at rest and during stress it is similar to a routine stress test but during a nuclear stress test a radioactive substance is injected into your bloodstream chest x-ray this test takes images of your heart and lungs this is to look for other conditions that might explain your symptoms and to see if you have an enlarged heart blood tests certain heart enzymes slowly leak out into your blood if your heart has been damaged by a heart attack samples of your blood can be tested for the presence of these enzymes coronary angiography coronary angiography uses x-ray imaging to examine the inside of your hearts blood vessels it's part of a general group of procedures known as cardiac catheterization cardiac computerized tomography or CT scan an x-ray tube inside the machine rotates around your body and collects images of your heart and chest which can show if any of your hearts arteries are narrowed or if your heart is enlarged cardiac MRI in a cardiac MRI you lie on the table inside a long tube like machine that produces detailed images of your heart structure and its blood vessels treatment if lifestyle changes alone don't help your angina you may need to take medications these may include nitrates aspirin clot preventing drugs beta blockers statins calcium channel blockers blood pressure lowering medications retina Lezyne or brain exha medical procedures and surgery angioplasty and stenting during an angioplasty also called a percutaneous coronary intervention or PCI a tiny balloon is inserted into your narrowed artery the balloon is inflated to widen the artery and then a small wire mesh coil or stent is usually inserted to keep the artery open coronary artery bypass surgery during coronary artery bypass surgery a vein or artery from somewhere else in your body is used to bypass a blocked or narrowed heart artery bypass surgery increases blood flow to your heart and reduce this or eliminates angina it's a treatment option for both unstable angina as well as stable angina that has not responded to 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