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Learning

Cardiac Catheterization

Introduction and Uses

Cardiac catheterization may be used as a diagnostic or treatment procedure. It involves advancing a catheter, a thin flexible tube, into the right or left side of the heart. Cardiac catheterization can provide information about the functioning of the heart. Cardiac catheterization is performed with fluoroscopy, an imaging technique, to record pictures of the heart as it beats. The results may identify heart defects, heart disease, heart enlargement, blood clots (embolisms), coronary artery blockage, valve problems, or aneurysm. As a treatment procedure, cardiac catheterization may be used to repair heart defects, open valves, or open arteries.

Test Procedure

A cardiac catheterization usually takes place in the hospital. You will be asked not to eat or drink for 6 to 8 hours before your procedure.

You will receive a mild sedative, but will remain awake during the test. A local anesthetic will numb the area where the catheter is inserted. The catheter may be inserted in an artery in your arm or groin area. You will be asked to remain still during the test. Your doctor will insert a dye to allow your heart and blood vessels to be viewed on an X-ray video picture. When the test is completed, the catheter is removed. Your doctor will review your results with you.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

 

Cardiac Arrhythmia – Irregular Heartbeat

Introduction

Heart arrhythmias, also called cardiac arrhythmias, are irregular heart rhythms that result when the heart beats too fast, too slow, or unevenly. A heart arrhythmia occurs if there is a disturbance anywhere along the nerve signal pathway in the heart chambers. There are many different types of heart arrhythmias and some are more serious than others, causing heart attack or sudden death. Heart arrhythmias are treated with medications, electrophysiologic ablations, and surgically placed pacemakers or implantable cardioverter-defibrillators.

Anatomy

The heart is the core of the cardiovascular system. Your cardiovascular system consists of your heart and the blood vessels that carry blood throughout your body. Your heart is located to the left of the middle of your chest. It is a large muscle about the size of your fist. It works as a pump. The blood carries nutrients and oxygen that your cells need for energy. It also carries waste products away.

Your heart is divided into four sections called chambers. The chambers are separated by the septum, a thick wall. The two top chambers are called atria, and they receive blood coming into the heart. The two bottom chambers are called ventricles and they send blood out from the heart.

Your heart contains two pumping systems — one on its left side and one on its right side. The left-sided pumping system consists of the left atrium and the left ventricle. Your left atrium receives blood that contains oxygen, which comes from your lungs. Whenever you inhale, your lungs move oxygen into your blood. The oxygenated blood moves from the left atrium to the left ventricle. The left ventricle sends the oxygenated blood out from your heart to circulate throughout your body.

The heart’s right-sided pumping system consists of the right atrium and the right ventricle. Your right atrium receives deoxygenated blood, blood that has circulated throughout your body and no longer has high levels of oxygen in it. The deoxygenated blood moves from the right atrium to the right ventricle. The right ventricle sends the blood to the lungs where it receives oxygen when you breathe.

As the blood travels through the heart chambers, four valves keep the blood from back flowing. The mitral valve and the tricuspid valve regulate blood flow from the atria to the ventricles. The aortic valve and the pulmonary valve control blood as it leaves the ventricles.

The four chambers of the heart contract in a very exact and coordinated manner. The contractions are controlled by electrical impulses from the sinus (SA) node, your heart’s natural pacemaker. The signals travel on a specific path, first from the SA node through the atrium and then through the atrio-ventricular (AV) node and through the ventricles.

Your doctor will listen to your heart with a stethoscope. A healthy heart has a regular rhythm and makes a lub-dub sound each time it beats. The first sound in your heartbeat occurs when the mitral valve and the tricuspid valve close. The second sound in your heartbeat occurs when the aortic valve and the pulmonary valve close after the blood leaves your heart.

Causes

A heart arrhythmia occurs if there is a disturbance anywhere along the nerve signal pathway throughout the heart. There are different types of heart arrhythmias depending on where the interruption in the conduction system occurs. Heart arrhythmias may result from heart conditions, heart attack, blood chemistry imbalances, and endocrine abnormalities. Medications, caffeine, and illegal drugs, such as cocaine or amphetamines, can cause irregular heart rhythms. Untreated heart arrhythmias can be life threatening.

Some of the specific types of heart arrhythmias are described below:

  • Bradycardia is a slow heart rate that generally results because of problems with the heart’s internal pacemaker, the SA node.
  • Tachycardia is a fast heart rate that may involve the atria or the ventricles.
  • Supraventricular tachycardia (SVT) is a fast heart rate that originates in the atria.
  • Ventricular tachycardia is a fast heart rate that originates in the ventricles.
  • Atrial fibrillation is an uneven and very fast heart rate. The atria may pump five to seven times faster than normal, causing the heart to pump blood improperly.
  • Atrial flutter is a very fast and steady heartbeat caused by abnormal nerve firing.
  • Premature atrial contraction (PAC) is an irregular heartbeat with extra beats or premature beats from problems in the atria.
  • Sick sinus syndrome is an irregular heartbeat caused when the SA node does not work properly and the heart rate slows down.
  • Premature ventricular contraction (PVC) is an irregular heartbeat with extra beats or premature beats from problems in the ventricles.
  • Ventricular fibrillation is a rapid irregular heartbeat. Little or no blood may be pumped from the heart. It requires immediate medical attention and can result in sudden death.

Symptoms

Heart arrhythmias may or may not produce symptoms. Heart arrhythmias can cause heart palpitations—you may feel your heart beating in your chest. Your heart may feel like it is beating fast, slow, or irregularly. It may feel like your heart skips a beat. You may feel faint, lightheaded, or dizzy. You may experience chest pain or shortness of breath. Your skin may become pale and sweaty. In severe cases, a heart attack may occur.

An ambulance should be called immediately if a heart attack is suspected. Symptoms of a heart attack include pain or pressure in the center of the chest, shortness of breath, nausea, vomiting, and pain that radiates from the chest into the teeth, jaws, shoulders, or arms. A heart attack can be fatal. Immediate emergency medical care is necessary.

Diagnosis

Your doctor can begin to diagnose heart arrhythmia by reviewing your medical history and conducting a physical examination and some tests. Your doctor will use a stethoscope to listen to your heart. There are several tests that can be used to diagnose heart arrhythmia.

The tests may include a chest X-ray, electrocardiogram (ECG), and echocardiogram. An ECG records the heart’s electrical activity. An echocardiogram uses sound waves to produce images of the heart on a monitor. An exercise stress test involves monitoring your ECG and blood pressure while you exercise on a treadmill. The exercise stress test provides information about how your heart works with an increased blood flow. You may wear a Holter monitor for periods of 24 hours or more. A loop recorder can also be used to detect rhythm abnormalities over a long period of time. If your arrhythmia is infrequent, you may wear an event recorder that you activate when you feel symptoms. An event recorder may also be surgically placed under the skin for long periods of time. An electrophysiologic (EP) study is an advanced procedure which can diagnose and even treat some arrhythmias.

Tilt table testing is used to check for sudden drops in blood pressure or heart rate that can cause fainting. For this procedure, you are secured to a table, which will be positioned at different inclines for various periods of time. Your blood pressure and ECG will be recorded.

Treatment

The treatment that you receive depends on the type, location, severity, and cause of your arrhythmia. Emergency treatment for arrhythmia includes electrical shock therapy (defibrillation or cardioversion) or intravenous (IV) medications. A pacemaker may be surgically implanted to maintain a regular heartbeat. Ablation is an advanced procedure, which can treat some arrhythmias. Some people may require lifelong medication. An implantable defibrillator may be surgically placed to treat ventricular tachycardia.

Prevention

You may prevent heart disease and decrease your risk of developing arrhythmias by taking steps to keep your heart healthy. It is important not to smoke, use illegal drugs, or abuse alcohol. You should eat a heart healthy diet and exercise regularly. Make and attend all of your doctor appointments and receive regular physicals.

Am I at Risk

People with heart conditions, a history of heart attack, blood chemistry imbalances, or endocrine abnormalities are at risk for heart arrhythmias. Using certain medications, caffeine, or illegal drugs can increase your risk for heart arrhythmias.

Complications

Some arrhythmias can be dangerous and potentially fatal. Some arrhythmias can lead to stroke, heart attack, heart failure, and sudden death. You should contact your doctor if you experience symptoms of arrhythmia. Early treatment is associated with better outcomes. You should call for an ambulance if you suspect that you or someone else is experiencing a heart attack or stroke.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

 

Balanced Diet and Nutrition

The food that you eat can directly affect your health. As Americans are facing higher rates of obesity, diabetes, cancer, and cardiovascular disease, it is more important than ever to make sure that you and your family are eating a well balanced diet. There are plenty of fad diet products on the market, and it can be difficult to determine what exactly a well balanced diet is. A well balanced diet consists of the nutritional elements that your body needs to function properly and maintain a healthy weight. The specific elements for a well balanced diet may be different for everyone, but are composed of the same basic food elements.

My Pyramid (www.mypyramid.gov) is a helpful food guide that you can use to develop your nutrition plan. The U.S. Department of Agriculture created My Pyramid after researching the rising obesity rates in America. The My Pyramid food guide ensures that you eat the proper nutrients and calories each day to maintain a healthy weight. My Pyramid also contains exercise guidelines.

My Pyramid contains six food groups- grains, vegetables, fruits, oils, milk products, and meat and beans. You should eat foods from each group daily. My Pyramid provides portion size guidelines. For example, My Pyramid suggests that average adults eat 6 oz. of grains, 2 ½ cups of vegetables, 2 cups of fruit, 3 cups of milk products, and 5 ½ oz. of meat and bean products each day, based on a 2,000 calorie diet. The exact portion size that you use depends on the amount of calories your body needs in one day. Your doctor or a nutritionist can recommend how many calories you need to meet or maintain your weight goal. The handy tools at the My Pyramid website can help you customize your eating plan.

In addition to eating guidelines, My Pyramid provides recommendations for exercise. My Pyramid suggests that adults participate in physical activity for at least 30 minutes each day on most days of the week. My Pyramid suggests 60 minutes of physical activity per day to prevent weight gain. To sustain a weight loss, 60 to 90 minutes of physical activity each day may be necessary. Your doctor can make specific recommendations depending on your health status.

My Pyramid is a great place to start for developing your well balanced nutrition plan. You should always use your doctor as a resource for guidelines specific to you. Your doctor can make recommendations that are specific to controlling certain medical conditions. For example, there are food guidelines for diabetes, heart disease, high blood pressure, and high cholesterol. Women’s nutritional needs may change when they are pregnant or aging. Ask your doctor for a referral to a nutritionist for specific help with daily meal planning and recipe recommendations.

It is important to teach your children and family members about healthy eating. Make sure that everyone in your family is getting enough daily exercise. By doing so, you may reduce the risk of obesity and serious health concerns.

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

Atrial Fibrillation

Introduction

Atrial Fibrillation, also known as A Fib or AF, is a common heart condition that causes an abnormal rhythm (arrhythmia). It is sometimes described as a quivering heart or fluttering heartbeat. A change in the electrical charge that travels through the heart’s upper chambers can cause the rhythm of the heart to get out of sync. During an episode, typical symptoms include heart palpitations, shortness of breath, and weakness that may come and go or last for extended periods of time. A Fib is a treatable condition that should be managed by a cardiologist to prevent serious complications, such as blood clots, heart failure, or stroke. AF is not life-threatening, but emergency treatment may be required at times to restore regular rhythm.

Anatomy

The heart is an organ whose primary function is to pump blood throughout the body. It is divided into four sections called chambers, with two on top and two on bottom. Blood comes in through the upper chambers (atria) and exists through the lower chambers (ventricles). There are four valves that regulate the flow of blood through the heart. The lub-dub sound your heart makes with each beat is the sound of heart values opening and closing. The pumping action of the heart is controlled by electrical impulses from the sinus node, which starts each heartbeat in a steady rhythm.

When the heart receives irregular electrical impulses, the rhythm becomes irregular. It will start beating irregularly in an attempt to correct and restore the natural rhythm. In the case of A Fib, the AV node, which connects the upper chambers to the lower chambers, is flooded with electrical impulses. This causes the bottom of the heart to beat more rapidly than the top, and the rhythm falls out of sync.

Causes

The cause of atrial fibrillation is an abnormality in the heart. In some cases a heart defect you are born with or cardiovascular disease of some kind can be the cause. A history of heart attack, high blood pressure, hyperthyroidism, and alcohol abuse can increase your risk. Lung disease, pneumonia, and previous heart surgery are other possible causes.

People with an otherwise healthy heart and no other risk factors can also have atrial fibrillation. The arrhythmia is caused by “hot spots” on the heart that act like abnormal pacemaker cells. They fire rapid electrical impulses, causing the upper chambers of the heart to flutter or quiver instead of beating normally.

Symptoms

Someone with atrial fibrillation may have no symptoms at all, making it difficult to detect and diagnose. During an episode, the classic symptom is a fast, irregular heartbeat, often described as a fluttering or quivering feeling in your chest. This is usually accompanied by shortness of breath, weakness, and fatigue (extreme tiredness). You may also experience dizziness, sweating, lightheadedness, anxiety, and chest pain.

Diagnosis

Some people may never know they have A Fib until their doctor examines their heart. Normally, your heart beats steadily without you noticing it at all. If you suddenly notice your heartbeat, it may be due to a change in the electrical impulses that regulate the rhythm. Be sure to consult your doctor right away. Take note of how long and how often you notice your own heart beat and what it feels like.

Lab tests and cardiac imaging are used to confirm the diagnosis. Common tests used to diagnose AF include a blood work (to eliminate other possible causes), chest x-ray, electrocardiogram (ECG), and echocardiogram. You may need to wear a Holter or Event monitor to detect an arrhythmic event during a 24 to 48-hour period.

Treatment

The type of treatment you need will depend on the frequency and severity of your symptoms. Most commonly, symptoms will last for less than a week, which can be managed relatively easily. But for some, the symptoms will last indefinitely, which requires a different treatment approach. The overall goal of treatment is the same – restore your natural rhythm and prevent complications, like blood clots.

There are two ways to reset the rhythm using a cardioversion. An electrical shock can be delivered to your chest to shock the heart back into sync, or special medication can be administered while your condition is monitored to see if your heart will reset on its own.

After getting the heart beat back on track, your doctor may prescribe certain medications to address the cause of A Fib. Normal treatment includes an anticoagulant (blood thinner) to prevent blood clots and reduce the risk of stroke. Anti-arrhythmia medication may also be prescribed to help regulate your heart beat and prevent future episodes. A combination of drugs may be needed to control heart rate, as well.

For some cases of A Fib, surgical intervention may be needed to repair diseased or damaged areas in the heart that restrict blood flow. A stent or pacemaker may be inserted during the repair. Or, a special technique can be used to create scar tissue on the heart to redirect electrical impulses because electricity cannot travel across scar tissue. This can be accomplished with a catheter ablation or surgical maze procedure. The scars are made using radiofrequency, cryotherapy, or heat. A catheter ablation can correct arrhythmias without the need for medication or an implantable device. Ablation of the AV node may be an option if a catheter ablation doesn’t work. A surgical maze procedure requires open heart surgery, which is not recommended unless all other options have failed.

Prevention

Preventing atrial fibrillation is usually handled with anti-arrhythmia medication and simple changes in lifestyle, like swapping coffee for caffeine-free tea. Even with medication, you are still at risk for stroke, heart failure, and other serious complications if you have had atrial fibrillation. If there is an underlying condition, such as hyperthyroidism causing your symptoms, treating the thyroid can prevent or reduce A Fib.

If you know that you are at risk for A Fib because of heart disease or certain risk factors, the best thing to do is avoid substances that can be stimulating, like alcohol, tobacco, caffeine, and some medications. You should also eat heart-healthy foods, get appropriate exercise, maintain a healthy weight, avoid stress, and of course, see your doctor regularly for check-ups to keep symptoms at bay.

Am I at Risk

Because atrial fibrillation is usually associated with cardiac abnormalities, having heart disease can increase your risk. Other risk factors include a family history of A Fib, obesity, alcohol abuse, high blood pressure, and some chronic conditions like sleep apnea, diabetes, hyperthyroid, and lung disease.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

 

Aortic Aneurysm

Introduction

An aortic aneurysm is a condition that results from the swelling of a weakened wall in the aorta. The aorta is the largest artery in your body. It branches off your heart and distributes blood throughout your body and organs. An aortic aneurysm may enlarge and burst. Emergency medical treatment and surgery is necessary for a ruptured aneurysm. If left untreated, an aortic aneurysm can cause massive internal bleeding and death.

Anatomy

The aorta is the largest blood vessel in your body. It carries oxygenated blood from the left ventricle of your heart. The aortic valve prevents the backflow of blood between heartbeats.

The aorta extends upwards from the heart, arches, and travels downward through the chest and into the abdomen. These sections of the aorta are called the ascending aorta, aortic arch, descending thoracic aorta, and the abdominal aorta.

Causes

The exact cause of aortic aneurysm is unknown. There appear to be several risk factors that may contribute to the development of aortic aneurysm. Aortic aneurysms occur most frequently in the abdomen below the kidneys in the abdominal aorta or in the chest area in the thoracic aorta.

Symptoms

Aortic aneurysms may develop over several years and may initially have no symptoms. The chance of an aortic aneurysm rupturing depends on its size. Larger aneurysms are more likely to rupture. You should call emergency services or go to a hospital emergency department immediately if you suspect that you have a ruptured aneurysm. Symptoms may develop suddenly when the aneurysm expands, ruptures, or leaks blood. A thoracic aortic aneurysm can cause severe, “tearing,” and sudden chest or back pain.

Symptoms of an abdominal aortic aneurysm include severe sudden pain in the abdomen or back. Your pain may be constant and spread to your buttocks, groin area, and legs. Your legs may feel numb and sense a pulsating in your abdomen. You may feel an abdominal mass or experience abdominal rigidity. Your heart may beat rapidly when you move from a sitting to a standing position. The skin may feel clammy and you may have nausea, vomiting, and shock.

Diagnosis

Your doctor can begin to diagnose an aortic aneurysm through a series of examinations and tests. A series of tests may be ordered to evaluate your heart structure and functioning. Common tests include echocardiogram and coronary angiography. An echocardiogram uses sound waves to produce an image of the heart. A dye and X-ray are used to show an image of the heart with a coronary angiography. A coronary angiography may be done with a heart catheterization. Heart catheterization involves inserting a long narrow tube through a blood vessel and into the heart to see how the heart and coronary arteries are working. The heart structures may also be viewed with imaging scans, including computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI) .

Treatment

Aortic aneurysms that are small and do not cause symptoms are monitored regularly. Aortic aneurysms that are large or that cause symptoms are treated surgically. The type of surgery depends on your aneurysm’s location and size.

A traditional open repair involves surgically removing the damaged portion of the aorta and replacing it with a synthetic graft. Another type called endovascular stent grafting involves placing a graft through a catheter that is placed through your groin area. This type of surgery is less invasive and associated with quicker recovery times.

Prevention

You may be able to prevent an aortic aneurysm by reducing the risk factors under your control. Keep your heart and blood vessels healthy. Do not smoke, eat a healthy well-balanced diet, exercise, and maintain a healthy weight, blood pressure, and cholesterol. If you are at risk for an aortic aneurysm, ask your doctor about a screening ultrasound.

Am I at Risk

Risk factors may increase your likelihood of developing aortic aneurysm, although some people that develop the condition do not have any risk factors.

Risk factors for aortic aneurysm:

_____ Males experience more aortic aneurysms than females.
_____ Age over 60
_____ High blood pressure
_____ Smoking
_____ High cholesterol
_____ Obesity
_____ Emphysema
_____ Genetic factors appear to play a role in the development of aortic aneurysm.
_____ Atherosclerosis, hardening of the arteries
_____ Syphilis
_____ Marfan syndrome
_____ Trauma

Complications

Aortic aneurysms can be fatal. A ruptured aneurysm can cause vast internal bleeding that without treatment, can lead to a quick death. Aneurysms can also cause blood clots that can lead to a heart attack or stroke.

 

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

 

Angina

Introduction

Angina is chest pain or discomfort that results from a lack of blood and oxygen flow to the heart muscle. A narrowed or blocked artery due to coronary artery disease is the most common cause of angina. When blood cannot reach the heart tissue, especially during physical activity, chest discomfort may occur that can last up to several minutes. Angina may be treated with rest, medication, cardiac rehabilitation, and surgery.

Anatomy

Your heart has several large arteries and veins connected to it that branch out and become smaller as they travel throughout your body. Your arteries deliver blood from the heart and veins return blood to the heart in a process called circulation.

The aorta is the largest blood vessel in your body. The aorta carries all the blood pumped out of your heart. Through its many branches, the aorta distributes blood to all of the areas and organs in your body. Two coronary arteries branch out from the aorta supplying the heart with oxygen, blood, and nutrients to keep it healthy.

Causes

The most common cause of angina is coronary artery disease caused by atherosclerosis, hardening of the arteries. Initially, plaque formation may narrow the arteries. Over time, the plaques may rupture to form a plug or clot that can block an artery. When an artery is narrowed or blocked, blood and oxygen cannot reach the heart muscle. This results in discomfort, especially upon exertion. Other less common causes of angina include a spasm of the artery, valvular heart disease, an enlarged heart, or uncontrolled high blood pressure.

Symptoms

Angina results when the heart does not get enough blood and oxygen. This may happen after you exercise or exert yourself, such as after climbing stairs, carrying in the groceries, or during sex. Angina may occur when you are emotionally upset, angered, or stressed. Having a full stomach or being in very hot or cold temperatures may also bring about angina.
Angina causes chest discomfort that typically lasts from about one to five minutes. The discomfort usually feels like pressure, heaviness, tightness, squeezing, burning, or pain. This may occur in the chest, back, neck, jaws, arms, stomach area, and shoulders. Your shoulders, arms, or wrists may feel numb or tingle. It may be difficult to breathe. You may sweat or feel nauseous.

Contact your doctor if you experience angina. People with angina have an increased risk for a heart attack, cardiac arrest, and sudden cardiac death. An ambulance should be called immediately if a heart attack is suspected. Symptoms of a heart attack include new, worsening, or persistent pain or pressure in the center of the chest, shortness of breath, nausea, vomiting, and pain that radiates from the chest into the teeth, jaws, shoulders, or arms. A heart attack can be fatal. Immediate emergency medical care is necessary to sustain life and prevent complications.

Diagnosis

Your doctor can begin to diagnose angina after reviewing your medical history, performing an examination, and conducting some tests. There are different types of angina. You should tell your doctor about your symptoms, medical history, and any family history of heart disease. Blood tests and other assessments will be done to determine how your heart is functioning. In some cases, blood tests can predict the likelihood of the progression from angina to a heart attack.

Several tests are used to identify angina. Common tests include an electrocardiogram (ECG), exercise stress test, nuclear stress test, and coronary angiogram. An ECG records the heart’s electrical activity. An ECG may be repeated over several hours. An exercise stress test, also called a cardiac stress test or treadmill test, involves monitoring your ECG and blood pressure while you walk on a treadmill. The exercise stress test provides information about how your heart works with an increased blood flow demand. A chemical or nuclear stress test involves infusing medication in a controlled setting to raise the heart rate in order to determine how well specific areas of the heart are working. There are several different chemicals and different imaging formats that can be used based on the patient’s individual needs. A dye and X-ray are used to show an image of the heart structures with a coronary angiogram.

Treatment

There are a variety of treatments for angina, depending on the type and severity. Your doctor may prescribe nitroglycerin medication to relieve angina. Depending on your condition, your doctor may prescribe other medications to lower your blood pressure, regulate your heartbeat, relieve anxiety, or thin your blood. Cardiac rehabilitation, to strengthen your heart muscles and improve your circulation, may be ordered. Some types of angina may require hospitalization. In some cases, surgery may be recommended.

A coronary angioplasty is a surgery that opens blocked coronary arteries. A stent may be inserted to ensure that the coronary artery remains open after angioplasty. Coronary artery bypass graft (CABG) surgery involves taking a blood vessel from another part of the body to create a detour around a clogged artery to restore the blood flow to the heart. Blood vessels are commonly taken from the leg and surgically attached to the coronary artery. It may be necessary to have bypass surgery on one or more coronary arteries.

Prevention

You may decrease your risk of angina by eliminating the risk factors that you can control. It is suggested to attain and maintain a healthy weight, cholesterol level, blood sugar level, and blood pressure. Stop smoking! If you are unable to quit smoking on your own, ask your doctor about smoking cessation products and support systems that may help you. Eat a well-balanced healthy diet. Your doctor can refer you to a nutritionist that can help you plan low-sodium, low-fat, and low-sugar meals. Regular exercise can help keep your heart strong.

Am I at Risk

Risk factors may increase your likelihood of developing angina, although some people that develop the condition do not have any risk factors. You should tell your doctor about your risk factors and discuss your concerns.

Risk factors for angina:

  • Coronary artery disease caused by atherosclerosis, or hardening of the arteries.
  • Males greater than females
  • Cigarette smoking
  • High cholesterol, in particular, high LDL and low HDL cholesterol
  • High blood pressure
  • People with a family history of heart disease
  • High blood sugar levels associated with diabetes
  • Obesity
  • Sedentary lifestyle
  • Advancing age
  • Drug use, especially cocaine

Complications

Angina may progress to a heart attack or sudden death from cardiac arrhythmias (irregular heartbeats). If you experience the symptoms of a heart attack, you should call an ambulance. While waiting for emergency care to arrive, it can help to take an aspirin, if you have some nearby.

Advancements

Some research studies have demonstrated that risk factor modification, such as a heart healthy diet, exercise, and smoking cessation, can slow the progression of artery blockages and in some cases, reduce their severity.

Copyright © – iHealthSpot, Inc. – www.iHealthSpot.com
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.