With the increase in prevalence and deaths due to heart diseases, world over, it is necessary to increase awareness. This is particularly more important in developing countries.

Here the incidence of these diseases is rising steadily due to changing life style factors and people being ignorant about the disease. Moreover the resources for investigations and treatment are limited.

Angina is the commonest form of coronary artery disease. It occurs due to imbalance between demand and supply of oxygen to the heart.

Thickening of the blood vessels of the heart due to atherosclerosis (fat plaques deposited on the inner layer of arteries), is the underlying cause for angina.

Other factors like smoking, alcoholism, lack of exercise and mental stress, precipitate and aggravate it. Persons suffering from hypertension or diabetes are more prone to attacks of angina.

Cause

As the demand of the heart for oxygen increases due to any kind of exertion, the amount of oxygen needed is not able to reach there.

This happens because oxygen is carried via blood and increased amount of blood cannot flow due to thickened blood vessels.

Symptoms
 
Angina manifests commonly as chest pain coming after exertion. The pain subsides after the person relaxes for few minutes. 

The pain is commonly felt in left side of chest, but can occur at other places depending on part of heart affected. Left arm, shoulder, left index or middle finger, left jaw, left side of upper back are other sites, manifesting pain.

In case of inferior surface of heart being affected, pain can also be felt in stomach. The pain felt in angina is suffocating or cutting in nature. 

It is often neglected due to ignorance about angina. Persons affected consider it to be some ordinary pain and tend to neglect it or indulge in self medication.

When neglected, it causes recurrent chest pain, thus disabling a person or can cause severe fatal heart attacks. Any chest pain if repetitive, occurring after walking, running or any exertion should raise suspicion of angina. 

Also if pain in the chest does not relieve with pain killers like aspirin or paracetamol, it should  alert one to possibility of angina. Diabetic patients have to be very vigilant because they can have angina without any pain.

Diagnosis and treatment
 
Diagnosis is confirmed by electrocardiography , cardiac echo and angiography. The disease can be fairly well controlled in its nascent stage.

Changes in life style like quitting smoking and alcohol, regular exercise, reduction of mental stress, have proved to be very helpful in both prevention and good control of angina.  

Brisk walking, light jogging, swimming and yoga are very good exercises for patients of angina. But weight lifting should be avoided as it could aggravate the problem.

Good control of hypertension and diabetes is important for good control of angina. Lastly, the most important tool in protection against angina is a well balanced healthy diet.

A diet low in fat, with plenty of fresh fruits and vegetables is the best. Freshly cooked food is better than fast ready to eat foods. Skimmed milk should be used in place of whole milk because milk cream is rich in fat.  

Fish is an ideal meat being low in fat; other kinds of meat should be avoided. The patients of high blood pressure or diabetes should stick to their dietary restrictions. Medicines like nitrates are used to control angina. If prescribed, one should take them regularly.

One can very well prevent development of angina. But if the disease has started, there is nothing to fear. It can still be prevented from progressing further. With rigid discipline, it can at times be stopped altogether also.

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