World Heart Day (September 29) is a reminder to people to keep their hearts healthy for a healthy life. Angina pectoris is the direct outcome of stress, strain and unnatural modern life, causing much sickness and deaths even in developed countries. It occurs due to narrowing of the vessels which supply blood to the heart, due to deposition of fat on their inner lining. Over time, they become blocked. A Fat-rich diet, hypertension, diabetes, alcohol, smoking, obesity, physical and mental stress, are all risk factors for angina. Hereditary factors are also involved. One can develop angina due to lifestyle factors and it can pass on to the next generation. Formerly known to be a disease of elderly people, now angina occurs in the young, especially due to mental stress. The narrowing of lumen of coronary vessels interrupts free and easy flow of blood to the heart. When one walks or does some work, there is increased demand for oxygen by the tissues. Due to narrowing of the arteries, this demand for more blood and oxygen is left unfulfilled. The result is chest pain after exertion. The pain subsides spontaneously after relaxation for few minutes. It’s commonly felt in the left side of chest. From here it can radiate to the upper back, left side of neck, arm, forearm or even index finger. It can occur at one or more of these sites, depending on the part of heart affected. If the inferior surface of the heart is involved, one can even feel pain in the stomach after meals thus confusing it with indigestion. The typical pain felt is suffocating or cutting in nature. As one gets relief after resting for few minutes, he thinks it to be some ordinary pain and neglects it. It occurs repetitively after exertion or any movement. Untreated, it can result in death of part of the heart muscle. One can also have palpitations, difficulty in breathing and sweating for few minutes. Any chest pain if repetitive, occurring after movements should raise suspicion of angina. A chest pain which is not relieved by pain killers can be angina. Diabetic patients have to be very vigilant because they can have angina without any pain. This happens because the sensation carrying nerves get damaged due to diabetes. The diagnosis of angina can be by electrocardiography and cardiac echo. Coronary angiography shows the presence and site of blockage in the coronary arteries. Where facilities for these tests are not available, a trial of sublingual nitrate helps to treat angina as well as confirm the diagnosis. When an individual experiences the chest pain, he can keep one tablet of nitrate (anti-angina drug), below the tongue. He will get quick relief within 10 minutes, only if the pain is due to angina. The condition can be fairly well controlled in its nascent stage. Changes in lifestyle like quitting smoking and alcohol, regular physical exercise and reduction of physical and 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 or pushing should be avoided as it could aggravate the problem. Good control of hypertension and diabetes is important for good control of angina. A well-balanced healthy diet, helps in prevention of angina. A diet low in saturated fat, with plenty of fresh fruits and vegetables is the best. Patients of high blood pressure or diabetes should stick to their dietary restrictions. Drugs prescribed for prevention or treatment of angina, should be taken regularly. Angina is a preventable heart problem. Only thing needed is a disciplined healthy, regular life. One can improve both his quality of life and survival by good control of angina.
