THAT SCARY ANGINA!

Angina is a type of chest pain caused by reduced blood flow to the heart muscle. Angina is a symptom of coronary artery disease. Angina is typically described as squeezing, pressure, heaviness, tightness or pain in your chest.
Angina, also called angina pectoris, can be a recurring problem or a sudden, acute health concern.

Angina is relatively common but can be hard to distinguish from other types of chest pain, such as the pain or discomfort of indigestion. If you have unexplained chest pain, seek medical attention right away.
Angina symptoms include:
-Chest pain or discomfort
-Pain in your arms, neck, jaw, shoulder or back accompanying chest pain
-Nausea
-Fatigue
-Shortness of breath
-Sweating
-Dizziness

The chest pain and discomfort common with angina may be described as pressure, squeezing, fullness or pain in the center of your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. For others, it may feel like indigestion.
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Video: Ischemia and Silent Ischemia






SIGNS OF CORONARY ARTERY DISEASE

If your coronary arteries narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any coronary artery disease symptoms. As the plaques continue to build up in your coronary arteries, however, you may develop coronary artery disease signs and symptoms, including:
-Chest pain (angina). You may feel pressure or tightness in your chest, as if someone were standing on your chest. The pain, referred to as angina, is usually triggered by physical or emotional stress. It typically goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and felt in the abdomen, back or arm.
-Shortness of breath. If your heart can’t pump enough blood to meet your body’s needs, you may develop shortness of breath or extreme fatigue with exertion.
-Heart attack. A completely blocked coronary artery may cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Women are somewhat more likely than men are to experience less typical signs and symptoms of a heart attack, such as nausea and back or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.






AM I HAVING A HEART ATTACK?

Your arteries carry blood, oxygen and nutrients to the heart and to the rest of the body. A heart attack occurs when an artery of the heart (also known as a “coronary artery”) is suddenly closed or blocked by a blood clot.
Although the closure happens suddenly, it often results from plaque that has built up in the arteries over time. This process is called atherosclerosis.
It is also known as hardening of the arteries. When the artery closes, the supply of blood and oxygen to the heart drops suddenly and sharply. This lack of oxygen causes damage to the heart.
Signs and symptoms
Most of the signs and symptoms of a heart attack are the same for both men and women. Someone having a heart attack may feel:
chest pain, which may also include feelings of:
-tightness
-discomfort
-crushing pain
-heaviness
-pressure
-squeezing
-fullness
-burning.

spreading pain, which may spread out:
-from the chest area
-down one or both arms
-to the neck, jaw or shoulders.

shortness of breath
paleness, sweating or overall weakness
nausea, vomiting and maybe indigestion
anxiety or fear.

If you notice any of these symptoms:
-Tell someone.
-Call 911
or your local emergency number to get help right away.






WHAT TO DO IN A HEART ATTACK EMERGENCY?

If you encounter someone who is unconscious from a presumed heart attack, call for emergency medical help. If you have received training in emergency procedures, begin cardiopulmonary resuscitation (CPR). This helps deliver oxygen to the body and brain.
According to guidelines by the American Heart Association, regardless of whether you’ve been trained, you should begin CPR with chest compressions. Press down about 2 inches (5 centimeters) on the person’s chest for each compression at a rate of about 100 a minute. If you’ve been trained in CPR, check the person’s airway and deliver rescue breaths after every 30 compressions. If you haven’t been trained, continue doing only compressions until help arrives.
Sudden cardiac arrest during a heart attack is commonly caused by a deadly heart rhythm in which the heart quivers uselessly (ventricular fibrillation). Without immediate treatment, ventricular fibrillation leads to death. The timely use of an automated external defibrillator (AED), which shocks the heart back into a normal rhythm, can provide emergency treatment before a person having a heart attack reaches the hospital. But, if you’re alone, it’s important to continue chest compressions. If there’s a second person present, that person can look for a nearby AED.






A HEART ATTACK WITHOUT KNOW IT?

When you have a heart attack, you know it because the main symptom—crushing chest pain—is overwhelmingly obvious. That’s what most of us believe about heart attacks. But it’s not always true.
What few people realize: Studies show that 20% to 60% of all heart attacks in people over age 45 are unrecognized or “silent.” And the older you are, the more likely it is that you’ve already had a silent heart attack. In a study of 110 people with a mean age of 82, an astounding 68% had suffered a silent heart attack.
What happens during a silent heart attack? You may have no symptoms at all. Or you may have symptoms that are so mild—for example, a bout of breathlessness, digestive upset or neurological symptoms such as fainting—that neither you nor your doctor connects them with a heart attack.
Scientists don’t know why some people have unrecognized heart attacks. But they do know that a silent heart attack is a real heart attack and can cause as much damage to heart muscle as a non-silent heart attack. And just like a person with a known heart attack, anyone who has had a silent heart attack is at higher risk for another heart attack, heart failure, stroke… or sudden death from an irregular heartbeat.
Recent scientific evidence: In a six-year study by cardiologists from the University of California in San Diego and San Francisco—published in Clinical Research in Cardiology in April 2011—people who were diagnosed with a silent heart attack at the beginning of the study were 80% more likely to have another “cardiovascular event,” such as a heart attack or stroke, by the end of the study period.
In a five-year study by cardiologists at the Mayo Clinic, people with an unrecognized heart attack were seven times more likely to die of heart disease than people who didn’t have an unrecognized heart attack.






A Heart Attack can occur Anytime!

Not all people who have heart attacks experience the same symptoms or experience them to the same degree. Many heart attacks aren’t as dramatic as the ones you’ve seen on TV. Some people have no symptoms at all, while for others, the first sign may be sudden cardiac arrest. Still, the more signs and symptoms you have, the greater the likelihood that you may be having a heart attack. The severity of heart attack symptoms can vary too. Some people have mild pain, while others experience severe pain.
A heart attack can occur anytime— at work or play, while you’re resting, or while you’re in motion. Some heart attacks strike suddenly, but many people who experience a heart attack have warning signs and symptoms hours, days or weeks in advance. The earliest warning of a heart attack may be recurrent chest pain (angina) that’s triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart.
Many people confuse a heart attack with a condition in which your heart suddenly stops (sudden cardiac arrest). Sudden cardiac arrest occurs when an electrical disturbance in your heart disrupts its pumping action and causes blood to stop flowing to the rest of your body. A heart attack can cause cardiac arrest, but it’s not the only cause of cardiac arrest.






What is Carotid Angioplasty?

Carotid angioplasty is a procedure that opens clogged arteries to prevent or treat stroke. The carotid arteries are located on each side of your neck and are the main arteries supplying blood to your brain. The procedure involves temporarily inserting and inflating a tiny balloon where your carotid artery is clogged to widen the artery
Carotid angioplasty and stenting may be an appropriate stroke treatment or stroke prevention option if:
-You have a history of heart problems, such as congestive heart failure, unstable angina or a failed stress test
-You have a carotid artery with a 70 percent blockage or more, especially if you’ve had a stroke or stroke symptoms, and you aren’t in good enough health to undergo surgery — for example, if you have severe heart or lung disease or had radiation for neck tumors
-You’ve already had a carotid endarterectomy and are experiencing new narrowing after surgery (restenosis)
-The location of the narrowing (stenosis) is difficult to access with endarterectomy
In some cases, traditional carotid surgery (carotid endarterectomy) may be advised to remove the buildup of plaques (fatty material) that is narrowing the artery.






What is Stable Angina?

Stable angina is the most common form of angina and typically occurs with exertion and goes away with rest. If chest discomfort is a new symptom for you, it’s important to see your doctor to find out what’s causing your chest pain and to get proper treatment. If your stable angina gets worse or changes, seek medical attention immediately.
Characteristics of stable angina:
-Develops when your heart works harder, such as when you exercise or climb stairs
-Can usually be predicted and the pain is usually similar to previous types of chest pain you’ve had
-Lasts a short time, perhaps five minutes or less
-Disappears sooner if you rest or use your angina medication






Silent Ischemia: Ischemia with No Pain

Ischemia is a condition in which the blood flow (and thus oxygen) is restricted or reduced in a part of the body. Cardiac ischemia is the name for decreased blood flow and oxygen to the heart muscle.
What is ischemic heart disease? It’s the term given to heart problems caused by narrowed heart arteries. When arteries are narrowed, less blood and oxygen reaches the heart muscle. This is also called coronary artery disease and coronary heart disease. This can ultimately lead to heart attack.
Ischemia often causes chest pain or discomfort known as angina pectoris.
What is silent ischemia?
Many Americans may have ischemic episodes without knowing it. These people have ischemia without pain — silent ischemia. They may have a heart attack with no prior warning. People with angina also may have undiagnosed episodes of silent ischemia. In addition, people who have had previous heart attacks or those with diabetes are especially at risk for developing silent ischemia.
Having an exercise stress test or wearing a Holter monitor – a battery-operated portable tape recording that measures and records your electrocardiogram (ECG) continuously, usually for 24-48 hours – are two tests often used to diagnose this problem. Other tests also may be used.






Angina and Coronary Artery Disease

Angina is pain or discomfort that comes when your heart does not get enough oxygen. Angina is usually a symptom of a heart problem known as coronary heart disease (CHD), also called coronary artery disease (CAD)
Your heart is a muscle. It pumps oxygen-rich blood to your whole body. Your heart also needs oxygen to work. Blood vessels called coronary arteries carry blood with oxygen to your heart.
In healthy coronary arteries, blood flows freely to bring oxygen to the heart. In coronary heart disease, these arteries become stiff and narrow. This lowers blood flow and the amount of oxygen that gets to the heart.

With exercise or emotional stress, the heart works harder and needs more oxygen. Lower blood flow can lead to angina. You could feel discomfort or pain in the chest, arm, shoulder, back, neck, or jaw. When angina has been present for months or years without much change, it is called chronic stable angina. It most often goes away with rest or nitroglycerin.
If a clot forms in a coronary artery, it can further block blood flow. This can lead to chest pain known as unstable angina. It often occurs at rest. Unstable angina is a medical emergency and requires medical help right away.