Angina pectoris, or simply angina, is a regular pain or painful sensation in the chest region. This arises when some section of the heart does not collect adequate blood. It is one of the prevalent signs of coronary heart disease (CHD), when vessels that bring blood to the heart become narrowed and hindered attributed to atherosclerosis

Angina usually feels like a pressing or squeezing pain, felt in the chest under the breast bone, but at times boosting up to the shoulders, arms, neck, jaws, or back.

Angina is typically brought on by exertion. It takes place when the heart's need for oxygen increases above the oxygen offered from the blood nourishing the heart. Physical exertion is the most typical prompt for angina. Other triggers can be mental anxiety, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.

But bear in mind, angina is different from a heart attack. Angina pain means that some of the heart muscle in not getting sufficient blood for the short term, such as during exercise, when the heart has to work harder. The pain does NOT mean that the heart muscle is suffering irrevocable, long-term injury. Episodes of angina seldom result in long-lasting damage to heart muscle. It is commonly relieved within a few minutes by resting or by taking prescribed angina medicine.

On the other hand, a heart attack takes place when the blood flow to a part of the heart is quickly and entirely cut off. This brings about permanent damage to the heart muscle. Usually, the chest pain is more severe, lasts longer, and does not go away with rest or with medicine that was previously effective. It may be accompanied by indigestion, nausea, weakness, and sweating. But, the indicators of a heart attack are diversified and may be noticeably less severe.

When a person has a repeating but firm pattern of angina, it does not mean that a heart attack is about to happen. Angina means that that there is underpinning coronary heart disease. Patients with angina are at an expanded risk of heart attack ın comparison with those who have no warning signs of cardiovascular disease, but the episode of angina is not a signal that a heart attack is about to transpire. On the flip side, when the pattern of angina changes--if episodes become more normal, last for a longer time, or appear without exercise--the danger of heart attack in pursuing days or weeks is much bigger.

A person who has angina ought to uncover the pattern of his or her angina--what causes an angina attack, what it feels like, how long episodes usually last, and whether medication minimizes the attack. If the pattern changes dramatically or if the symptoms are those of a heart attack, one should get medical help immediately, perhaps best done by seeking an examination at a nearby hospital emergency room.

Take note, however, that not all chest pain is angina, or connected to the heart. If the pain lasts much less that 30 seconds or if it goes away during a deep breath, after drinking a glass of water, or by simply changing position, it nearly definitely is NOT angina and should not cause concern. But long term pain, unrelieved by rest and followed by other signs and symptoms may signal a heart attack.

Usually the doctor can make out angina by observing the symptoms and how they arise. Then again one or more diagnostic tests may be necessary to leave out angina or to establish the severeness of the underlying coronary disease. These include the electrocardiogram (ECG) at rest, the stress test, and x- rays of the coronary arteries (coronary "arteriogram" or "angiogram").

The ECG records electrical impulses of the heart. These may reveal that the heart muscle is not receiving as much oxygen as it should have ("ischemia"); they may also reveal problems in heart rhythm or some of the other feasible unusual features of the heart. To record the ECG, a technician positions a number of tiny contacts on the patient's arms, legs, and across the chest to connect them to an ECG machine.

For many patients with angina, the ECG at rest is regular. This is not unexpected because the symptoms of angina occur during tension. Therefore, the performance of the heart may be analyzed under stress, normally exercise. In the easiest stress test, the ECG is obtained before, during, and after exercise to look for stress related abnormalities. Blood pressure is also assessed during the stress test and symptoms are observed.

A more complex stress examination involves picturing the blood flow pattern in the heart muscle in the course of peak exercise and after rest. A tiny amount of a radioisotope, usually thallium, is injected into a vein at peak exercise and is consumed up by normal heart muscle. A radioactivity detector and computer record the pattern of radioactivity distribution to numerous parts of the heart muscle. Regional differences in radioisotope concentration and in the rates at which the radioisotopes disappear are measures of imbalanced blood flow due to coronary artery narrowing, or due to malfunction of uptake in scarred heart muscle.

The most complete way to assess the occurrence and severeness of coronary disease is a coronary angiogram, an x-ray of the coronary artery. A long slim flexible tube (a "catheter") is threaded into an artery in the groin or forearm and advanced through the arterial system into one of the two major coronary arteries. A fluid that blocks x-rays (a "contrast medium" or "dye") is injected. X-rays of its distribution show the coronary arteries and their narrowing.