What is Crescendo Angina?

History

A doctor named Sushruta identified the concept of heart pain as early as the sixth century B.C. His description of the disorder outlined the same essential components of the modern definition of angina pectoris and had illustrated a connection between this type of pain and obesity.

Features

Angina is considered unstable if any of three distinguishable features are present. These features include angina that occurs for short periods of time, usually less than 10 minutes, when the sufferers are resting or otherwise not exerting themselves; severe angina that is of a new iteration, usually within the previous four to six weeks; and when each onset of angina is increasingly severe, frequent, and/or prolonged.

Cause

Angina pectoris is a result of an imbalance in the supply and demand of the heart's oxygen. An increased demand of oxygen is caused by physical exertion. The more effort a person makes in their movements, the more the heart needs to pump blood around the body. The proportional supply might not meet the heightened demand if there are blocked, narrow blood vessels or coronary artery atherosclerosis.

Symptoms

Although sometimes referred to as intermediate chest pain syndrome, angina pectoris sufferers usually express discomfort in their chest as opposed to actual pain. This symptom is described as a choking, tight, squeezing sensation. Additionally, people suffering from angina pectoris may experience pain in their arms, shoulders, back and neck. Sweating, breathlessness, and nausea can accompany this pain.

Risk Factors

Generally speaking, maintaining a healthy diet and an active lifestyle can prevent angina pectoris. Studies have shown that specific major risk factors include cigarette smoking, dyslipidemia, hypertension, kidney disease, obesity, physical inactivity, diabetes mellitus and a family history of premature cardiovascular disease. Some medications can exacerbate angina, as can vasoconstrictors and the excessive replacement of thyroids.

Treatment

Angina pectoris is usually treated with nitroglycerin, as it is a vasodilator and provides more access for oxygen to reach the heart. In more acute angina, a balloon can be inserted into the end of a catheter, and then inflated inside the arterial lumen to widen the passageway. A more invasive method is coronary bypass surgery, whereby constricted arteries are bypassed with venous grafts.