Heart Pain-Angina Pectoris

Angina Pectoris

(Heart Pain)

 In Indian phenomena, Angina Pectoris is a weeping  of Heart muscles, it causes  temporary chest pain with discomfort that results when the heart’s demand for oxygenated blood exceeds supply from the coronary arteries. This decreased supply of oxygenated blood usually results due to spasm in the coronary artery. Symptoms and signs of angina pectoris resemble myocardial infarction.

Angina, sometimes called angina pectoris, is the pain that occurs when your heart isn’t getting enough oxygen. You feel a sensation of heaviness or pressure in the middle of your chest. Sometimes the pain radiates to your left arm, throat, or jaw.

Patients with established coronary disease and low HDL cholesterol levels are at high risk for recurrent events and should be targeted for aggressive nonpharmacological (ie, dietary modification, weight loss, physical exercise) and pharmacological treatment.

Pathophysiology of angina pectoris

Acute myocardial ischemia occurs when myocardial oxygen demand exceeds supply-

·         Narrowing of the coronary artery due to arthrosclerosis

·         Non arthrosclerosis coronary artery disease such as coronary spasm

·         Valvular heart disease

·         Systemic hypertension

·         Pulmonary hypertension

·         Anemia

·         Hypertrophic or dilated cardiomyopathy

·         Precipitating causes of angina pectoris

Precipitating causes of angina pectoris

·         Heavy meal

·         Physical exertion

·         Emotion or excitement particularly anger and anxiety

·         Exposure to cold

·         Hyperinsulism in diabetic patients

·         Straining at stool

·         Sexual intercourse

·         Micturition

Exercise, a large meal, emotional upset, or stress can bring on an attack of angina. But the condition that makes such attacks possible is narrowing of the coronary arteries, which carry oxygen-rich blood to the heart.

Little clumps of cholesterol-based substances called plaques, makes these arteries leading to the heart become narrower, which accumulate along the artery walls. It’s similar to the substance that builds up in the pipe draining your kitchen sink.

Elevated blood cholesterol is one cause of plaque, but it’s not the sole cause. According to current theories, the initial step for plaque formation is a injury to the inner lining of the artery, called the endothelium.

What causes that injury? Researches don’t yet know for certain. But as in the beginning of a murder mystery, many suspects have been implicated.

Cigarette smoking is one common cause,

Vitamin B6 deficiency

physical injury, viral, bacterial, or chemical assaults; drug use; and poor diet.

Blood cells called platelets to clump together,

Angina is a serious problem and should never be ignored; it can lead to a heart attack. This is not time to play the stoic. If angina-like symptoms begin to occur with greater frequency or with less provocation than usual, they could be a sign of deterioration heart disease and impending heart attack. And if you have any undiagnosed chest pain, see your doctor immediately for an evaluation.

Because angina is such a serious disease, you must continue to see your family physician or cardiologist on a regular basis. If you are on medications for angina, work with an experienced herbalist-there are many potentially dangerous ways that drugs for the heart and herbs can interact. Do not stop taking prescribed medications on your own.

Types of angina pectoris

Angina is classified in two main types

1.   Stable angina

2.   Unstable angina

Stable angina – Angina is said to be stable when there is no change in frequency, duration and precipitating factors, mostly symptoms occurs during exertion and last for less than five minutes and relieved by rest.

Unstable angina – During  unstable angina symptoms are the symptoms are more severe, angina of effort with increasing frequency and duration, provoked by less than usual stimuli and occurs at rest.

Symptoms of angina pectoris

·         Breathlessness or dyspnoea

·         Chest pain over middle or lower sternum or behind the sternum

·         Palpitation

·         Sweating

·         Chest pain with “vice like” constriction or chocking

·         Extension of pain to right or left arm, to neck, jaw

·         Dizziness

·         Faintness

·         Apprehension

·         Rapid heart rate

Investigations-

Investigations in case of stable angina

·         Echocardiography

·         Stress echocardiography

·         Intravascular ultrasonography

·         Intracoronary Doppler

Main Investigations in case of unstable angina pectoris

ECG – At rest may show ischemia changes especially in acute phase of illness.

Coronary angiography – This Investigation is must for all type of cases.

Role of Homeopathic treatment in Angina Pectoris

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. The aim of homeopathy is not only to treat angina pectoris but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat angina pectoris that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of angina pectoris:

Aconite – sudden attack of angina with acute pain in the region of heart, arm and shoulder, pulse full, hard, and bounding, great palpitation, much restlessness with obstructed feeling in the chest. Cough may also associate with angina.

Amyl nitrate – heart’s action is rapid, feeling of band around the head; oppressed breathing with constricted feeling about the heart, face flushed with anxiety and apprehension

Arsenic album – remarkable remedy for angina pectoris, violent throbbing in heart when lying on back, aggravation after 12 a.m

Argentum Nitricum – well known medicine in cases of angina pectoris where complaints occur after taking meal.

Ammonium carb – complaints occur after long continued illness

Bryonia Alba – pains are stitching and tearing in the region of heart, aggravated by motion, and better by rest and lying on painful side.

Crataegus – pain in the region of heart, and under left clavicle. Pulse, feeble, accelerated and irregular, Blueness of fingers and toes

Cimicifuga – heart action suddenly ceases with severe pain in the region of heart, pulse week and feeble.

Cactus – excellent remedy of the cases of angina pectoris, constriction and congestion of the heart, marked palpitation with prostration

Digitalis – sensation as if heart would stop working, condition of patient is worse by motion. Pulse is slow

Glonoinum – violent heart beat as if it would burst pain radiates in all direction, throbbing all over the body

Lachesis – shooting type of pain in the heart, left side of chest and left arm

Lilium Tig – angina pectoris with pain in the right arm, pulsation all over the body, patient feels much suffocated.

Naja – severe pain in the region of the heart, extending to nape of the neck, pulse slow and irregular with fluttering and palpitation

Secale cor – angina pectoris results due to spasms or constrictions of the coronary artery.

Spigelia – shooting, stabbing pain with pressure and oppression in chest down the left arm. Acts well in smokers and drunkards

Strophanthus – angina pectoris due to weakness of the heart

Veratrum album – heart action stopped in tobacco chewers, much palpitation, anxiety and rapid respiration

.Nutritional Supplements

( Use only  with the consultation help of cardiologist)

There are several nutritional supplements which will act to   strengthen   the   heart   and   reverse atherosclerosis.

It has been known and well documented in mainstream medicine that a diet high in animal protein will lead to an abnormal accumulation of  Homocysteine  levels  if there is not enough Vitamin B6, B12, and Folic acid in the diet. Elevated levels of homocysteine are responsible for atherosclerosis of arteries including the coronary, and cerebral  arteries and will in time result in angina, heart attacks and or strokes.

The use of Co enzyme Q 10 as well as magnesium supplements will also help to strengthen the heart and improve the stress response as pioneered .

Natural cures for angina

( Use only  with the consultation help of cardiologist)

Herbal treatments for angina focus on preventing attacks. Once and episode of angina is occurring, take your nitroglycerin. Herbs can do much for angina-lower blood cholesterol, prevent and heal injuries to the endothelium of arteries, prevent the clumping of blood platelets, shrink plaques, and expand or dilate involved arteries. Herbs can also strengthen the heart in general, especially the herbs that improve energy metabolism within the heart.