Angina
Pectoris
(Heart Pain)
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.
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