What is the difference between angina and a heart attack? What is the difference between angina and a heart attack? Although the pain of a heart attack may be similar to the discomfort of angina, the two are different in many regards. Angina is a symptom resulting from a transient lack of oxygen to the heart. Once the demand for oxygen abates, so do the symptoms of angina. No permanent damage is done to the heart. During a heart attack or myocardial infarction, there is a complete loss of blood flow through one or more of the coronary arteries. If the blood is cut off for more than thirty minutes, it is increasingly likely that permanent damage will be done to the heart muscle. In some instances, significant portions of the heart muscle will actually turn to scar. What is the relationship between angina and a heart attack? Both imply the presence of coronary artery disease. Angina is the day-to-day consequence of this narrowing. Patients with angina are at risk of a heart attack but not all experience one. On the contrary, a heart attack is a solitary, severe and even life-threatening consequence of coronary artery disease. Many people who have had heart attacks say they had angina before the attack. But others say they never experienced any cardiac pain until they had a heart attack. What is the difference between stable and unstable angina? Stable angina implies the presence of angina, evoked by a predictable level of exercise, which is not changing in its pattern of occurrence. Such a pattern is usually considered safe and may remain unchanged for years or decades. Unstable angina, on the other hand, refers to angina which occurs at rest or with minimal or no provocation. Someone who has been diagnosed with stable angina and who begins to experience more symptoms more frequently may be diagnosed with unstable angina. Changes in symptoms may signal a heightened risk of heart attack. Unstable angina is often a cause for hospitalization and treatment, possibly surgery This form of angina is uncommon. Variant or “Prinzmetal’s” angina is caused by a temporary spasm of the muscular layer within the wall of the artery producing narrowing. Attacks can be very painful, may occur at any time, and are similar in symptoms to other types of angina. One major characteristic of variant angina is that it comes on even at rest. This form of angina may be dangerous since it may lead both to heart attack and potentially lethal heart rhythm disturbances when severe or prolonged. Many people with Prinzmetal's angina go through what doctors call an "acute, active phase" in which symptoms occur frequently for six months or longer. For most people, symptoms become stable and then diminish after this period. When the acute phase has passed, their chance of survival is excellent. What else can cause chest discomfort? Many other conditions have symptoms that mimic angina. Among the more common are disorders of the esophagus such as gastroesophogeal reflux or common heartburn, and esophageal spasm, biliary colic, which is pain arising from stones and other abnormalities of the liver drainage system, costosternal syndrome, which is inflammation of or trauma to the chest wall, and a number of others. Understanding how angina affects your body, mind and family Angina is the body’s way of warning of a problem with a vital organ. The pain is difficult to ignore, and may force an individual to halt certain activities. Mowing the lawn, climbing steps, playing sports and sex may become difficult – or impossible. That can be deeply depressing, especially for people for whom physically activity and independence have been important. Even beyond that, a diagnosis of heart disease can be emotionally devastating. First comes a flurry of medical testing, which is stressful to schedule and undergo. Medication may be prescribed, and the doctor may suggest some major lifestyle changes in diet or exercise that may be stressful or bothersome to implement. . As a result, many people experience fear, anxiety, and difficulty sleeping after being diagnosed with angina. Others try to deal with the stress of a diagnosis of disease by denying the problem. That can be particularly dangerous in the case of angina. Failure to take medications, failure to seek medical attention, or failure to follow a doctor’s suggestions regarding diet and exercise could be catastrophic. That is, angina ignored could result in a heart attack or death. What are the effects of angina on family and friends? Families of people who are newly diagnosed with angina may themselves be anxious or depressed over the news. Often, family members respond by trying to overprotect the person with angina. Sexuality is a topic that causes a lot of concern among patients. Both partners may be nursing silent worries about the possibility of chest pain during sex – or even a heart attack. The best way to cope is to learn more about angina. Talk to your doctor, and if he or she seems uncomfortable with the discussion, ask for a referral. You may be surprised to learn that sexual intercourse is not only possible but encouraged by your doctor. For some, taking a nitroglycerin tablet before strenuous activity may prevent symptoms.
Your doctor first must be certain of the diagnosis. Once a firm diagnosis has been made, your doctor will assess your condition and determine the likelihood of a heart attack. Your doctor will want to know why you developed coronary artery disease and what can be done to prevent its progression. Your doctor probably will recommend some changes to your diet and your level of physical activity. Your doctor also may prescribe drugs to control blood pressure, cholesterol or diabetes, if these conditions are a factor. Over time, your doctor will want detailed reports on your symptoms. If episodes or angina are rare and do not cause any significant changes in lifestyle, you may remain on a stable regimen of medicines. But a worsening of symptoms that forces you to abandon cherished habits such as sports or sex may lead your doctor to recommend new drugs or surgical treatment to improve your heart blood flow. Experiencing symptoms at rest, particularly if they can’t be quickly relieved with nitroglycerine, is considered a medical emergency. Advice for those newly diagnosed with angina No one is happy to get a diagnosis of coronary artery disease. But there are a number of reasons to feel relief. Most likely, your disease has been slowly progressing over years, even decades. Knowing about the disease can be a powerful motivator to change your habits, and perhaps regain cardiac health. Keep in mind that decades of research into coronary artery disease is giving us a vast array of new tools, including drugs and new surgical procedures, with which to treat the disease. Our ability to control symptoms and reverse the course of the disease is advancing rapidly. Even with a diagnosis of angina, there is every reason to believe that you can continue to live an active life full of the pleasures you enjoy. |
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