Call your doctor if you experience chest pain, even if you think you are too young to have angina pectoris and no history of heart problems in his family. Your doctor will recommend the next steps depending on how you describe your symptoms and risk factors.

Forecast

In people with coronary disease, the outlook depends on many factors, including the location and severity of the narrowing of the artery, and the number of coronary arteries involved. Proper treatment greatly improves the outlook for people with coronary artery disease.

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* Changes in lifestyle, including weight loss for obese patients, smoking cessation therapy, drugs to reduce high cholesterol, regular exercise program to reduce high blood pressure and stress reduction techniques.

* Nitrates: nitroglycerin including: nitrates are medications that widen blood vessels (vasodilators). Increase blood flow in coronary arteries provide the heart and pumping blood to the rest of the body.

* Beta blockers: atenolol (Tenormin) and metoprolol (Lopressor, Toprol-XL). These medications decrease the heart’s workload by decreasing heart rate and lessen the force of contractions of this, especially during exercise.

* Calcium channel blockers, such as nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem, Tiazac), amlodipine (Norvasc). These medications can help improve the efficiency of heart muscle function and may reduce the number and severity of episodes of chest pain.

* Aspirin: Aspirin helps prevent blood clots in narrowed coronary arteries, which can reduce the risk of heart attacks in people who already have heart disease.

If you changed your lifestyle and medications do not improve angina or when the risk of a heart attack is high, your doctor may recommend a balloon angioplasty or heart bypass surgery.

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A crisis of angina usually lasts less than five minutes. Pain that lasts longer than that or acute may suggest a more significant decrease in blood flow to heart. This can happen when someone is having a heart attack or unstable angina.

Prevention

You can help prevent angina, which causes blockage of arteries caused by coronary heart disease by controlling your risk factors.

* High cholesterol: follow your doctor about a diet low in fat and cholesterol, if necessary, take medications to lower cholesterol.

High blood pressure: follow your doctor’s recommendations to modify your diet and take your medicine.

* Smoking: If you smoke, quit. If you do not smoke, do not start.

* Diabetes: check your blood sugar frequently, follow your special diet and take insulin or oral medication (pills) as prescribed by your doctor.

It is advisable to exercise regularly and maintain a healthy weight. If emotional stress provokes the crisis of angina pectoris, learning to manage stress or relaxation techniques can help.

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Check your blood pressure and pulse, and examine your heart and lungs. You may need one or more diagnostic tests to determine if you have coronary artery disease. Tests may include:

* Electrocardiogram (EKG) is a record of electrical impulses from your heart. It can identify problems in the frequency and heart rate. Sometimes it can show changes that indicate a blocked artery.

* Stress test: If your ECG is normal and can walk, ask for a stress test. Walk on a treadmill while monitoring your heart rate. Other stress tests use drugs to stimulate the heart, injecting contrast material (dye) to detect blockages and take ultrasound images to provide more information.

* Coronary angiography: the x-ray of the coronary arteries are the most accurate way to measure the severity of coronary disease. This inserts a thin tube, long and flexible (called a catheter) through an artery in the arm or groin. The doctor guides the catheter into the heart using a special camera. Once the catheter is placed, the dye is injected to show the blood flow inside the coronary arteries, highlighting any areas that are narrowed or blocked.

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Coronary heart disease is usually caused by atherosclerosis, a disease in which fatty deposits (called plaque) on the inner walls of blood vessels. Although angina most commonly affects middle-aged men or older, can occur in both sexes and all ages. Angina is also known as angina pectoris.

Normally, this disease is manifested by pressure, burning, or tightness in the chest. The pain is usually under the breastbone, but may radiate to the throat, arms, jaws, between the shoulders (shoulder) or into the stomach. Other symptoms that may accompany angina include nausea, dizziness, difficulty breathing or shortness of breath and sweating.

Doctors divided angina into two types:

* Stable angina: chest pain following a specific pattern, which occurs when someone has an intense physical activity or have an extreme emotion. Other situations that trigger include smoking cigarettes or cigars (cigars), cold weather, a large meal or try to go to the bathroom. The pain usually disappears when the employer or the cause that triggered it are completed.

* Unstable angina symptoms are less predictable and if the note, you should call your doctor immediately. This chest pain occurs when a person is resting, sleeping, or very often, performing minimal effort. The discomfort may be prolonged and may be intense.

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* Angina pectoris;
* Myocardial infarction.

Other cardiac disorders, there are problems such as congenital (malformations of the heart), diseases caused by inflammation of the heart muscle (pericarditis, endocarditis, etc..), A weak heart muscle (heart failure) and problems of arrhythmia or heart valves.

Major Cardiac

Angina pectoris. It is expressed by a crisis of pain which focuses on the chest. It is caused by oxygen deficiency in the heart muscle. The term “angina” comes from the Latin anger, which means “to strangle”. Angina may be stable or unstable. Rest and taking nitroglycerin, if any, relieve the symptoms.
* The stable angina pectoris. Stable angina has a predictable behavior, that is to say that the intensity of physical activity that triggers an attack of angina remains the same. For example, it appears almost always to a certain speed or walk after climbing the stairs one floor. The crisis usually lasts less than 20 minutes and leaves no sequelae.
* The unstable angina. The symptoms are similar to those of stable angina, but they occur after efforts less important and are sometimes more intense and difficult to alleviate. The unstable angina pectoris may occur even at rest.

Angina is often the result of a slow process of atherosclerosis that occurs in arteries that supply the heart muscle. This reduces the oxygen supply to tissues (for details, see box below). Other factors may be responsible, such as arrhythmia, severe anemia or heart valve problems.
The unstable angina may be a harbinger of stroke.

Myocardial infarction. It is commonly called a heart attack. Over 90% of cases, myocardial infarction occurs when a blood clot completely blocks an artery that supplies oxygenated blood to the heart.
This lack of blood causes death (called infarction in medical term) in a region of heart muscle. Such damage is permanent and irreversible if not corrected quickly blocked. The infarction may be a cause of heart failure. But if the damage to the heart is too large, this can lead to cardiac arrest and death.
According to the latest Canadian data, up to 11% of victims of a heart attack who were hospitalized died within 30 days of admission44.
The evolution of the clogging of arteries

Atherosclerosis refers to the presence of a plaque on the inner walls of arteries that impedes blood flow. It is often associated with hardening, thickening and loss of elasticity of arteries atherosclerosis.

For an artery is blocked, three phenomena must succeed.
- First, the internal wall of the artery should undergo inflammation. Various factors contribute, such as dyslipidemia (abnormal lipid levels in the blood), diabetes, smoking and hypertension.
- Then, in a clumsy attempt of the body to heal this condition, there will deposit cholesterol and other substances, including calcium, on the walls of the artery, then a hardening and narrowing of the artery.
- Finally, the deposit increase is sufficient size to block the artery (thrombosis) or a blood clot will detach, circulate in the blood vessels until it reaches an artery to the smallest size, then the clog (embolism).

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