Angina pectoris usually occurs when myocardial(heart) demand for oxygen exceeds the ability of the coronary arteries to supply oxygenated blood which carries throughout our body. Common cause is usually coronary artery obstruction or obstruction due to atherosclerosis. There are several types of angina pectoris, and the most common form is stable angina. It is due to physical exertion or other forms of stress, including exposure to cold, heavy meals or intense emotion, and is relieved by rest. On the other hand, unstable angina is a syndrome of attacks of increasing severity and frequency, occurring on minimal exertion or at rest. This often often leads to Myocardial Infarction.
About 1 million people in the United Kingdom have or have had angina pectoris. And statistic for about 9% of men and 5% of women aged 55–64, and 14% of men and 8% of women aged 65–74 have them. In the United states, there are about 6.3 million patient have been diagnosed with angina pectoris. common risk factors include obesity and smoking especially in western countries.
Signs and Symptoms
Most of the patients may experience a sensation in the middle of the chest variously described as fullness, squeezing, pressure, choking, tightness, burning or a heavy weight. Other patient experience as pain in the epigastric region, back or jaw, which may radiate to the neck, shoulders, or arms.
The pain ranges in intensity from mild to severe. Compared to Myocardial Infarction, pain is reversible on rest; angina pectoris attacks last only a few minutes and are relieved by coronary vasodilators(e.g anti-anginal agents).
Compare to Myocardial Infarction,it but may be more difficult to distinguish from other conditions causing pain and other symptoms in the chest and epigastric region.
Tips for Pharmacist
When patient comes to your pharmacy, allow the patient to sit down in a quiet area, make the patient comfortable as much as possible. Allow the person to use his/her coronary vasodilator medication he is carrying or prescribed by his physician. (If the individual has no medication but confirms that he or she has angina, you may give a glyceryl trinitrate tablet or similar medication.) Allow the person to rest until the attack is over.
- Nitrates (Isosorbide dinitrate, isosorbide-5-mononitrate)
- Calcium Channel blockers (Nifedipine, verapamil, diltiazem)
- Beta blockers