Angina is a term used for chest pain caused by reduced blood flow to the heart muscle. Angina  is a symptom of coronary artery disease. Angina is typically described as squeezing, pressure, heaviness, tightness or pain in your chest.
Angina, also called angina pectoris, can be a recurring problem or a sudden, acute health concern.
Angina is relatively common but can be hard to distinguish from other types of chest pain, such as the pain or discomfort of indigestion. If you have unexplained chest pain, seek medical attention right away.
Causes- Angina is caused by reduced blood flow to your heart muscle. Your blood carries oxygen, which your heart muscle needs to survive. When your heart muscle isn't getting enough oxygen, it causes a condition called ischemia.
The most common cause of reduced blood flow to your heart muscle is coronary artery disease (CAD). Your heart (coronary) arteries can become narrowed by deposits called plaques. This is called atherosclerosis.
This reduced blood flow is a supply problem — your heart is not getting enough oxygen-rich blood. You may wonder why you don't always have angina if your heart arteries are narrowed due to fatty buildup. This is because during times of low oxygen demand — when you're resting, for example — your heart muscle may be able to get by on the reduced amount of blood flow without triggering angina symptoms. But when you increase the demand for oxygen, such as when you exercise, this can cause angina.
Stable angina. Stable angina is usually triggered by physical exertion. When you climb stairs, exercise or walk, your heart demands more blood, but it's harder for the muscle to get enough blood when your arteries are narrowed. Besides physical activity, other factors, such as emotional stress, cold temperatures, heavy meals and smoking, also can narrow arteries and trigger angina.
Unstable angina. If fat-containing deposits (plaques) in a blood vessel rupture and a blood clot forms, it can quickly block or reduce flow through a narrowed artery, suddenly and severely decreasing blood flow to your heart muscle. Unstable angina can also be caused by blood clots that block or partially block your heart's blood vessels.
Unstable angina worsens and is not relieved by rest or your usual medications. If the blood flow doesn't improve, heart muscle deprived of oxygen dies — a heart attack. Unstable angina is dangerous and requires emergency treatment.
Variant angina. Variant angina, also called Prinzmetal's angina, is caused by a spasm in a coronary artery in which the artery temporarily narrows. This narrowing reduces blood flow to your heart, causing chest pain. Variant angina can occur even when you're at rest, and is often severe. It can be relieved with medications
Symptoms-- Symptoms associated with angina include:
·         Chest pain or discomfort
·         Pain in your arms, neck, jaw, shoulder or back accompanying chest pain
·         Nausea
·         Fatigue
·         Shortness of breath
·         Sweating
·         Dizziness
The chest pain and discomfort common with angina may be described as pressure, squeezing, fullness or pain in the center of your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. For others, it may feel like indigestion.
The severity, duration and type of angina can vary. It's important to recognize if you have new or changing chest discomfort. New or different symptoms may signal a more dangerous form of angina (unstable angina) or a heart attack.
Stable angina is the most common form of angina, and it typically occurs with exertion and goes away with rest. If chest discomfort is a new symptom for you, it's important to see your doctor to find out what's causing your chest pain and to get proper treatment. If your stable angina gets worse or changes, seek medical attention immediately
Characteristics of stable angina
·         Develops when your heart works harder, such as when you exercise or climb stairs
·         Can usually be predicted and the pain is usually similar to previous types of chest pain you've had
·         Lasts a short time, perhaps five minutes or less
·         Disappears sooner if you rest or use your angina medication
Characteristics of unstable angina (a medical emergency)
·         Occurs even at rest
·         Is a change in your usual pattern of angina
·         Is unexpected
·         Is usually more severe and lasts longer than stable angina, maybe as long as 30 minutes
·         May not disappear with rest or use of angina medication
·         Might signal a heart attack
Angina in women
A woman's angina symptoms can be different from the classic angina symptoms. For example, women often experience symptoms such as nausea, shortness of breath, abdominal pain or extreme fatigue, with or without chest pain. Or a woman may feel discomfort in her neck, jaw or back or stabbing pain instead of the more typical chest pressure. These differences may lead to delays in seeking treatment.
Risk factors-- The following risk factors increase your risk of coronary artery disease and angina:
Tobacco use. Chewing tobacco, smoking and long-term exposure to secondhand smoke damage the interior walls of arteries — including arteries to your heart — allowing deposits of cholesterol to collect and block blood flow.
Diabetes. Diabetes is the inability of your body to produce enough insulin or respond to insulin properly. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, which is a form of sugar from foods. Diabetes increases the risk of coronary artery disease, which leads to angina and heart attacks by speeding up atherosclerosis.
High blood pressure. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Over time, high blood pressure damages arteries.
High blood cholesterol or triglyceride levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of the wrong kind of cholesterol, known as low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol), increases your risk of angina and heart attacks. A high level of triglycerides, a type of blood fat related to your diet, also is undesirable.
History of heart disease. If you have coronary artery disease or if you've had a heart attack, you're at a greater risk of developing angina.
Older age. Men older than 45 and women older than 55 have a greater risk than do younger adults.
Lack of exercise. An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes and obesity. However, it is important to talk with your doctor before starting an exercise program.
Obesity. Obesity raises the risk of angina and heart disease because it's associated with high blood cholesterol levels, high blood pressure and diabetes. Also, your heart has to work harder to supply blood to the excess tissue.
Stress. Stress can increase your risk of angina and heart attacks. Too much stress, as well as anger, can also raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina.
Complications- The chest pain that can occur with angina can make some normal activities, such as walking, uncomfortable. However, the most dangerous complication to be concerned about with angina is a heart attack.
Common signs and symptoms of a heart attack include:
·         Pressure, fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes
·         Pain extending beyond your chest to your shoulder, arm, back, or even to your teeth and jaw
·         Increasing episodes of chest pain
·         Prolonged pain in the upper abdomen
·         Shortness of breath
·         Sweating
·         Impending sense of doom
·         Fainting
·         Nausea and vomiting

LATRODECTUS MACtANS  6—Latrodectus mac. is  a spider remedy and it is considered to be a specific remedy for angina pectoris. There is severe pain in the chest muscles , left shoulder, back and neck. The pain radiate from the chest to left arm  and fingers. There is intense restlessness , depression and pain after the attack is over. Sometimes the pain may be extend to abdomen. The patient have great anxiety about the heart. Thinks he will suffocate , fear  that he would lose breath and die.

CACTUS GRANDIFLORUS  Q—Cactus grandiflorus is one of the top remedies for the treatment of Angina pectoris. There is pain as if the heart were gripped with an iron band. Heat feels clutched and released alternately by an iron band and constriction as from an iron band. Pain from the apex shooting down the left arm. The pulse is feeble , irregular, quick without strength. Another symptom is great palpitations, worse lying on left side.

DIGITALIS PURPUREA 30-Digitalis is best for Angina pectoris with a feeling as if heart would cease working, if he moves, must hold the breath and keep still. There is sudden sensation as if heart stood still. There is attacks of Angina worse rising arms. The least movement causes violent palpitations. The patient is anxious about the future.

SPIGELIA 30- Spigelia is effective for Angina , especially indicated in smokers and drunkards. There is pressure, oppression, darting , shooting and stabbing pains in the chest and down the left arm.There is violent sticking or compressive pains , radiating to throat , arms, scapula, worse least motion or bending double. Another marked symptom is, violent palpitations which is audible, faintness and dyspnoea.

NAJA TRIPUDIANS 6—Naja tripudians, a snake remedy should be tried in the absence of specific indications. There is dragging and anxiety in precordia. There is a feeling of weight on heart, and stitching pain in region of heart. Angina pains extends extending to nape of neck , left shoulder and arm with anxiety and fear of death. There is pain in forehead and temples along with heart symptoms.

HYDROCYANIC ACID 3X—Hydrocyanic acid is effective for Angina pectoris with severe pain. There is clutches at the heart as if in distress, palpitation, anxiety and small pulse. Angina pectoris with epilepsy.

AMYLENUM  NITROSUM 3- Amyl nitrate is best for Angina with great anxiety. There is aching pain and constriction around the heart. Tumultuous action of the heart.Another symptoms is violent beating of the heart and carotids.
A cotton drenched in Amylenum nitrosum Q may be placed near the nostril of the patient for inhaling. It gives immediate relief after which the indicated remedy can be given.

ACONITUM NAPELLS 30-Aconitum napellus is effective for sudden attack of Angina with acute pain in the region of the heart, left arm and left shoulder.Pain worse when sitting erect.  It should be given immediately at the onset of the feeling of pain when there is a previous history of the disease in the patient. There is great fear , anxiety and restlessness. There is palpitation with anxiety. The pulse is full ,hard, tense and bounding. Sometimes cough may present along with heart pains.

TERMINALIA  ARJUNA Q-Terminalia arjuna is excellent for Angina pectoris with weakness and pain in heart. There is palpitation with pain, extend to left shoulder and left hand, worse from walking, after eating. Another symptoms are  vertigo and darkness before the eyes.

AMMONIUM CARB 30-Ammonium carb is best for Angina pectoris where circulation becomes sluggish and under –oxygenation of blood produces. There is great weakness of heart with drowsiness. Danger of heart failure due to a prolonged illness.

ARGENTUM NITRICUM 30-Argentum nitricum is prescribed when heart attack occurs after taking meals. Angina pain worse at night. There is palpitation with nausea, worse lying on right side.

ARSENIC ALBUM 30-Arsenic alb is prescribed for Angina with great anxiety , restlessness and fear of death. Heart pain into neck and occiput with anxiety , difficult breathing, fainting spells.There is thirst for small quantities of water at short intervals.Irritable heart in smokers and tobacco chewers.

BRYONIA ALB Q- Bryonia alb is prescribed where stitching pain occurs in cardiac region and  the pain persists and is worse by motion.

CIMCIFUGA RACEMOSA 30-Cimcifuga is best for Angina where there is pain in the heart region and left arm. Heart action ceases suddenly and there is immediate suffocation.

GLONOINUM 30-Glonoinum is prescribed where violent beating of the heart occurs as if it will burst open. There is strenuous breathing. Pain radiates in all directions, down the left arm with weakness.

STOPHANTHUS HISP. Q-Strophanthus is best for Angina due to weakness of heart.

VERATRUM ALB 30-Vertrum alb is prescribed for Angina with collapse and extreme coldness, blueness and weakness of the body. Veratrum alb is an excellent heart stimulant.

CRATAEGUS OXY. Q- Crataegus is a an effective heart tonic which strengthen the heart.

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