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How Angina pectoris affects the Cardiovascular system.

The cardiovascular system is a system with the heart as the main organ with a network of blood vessels which are responsible for transporting nutrients and oxygen as well as other materials within the blood and the removal of metabolic waste materials.

Angina pectoris is a condition that affects the heart and is characterized by a feeling of squeezing, strangulation and excessive pressure within the chest region. This attributed to insufficient oxygen supply within the tissues of the body which eventually result in reduced available nutrients for proper functioning of the heart muscles. Thus the heart muscles are strained. It can be experienced while one is either sleeping or at rest. The disease is felt like a form of pain that proceeds from the center of the chest and may often spread to the left of the heart affecting the shoulders and the arms as well as the neck, back of the body or jaw of the mouth.

The primary cause of Angina Pectoris is atherosclerosis, also known as platelet et aggregation. Other reasons include- nonvascular mechanisms such as hypoglycemia, increased metabolic requirement, i.e., hyperthyroidism as well as spasms within the coronary artery. Atherosclerosis is preceded by the formation of plaque within the arteries leading to their blockage.

1. The effects of Angina Pectoris on the Cardiovascular system

The results are quite varied with disharmonies arising between the heart, spleen, the kidney as well as the liver:- the patient may experience pain in the chest, jaw or the neck. The pain may happen so fast within the chest, or it may sound like a clenched fist in the chest. This pain at times is unpredictable, within the body the patient may experience fatigue, sweating, dizziness, mild headaches, and exercising becomes difficult, in the respiratory system, there is a challenge of breathing resulting in low oxygen supply, in the alimentary canal the patient will experience heartburn as well as indigestion problems. The appetite may also be compromised. This may be due to changes in metabolism attributed by ischemic myocardium; other experiences may include anxiety, the chest might become tight hence resulting in the fast heartbeat to supply the heart with its requirements. This may also be attributed to by the constriction of the arteries due to the presence of the plaque.

This may result in the limited amount of oxygen in the heart. This limited oxygen may result in myocardial ischemia which will further be followed by the manifestation of the clinical symptoms of angina pains. The limited amount of available oxygen for heart demands increases the work of the heart to avail sufficient resources for itself as shown by increased heart rate which raises the blood pressure. (Chen, Wenjia, et al. 2015). Shortage of oxygen flowing within the coronary arteries will result into myocardial ischemia which may further aggravate the fatal forms, ventricular dysrhythmia. Cells affected by myocardial ischemia will produce a range of chemicals such as histamine, serotonin, adenosine, and bradykinin. Such compounds act on the intracardiac sympathetic nerves.

These nerves terminate at the cardiac plexus as well as the sympathetic ganglia. Impulses arising from the presence of these chemicals are transmitted through the spinal chord to the central nervous system. The effect of this is increased blood pressure and heartbeat observed during moments of acute angina episodes which appear regularly before pain is felt. There will be variations of the electrocardiogram before the pain is felt. This points to the fact that the buildup of the products of metabolism arising from ischemia must precede feeling of pain. Most of the fatal experiences during an anginal episode will include tachycardia and increase blood pressure. These two feedbacks are not suitable for human health. Either of the feedback can result in sudden deaths in patients suffering from symptomatic arterial spasm as well as asymptomatic patients suffering from the same condition. Older patients with arterial spasm may suffer from cerebral emboli which leads to stroke, or maybe attacked by bacterial endocarditis as well as transient cerebral ischemia. (Yang, Mingxiao, et al. 2018).

2. Signs and Symptoms

Patient’s experiences this disease will show some symptoms:- there is a characteristic of healthy emotional reactions coupled with physical exertion, the disease starts from the back of the chest cavity and proceeds to the left arm, upwards to the shoulder and the jaw. This experience results to some form of heaviness in the patient there may also be experiences of irregular heartbeat arising from the constriction of the chest cavity and the arteries serving the heart, paleness as the required amount of blood is not reaching all the body tissues, anxiety, and cold sweat. These kind of experiences are similar to those of heart attack. Apart from these experiences chest pain may also arise from other heart-related conditions like diseases which affect the muscles of the heart or the valves that ensure that blood only flows in one direction. Moreover, the chest pain may arise from ulcers, abnormal contraction, and relaxation of the esophagus, severe anxiety, and gallstones. (Friis, Karina, et al.2016)

3. Treatment

Diagnosis

Correct treatment is dependent on the successful diagnosis of the problem. Angina Pectoris is diagnosed based on the patient’s history of chest pain arising from exertion and use of laboratory tests which endeavor to demonstrate for the presence or absence of coronary artery disease.

Once the disease has been diagnosed, it’s important to seek proper medical attention. Just as the disease affects a patient while sleeping or resting, some of the symptoms can be controlled through mere resting such as strong emotional reactions and physical exertion; the patient is also advised to lie down with their head slightly raised to ensure that blood is flowing to the vital organs of the body. If the patient is not allergic to penicillin, it is advisable to take aspirin. These are precautionary measures that the patient should receive even before they plan to visit a medical facility just to ensure that the patient is a bit safer. Some of the treatment may also involve feeding on the right kinds of food. ( Degerud, Eirik, et al. 2018)

Angina Pectoris can be treated using drugs, which is sufficient. If drugs may not achieve the desired levels of health, then surgery is recommended. The drugs that are available for treating this disease include:-

Calcium-channel Blocking Drugs. Calcium is structure strengthen salts. When deposited in the walls of the arteries, they impair their elasticity. The use of these drugs ensures that the arteries contract and expand voluntarily and hence blood can flow freely without causing a plaque. The use of these drugs ensures that the arterial lumen is wide enough to allow blood flow. If it were narrow, this would cause the unnecessary heart pressure of pumping blood thus resulting in the disease.

Beta-blocking Drugs. When a patient is under stress and also anxious, the sympathetic nervous system may be triggered resulting in an increased heartbeat, increased blood pressure and increased oxygen demand to be able to face the problem at hand. The presence of these drugs counteracts the effects of the said experiences hence arrests any occurrence or prevalence of the disease or its precipitating factors.

Nitrates. They work by reducing heart muscles oxygen demand. They are administered in different forms such as nitroglycerine tablets which are placed under the tongue with an anticipated attack or after the attack, the ointment which is rubbed on the skin, or as tablets which has a long lasting effect in the body.

If the drugs don’t work then the following surgical measures may be pursued: angioplasty will be useful for dealing with chest pains or challenges of short breath while coronary bypass graft surgery may be sufficient for narrowings in more than one coronary artery.

4. Does Angina Pectoris cause narrowing of the arteries, or does narrowing of arteries caused

Angina Pectoris

Angina Pectoris does not cause narrowing of the arteries. It is the narrow artery that causes Angina Pectoris. Atherosclerosis or blocked arteries arise from deposition of fibrous, calcium as well as fatty materials inside the lumen of the artery. This leads to thickening and hardening of the arteries thus they lose their elasticity. Over time, the fatty materials combine with the calcium and other cellular wastes and other deposits to form a plaque. The plaque formed obstructs the flow of blood in the vessel leading to coronary heart disease as well as other diseases of the circulatory system. Atherosclerosis affects mainly the arteries that serve the brain, the heart, and the legs. The effects of the prevalence of these experiences are chest pain (angina) or may lead to fatal conditions such as heart attack or cerebral thrombosis.

5. Risk factors

People need to conscious of some factors that may pre-dispose then to Angina Pectoris. Some of these factors include lifestyles such as heavy intake of cholesterol, hypertension, and cigarette smoking lack of general body exercise, obesity, diabetes mellitus, family history, and male sex.

Exercise- it should emphasize once a patient has been diagnosed with the disease, as the patient may be a bit resistant to engage in physical activity as a lifestyle. Standard advice on exercise should be availed to the patient. This may be informed of electronic or pamphlets to ensure that the right task is being carried out as it can turn out to be counterproductive. (Anderson, Lindsey, et al. 2016).

Cholesterol- it increases the chances of reducing the elasticity of the arteries because when it combines with other deposits and calcium, it reduces the diameter of the lumen. People should be encouraged to use plant oil and avoid cholesterol

Hypertension- it results in the heart having more pressure than it can hold. The heart gets overworked, and this may result in its failure. Hypertension may occur in ruptured arteries and capillaries. If blood vessels in the brain burst, a stroke may arise and brain cells in the affected areas will die. This causes paralysis, which if prolonged may result in stroke, regular exercise is key to ensuring that the heart is working regularly.

Cigarette smoking- it damages the lining of the arteries which allow for the buildup of fatty materials which reduce the lumen of the artery. Its intake also results in high blood pressure This increases the risk of developing circulatory diseases which may end up as angina, stroke or heart attack.

Lack of general body exercise limits the adequate flow of blood within the body.

Obesity- it results in high blood pressure, their very high levels of cholesterol precipitates cardiovascular diseases as the cholesterol reduces the diameter of the artery lumen as it gets deposited and combines with other materials and deposits.

Male sex- sex for men is sufficient exercise and hence blow flow is kept at optimum:

Sex being a form of physical activity engages one’s body, and burns carry which is useful in reducing high blood pressure and other precipitants of angina disease. During sexual intercourse, one’s blood pressure increases and normalizes after the experience. This is healthy in addressing circulatory diseases. Mental health, hormonal and physical imbalance may affect the flow of blood in a male. Such a man may suffer from erectile dysfunction a condition which will affect the normal flow of blood. This may trigger the prevalence of circulatory diseases in such a male. If a person experiences chest pain after sex, it is advisable to visit a health facility as this may be a signal of the presence of angina pectoris. Clinical interventions such as the use of Viagra during sexual intercourse have shown that sex is appropriate in addressing circulatory diseases. Viagra increases the urge for sex and causes a good volume of blood to flow into the male organ.

It has been discovered that the frequency of sex is critical in addressing circulatory diseases. It is like a pipe which is meant to accommodate flowing water. If it happens that there is some dirt in the pipeline and the amount of water streaming is minimal, this may result in obstruction of the pipe. Therefore sex ensures that blood flow in the body is maintained.

Family history- if a member of the family had fallen sick, especially with diabetes mellitus, the offsprings of such a family may also suffer from the same. There is a definite correlation between family history and the prevalence of circulatory diseases. Apart from diabetes mellitus, families that have been brought up by drank parents have also resulted to drinking in their adult age, a condition that pre-disposes them to circulatory diseases. The members should, therefore, be encouraged to desist from lifestyles that can compromise their health.

People in old age are more susceptible to the disease than the young one. (Anderson, Lindsey, et al.2016) Found that angina’s grade of the patient’s had a positive relationship with all aspects of the perceived status of their health. Angina patients had a bad health-related quality of life as compared to patients without angina. For patients suffering from angina, their mortality risk had increased while they experienced the lower health-related quality of their life levels.

6. What needs to be done

A segment of the society who are physically active such as coaches, athletes need to diagnosed with the disease as well as put under preventive measures beyond treatment. Such measures include taking of drugs which will reduce oxygen dependence by their heart muscles.

Since circulatory related diseases are fatal, there is need to mitigate their occurrence by subscribing to an insurance cover since the cost of health may be out of reach of many poor households. (Li, Suhui, et al., et al. 2015) Notes that since that circulatory related diseases are fatal, there is a need for improved disease prevention measures through the use of a health insurance cover and preventive care. He noted that potential health public benefits from such efforts had improved hypertension treatment rates due to insurance expansions and this would prevent 174,000 to 408,000 new coronary heart disease and stroke cases by 2050, a 0.61% to 1.43% decline from the baseline.

On the scientific, social and cultural measures, the society should be enlighted on the causes and effects of circulatory diseases.

Scientifically, there should be the development of curative means that may lead to the transfer of some triggers of the circulatory diseases from one generation to the next. Socially people are supposed to engage in activities that will enhance their physical fitness while culturally they should check on their lifestyle and eating habits which may compromise their physical fitness. Hypertension as one of the risk factors for circulatory diseases should be mitigated through regular physical exercise. (Shimada, Yuichi J., et al. 2016)

Works cited

Anderson, Lindsey, et al. “Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis.” Journal of the American College of Cardiology 67.1 (2016): 1-12.

Bangalore, Sripal, et al. “Renin angiotensin system inhibitors for patients with stable coronary artery disease without heart failure: systematic review and meta-analysis of randomized trials.” bmj 356 (2017): j4.

Bjørnestad, Espen Ø., et al. “Neopterin as an Effect Modifier of the Cardiovascular Risk Predicted by Total Homocysteine: A Prospective 2‐Cohort Study.” Journal of the American Heart Association 6.11 (2017): e006500.

Chen, Wenjia, et al. “Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.” The Lancet Respiratory medicine 3.8 (2015): 631-639.

Degerud, Eirik, et al. “Plasma 25-hydroxyvitamin D and mortality in patients with suspected stable angina pectoris.” The Journal of Clinical Endocrinology & Metabolism (2018).

Fihn, Stephan D., et al. “2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.” The Journal of Thoracic and Cardiovascular Surgery

Friis, Karina, et al. “Peer Reviewed: A National Population Study of the Co-Occurrence of Multiple Long-Term Conditions in People With Multimorbidity, Denmark, 2013.” Preventing chronic disease 13 (2016).

Li, Suhui, et al. “Peer reviewed: impact of health insurance expansions on nonelderly adults with hypertension.” Preventing chronic disease 12 (2015).

Lim, Hadyanto, et al. “Intravenous Mobilized Autologous Peripheral Blood CD34+ Stem Cell Transplantation for Angina.” (2016): A32-A32.149.3 (2015): e5-e23.

Mygind, Naja Dam, et al. “Coronary microvascular function and cardiovascular risk factors in women with angina pectoris and no obstructive coronary artery disease: the iPOWER study.” Journal of the American Heart Association 5.3 (2016): e003064.

Page, Robert L., et al. “Comparative effectiveness of ranolazine versus traditional therapies in chronic stable angina pectoris and concomitant diabetes mellitus and impact on health care resource utilization and cardiac interventions.” American Journal of Cardiology 116.9 (2015): 1321-1328.

Shimada, Yuichi J., et al. “Association between bariatric surgery and rate of hospitalisations for stable angina pectoris in obese adults.” Heart (2017): heartjnl-2016.

Yang, Mingxiao, et al. “Acupuncture for stable angina pectoris: a systematic review protocol.” BMJ open 8.4 (2018): e019798.

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