Whatisg Essay, Research Paper
What is Angina? what is the cure?================================RESPONSE: Angina refers to the pain arising from lack of adequate blood supply to theheart muscle. Typically, it is a crushing pain behind the breastbone in thecenter of the chest, brought on by exertion and relieved by rest. It may attimes radiate to or arise in the left arm, neck, jaw, left chest, orback. It is frequently accompanied by sweating, palpitations of theheart, and generally lasts a matter of minutes. Similar pain syndromesmay be caused by other diseases, including esophagitis, gall bladderdisease, ulcers, and others. Diagnosis of angina begins with the recognition of the consistentsymptoms. Often an exercise test with radioactive thallium is performedif the diagnosis is in question, and sometimes even a cardiaccatheterization is done if the outcome is felt necessary to makemanagement decisions. This is a complex area which requires carefuljudgment by physician and patient. Angina is a manifestation of coronary artery disease, the samedisease leading to heart attacks. Coronary artery diseas refers tothose syndromes caused by blockage to the flow of blood in thosearteries supplying the heart muscle itself, i.e., the coronary arteries. Like any other organ, the heart requires a steady flow of oxygen andnutrients to provide energy for rmovement, and to maintain the delicatebalance of chemicals which allow for the careful electrical rhythmcontrol of the heart beat. Unlike some other organs, the heart cansurvive only a matter of minutes without these nutrients, and the restof the body can survive only minutes without the heart–thus thecritical nature of these syndromes. Causes of blockage range from congenital tissue strands within orover the arteries to spasms of the muscular coat of the arteriesthemselves. By far the most common cause, however, is the deposition ofplaques of cholesterol, platelets and other substances within thearterial walls. Sometimes the buildup is very gradual, but in othercases the buildup is suddenly increased as a chunk of matter breaks offand suddenly blocks the already narrowed opening. Certain factors seem to favor the buildup of these plaques. A strongfamily history of heart attacks is a definite risk factor, reflectingsome metabolic derangement in either cholesterol handling or some otherfactor. Being male, for reasons probably related to the protectiveeffects of some female hormones, is also a relative risk. Cigarettesmoking and high blood pressure are definite risks, both reversible in
most cases. Risk also increases with age. Elevated blood cholesterollevels (both total and low density types) are risks, whereas the highdensity cholesterol level is a risk only if it is reduced. Possible,but less well-defined factors include certain intense and hostile ortime-pressured personality types (so-called type A), inactive lifestyle,and high cholesterol diets. Medications are increasingly effective for symptom control, as wellas prevention of complications. The oldest and most common agents arethe nitrates, derivatives of nitroglycerine. They includenitroglycerine, isosorbide, and similar agents. Newer forms includelong acting oral agents, plus skin patches which release a small amountthrough the skin into the bloodstream over a full day. They act byreducing the burden of blood returning to the heart from the veins andalso by dilating the coronary arteries themselves. Nitrates are highlyeffective for relief and prevention of angina, and sometimes forlimiting the size of a heart attack. Used both for treatment ofsymptoms as well as prevention of anticipated symptoms, nitrates areconsidered by many to be the mainstay of medical therapy for angina. The second group of drugs are called “beta blockers” for theirability to block the activity of the beta receptors of the nervoussystem. These receptors cause actions such as blood pressure elevation,rapid heart rate, and forceful heart contractions. When these actionsare reduced, the heart needs less blood, and thus angina may be reduced. The newest group of drugs for angina is called the calcium channelblockers. Calcium channels refer to the areas of the membranes of heartand other cells where calcium flows in and out, reacting with otherchemicals to modulate the force and rate of contractions. In the heart,they can reduce the force and rate of contractions and electricalexcitability, thereby having a calming effect on the heart. Althoughtheir final place in heart disease remains to be seen, they promise toplay an increasingly important role. When medications are unsuccessful, or if there is concern about animpending or potential heart attack, coronary bypass surgery is highlysuccessful in reducing symptoms. Whether or not it prolongs survival isquestionable for most patients. Angina which is new or somehow different from previous episodes inany way is termed unstable angina, is a medical emergency, andrequires urgent attention. Research is active, and careful medicalfollow-up is important.mergency, andrequires urgent attention. Research is active, and careful medicalfollow-up is important.