Angina – Causes, Symptoms and Treatment
Angina refers to chest pain caused by reduced blood flow to the heart, or to a throat infection involving the tonsils. Learn about causes, symptoms, and treatment.
Things worth knowing about "Angina"
Angina refers to chest pain caused by reduced blood flow to the heart, or to a throat infection involving the tonsils. Learn about causes, symptoms, and treatment.
What is Angina?
Angina is a medical term that can refer to two distinct conditions: angina pectoris (chest pain caused by reduced blood supply to the heart) and angina tonsillaris (tonsillitis, an inflammation of the tonsils). The correct interpretation depends on the clinical context in which the term is used.
Angina Pectoris
Angina pectoris is a symptom of coronary artery disease (CAD). It occurs when the heart muscle does not receive enough oxygen-rich blood, typically due to narrowing of the coronary arteries (coronary stenosis), most often caused by atherosclerosis.
Causes of Angina Pectoris
- Atherosclerosis (plaque buildup in arterial walls)
- Coronary artery disease (CAD)
- High blood pressure (hypertension)
- Diabetes mellitus
- Smoking and elevated blood lipid levels
Symptoms of Angina Pectoris
- Pressure, tightness, or burning sensation in the chest
- Pain radiating to the arm, shoulder, jaw, or back
- Shortness of breath and sweating
- Nausea or dizziness
- Symptoms typically triggered by physical exertion or stress (stable angina) or occurring at rest (unstable angina)
Diagnosis of Angina Pectoris
Diagnosis involves a thorough medical history, a resting ECG, and a stress ECG. Additional investigations include blood tests, echocardiography (cardiac ultrasound), and coronary angiography (cardiac catheterization) to visualize narrowings in the coronary arteries directly.
Treatment of Angina Pectoris
- Medications: Nitrates (for acute vessel dilation), beta-blockers, calcium channel blockers, antiplatelet agents (e.g., aspirin)
- Interventional procedures: Balloon angioplasty (PTCA) with or without stent placement
- Surgical treatment: Coronary artery bypass grafting (CABG) for severe narrowings
- Lifestyle changes: Smoking cessation, healthy diet, regular physical activity, weight management
Angina Tonsillaris (Tonsillitis)
Angina tonsillaris is an acute inflammation of the palatine tonsils, most commonly caused by bacteria -- particularly Group A Streptococcus -- or by viruses.
Causes of Angina Tonsillaris
- Bacterial infection, especially Streptococcus pyogenes
- Viral infections (e.g., Epstein-Barr virus, adenoviruses)
- Weakened immune system
Symptoms of Angina Tonsillaris
- Severe sore throat, often with difficulty swallowing
- Red, swollen tonsils, sometimes with white or yellowish patches
- Fever and general feeling of illness
- Swollen lymph nodes in the neck
- Bad breath (halitosis)
Diagnosis of Angina Tonsillaris
Diagnosis is based on a clinical examination of the throat and a throat swab to detect streptococcal infection. A rapid antigen test (strep test) may be used for quick confirmation at the point of care.
Treatment of Angina Tonsillaris
- Bacterial cause: Antibiotics, typically penicillin or amoxicillin
- Symptomatic relief: Pain-relieving and fever-reducing medications (e.g., ibuprofen, paracetamol), adequate fluid intake, and rest
- Surgical option: Tonsillectomy (surgical removal of the tonsils) may be considered in cases of recurrent tonsillitis
When to Seek Medical Attention
New or sudden chest pain requires immediate emergency medical assistance (call 911 or your local emergency number) to rule out a heart attack. Severe sore throat with high fever, difficulty swallowing, or prolonged illness also warrants prompt medical evaluation.
References
- World Health Organization (WHO): Cardiovascular Diseases -- Key Facts. www.who.int (2023)
- European Society of Cardiology (ESC): Guidelines on the Management of Stable Coronary Artery Disease. European Heart Journal (2019)
- Shulman, S.T. et al.: Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis. Infectious Diseases Society of America (IDSA), Clinical Infectious Diseases (2012)
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