MATTERS OF THE ANGINA SYNDROME

DR.S.M.ALAM
July 28 - Aug 03, 2008

Angina is an uncomfortable feeling in the chest by a human being. The common complaint is of a heaviness or tightness in the middle of the chest. This may normally spread to the left shoulder, arm and hand or to the neck, throat and even to jaw. Sometimes, though not often, an attack of angina can come on when one is resting on the bed. An attack is more likely when one is walking quickly, walking uphill, when one is upset or when one is excited. It is more likely after a meal or in cold weather or when one is carrying weight in his hand. Angina sometimes is known as a warning pain.

The strong muscles of the heart need their own supply of foods and oxygen so that they can pump blood to the whole body. The coronary arteries are the tubes that run round the outside of the heart, delivering blood, with food and oxygen, to heart's muscles. Two arteries branch off from the main blood flow out of the heart. One of these forks into two, so that there are three main coronary arteries, which supply blood to heart's muscular wall.

If one or more coronary arteries become narrowed or become thick, the smooth blood supply to heart muscle may by limited. During exercise the heart has to do more work than usual so the muscle needs more oxygen. If the blood can not supply enough oxygen, the muscle will complain by causing angina. The most common cause of narrowing of the coronary arteries is the gradual build up of fatty materials in the walls. This is usually called atherosclerosis. The atherosclerosis phenomenon is the hardening or thickening of blood vessels and has the blood supply to heart muscle is restricted or slowed down. Some genuine risk factors for development of such scenario are: smoking, high blood pressure, high blood cholesterol, obesity, diabetes, a sedentary lifestyle, little exercise and an unhealthy food intake.

Pain in the chest does not always mean that there is anything wrong with one's heart. Some people mistake simple aches from muscles and nerves in the chest for angina. Anxiety and tension are also common causes of pain in the chest. Gall bladder trouble or indigestion can also cause pain, which seems to be near the heart. Pain from these causes is usually related to food rather than exercise.

A heart attack (coronary thrombosis) occurs when an artery has become very narrow or completely blocked. The pain is more severe and lasts longer. The affected person may sweat and feel sick. However, to know the exact causes of such pain there needs to be carried out certain medical tests which include:

i) An electrocardiogram (ECG): This is a record of the electrical activity of the heart. The ECG usually becomes abnormal if angina occurs. For this reason an exercise ECG test is often carried out on a stationary bicycle, ii) A thallium scan: This is useful for some patients. A small amount of radioactive material is injected into the blood. A gamma camera may row up which parts of heart muscle are short of blood, iii) A blood cholesterol test: The amount of cholesterol and other fatty substances in the blood can be checked from a blood sample, IV) Coronary angiograph: This is undertaken by a cardiologist in the hospital. Under local anesthetic a fine tube (catheter) is introduced into an artery in the forearm and passed along the body's arteries to the coronary arteries. A dye is injected to help and to give a clear picture of the arteries on X-ray film. This will show where and how much, they are narrowed. It is essential test if angioplasty or coronary artery surgery is being considered further more.

Treatment: Different drugs are normally used at first, but for some people angioplasty or surgery may be needed. i) Nitrates: These have been used to treat angina for many years. They open up the body's blood vessels. With blood flowing more freely around the body the heart's work is easier. It helps too to widen the coronary arteries. A tablet can be sucked before the patient starts to exercise, so that he can prevent an attack of angina. Nitrates may cause headaches and faintness particularly when used first time--these side effects lessen with time. Types of nitrates are glyceryl Trinitrate (Trinitrin), Isosorbide, Mononitrate and Dinitrate etc. These tablets are usually swallowed whole and are used in the prevention of attacks, ii) Beta blockers: Beta blocker drugs are swallowed whole and act by slowing down the heart rate. They reduce the heart's work so that it needs less oxygen. When they are taken regularly they can reduce the frequency of angina attacks. Beta blockers can sometimes cause cold hands and feet and tiredness. They are not suitable if the patient has asthma and bronchitis, iii) Calcium blocking drugs: Like beta blockers, they reduce the frequency of angina attacks. Sometimes they cause headaches, constipation and puffiness of the ankles.

Prevention: For angina, the methods of primary and secondary are: i) No smoking, ii) Lowering blood pressure, iii) Lowering high blood cholesterol, iv) Reducing overweight, v) Reducing stress, vi) Regular exercise, vii) Avoid sexual activity, viii) Avoid driving, ix) Holidays and Travel etc.

Conclusion and Suggestions: One must be frightened by the word 'Angina' or any simple or fatal disease entered into the body of a man. A man is totally responsible for what is good or bad happening with him in his daily life. The Holy Quran has described such matters in different verses: i) Whosoever does righteous good deed, it is for (the benefit of) his own self, and whosoever does evil, it is against his own self. And your Lord is not at all unjust to (His) slaves (Surah Ha Mim Sijjda or Fussilat 41, Verse 46), ii) And whatever misfortune befalls you, it is because of what your hands have earned. And He pardons much (Surah Ash-Shura 42, Verse 30), iii) No calamity befalls on the earth or in yourself but it is inscribed in the Book of Decrees (Al-Lauh Al-Mahfuz) before We bring it into existence. Verily, it is easy for Allah ( Surah Al-Hadid 57, Verse 22), iv) No calamity befalls but by decision of Allah, and whosoever believes in Allah, He guides his heart to the true faith with certainty. And Allah is the All-Knower of everything (Surah At-Taghabun 64, Verse 11). The other Suraahs with similar meanings and statements are: (20:75 &82; 29:9; 30:45; 32:19; 35:7; 41:8; 42:22; 43:72; 45:30; 47:12; 48:17: 65:11; 95:6; 98:7-8). In another Surah as a warning to men, Allah says: i) And if Allah were to punish men for what they earned, He would not leave a moving (living) creature on the surface of the earth; but he gives them respite to an appointed term: and when their term comes, then verily, Allah is Ever All-Seer of His slaves (Surah Fatir 35, Verse 35). To get rid of these calamities we have to obey the orders of Allah, Allah is and only One, follow the sayings of Prophet (PBUH), recite the Holy Quran daily, offer five times prayers daily, fasting, giving Zakat, and performing Hajj.

We must avoid giving false statement, backbiting, taking interest (Riba) from the Banks, and other institutions, bribe, corrupt money, mongering. We have to true to our words to help poor, spread salams to others .We have to spread our feet according to size of the sheet.

InshaAllah Allah will save us from the bad effects of countless diseases such as diabetes, heart attack, goiter, cancer, asthma, bronchitis, chest pain, chronic cough, heart enlargement, heart murmur, lung tumors, pneumonia, HBP, LBP, leg cramps, head trauma, skin tumors, chicken pox, sexual impotency, sexual dissatisfaction, sore on penis, thrombophlebitis, chronic skin infections, gonorrhea, urethral infection, headache, tuberculosis, syphilis, hearing loss, mouth infections, memory problems, joint pain, stomach diseases, tremor (shaking), leprosy, blindness, paralysis, accidents, and many other maladies.