Angina pectoris, commonly known as angina, is chest pain due to ischemia (a lack of blood, thus a lack of oxygen supply

and waste removal) of the heart muscle, generally due to obstruction or spasm of the coronary arteries (the heart's blood vessels). Coronary artery disease, the main cause of angina, is due to atherosclerosis of the cardiac arteries. The term derives from the Latin angina ("infection of the throat") from the Greek ankhon ("strangling"), and the Latin pectus ("chest"), and can therefore be translated as "a strangling feeling in the chest".

There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle (i.e., there can be severe pain with little or no risk of a heart attack, and a heart attack can occur without pain).

Worsening ("crescendo") angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina (usually grouped with similar conditions as the acute coronary syndrome). As these may herald myocardial infarction (a heart attack), they require urgent medical attention and are generally treated as a presumed heart attack.

Type :

Stable angina
Also known as effort angina, this refers to the more common understanding of angina related to myocardial ischemia. Typical presentations of stable angina is that of chest discomfort and associated symptoms precipitated by some activity (running, walking, etc.) with minimal or non-existent symptoms at rest. Symptoms typically abate several minutes following cessation of precipitating activities and reoccur when activity resumes. In this way, stable angina may be thought of as being similar to claudication symptoms.

Unstable angina
Unstable angina (UA) (also "crescendo angina;" this is a form of acute coronary syndrome) is defined as angina pectoris that changes or worsens. It has at least one of these three features: it occurs at rest (or with minimal exertion), usually lasting >10 min; it is severe and of new onset (i.e., within the prior 46 weeks); and/or it occurs with a crescendo pattern (i.e., distinctly more severe, prolonged, or frequent than before).

UA may occur unpredictably at rest which may be a serious indicator of an impending heart attack. What differentiates stable angina from unstable angina (other than symptoms) is the pathophysiology of the atherosclerosis. The pathophysiology of unstable angina is the reduction of coronary flow due to transient platelet aggregation on apparently normal endothelium, coronary artery spasms or coronary thrombosis.The process starts with atherosclerosis, and when inflamed leads to an active plaque, which undergoes thrombosis and results in acute ischemia, which finally results in cell necrosis after calcium entry.Studies show that 64% of all unstable anginas occur between 10 PM and 8 AM when patients are at rest. In stable angina, the developing atheroma is protected with a fibrous cap. This cap (atherosclerotic plaque) may rupture in unstable angina, allowing blood clots to precipitate and further decrease the lumen of the coronary vessel. This explains why an unstable angina appears to be independent of activity

Microvascular angina
Microvascular Angina or Angina Syndrome X is characterized by angina-like chest pain, but have different causes.The cause of Microvascular Angina is unknown, but it appears to be the result of poor function in the tiny blood vessels of the heart, arms and legs.Since microvascular angina isn't characterized by arterial blockages, it's harder to recognize and diagnose, but its prognosis is excellent. Basic
Handling of angina includes lifestyle changes, medications, special procedures, and cardiac rehabilitation. The main purpose of the handling of angina include: Reduce the frequency and severity of symptoms Prevent or reduce the risk of AMI and death. Lifestyle changes and medications are needed or can be used if symptoms are mild and do not deteriorate. Unstable angina is a condition of distress requiring hospital treatment. a. Lifestyle changes. The first thing to do to change the habits of life is to avoid things that trigger angina: Do activities slowly (not in a hurry) and take a break, do not push yourself if angina is triggered by the activity. Avoid excessive foods to make full, if angina comes after a lot of food. Trying to avoid situations that give depth to upset, sad, or stressed, if angina dating because of stress, learn stress management techniques. Besides lifestyle that needs to be changed include: Eat a healthy diet to prevent and reduce hypertension, cholesterol, and obesity. Avoid cigarette. Aktive role in physical activity, according to doctor's instructions. Keep your weight within the ideal range. Avoid obesity. Follow your doctor's instructions regarding the use of drugs, especially if you have diabetes. b. Drugs. Nitrates are the most common drug used to treat angina. Immediately use nitrate if angina occurs or is expected to happen. Nitrate will relax and dilate blood vessels, so blood flows more easily and reduce the heart's workload. There are several forms of nitrate use include:

 Eliminate the symptoms of angina that occurs with using it when the pain begins Prevent the incidence of angina by using it before the pain or discomfort which has been estimated to occur. Reduce the frequency of angina by menggunakannyaa regularly in a certain time. Nitroglycerin is the most common type of nitrate used in angina. Nitroglycerin is dissolved dbawah tongue or between cheek and gum is used to relieve angina. Nitroglycerin in the form of tablets and skin patches (rich patches) is used to prevent angina attacks, because the action is too slow for the relief of pain during angina attack .. Types of other drugs: Beta blockers slow the heart rate and lowers blood tekanana. Jens drugs can delay or reduce blood pressure. Calcium channel blockers relax blood vessels so more blood flow to the heart, mwnurunkan pain in angina. These drugs can also lower blood pressure .. ACE (angiotensin-converting enzyme) inhibitors lower blood pressure and reduce strain on the heart. In addition to lowering the risk of future heart attacks and the failure of dating. Also people who have been suffering from angina can then use the drugs as follows: Cholesterol-lowering Drugs Drugs of blood pressure-lowering medicines. . Oral Antiplatelet drugs (eg aspirin and clopidigrel) drink each day, to stop the blood clotting activity of platelets. Platelets are small blood cells that circulate to help stop bleeding by combining themselves with one another to seal small cuts or tiny blood vessels. Antiplatelet drugs may not be suitable for people who have a risk of bleeding .. Glycoprotein IIb-IIIa inhibitors are potent antiplatelet agent that prevents clots from arteries. Administered intravenously in hospitals to treat angina and seteleh during angioplasty. anticoagulants to prevent clots that form in the arteries and block blood flow