Angina pectoris is a very lethal condition that develops in people as they progress in age. It usually makes its appearance as a person reaches the age of 50 years and most often, it claims the life of the person it affects. It is today one of the leading causes of deaths of people all over the world.

Angina pectoris or angina, as it is simply referred to, is a chronic pain in the chest which obstructs the flow of blood to the heart. The obstruction in the flow of blood is usually due to atherosclerosis which builds up cholesterol in the arteries providing blood to the heart, leading in severe chest pains.

The name of the disease is derived from the Greek word ankhon which means ‘strangling’ and the Latin word pectus which means ‘chest’. Hence, angina pectoris literally means ‘a strangling feeling in the chest’. Its Sanskrit term is also derived from two words – hriday meaning ‘heart’ and shool meaning ‘thorn’. So hrichool means ‘a thorn in the heart’. Both these names are indicative of the type of pain that is a characteristic of angina pectoris.

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There are three main types of angina pectoris. Refer to the following table for details.

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The major cause of angina pectoris is ischemia, i.e. congestion of the chest cavity. The coronary arteries bring the blood to the heart. If there is any congestion in the coronary arteries, then the blood supply to the heart is obstructed and the result is angina pectoris.

The following are the major reasons why the heart arteries can be blocked:-

(i) Atherosclerosis – Atherosclerosis is the accumulation of cholesterol in the major arteries bringing blood to the heart. Due to this accumulation, the lumens of the arteries become narrow and the blood supply to the heart is obstructed.

(ii) Stress and tension – People living in a constant state of stress and tension require more blood supply to their brain as their brain is working more than normal. As a result, the heart has to pump more blood into the cranial region. After some time, the heart gets exerted and could lead to an angina pain.

In Ayurveda, the air element of the body is called as the vata dosha. Hrichool is caused when there is an imbalance in the vata dosha of the body. The major causes which trigger hrichool according to Ayurvedic principles can be:-

• Ativyaam – means overexertion of the body
• Ativyavaya – means overindulgence in sex
• Abhighaat – means mental trauma
• Bhojana – means diet
• Patan – means a sudden fall or physical shock

People who are at Risk of Angina Pectoris (Hrichool)

There is a large category of people who are at high risk of angina pectoris in the world today. Since angina is largely considered to be a lifestyle disease, there are particular groups of people who are more susceptible to develop angina than others. The following is a list of the people with higher risks of angina:-

People with diabetes and high blood pressure

People who have a family history of angina pectoris

People who are addicted to cigarette smoking

People who are in a constant state of stress and tension

People who live a sedentary lifestyle with less exercise

People whose diet is rich in cholesterol sources, such as fatty foods

People who are overweight

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The prominent symptoms of angina pectoris are almost the same in all people suffering from the condition. The following are the key aspects of anginal pains:-

The initial symptoms of angina pectoris are chest congestions, which can be described as pressing, choking, squeezing and burning kind of sensations. There may be a constriction in the throat.

The anginal pains originate in the epigastrium, i.e. in the upper central region of the chest cavity. This is the region behind the breastbone.

From the epigastrium, the pain can radiate to the back, neck, jaw and shoulders.

Angina pains last for more than one to five minutes, depending on the severity of the condition.

There is generally breathlessness and violent gasping accompanied by the pain.

Nausea and vomiting is common.

One important factor to note is that most angina pains are brought about by some kind of trigger (except in unstable angina). The major triggers for anginal pains are as follows:-

• Physical exertion
• Emotional stress
• Heavy food
• Going to bed immediately after a heavy food
• Extreme emotions such as anger, fear or happiness
• Cold weather

Variant angina can also be triggered by nightmares.

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The most important and serious complication of an anginal pain is myocardial infarction, i.e. heart attack. Heart attacks usually accompany pains of unstable angina, and they could be lethal.

Most stable angina pains develop into unstable angina if ignored. Hence it is absolutely vital to get medical attention when there is the beginning of any kind of chest pain.

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Angina pectoris is a non-communicable disease. It is a metabolic disorder which runs in families. Hence, there is no question of transmission of the condition from one person to the other.

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Whether or not a person will have angina pectoris depends vastly on the kind of diet and lifestyle the person has. Prevention of angina pectoris is very effective if one keeps away from the triggering factors of the condition, which are as follows:-

A diet rich in fats, i.e. a cholesterol-rich diet

Having a full meal and going to bed immediately

A sedentary lifestyle without exercise

Heavy physical work, especially in the old age

Extreme changes of climate, especially in the old age

Emotional stresses and tensions

Smoking

High blood pressure and diabetes

Obesity

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