Angina Treatment in Raipur

Angina is chest pain caused by reduced blood flow to the heart muscle. It is a warning sign that the heart is not receiving enough oxygen usually because a coronary artery has narrowed due to atherosclerosis (build-up of fatty deposits). It affects millions of people in India and is one of the most common reasons for emergency cardiac referral. Without treatment, angina can progress to an acute coronary syndrome (ACS) - a sudden serious blockage or a full heart attack. Ramkrishna CARE Hospitals, Raipur provides full angina evaluation and management through a 24-hour specialist heart team.

Types of Angina

Angina is classified by its pattern and the underlying artery problem. They are:

• Stable angina: This is the most common type and is characterised by chest discomfort that is typically triggered by physical activity or emotional stress. It relieves with rest or medicine. Stable angina is usually caused by the narrowing of the coronary arteries that limits blood flow. 
• Unstable angina: It is a medical emergency. Chest pain occurs at rest, arrives more frequently or is more severe. It often signals a sudden and significant drop in blood flow caused by a ruptured plaque within a coronary artery and requires immediate coronary angiography. 
• Variant angina (Prinzmetal angina): This is caused by coronary artery spasm that briefly restricts blood flow to the heart muscle. Unlike stable angina it tends to occur at rest rather than during exertion and is more commonly experienced during the night or in the early hours of the morning. 
• Microvascular angina: Affects the tiny coronary arterioles rather than a blockage in the major coronary arteries. Patients experience genuine angina symptoms but coronary angiography often returns normal findings, making this type more challenging to diagnose and manage.

Symptoms of Angina

Angina symptoms vary in character and location:

• Chest tightness, heaviness or squeezing lasting two to ten minutes on exertion, cold, or stress in stable angina, at rest in unstable angina 
• Pain radiation to the left arm, jaw, neck, or shoulder is common; in women, diabetics, and older adults, jaw or arm pain without chest discomfort can be the only presentation.
• Breathlessness is common in diabetics, women over 60, and those with heart failure. 
• Nausea, sweating, or light-headedness indicates more severe ischaemia (reduced blood flow to the heart).

Causes of Angina

Most angina is caused by coronary artery disease (narrowing of the coronary arteries), but other conditions can trigger it too. They are:

• Atherosclerosis (fatty plaque build-up) is the main cause
• Coronary artery spasm triggered by smoking, cold, or hyperventilation causes variant angina
• Aortic stenosis (narrowing of the main heart valve)
• Anaemia (low haemoglobin - the oxygen-carrying protein)
• Tachyarrhythmia including AF (atrial fibrillation) or SVT (supraventricular tachycardia).

Diagnosis of Angina

Diagnosis starts with clinical history and risk assessment. Doctors perform tests that measure blood flow or directly image the coronary arteries. Investigations include:

• Electrocardiogram (ECG): Records the heart's electrical activity and shows ST-segment changes, Q-waves or arrhythmias.
• Exercise stress testing: Treadmill test detects how the heart responds to physical exertion and helps identify exercise-induced reduction in blood flow to the heart.
• CT coronary angiography (CTCA): Provides detailed images of the arteries without a catheter
• Coronary artery calcium (CAC) score: Measures calcium deposits within the coronary arteries 
• CT-derived fractional flow reserve (CT-FFR): This software blood flow analysis detects a coronary narrowing
• Invasive coronary angiography: Through a thin catheter via the wrist is the gold standard for seeing the site and severity of narrowing
• FFR (fractional flow reserve) or iFR (instantaneous wave-free ratio): Pressure wire confirms whether the narrowing justifies a stent.

Treatment for Angina

Treatment targets symptom relief and heart attack prevention; choice depends on angina type and severity of coronary narrowing.

• Optimal medical therapy (OMT): OMT is the starting point. A GTN (glyceryl trinitrate) spray for acute relief, a beta blocker as first-line prevention, a long-acting nitrate or calcium channel blocker for added control and a statin plus antiplatelet drug to stabilise the plaque. An ACE inhibitor (angiotensin-converting enzyme inhibitor) is added in diabetes or reduced pump function. 
• Percutaneous coronary intervention: When angina persists and FFR (fractional flow reserve) or iFR (instantaneous wave-free ratio) confirms genuine blood flow restriction doctors recommend PCI (angioplasty) with a drug-eluting stent and dual antiplatelet therapy continues for six to twelve months. 
• Coronary artery bypass grafting: CABG using the left internal mammary artery (LIMA) outperforms PCI for complex three-vessel disease, left main disease or diabetic patients. 
• EECP: Enhanced external counterpulsation treats refractory angina using pneumatic leg cuffs that increase coronary blood flow between heartbeats.

Risk Factors for Angina

The risk factors for angina are:

• Hypertension (sustained systolic pressure above 130 mmHg) is the most common modifiable risk factor for angina in India
• Dyslipidaemia (abnormal blood fat levels) including raised LDL, raised triglycerides, and low HDL 
• Type 2 diabetes doubles CAD-related angina risk
• Tobacco including bidi and smokeless tobacco ctivates platelets and raises fibrinogen 
• Central obesity accelerates coronary disease.

Complications of Angina

Without proper diagnosis and treatment, angina carries serious complications beyond chest pain. They are:

• Acute myocardial infarction or heart attack
• Cardiac arrhythmias including ventricular fibrillation and ventricular tachycardia
• Heart failure with reduced ejection fraction
• Anxiety and depression are common in stable angina.

Why Choose Ramkrishna CARE Hospitals for Angina Treatment in Raipur?

Ramkrishna CARE Hospitals, Raipur provides a full angina service ranging from treadmill testing and coronary angiography to complex PCI and CABG. Complex cases are reviewed by our heart team before a management plan is agreed. The catheterisation laboratory operates 24 hours a day with same-day FFR and iFR assessment and emergency angiography for unstable angina; EECP is available in our hospital for patients not suitable for revascularisation.

All patients join a secondary prevention programme with regular cholesterol, blood pressure, and blood sugar reviews. Cardiac rehabilitation including supervised exercise, dietary advice, and psychological support is offered after every revascularisation procedure, substantially lowering the risk of progressing from angina to a heart attack across Chhattisgarh.