Angina is chest pain that occurs because of inadequate delivery of oxygen to the heart muscle (often described as a heavy or squeezing pain in the midsternal area of the chest). Angina signals that a part of your heart muscle is not receiving an adequate supply of blood and oxygen. The heart requires a particularly rich blood supply because of its heavy workload, and receives this nourishment through the coronary arteries. When these vessels are narrowed or blocked, restricting blood flow, they fail to supply adequate oxygen.
The body has a response to pain and problems caused by narrowed arteries. The body often can increase the amount of blood flowing to the muscle by opening up tiny branches of nearby vessels. This network of tiny blood vessels – known as ” collateral circulation ” – makes it possible for blood to detour around blocked or narrowed arteries. The development of collateral circulation is particularly important in the heart muscle where it may be life-saving. However, the development of collateral circulation is a gradual process and not everyone has the same natural ability to develop these networks at the rate that will relieve angina.
Carotid Artery Disease
The carotid arteries are the blood vessels that carry oxygen-rich blood away from the heart to the head and brain.
Located on each side of the neck, these arteries can easily be felt pulsating by placing your fingers gently on either side of your windpipe.
Another smaller set of arteries, the vertebral arteries, are located along the back of the neck adjacent to the spine, and supply blood to the back of the brain.
Carotid artery disease is defined by the narrowing or blockage of this artery due to plaque build-up. The process that blocks these arteries (atherosclerosis) is basically the same as that which causes both coronary artery disease (CAD) and peripheral artery disease (PAD). The slow build-up of plaque (which is a deposit of cholesterol, calcium, and other cells in the artery wall) is caused by high blood pressure, diabetes, tobacco use, high blood cholesterol, and other modifiable risk factors. Over time, this narrowing may eventually become so severe that a blockage decreases blood flow to the brain and may tragically cause a stroke.
A stroke can also occur if a piece of plaque or a blood clot breaks off from the wall of the carotid artery and travels to the smaller arteries of the brain.
Treatment options: Carotid endarterectomy, carotid stenting, medical therapy.
Coronary Artery Disease
Coronary artery disease (CAD) is the leading cause of death of men and women in the United States.
CAD occurs when there is a hardening or narrowing of the arteries that supply the heart muscle. This occurs when there is a build-up of plaque or cholesterol on the inside of the arteries. Over time, the build-up can prevent blood from flowing through your arteries, resulting in lack of blood or oxygen to the heart muscle. When this occurs, you may experience chest pain (also known as angina) or a heart attack. Most heart attacks occur when a blood clot suddenly cuts off the heart’s blood supply, causing permanent heart damage (National Heart, Lung, and Blood Institute).
Treatment options: stent, angioplasty, coronary artery bypass grafting, drug eluting stent, atherectomy, medical therapy.
Peripheral Artery Disease
Learn more from the American Heart Association.