on the artery walls). Other causes inc-
lude coronary artery spasm, in which
the blood vessels narrow suddenly for a
in which the
heart’s aortic valve is narrowed, and
(abnormal heart rhythms).
The pain of angina pectoris is brought
on by exertion and is relieved by rest.
If the pain continues, it may be due to a
heart attack (see
Rarer causes of the pain include severe
which reduces the
which thickens the blood and
causes its flow through the heart muscle
to slow down.
The chest pain of angina varies from
mild to severe and is often described as
a sensation of pressure on the chest. The
pain usually starts in the centre of the
chest but can spread to the throat,
upper jaw, back, and arms (usually the
left), or between the shoulderblades. If
it develops during sleep or without
provocation, it is called unstable angina.
Other possible symptoms of angina
pectoris include nausea, sweating, dizzi-
ness, and breathing difficulty.
DIAGNOSIS AND TREATMENT
Diagnostic tests usually include an
(measurement of the electrical activity
of the heart), which may register nor-
mal between attacks, and a
(an ECG undertaken while the
patient is exercising enough to cause
chest pain). Blood tests and coronary
examination of the
blood vessels) may also be performed to
look for an underlying cause.
To help to control the symptoms of
angina pectoris, it is important for the
person to stop smoking and to lose
weight if necessary. Attacks may be
prevented and treated by
which increase blood flow through the
channel blockers, lipid-lowering drugs,
may also be prescribed.
Drug treatment can control the symp-
toms for many years but cannot cure
the disorder. If attacks become more
severe or more frequent, despite treat-
coronary artery bypass
may be necessary.
A type of unstable angina pectoris (see
) in which the attacks of
chest pain occur while the body is at
rest and are not brought on by exertion.
A type of
(chest pain due
to impaired blood supply to the heart
muscle) that occurs during sleep or
without provocation (such as exertion).
A type of reaction caused by
(hives) and is characterized by large,
well-defined swellings, of sudden on-
set, in the skin, larynx (voice-box), and
other areas. If they are left untreated,
the swellings may last a number of days.
The most common cause of angio-
edema is a sudden allergic reaction to
a food. Less commonly, the condition
may be due to a drug allergy (such as
), a reaction to an insect bite
or sting, or it may occur as a result of
infection, emotional stress, or exposure
to animals, moulds, pollens, or cold
conditions. There is also a hereditary
form of angioedema.
Angioedema may cause sudden diffi-
culty in breathing,
speaking, accompanied by swelling of
the lips, face, and neck, depending on
the area of the body affected.
Angioedema that affects the throat
and the larynx is potentially life-threat-
ening because the swelling can block the
airway, causing asphyxia (suffocation).
Severe cases are treated with injections
require intubation (a breathing tube
inserted via the mouth into the wind-
Angiogram of brain
Contrast medium is passed through a catheter into
the arteries at the back of the brain, and a series of
X-rays is taken.
of a hole in the windpipe) to prevent
be given. In less severe cases,
may relieve symptoms.
Angiogenesis is the process that enables
tumours to grow: cancerous cells pro-
duce chemicals (called
that stimulate new blood vessels to
form near the tumour, supplying it with
nutrients and oxygen.
blood vessels to be seen clearly on
X-ray film following the injection of a
(a substance that is
angiography uses computer techniques
to process images and remove unwanted
background information. Magnetic res-
onance angiography (MRA) can produce
images of blood vessels without the use
of a contrast medium.
WHY IT IS DONE
Angiography is used to detect condi-
tions that alter the appearance of blood
vessels, such as an
of an artery) and narrowing or blockage
of blood vessels by
deposits lining artery walls), a
(abnormal clot), or an
ment of a clot that is carried in the
blood). Angiography is also used to
detect changes in the pattern of blood
vessels that supply organs injured or
affected by a tumour.
Carotid angiography (angiography of
the arteries in the neck) may be used to
Magnetic resonance angiogram of groin
This MRA provides a clear image of the arteries
of the groin area without the need for X-rays or
the injection of radio-opaque dye.