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Find Angina Pectoris Through Pain During Exercise

Caution is needed as the risk of blood vessel-related diseases such as high blood pressure, cerebral infarction, and angina increases due to the contraction of blood vessels in the event of a cold wave. In particular, angina pectoris should be extra careful as it can progress to myocardial infarction, which causes "sudden death" if left unattended.


(Picture from Unsplash)


With the aging population, the number of angina patients is steadily increasing. According to the Health Insurance Review and Assessment Service, the number of angina patients has increased by 33% over the past decade from 530,000 to 703,000. Among them, 70-80% are in their 60s or older.


Experts point out that aging is a major factor in the increase in angina patients, but it is important to maintain a healthy lifestyle as the number of young angina patients is increasing due to lack of exercise and the increase in the obese population.


Angina pectoris is caused by insufficient blood supply to the heart muscle as the coronary artery, a blood vessel that supplies blood to the heart, narrows due to arteriosclerosis.


The most common symptom is chest pain that weighs on the chest or feels stiff. Many patients complain of shortness of breath. However, not all symptoms of chest pain are angina. Chest pain may occur due to gastrointestinal diseases, neurosis, and muscle pain.


One of the main characteristics that can be distinguished at this time is pain that occurs during exercise. Most angina pectoris have no symptoms when stabilizing, and symptoms occur in exercise, stress, and excitement situations. Unlike myocardial infarction, where blood vessels are almost blocked and necrosis occurs in the myocardium, angina pectoris occurs when oxygen demand increases due to stress and exercise while blood flow is maintained to some extent. Pain duration is less than 5 to 10 minutes. In some cases, pain is taken lightly as a lack of exercise or aging because it improves when stabilized. However, if stenosis worsens due to neglecting angina, the cross section of the coronary artery decreases by more than 80 to 90%, reducing blood flow supply during stabilization, and unstable angina, which causes pain during rest, may occur. Above all, it can lead to myocardial infarction, which completely blocks the coronary arteries. In addition, stable angina, which occurs when exercising, unstable angina, and myocardial infarction do not progress sequentially.


A 50% decrease in the cross-section of the coronary artery limits the ability to supply blood flow, but symptoms usually occur when there is a 70-80% decrease. When symptoms appear, it means that they have already progressed a lot, so angina should not be considered easily because the symptoms disappear after resting after exercise.


The treatment for angina varies depending on the severity of the symptoms. In mild cases, symptoms are controlled through medication such as antiplatelet drugs, cholesterol lowering drugs, and vasodilators. However, drug treatment is not a blood vessel "recovery to its original state," but rather a slow progression. If the degree of coronary stenosis is severe and cannot be controlled with drugs, coronary intervention or coronary bypass surgery should be performed. Coronary artery intervention refers to coronary balloon dilatation or intravascular stent implantation. It is a method of expanding the narrowed blood vessel by inserting a small conduit of 3 to 4 mm through the thigh. Unlike surgery, it is often used to treat angina pectoris because it does not require anesthesia, and the recovery period is short and scars do not remain. Coronary bypass is the last option left if calcification is severe or anatomically inadequate coronary intervention.


For prevention, it is important to prevent oily substances from accumulating in the walls of blood vessels. This is why people with underlying diseases such as hyperlipidemia, diabetes, and high blood pressure should pay particular attention. Bad lifestyle habits such as obesity, lack of exercise, stress, and smoking can lead to angina even at a young age. For the same reason, it is not right for angina patients to avoid exercise due to pain. In particular, if there is a family history of cardiovascular disease in men under the age of 55 and women under the age of 65, there is a high possibility of early occurrence.


Angina patients are recommended to exercise at 80% of the maximum heart rate. Usually, by subtracting the age from 220, for example, for a 60-year-old, the heart rate in his 160s is the maximum heart rate, and he is told to exercise below 130 to 140 heart rates per minute, which is 80%. Since you do not measure your heart rate and exercise, to explain the intensity of exercise easily, you can think of it as the intensity of exercise when you walk up the third floor of the stairs without a break.


Writer: Yeyoung Jeon


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