Angina pectoris is a transient chest pain with discomfort that results when the heart’s demand for oxygenated blood exceeds supply from the coronary arteries. This decreased supply of oxygenated blood usually results due to spasm in the coronary artery. Symptoms and signs of angina pectoris resemble myocardial infarction.

Pathophysiology of angina pectoris

Acute myocardial ischemia occurs when myocardial oxygen demand exceeds supply-

• Narrowing of the coronary artery due to arthrosclerosis
• Non arthrosclerosis coronary artery disease such as coronary spasm
• Valvular heart disease
• Systemic hypertension
• Pulmonary hypertension
• Anemia
• Hypertrophic or dilated cardiomyopathy
• Precipitating causes of angina pectoris

Precipitating causes of angina pectoris

• Heavy meal
• Physical exertion
• Emotion or excitement particularly anger and anxiety
• Exposure to cold
• Hyperinsulism in diabetic patients
• Straining at stool
• Sexual intercourse
• Micturition

Types of angina pectoris

Angina is classified in two main types

1. Stable angina
2. Unstable angina

Stable angina – angina is said to be stable when there is no change in frequency, duration and precipitating factors, mostly symptoms occurs during exertion and last for less than five minutes and relieved by rest.

Unstable angina – in unstable angina symptoms are symptoms are more severe, angina of effort with increasing frequency and duration, provoked by less than usual stimuli and occurs at rest.

Symptoms of angina pectoris

Symptoms of angina pectoris mainly include

• Breathlessness or dyspnoea
• Chest pain over middle or lower sternum or behind the sternum
• Palpitation
• Sweating
• Chest pain with “vice like” constriction or chocking
• Extension of pain to right or left arm, to neck, jaw
• Dizziness
• Faintness
• Apprehension
• Rapid heart rate

Investigations-

Investigations in case of stable angina

• Echocardiography
• Stress echocardiography
• Intravascular ultrasonography
• Intracoronary Doppler

Main Investigations in case of unstable angina pectoris

ECG – at rest may show ischemia changes especially in acute phase of illness.

Coronary angiography – should be done in all cases.

Homeopathic treatment of angina pectoris

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat angina pectoris but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat angina pectoris that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of angina pectoris:

Aconite – sudden attack of angina with acute pain in the region of heart, arm and shoulder, pulse full, hard, and bounding, great palpitation, much restlessness with obstructed feeling in the chest. Cough may also associate with angina.

Bryonia Alba – pains are stitching and tearing in the region of heart, aggravated by motion, and better by rest and lying on painful side.

Digitalis – sensation as if heart would stop working, condition of patient is worse by motion. Pulse is slow

Lachesis – shooting type of pain in the heart, left side of chest and left arm

Crataegus – pain in the region of heart, and under left clavicle. Pulse, feeble, accelerated and irregular, Blueness of fingers and toes

Glonoinum – violent heart beat as if it would burst pain radiates in all direction, throbbing all over the body.

Amyl nitrate – heart’s action is rapid, feeling of band around the head; oppressed breathing with constricted feeling about the heart, face flushed with anxiety and apprehension

Naja – severe pain in the region of the heart, extending to nape of the neck, pulse slow and irregular with fluttering and palpitation

Secale cor – angina pectoris results due to spasms or constrictions of the coronary artery.

Spigelia – shooting, stabbing pain with pressure and oppression in chest down the left arm. Acts well in smokers and drunkards

Arsenic album – remarkable remedy for angina pectoris, violent throbbing in heart when lying on back, aggravation after 12 a.m

Cimicifuga – heart action suddenly ceases with severe pain in the region of heart, pulse week and feeble.

Cactus – excellent remedy of the cases of angina pectoris, constriction and congestion of the heart, marked palpitation with prostration

Veratrum album – heart action stopped in tobacco chewers, much palpitation, anxiety and rapid respiration

Lilium Tig – angina pectoris with pain in the right arm, pulsation all over the body, patient feels much suffocated.

Argentum Nitricum – well known medicine in cases of angina pectoris where complaints occur after taking meal.

Ammonium carb – complaints occur after long continued illness.

Strophanthus – angina pectoris due to weakness of the heart.