Causes of Angina in the Elderly

Angina in older adults is primarily caused by reduced blood flow to the heart muscle, often due to conditions such as myocardial ischemia, coronary artery spasm, or atherosclerosis. These conditions limit the supply of oxygen-rich blood to the heart, especially during periods of increased demand. Other contributing factors include chronic diseases like hypertension and diabetes, as well as lifestyle-related issues such as stress, anxiety, and a sedentary lifestyle, all of which can accelerate the development of arterial plaque and worsen ischemia.

Understanding the Symptoms

Angina typically presents as a feeling of tightness, pressure, or squeezing behind the breastbone. This discomfort may radiate to other areas such as the neck, jaw, shoulders, or arms. It is often triggered by physical exertion or emotional stress and usually subsides with rest or the use of medications like nitroglycerin. It's important to distinguish angina from a heart attack—while angina episodes are usually brief, lasting only a few minutes, heart attacks involve prolonged chest discomfort that does not improve with medication and may require diagnostic tools like an electrocardiogram (ECG) or blood tests to detect heart damage.

Unique Risk Factors in Older Adults

In addition to the common causes, elderly individuals are particularly vulnerable to sudden triggers such as exposure to cold temperatures, overeating, emotional distress, and arrhythmias like atrial fibrillation. These factors can lead to abrupt increases in heart rate and blood pressure, thereby increasing the heart's oxygen demand and potentially triggering an angina episode. Managing these risks through lifestyle adjustments and proper medical care is crucial for preventing acute episodes in older patients.