Inadequate blood supply to the heart is usually due to coronary artery disease. Other causes include coronary artery spasm, in which the blood vessels narrow suddenly for a short time, aortic stenosis, in which the aortic valve in the heart is narrowed, and arrhythmias. If the pain of angina pectoris continues, it may be due to myocardial infarction. Rare causes include severe anaemia and polycythaemia, which thickens the blood, causing its flow through the heart muscle to slow.
The pain usually starts in the centre of the chest but can spread to the throat, upper jaw, back, and arms (usually the left one) or between the shoulderblades. The pain usually comes on when the heart is working harder and requires more oxygen, for example during exercise. Angina developing during sleep or without provocation is known as unstable angina. Other symptoms may include nausea, sweating, dizziness, and breathing difficulty.
Diagnostic tests usually include an ECG, which may register normal between attacks, and a cardiac stress test. Blood tests and coronary angiography may also be performed.
To help control the symptoms, it is important to stop smoking and to lose weight if necessary. Attacks of angina pectoris may be prevented and treated by nitrate drugs. However, if nitrates are not effective or are causing side effects, beta-blocker drugs or calcium channel blockers may be used.
Drug treatment can control the symptoms for many years.
If attacks become more severe or more frequent, despite treatment, coronary artery bypass surgery or angioplasty may be necessary.... angina pectoris
cavities; it may be red or yellow. Red bone marrow is present in all bones at birth and is the factory for most of the blood cells. During the teens, red bone marrow is gradually replaced in some bones by less active yellow marrow. In adults, red marrow is confined chiefly to the spine, sternum, (breastbone), ribs, pelvis (hip-bones), scapulae (shoulderblades), clavicles (collarbones), and bones of the skull.
Stem cells within the red marrow are stimulated to form blood cells by the hormone erythropoietin.
Yellow marrow is composed mainly of connective tissue and fat.
If the body needs to increase its rate of blood formation, some of the yellow marrow will be replaced by red.
Sometimes marrow fails to produce sufficient numbers of normal blood cells, as occurs in aplastic anaemia (see anaemia, aplastic) or when marrow has been displaced by tumour cells.
In other cases, marrow may overproduce certain blood cells, as occurs in polycythaemia and leukaemia.... bone imaging
Brown fat is located between and around the scapulae (shoulderblades) on the back.
It is a source of energy and helps infants to maintain a constant body temperature.... brown fat
It is attached to the top and back of the shoulderblade and to the outermost part of the collarbone.
The trapezius helps support the neck and spine and is involved in moving the arm.... trapezius muscle