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Lotrel (Amlodipine-Benazepril)

In order to help you understand why angina occurs, we need to look at the workings of the heart and blood vessels and at the common diseases which affect them. The causes of heart disease will be discussed, and those over which you have most control in your daily life will be introduced in preparation for subsequent chapters. Angina is the pain that is experienced when the heart muscle cannot get enough oxygen to cope with the task it is being asked to do. It is the heart’s way of saying ‘slow down, I’m struggling here!’ In order to understand angina better it helps to know more about the heart, and especially the blood vessels associated with it.
The heart
The heart is a hollow, muscular pump about the size of a large clenched fist. It is situated in the centre of the chest with the bottom end lying slightly towards the left side. The heart walls are made up of a special type of muscle which contracts rhythmically and, unlike the muscles in our legs and arms, it does not tire. The inside is made up of four chambers, two smaller ones at the top called atria (sing, atrium) and two larger ones at the bottom called ventricles. The chambers are divided by valves which control the flow of blood through them. This blood flow is strictly regulated and usually occurs only in one direction. The heart receives used blood from the body, pumping it to the lungs to collect oxygen and remove carbon dioxide and also to collect fresh blood from the lungs to pump around the vital organs, nourishing them. It is the sound of the valves opening and closing that your doctor will be listening for when examining your chest with a stethoscope. Each heartbeat consists of the two top chambers (atria) filling with blood and the bottom two chambers (ventricles) expelling the blood, which makes the characteristic ‘lub-dub’ sound.
The blood pressure
The blood is being pumped from the heart to the blood vessels under pressure to allow it to reach all parts of the body. This pressure will vary between people and within each person depending on circumstances. The circumstances within the body which maintain the pressure include the amount of blood being pumped through the heart chambers and the degree of resistance in the vessels through which it flows. So, if the vessel is wide and clear, the pressure will be lower than if the vessel is narrowed or constricted, which is what can occur with heart disease. Hard exercise or stress can also cause a rise in the blood pressure.
The coronary arteries
The heart has to have its own supply of oxygen-rich blood in order to perform its task of beating continuously throughout life. The blood vessels which supply the heart with this blood are called the coronary arteries. There are two main arteries, right and left, which encircle the heart, subdividing into many smaller connecting branches called the collateral system. The left artery is the larger of the two. This left artery divides into two main branches which is why doctors talk of there being three coronary arteries. These are named the right coronary artery, the left circumflex artery and the left anterior descending artery. The heart muscle is covered with arteries which supply it with the much-needed blood and oxygen, its energy source.

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