Angina is a recurring heart-related discomfort usually felt in the chest. The discomfort is often described as pressure, tightness, or a burning sensation. Sometimes it spreads from the chest to the neck, jaws, arms or upper back. Although angina may feel like a heart attack, it is not — although it can be a warning sign. Therefore, any chest discomfort should be evaluated by a doctor.
WHAT CAUSES ANGINA?
Angina is caused by an inadequate supply of blood to the heart muscle. This is usually due to atherosclerosis, a build up of plaque in the coronary arteries. When the arteries leading to the heart are clogged by atherosclerosis, their blood flow is partially obstructed. Blood carries oxygen and other nutrients essential for heart function. When the work of the heart is increased — such as by exercise, a large meal, or emotional stress — it needs extra blood flow. If it doesn’t get that blood due to atherosclerosis, the result can be anginal pain. In a very small percentage of cases, the inadequate blood supply may be due to spasm of the arteries leading to the heart, again, diminishing the blood supply.
HOW IS ANGINA DIAGNOSED?
Often, a physician can make the diagnosis based on your symptoms and when they occur. Then you will likely be referred to a cardiologist for such evaluations as an electrocardiogram (ECG) and an exercise stress test. If you develop chest pain during the test, you may be given a nitroglycerin tablet to place under your tongue. Such tablets cause blood vessels to expand temporarily. Disappearance of the pain within a few minutes, as the tablet dissolves, helps confirm the diagnosis of angina. Your doctor may also recommend an angiogram — “a moving picture” X-ray taken after dye is injected into your blood vessels — to assess the degree and location of coronary artery blockage. This information is helpful in developing a treatment plan.
CAN ANGINA BE PREVENTED?
There are no guarantees, but your lifestyle can certainly influence your risk of coronary artery disease. The key is a heart-healthy lifestyle: not smoking, maintaining ideal weight, exercising regularly, and controlling levels of cholesterol, blood pressure and, if you are diabetic, blood sugar. The same tips — plus a few more — can reduce your risk of frequent attacks if you have already been diagnosed with angina. If you are a smoker, you should quit because tobacco use further constricts arteries. If you are overweight, losing weight will lessen the heart’s workload. Eat five light meals a day, rather than three full ones — again to reduce the heart’s work. Rest for an hour after meals before undertaking any stress or major activity. Decrease your intake of fat, especially saturated fat, to reduce or help reverse atherosclerosis. Avoid going out in extremely cold weather; cold constricts your arteries. Avoid any other activities that bring on anginal attacks, such as more physical exertion or emotional stress than you can handle. Ask your doctor for guidelines for exercise.
HOW IS ANGINA TREATED?
In addition to lifestyle changes, your doctor may prescribe medications to help reduce your angina, such as nitroglycerin tablets to treat attacks immediately and longer-acting forms to be taken regularly as a preventive measure. Other helpful medications include beta blockers and calcium channel blockers. In some cases of severe angina, your doctor may recommend invasive treatments, such as angioplasty to open clogged arteries or cardiac bypass surgery to replace them.
