What You Should Know about Angina: A Basic Overview

Aleena Suryadevara, MD
PersonalMD.com, Medical Contributor

Do a lot of people suffer from angina?

Several million individuals throughout the United States suffer from angina (angina pectoris) every year.

However, a vast majority has learned to recognize their symptoms early and have learned both how to control it as well as knowing when to ask for help from health professionals.

What is angina?

Angina has classically been described as discomfort or pressure in the chest area. Other describe feelings of burning, pain, squeezing, or crushing sometimes associated with difficulty breathing, excessive sweating, nausea, or vomiting. Pain may radiate into the jaw, shoulder, or left arm and fingers.

These symptoms usually begin at a low intensity and gradually increase over a period of a few minutes. Sudden onset of sharp pain is not typical for angina. All chest pain is not angina, but it is critical to recognize chest pain that is angina so that further complications can be prevented.

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	Your heart is the size of your fist. Beats about100,000 times a day. Pumps about 8,000 liters of blood. Never stops.

What causes angina?

Angina is caused by ischemia. Ischemia occurs when there is a lack of adequate blood flow through the coronary arteries. This results in poor oxygenation of the heart muscle. Angina usually occurs when there is an increased workload placed on the heart resulting in a mismatch of the supply and demand for oxygen by the heart.

Without adequate oxygenation for a prolonged period of time the heart muscle can die and therefore prompt attention is important. For example, exercise, eating meals, very hot or cold weather, or highly stressful situations which all increase the oxygen demands of the heart can precipitate angina.

 

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What should I do if I have angina?

While angina may be an early indication of a heart attack - it is not a heart attack itself. These symptoms usually last from less than 30 seconds to up to more than 30 minutes. If you have been prescribed nitroglycerin tablets - place one under your tongue. If the pain does not go away after 1-3 tablets go to the hospital immediately.

If angina occurs at rest it is more worrisome because it indicated that these is a decreased supply of blood to the heart rather than increased demand. This is usually more indicative of occlusion of the blood vessels supplying the heart and leads to damage more often.

Angina requires prompt attention by a doctor when the condition first develops, or later if the usual pattern of angina, for an individual, changes. If your angina attacks start to occur more often, are brought on by less strenuous activity compared to previously, last for a longer time, or feel different to you in any way contact your doctor. Do not be afraid to ask for help - it is better to be safe than sorry.

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How is angina treated in the long-term?

Lifestyle modifications are critical. Starting an exercise program, stopping smoking, decreasing high blood pressure, losing weight, decreasing cholesterol levels and eating a low fat diet are important.
Oral nitroglycerin tablets, nitroglycerin paste, or nitroglycerin patches along with Aspirin, Beta-blockers, or Calcium channel antagonists are used. Nitroglycerin works by dilating the blood vessels supplying the heart leading to increased flow of blood to areas of ischemia.

Beta-blockers and calcium antagonists decrease the workload of the heart therefore decreasing the demand for blood and oxygen. Most individuals learn to understand their condition, adjust their lives to minimize anginal episodes, learn to take adequate precautions and medications, and can easily continue to lead happy, productive lives.

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Can I exercise if I have angina?

Yes! under a doctors guidance. When initiating an exercise program discuss it with your doctor and always start slowly. Exercise is very beneficial and can help strengthen the heart as well as control weight. However, if you start having any pain or difficult breathing stop exercising.

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Can I have angina if I don't have any chest pain?

This occurs very rarely. Individuals may experience all the associated symptoms of angina and not actually have the chest pain or chest pressure. People with diabetes are often known to have some ischemia without any associated chest pain.

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What other types of angina are there?

Prinzmetal's angina is known as a variant form of angina that occurs secondary to vasospasm of the coronary arteries leading to decreased oxygenation of the heart muscle. The cause of this vasospasm is not well understood. This type differs from typical angina because symptoms occur independent of the supply and demand of oxygen by the heart muscle.Symptoms often occur at rest or at night.

If you experience any of these symptoms you should seek medical care from your physician.

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