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Angina
Overview

If you have ever rushed to the hospital with a crushing pain in your chest only to be told you did not have a heart attack, you may be suffering from a condition known as Angina Pectoris. Many things can bring on an attack of this type of chest pain from coronary artery spasms, to an irregular heartbeat. One of the most common causes is coronary artery disease that cuts off the blood supply to the heart.
About 10 million Americans suffer from angina. There are around 500,000 new cases of angina diagnosed every year. Research shows that angina is a strong indication of coronary artery disease and could be a precursor to heart attacks. This article will help you understand angina and what to do about it.

What Is Angina?

What Is Angina?

Chest pain that happens due to lack of blood flow to the heart is known as angina. The difference between an actual heart attack and angina is that the blood flow is only cut off temporarily. A heart attack happens when there is complete blockage of the artery that does not clear up. While they both have the same cause, angina is less likely to cause damage to the heart muscle. Angina should not be ignored and needs to be worked up by a doctor since it is a symptom of coronary artery disease and can progress to a heart attack in the future.

There are a few different types of angina including:

Stable Angina
Unstable Angina
Variant Angina
Microvascular Angina

Symptoms of Angina

Angina Symptoms

The most prominent symptom of angina is pain. There may also be other symptoms including chest pressure, squeezing feeling, tightness, and burning. It most commonly starts in the middle of the chest under the sternum.

Angina pain can sometimes be felt in the jaw, neck, or shoulders. Often, people think they have heartburn or don’t even know exactly where the pain is. This is known as referred pain. Women usually feel this and men usually experience classic “middle of the chest” type pain.
There can be other symptoms such as severe tiredness, trouble breathing, cold sweats, dizziness, weakness, and nausea.

If any of the above symptoms persist more than just a few minutes, call 9-1-1 immediately. Do not attempt to drive yourself to the hospital. Below are the symptoms listed by type of angina:

Stable Angina
Happens during exercise/physical work or during emotional states
Comes on gradually and repeatedly
Lasts less than 5 minutes
Relieved by rest
Feels like indigestion
Radiates to back, arms, or neck

Unstable Angina
Comes on during rest or physical/emotional activity
Comes on suddenly
Severe pain that can last up to 30 minutes
Not relieved by rest
Gets worse with each episode
May precede a heart attack

Variant Angina
Happens when resting (night or morning)
Severe pain
Medication relieves it

Microvascular Angina

Tends to last longer than other angina
More severe than other angina
Occurs with shortness of breath, tiredness, low energy
Happens during daily work or stressful situations

Causes Of Angina

When the blood supply to the heart is reduced, the heart does not get enough oxygen. Blood flow is cut off from coronary artery disease that blocks the blood vessels that carry oxygenated blood. The blockage is known as atherosclerosis. When the heart muscle does not get enough oxygen to do its job, the tissue begins to suffer and pain sets in. Variant angina is caused by a spasm of the vessels that supply the heart. This spasm decreases blood flow and tends to occur in cycles.

Risk Factors for Angina

Since angina is a symptom of heart disease, the risk factors usually coincide with a person’s risk for heart disease. Here are the risk factors for angina and heart disease:

High cholesterol
High blood pressure
Tobacco use
Diabetes
Obesity
Lack of exercise
Poor dietary choices
Age over 45 in men and over 55 in women
Family history of coronary artery disease

How is Angina Diagnosed?

If you have chest pain, you need to see a doctor right away. They will take a family and personal medical history, along with a list of medications you are taking. The following tests will be ordered right away to rule out a heart attack:

EKG (electrocardiogram)
This test is performed by hooking up electrodes to your chest, arms, and legs. It picks up irregular heartbeats and checks for heart muscle damage.

Chest X-Ray
They can look to see if your heart is enlarged

Blood Testing
If you have symptoms of angina or a heart attack, they will check the levels of cardiac enzymes in the blood.

Heart Catheterization
To rule out acute heart attacks, you may need to have a catheter inserted into an artery in the leg. This catheter (small plastic tube) is threaded from the leg into the heart vessels. They inject dye into the arteries to check for blockage. This test can tell doctors if you have heart disease and how severe it is. If it is severe, a doctor may reopen the blocked vessel with a small balloon at the end of the catheter. This is usually followed by placing a stent (small metal tube), which helps to prevent the artery from becoming blocked again.

If an acute heart attack isn’t the issue, the doctor will schedule you for other tests to find the cause of your angina including stress testing on a treadmill, echocardiogram, nuclear stress testing, and/or a cardiac CT scan.

Treatments for Angina

Angina Treatment

Treatments involve reducing the risk for having a heart attack, addressing pain, and improving blood flow. These include:

Lifestyle Modifications

Quit smoking

Eat a healthy low-fat diet

Exercise

Lower cholesterol levels/Blood pressure

Avoid stress

Lose weight

Medications

Blood pressure medications

Cholesterol medications

Aspirin (thins the blood)

Nitroglycerin (opens blood vessels)

Procedures

Stenting (a stent is placed to keep arteries open)

Coronary Bypass Grafting (blocked arteries are removed and replaced with another from the leg)

Home Remedies for Angina & Prevention Tips

Home Remedies For Angina And Prevention Tips

The first attack of angina needs to be immediately evaluated in the emergency room. Once your doctor gives you the “all-clear” there are certain things you can do at home in addition to any medical treatment to help reduce angina attacks. These include:

Stop and Rest. If you feel an attack coming on, sit or lie down and rest. Sometimes attacks will go away with just a position change.

Find ways to Relieve Stress. Try meditation or breathing exercises. Turn on some soft music or try aromatherapy for relaxation.

Omega-3 Fatty Acids. Check with your doctor first, but these have been found to reduce the risk of heart disease. Use caution if you are on a blood thinner. Make sure you are eating cold water fatty fish at least two times a week.

Eat Garlic. Eating the amount equivalent to a clove of garlic a day can help bring down cholesterol levels. It can also help as a blood thinner. Find creative ways to use garlic in your cooking.

Eat Smaller More Frequent Meals. Large meals increase the work done by your heart. More work means more blood is needed to provide oxygen which may not be possible because of blocked arteries, hence triggering an attack. Try eating smaller meals and rest after eating.

Avoid Extreme Cold. Cold weather can shrink blood vessels and bring on angina.

With your doctor’s okay, if you have a prolonged angina attack and need to call 9-1-1 chew 300 mg of aspirin and swallow with a sip of water while waiting for the ambulance. This could save your life if you are having a heart attack.

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