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Angina or Angina Pectoris (more information)

Overview

Angina is the most common symptom of coronary artery disease (CAD) and other heart diseases. During angina the heart does not receive enough blood or oxygen. In CAD, blockages in the coronary arteries, called plaques, prevent an adequate amount of blood from reaching the heart muscle. Situations that require increased blood flow to the heart may cause angina in people with CAD. These include exercise, heavy meals, and stress.

Angina is a specific type of chest discomfort and can be divided into two categories: stable angina and unstable angina.

Risk factors

The risk factors for both types of angina and coronary artery disease are similar:

  • male gender
  • age
  • cigarette smoking
  • high cholesterol levels (in particular, high LDL cholesterol and low HDL cholesterol)
  • high blood pressure
  • diabetes
  • family history of coronary heart disease before age 55
  • inactive lifestyle (being busy at work or working long hours does not count)
  • obesity

Occasionally, sudden overwhelming stress can cause an episode of angina.

Prevention and Planning Ahead

You can change your way of life and lower your chance of having angina attacks:

  • Stop smoking, and avoid secondhand smoke.
  • Maintain a healthy diet low in saturated fat, cholesterol, and salt.
  • Control high blood pressure and blood cholesterol levels.
  • Manage stress.
  • Avoid extreme temperatures.
  • Avoid strenuous activities.
  • Participate in 30 minutes or more of continuous aerobic activity or exercise on most days of the week.

Warning Signs and Symptoms

Stable angina is characterized by a feeling of tightness, heavy pressure, or squeezing or crushing chest pain that:

  • is mid-sternal (under the breastbone) or slightly to the left
  • is not clearly localized
  • may radiate to shoulder, arm, jaw, neck, back, or other areas
  • may feel similar to gas or indigestion.
  • is precipitated by activity, stress, or exertion
  • lasts 1 to 15 minutes
  • is usually relieved by rest and/or nitroglycerin

You may experience angina when you climb steps, work in very hot or cold weather, or have sex. If symptoms are not relieved by 1 nitroglycerin tablet taken 5 minutes apart and lasts longer than 15 minutes, you may be experiencing unstable angina or a heart attack.

Diagnosis

Your doctor may give you the following to test to see if you have angina:

  • Blood test
  • Eclectrocardiogram (ECG or EKG)
  • Treadmill exercise
  • Cardaic catherization, which shows where the artery is blocked

Complications of disease

Unlike stable angina, unstable angina may occur while you are at rest and without any precipitating factors. Pain may increase in severity, frequency, or duration at low levels of activity or for no identifiable reason. This type of angina may also occur soon after a heart attack. Unstable angina is different from stable angina in that the pain may:

  • occur at rest
  • be new in conditions of onset or last longer than previous anginal attacks
  • be less responsive to medication

Angina vs. Heart Attack

The symptoms of a heart attack are similar to angina with three potential differences:

  1. The pain is more severe.
  2. The pain usually last for more that 5 minutes.
  3. Rest does not relieve pain.

Intervention/Treatment

Your doctor may give you nitroglycerin, a medicine to dilate the coronary arteries, which will relieve the discomfort. Nitroglycerin may comes as a tiny tablet, a spray, capsules, skin patches and ointment. It may also be administered as an intravenous medication. Nitroglycerin usually causes a headache. However, the headache is usually relieved by tylenol.

Unstable angina does not respond to nitroglycerin and/or rest and may signal the onset of a heart attack. Contact your doctor and go to the hospital if you have already been diagnosed with CAD or angina, and the nitroglycerin is not relieving your anginal symptoms.

Alternative Medicine

You may want to consult the following sites for alternative treatments for angina:

Frequently Asked Questions

Q: What is angina?

A: Angina is a specific type of chest discomfort that signals that the heart is not receiving enough blood.

Q: What does angina feel like?

A: Patients say that angina feels like gas or indigestion. Others say that stable angina gives a feeling of tightness, heavy pressure, or squeezing or crushing chest pain that is under the breastbone or slightly to the left, clearly localized, and may radiate to shoulder, arm, jaw, neck, back or other areas.

Q: Is angina the same thing as a heart attack?

A: No. Unlike a heart attack, angina disappears after about 10 minutes. When blood clots in an artery and totally blocks blood from flowing to the heart a heart attack occurs, causing permanent damage to the heart. However, angina is a warning sign for heart attack.

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