Information From Your Health Care Provider

ANGINA PECTORIS

Basic information

description

Angina pectoris is chest pain or discomfort due to a decrease in the blood (and oxygen) supply to the heart muscle (myocardium). Angina may be stable (symptoms are predictable), or unstable (symptoms are unexpected and usually occur while at rest). Angina affects adults of both sexes.

FREQUENT SIGNS & SYMPTOMS

Tightness, squeezing, pressure, fullness, ache, or pain in the center of the chest. Pain may feel like indigestion.
Discomfort or pain may also occur in the neck, jaw, shoulder, arm, or back.
Symptoms may occur with exercise, strong emotions, heavy meals, or with temperature extremes. Some persons have angina while resting.

causes

Angina occurs when the heart needs more blood and oxygen and is unable to get what it requires. This is called ischemia. Coronary artery disease (CAD) is the main cause. In CAD, one or more of the arteries supplying blood to the heart is narrowed or blocked. Angina also occurs if the blood does not carry enough oxygen.

risk increases with

High blood pressure, atherosclerosis, diabetes, high cholesterol, personal or family history of heart disease.
Obesity, inactivity, smoking, or excess alcohol use.
Metabolic syndrome (a group of risk factors).

PREVENTIVE MEASURES

Prevention involves preventing the coronary artery disease that leads to angina. Don't smoke. Get treatment for chronic disorders such as diabetes, high blood pressure, and obesity. Exercise regularly. Reduce high cholesterol with diet or drugs.

expected outcomes

Most angina symptoms can be relieved with lifestyle changes and/or drug therapy. Other treatment may be needed to correct underlying diseases.

possible complications

Heart attack, unstable angina, and/or death.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms. A number of medical tests will be done to assess heart function and to diagnose any underlying disorder.
Treatment usually involves drug therapy to relieve angina symptoms, slow the progress of heart disease, and prevent complications.
If drugs cannot control the angina, there are other treatment options. They include balloon angioplasty to open blocked coronary arteries, stenting (a tiny metal tube or coil is placed in the artery to keep it open), or surgery to bypass severely blocked coronary arteries.
Don't smoke. Find a way to quit that works for you.
Avoid angina triggers, if possible, that increase the heart's workload, such as anger, temperature extremes, high altitude (except in commercial airline flights), or sudden bursts of activity.
To learn more: American Heart Association, local branch listed in telephone directory, or call (800) 242-8721; website: www.americanheart.org.

medications

Nitroglycerin relieves acute symptoms of angina or it can be used before activities. It does not affect symptoms of other disorders. It can work within seconds to relieve pain. Keep it with you for immediate use.
Drugs to prevent blood clots will be given after procedures such as balloon angioplasty or stenting.
Other drugs for coronary disease, such as aspirin, beta-blockers, cholesterol-lowering drugs, ACE inhibitors, or calcium channel blockers may be prescribed. If they are, it is important to follow the prescribed drug regimen.

activity

Learn to adjust activities to lessen angina attacks.
Don't use angina as an excuse not to exercise. A regular moderate exercise routine (determined by your health care provider) can help to control symptoms.

diet

Low-fat, low-cholesterol diet is often recommended.
Weight loss diet if overweight.

notify our office if

You or a family member has symptoms of angina pectoris.
Angina pain lasts longer than 10 to 15 minutes, despite rest and treatment with nitroglycerin.
You wake from sleep with chest pain that does not go away with 1 nitroglycerin tablet. If these attacks continue, report them, even if nitroglycerin relieves them.