MHVI Owners Manual . Conditions . Coronary Artery Disease . Angina Pectoris

What Is It?
Illustrated View

Angina pectoris (or simply angina) is the discomfort or pain in your chest that is caused when your heart muscle does not get enough blood and oxygen.

Symptoms
This discomfort can take different forms and can include any or all of the following:

A feeling of pain, heaviness, pressure, tightness or burning in your chest or back or both.
An ache, discomfort or tightness in your shoulders, neck, jaw or throat, especially when it occurs with chest discomfort.
An ache, heaviness, pressure, numbness, or discomfort in your arms, especially in your left arm (sometimes both arms).
Nausea, heartburn, or feelings of indigestion

Each of these symptoms can occur by themselves or in combination with others in the list. They usually occur with some type of physical or emotional exertion, when your heart rate increases and creates an extra demand for oxygen. If your blood vessels are narrowed by atherosclerosis, this increased demand can trigger angina. Along with the symptoms listed, you may also experience shortness of breath and you might notice increased sweating.

While there are several other causes of chest pain besides coronary artery disease, don't try to decide what is causing your chest pain on your own. You should be evaluated by your doctor or by emergency room staff. By listening to your description of symptoms, your doctor can often determine that you are experiencing angina. Sometimes it's more difficult to tell. You may be asked to take nitroglycerin when you experience angina. If the discomfort is happening frequently, occurring while you are at rest, or you are not sure it is your heart, seek medical care quickly. Chest discomfort that is prolonged or occurs at rest is considered to be unstable angina pectoris.

While angina does not actually cause heart damage, it is a sign that some area of your heart is not getting enough oxygen. Therefore, it is very important that you adhere to the therapy your doctor has prescribed for you.

Treatment
Treatment for angina centers on increasing the flow of blood through arteries that have been narrowed and by reducing the level of demand on the heart. The choice of which treatment is best for you is based on many factors, including the size and location of the narrowing, your other medical conditions, and your previous medical history. For most people, a combination of medications and lifestyle change will be prescribed. For some, specific procedures will also be necessary.

Treatment often begins with medications that expand and relax blood vessels to allow more blood to pass through them. These medications are called vasodilators. A vasodilator familiar to many is nitroglycerin,which is given in the form of a tiny tablet you place under your tongue or a liquid that you spray under your tongue when you experience chest discomfort. Longer acting nitroglycerin products are given to prevent the angina attacks. The other vasodilators that are useful in preventing or reducing angina are the calcium blockers, which are also often used to treat hypertension.
Beta blockers are medications that help control angina by decreasing demand on the heart by slowing the heart rate and reducing blood pressure.
You will be asked to take an aspirin every day. Aspirin helps reduce the chance of heart attack when you have angina pectoris.
In most cases, your doctor will recommend that you begin a regular exercise program, which may include participation in a cardiac rehabilitation program. Regular exercise increases your body's efficiency, reducing demand on your heart. It also can help improve your blood lipids, like cholesterol. Exercise is a good stress reducer, too.
You will be encouraged to follow a high- fiber, low-fat diet to decrease the further buildup of plaque in your arteries.
If you are a smoker, you will need to quit! Nicotine and smoke bi-products cause damage to the artery walls and the speed up the development of atherosclerosis.
If you are having difficulties managing stress, you may need help reducing its effects. You might benefit from a structured stress management program.
If necessary, angina can also be treated effectively by procedures such as angioplasty, the placement of coronary stents, coronary artery bypass surgery, or in unusual, very difficult cases, a newer procedure called laser transmyocardial revascularization. For further information about these methods of treatment, please refer to the Therapeutic Procedures, Lifestyle, and Cardiovascular Medications sections of this manual. As is the case with all cardiovascular disease, new therapies are being discovered regularly, and your doctor can share this information with you.

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