What is angina?
Angina is the first warning sign of coronary artery (heart) disease. It happens when plaque or blood clots build up in your heart’s arteries and slow down the flow of blood to your heart muscle. You may experience more symptoms of angina when you exercise or face emotional stress. The increased demand for blood is too high for your heart’s supply.
Symptoms of angina can be very similar to a heart attack. Both conditions are serious, but a heart attack is life-threatening and should be addressed immediately.
Typical symptoms of angina include:
- Pressure, aching, or burning in the middle of your chest (feels like someone is sitting on your chest)
- Pressure, aching, or burning in your neck, jaw, or shoulders (typically on the left side)
- A feeling of uneasiness or anxiety
Angina symptoms typically appear when you’re doing physical activity, facing emotional stress, exposed to cold temperatures, or after a big meal. Sometimes angina can occur while you are in a rested state. This is called unstable angina and is more severe.
Angina will usually subside after a few minutes once you start resting. However, if your pain lasts over 10 minutes, it could be a sign of a heart attack and you should seek immediate medical attention.
Diagnosis for angina?
To diagnose angina, your doctor will discuss your symptoms and may run blood tests. They will also take X-rays or order an electrocardiogram (EKG) and exercise stress test. They will want to rule out a heart attack or other heart problems.
The doctor will evaluate you for microvascular angina. This can occur when your heart’s arteries are not supplying enough oxygen-rich blood due to spasm or cellular dysfunction. Once a heart attack has been ruled out, they will ask about family history with heart disease and determine if your angina is stable or unstable.
There are three types of angina you can be diagnosed with:
- Stable angina – the most common type. It has a regular pattern and happens when your heart is working harder than usual.
- Unstable angina – this is the most dangerous type. There is no pattern or obvious reason for its arrival. It could be a sign of an impending heart attack.
- Variant angina – this is rare, and happens when you are resting.
Treatments for angina
After you’ve been diagnosed with angina, your doctor will determine the best route for treatment depending on your type of angina. Typically your doctor will prescribe medication and lifestyle changes before they suggest surgery. However, if you have severe angina, you may need to undergo an angioplasty or stenting.
The fastest way to treat angina is by getting rest and making lifestyle changes. Angina is likely a symptom of plaque buildup in your arteries, so making better eating choices and reducing your risk for heart attack is important.
Your doctor may first prescribe aspirin for your angina, to prevent and dissolve clots in your arteries. They may also prescribe another blood thinner, known as antiplatelet medications (such as Plavix or Effient). This also helps prevent and dissolve artery clogs.
To relieve or prevent angina symptoms in the moment, your doctor may have you take short-term or long-term nitrates. These will be taken on an as-needed basis.
Reducing your risk of heart disease and having a healthy lifestyle is the fastest way to treat angina. Making good choices every day can slow the buildup of plaque in your arteries. Ways to change your lifestyle include:
- Eating a heart-healthy diet of low-fat and low-salt foods to reduce your risk of heart attack and stroke
- Give up smoking
- Maintain a healthy body weight through regular exercise and movement
- Manage your stress
- Exercise at least 30 minutes for 5 times a week
In some cases, your doctor may recommend cardiac rehab. This treatment helps you improve your cardiovascular health. Your doctor will take into account outlying factors before determining if this is the right option for you.
In cardiac rehab, you will be medically supervised, and you will experience exercise counseling and training, education for heart-healthy living, and counseling to reduce stress. Throughout your treatment plan, you will be supported by doctors, nurses, pharmacists, and your family and friends.
If lifestyle changes and medication do not help your angina, your doctor will order stenting or coronary artery bypass graft surgery.
In some cases, after appropriate testing, your doctor may perform angioplasty and stenting. They will use balloons and/or stents to open the blockage in your coronary arteries to improve blood flow to the heart.
If your blockage is severe, your doctor will determine surgery as the best treatment. This surgery places a vein or artery from another part of your body to divert blood flow around the area of blockage in your coronary arteries to increase blood flow to your heart.
Possible complications and side effects
There are potential side effects of the medication your doctor has prescribed. If you are on beta-blocker therapy, you may experience fatigue, dizziness, depression, or erectile dysfunction. Another medication, sublingual nitrate administration, could cause headaches, dizziness, hot flushing, and nausea. If you experience these symptoms and they worsen, you should contact your doctor for immediate medical care.
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American Heart Association: "What is Cardiac Rehabilitation?"
Clinical Medicine: "Pharmacological treatment of chronic stable angina pectoris."
Harvard Health Publishing: "Angina: Symptoms, diagnosis and treatments."
Harvard Health Publishing: "Dealing with the discomfort of angina."
Johns Hopkins Medicine: "Angina Pectoris."
John Hopkins Medicine: "Microvascular Angina: Why Women Shouldn't Ignore Chest Pain and Fatigue."
Medline Plus: "Angina."
The Society for Cardiovascular Angiography and Interventions: "Treatment of Angina."
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