Attacking Angina

You feel sharp pains in your chest. You have felt pain before but never this intense. You could have angina.

Angina occurs when the heart is starved of oxygen because it doesn’t make enough blood. This oxygen deprivation, or ischemia, is usually considered more serious if it occurs soon after a heart attack—what doctors call a myocardial infarction.

Angina is caused when arteries that supply blood to the heart become partially blocked with fatty plaque. As the plaque continues to accumulate, blood flow declines. This reduction often is not a problem when the heart is at rest, but upon exertion, heart cells are suddenly deprived of blood and oxygen, producing chest pain. Chest pain signals the death of heart cells (ischemia). If enough cells die, a heart attack occurs.

About 10 million people in the United States experience angina. It is slighter more prevalent in women than men. In fact, this condition is common among Black females and White males than among people in other racial groups.

According to the Cleveland Clinic, angina feels like chest pain or pressure. Some people describe it as indigestion or a squeezing sensation or tightness in the chest. The discomfort usually begins behind your breastbone. Sometimes you can’t pinpoint just where the pain is coming from. The pain may radiate to other parts of your body like your neck, jaw, shoulders, arms, back or belly.

Other symptoms you may have include fatigue, nausea or vomiting, shortness of breath, and sweating a lot.

There are four types of angina: Stable angina, unstable angina, microvascular angina and prinzmetal (variant) angina. Stable angina is the least severe while prinzmetal is the least common form of angina. Angina pectoris is another name for stable angina. It refers to the brief chest pain or discomfort that comes and goes in a predictable pattern.

Both angina and a heart attack are consequences of coronary artery disease. But angina is temporary and doesn’t cause damage to your heart. A heart attack does. Angina causes a temporary reduction in blood flow whereas a heart attack causes a longer reduction in blood flow. At which time, some of your heart muscle begins to die.

Another difference between angina and a heart attack is that with rest and medication (nitroglycerin) angina will go away whereas rest and medication do nothing for a heart attack.

Stable angina doesn’t require emergency care unless the pain you experience gets worse or rest and medication don’t help your symptoms. A heart attack requires emergency care right away.

Some risk factors for angina include:

·       Anemia (low red blood cells).

·       Chronic stress.

·       Diabetes.

·       Diet high in saturated fat, trans fat, sugar, sodium or refined carbohydrates.

·       Drinking too much alcohol.

·       Exposure to “particle” air pollution (like dust from roads, farms or construction sites).

·       Family history of early heart disease.

·       Heart failure.

·       Heart valve disease.

·       High blood pressure.

·       High cholesterol.

·       Hypertrophic cardiomyopathy (enlarged heart).

·       Inflammation.

·       Long-term exposure to secondhand smoke.

·       Metabolic syndrome.

·       Not moving around enough (physical inactivity).

·       Obesity.

·       Older age (for men 45 and over, for women 55 and over).

·       Smoking, vaping or using other tobacco products.

·       Use of street drugs.

Treatment involves taking care of the underlying heart problem that is causing your angina. The goals of treatment are to improve blood flow to your heart and reduce your risk of complications. Your health provider will perform a physical exam and do testing to learn about your condition.

Some treatment options may include:

·       Anticoagulants or antiplatelet drugs to reduce your risk of blood clots.

·       Blood pressure medications.

·       Cholesterol medications.

·       Medications that specifically treat angina.

·       Lifestyle changes.

·       Coronary artery bypass grafting.

·       Percutaneous coronary intervention, also called coronary angioplasty and stenting.

·       Nitroglycerin (a common medication for angina).

Another option for people with continued pain is enhanced external counterpulsation. This therapy works by applying pressure to your lower legs to improve blood flow to your heart, which improves your angina.

You can prevent angina by making healthy lifestyle choices. Some of these choices include avoiding smoking, eating a heart-healthy diet, practicing effective stress management, maintaining a healthy weight, exercising 150 minutes per week, managing risk factors for coronary artery disease, and taking medication prescribed by your cardiologist.