Angina – Causes and Treatment

Medication or no, your first response to angina should be to sit down and relax, says Dr. Ouyang. If you're having an arterial spasm, it will subside in a minute or two and release its grip on your artery. If clogged arteries are to blame, relief upon resting may suggest that whatever you were doing when the pain hit required more oxygen than your clogged arteries could deliver. Sitting down reduces the workload on your heart and should relieve the pain. Angioplasty and stent placement is a common angina treatment strategy. Chronic stable angina is a form of chest pain that happens when your heart is working harder and needs more oxygen, such as during exercise.

Why do I get angina? Angina occurs when one or more of the coronary vessels are narrowed. As a result of that, the heart muscle receives less oxygen than it needs for it to pump normally. The blood supply may be adequate when you are at rest, however, this may not be adequate when your heart starts to pump faster. For instance, when you start to climb stairs or walk uphill. As the heart rate increases, oxygen demand increases, however, blood could not get past the narrowed arteries and, as a result of that, your heart 'screams' with pain.

Rarely, angina can occur in the absence of any coronary disease. People with a heart valve problem called aortic stenosis have decreased blood flow to the coronary arteries from the heart. People with severe anemia may have angina because their blood doesn't carry enough oxygen. People with thickened heart muscles need more oxygen and can have angina when they don't get enough oxygen.

Symptoms

Not everyone with ischemia will experience angina. This is referred to as "silent ischemia." More commonly, however, people will experience chest pain. The pain of angina comes from the heart, but it's not generally felt exactly over the heart. The most common focus of pain is under the sternum (breastbone), midway between the breasts or pectoral muscles.

Stay calm during an angina attack by remembering that angina is not a heart attack. The symptoms feel as if you're having a heart attack, though, and this is what's so unnerving. Angina causes chest pain, pressure and sometimes a burning sensation. You can even experience pain in your arm, jaw or neck. Get your thoughts under control immediately and remind yourself that you are not having a heart attack.

What is medical therapy for stable angina?

Medical therapy includes making lifestyle changes and taking medicines. Lifestyle changes play a big role in helping you live longer. They include eating a healthy diet, not smoking, and getting daily exercise. Changing your habits may not be easy, but it could keep your heart disease from getting worse. It could even reverse some of the damage.

Nitrates, such as nitroglycerin*, help to open the coronary arteries which then supply more blood to the heart. A tablet or spray of fast-acting nitroglycerin, also called sublingual nitroglycerin, can be placed under the tongue to provide rapid relief of angina pain. Longer-acting nitrates can be given in tablet form from one to three times a day to help control and prevent angina attacks. Nitroglycerin is also available in patches and ointment that can be applied to the skin for continuous control.