ANGINA PECTORIS

BAsic information

description

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 and symptoms

• Tightness, squeezing, pressure, fullness, ache, or pain in the center of the chest.
• Chest pain similar to 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 it is unable to get what it requires. This is called ischemia. Most often it is due to coronary heart disease. With heart disease, one or more of the arteries that supply blood to the heart is narrowed or blocked. Another cause is when the blood does not carry enough oxygen, such as in severe anemia or carbon monoxide poisoning.

risk increases with

• Coronary heart disease.
• Valvular heart disease.
• Hypertrophic cardiomyopathy (enlarged heart).
• Anemia.

preventive measures

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

expected outcomes

Minor angina can be relieved with rest and use of nitroglycerin and other drugs. Other treatment may be needed to correct underlying diseases.

POSsible complications

• Heart attack.
• Unstable angina.
• 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.
• The goal in treatment is to relieve angina symptoms, slow the progress of heart disease, and prevent complications, such as a heart attack. Treatment is usually with drugs, both for the angina and for the heart disease.
• If drugs cannot control the angina, other treatment options include balloon angioplasty to open blocked coronary arteries 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. Always keep it with you for immediate use.
• 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

• A low-fat, low cholesterol is often recommended.
• Try a 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 one nitroglycerin tablet. If these attacks continue, report them, even if nitroglycerin relieves them.