Angina, also called ischeamic chest pain and angina pectoris, is not a disease, but is a symptom of heart disease. Indeed, it is a symptom of coronary artery disease. Angina usually goes away quickly, but it can be a sign of a life-threatening heart problem. If you suffer from angina it is important to find out what is going on and what you can do to avoid a heart attack.
What is angina?
Angina is chest pain or discomfort caused when your heart muscle does not get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The discomfort can also occur in your shoulders, arms, neck, jaw or back. Angina pain may even feel like indigestion, but it is not indigestion. Angina can be described as stable angina, or unstable angina. Stable angina is the most common form of angina. It usually happens when you exert yourself and goes away with rest. The severity, duration and type of angina can vary. New or different symptoms may signal a more dangerous form of angina (unstable angina) or a heart attack. There is one other type of angina, but this is very rare and it is called variant angina or Prinzmetal’s angina.
Symptoms associated with angina?
Angina symptoms include chest pain and discomfort, possibly described as pressure, squeezing, burning or fullness. You may also have pain in your arms, neck, jaw, shoulder or back.
Other symptoms that you may have with angina include:
• Dizziness
• Fatigue
• Nausea
• Shortness of breath
• Sweating
These symptoms need to be evaluated immediately by a doctor who can determine whether you have stable angina, or unstable angina which can be a precursor to a heart attack.
Angina in women
Many studies have shown that the symptoms associated with angina in women are different to those seen in men. This might help to explain the reason why women tend to delay seeking urgent treatment when they have angina. The chest pain is a common symptom in women with angina, but it may not be the only symptom or the most prevalent symptom for women. Women may also have symptoms such as:
• Nausea
• Shortness of breath
• Abdominal pain
• Discomfort in the neck, jaw or back
• Stabbing pain instead of chest pressure
When to contact your doctor?
This is often a difficult question as many individuals have chest pain associated with other disorders such as indigestion and drinking too much alcohol.
If your chest pain lasts longer than a few minutes and does not go away when you rest or take your angina medications, it may be a sign you are having a heart attack. Either call 911 or seek emergency medical help. Arrange for transportation. You should only drive yourself to the hospital as a last resort.
If chest discomfort is a new symptom for you, it is important to see your doctor to find out what is causing your chest pain -and to get proper treatment. If you have been diagnosed with stable angina and it gets worse or changes, seek medical attention immediately.
What factors can increase your risk of angina?
Anyone regardless of sex, ethnic or social group can develop angina and heart disease, but there are certain factors that can increase your risk of getting angina – and include the following:
Tobacco use.Chewing tobacco, smoking, and long-term exposure to secondhand smoke, damage the interior walls of arteries — including arteries to your heart — allowing deposits of cholesterol to collect and block blood flow.
Diabetes. Diabetes increases the risk of coronary artery disease, which leads to angina and heart attacks, by speeding up atherosclerosis and increasing your cholesterol levels.
High blood pressure. Over time, uncontrolled high blood pressure damages arteries by accelerating hardening of the arteries.
High blood cholesterol or triglyceride levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, increases your risk of angina and heart attacks. A high level of triglycerides is also unhealthy.
Family history of heart disease. If a family member has coronary artery disease, or has had a heart attack, you are at a greater risk of developing angina.
Lack of exercise. An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes and obesity. However, it is important to talk with your doctor before starting an exercise programme.
Obesity. Obesity is linked with high blood cholesterol levels, high blood pressure and diabetes, all which increase your risk of angina and heart disease. If you are overweight, your heart has to work harder to supply blood to the body.
Stress. Stress can increase your risk of angina and heart attacks. Too much stress, as well as anger, can also raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina.
Diagnosis
After a detailed history and clinical examination, your doctor will arrange a series of investigations and usually the diagnosis can be made. In a few cases you might be referred to a cardiologist for further evaluation and management.
Treatment
There are many options for angina treatment, including lifestyle changes, medications, angioplasty and stenting, or coronary bypass surgery. Treatment will vary depending on the individual patient. The goals of treatment are to reduce the frequency and severity of your symptoms and to lower your risk of a heart attack and death. In a few cases hospitalisation might be needed.
Complications of angina
There are many complications of angina, such as preventing you from walking and doing normal activities, but the most serious complication is a heart attack that can result in sudden death if not treated.
Prevention and lifestyle changes
Many heart diseases are often associated with angina, so it is important to reduce or prevent angina by working on reducing your heart disease risk factors. Making lifestyle changes is the most important step you can take.
• If you smoke, stop smoking. You should also avoid exposure to secondhand smoke.
• If you are overweight, talk to your doctor about weight-loss options.
• Eat a healthy diet with limited amounts of saturated fat, lots of whole grains, and many fruits and vegetables.
• Talk to your doctor about starting a safe exercise plan.
• Treat diseases or conditions that can increase your risk of angina, such as diabetes, high blood pressure and high blood cholesterol.
• Avoid large meals that make you feel overly full.
• Avoiding stress is easier said than done, but try to find ways to relax. Talk with your doctor about stress-reduction techniques.
• Limit alcohol consumption to two drinks or fewer a day for men, and one drink a day or less for women.
Conclusion
Angina is a common symptom associated with heart disease. If you have angina you should see your doctor to determine the cause. Women should be aware that the symptoms associated with angina are different from men. There are various treatment options for angina. Often a number of lifestyle changes are recommended. Healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active, are all important as the primary lines of defense against angina and its complications – including a heart attack and stroke.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
