Angina is a common term shortened for the medical term "angina pectoris." The word angina itself means pain; pectoris means chest. Angina is the chest pain or discomfort brought on by decreased circulation in the heart and heart muscle itself. It results from a shortage of oxygen and other nutrients to any part of the heart muscle.
Signs and Symptoms
Squeezing pressure,
heaviness, or mild ache in the chest (usually behind the breastbone)
Aching in a tooth with or without squeezing
pressure or heaviness in the chest
Aching into the neck muscles or jaw
Aching into one or both arms
Aching into the back
A feeling of gas in the upper abdomen and
lower chest
A feeling that you're choking or shortness
of breath
Paleness and sweating
These symptoms may not be extreme, so are often neglected. It is better for you to
report an episode of angina to your doctor than not to, even if you might feel foolish
later if something minor is the cause. Episodes of angina are usually associated
with:
Anger or excitement
Emotional shock
Exertion or physical work, especially if it
strains the muscles of the chest or arms
Walking rapidly uphill
Waking up at night with discomfort due to
decreased blood flow to the heart
In all of these situations, there is relief from the distress when the activity is stopped. Moderate daytime activity helps relieve nighttime angina, though.
Many people who experience angina for the first time fear they're having a heart
attack. Here's why angina and heart attack are mistaken for each other:
Both can be caused by a buildup of fatty
plaque (atherosclerosis) in the heart arteries (coronary arteries). These plaques cause a
decrease in flow to the heart muscle beyond the partial obstruction. In both, the pain can
be felt in the chest, arms, shoulders, and/or neck.
Both may be brought on by physical
exertion.
Both are most prevalent in men who are 50
and older and women who are past menopause.
The difference between angina and a heart attack is that a heart attack results in a damaged or injured heart muscle. Angina does not. Rather, anginal pain is a warning sign of a potential heart attack. The pain indicates that the heart muscle isn't getting enough blood.
It is hard, sometimes, to tell the difference between angina and a heart attack. A person may have to be given tests and be observed for a day in the hospital or emergency room to tell the difference.
A doctor can diagnose angina as stable or unstable based on your description of the painful episode, but he or she may need to confirm it with a stress test (a measurement of heart function taken while you exercise on a treadmill). Unstable angina, a symptom of coronary artery disease, needs immediate attention. This serious medical condition affects many Americans, some of whom may not know they have heart disease. Although unstable angina can precede a heart attack, prompt treatment can lower the risk of death or serious cardiac events.
Factors like high blood pressure, obesity, diabetes, high cholesterol, smoking, or a family history of atherosclerotic heart disease increase the odds of angina.
Treatment and Care
Seek emergency care for any chest pain which is suspicious for angina.
Contact your physician or a cardiologist, who should insist on close follow-up,
appropriate studies to diagnose your condition, and therapy to treat it. The keystones to
treatment are:
Medications such as:
Nitroglycerin (or other medication to temporarily dilate or widen the coronary arteries),
which
eases blood flow to the heart. Nitroglycerin
takes effect within a minute or two.
Medicine(s) to control high blood pressure
Low-dose daily aspirin
Daily physical exercise for endurance. This
should be prescribed just for you by an exercise physiologist to whom a cardiologist has
referred you. Exercise must be maintained below the onset of any discomfort. Exercise may
not be a part of treatment for some individuals.
Don't smoke. Nicotine in cigarettes
constricts the arteries and prevents proper blood flow.
Avoid large, heavy meals. Instead, eat
lighter meals throughout the day.
Rest after eating, or engage in some quiet
activity.
Minimize exposure to cold, windy weather.
Lower your cholesterol level, if high, by
eating a low-saturated-fat diet and/or taking lipid (fat)-lowering medication, if
necessary and prescribed.
Avoid sudden physical exertion, such as
running to catch a bus.
Avoid anger and frustration whenever
possible.
(See "Places to Get Information & Help" under Heart Disease/High Blood Pressure.)
HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine.
Date updated 02/01/99