Living With Angina

Angina, or angina pectrosis, is a type of chest pain that happens what your heart muscles don't get enough blood. Most people don't know the symptoms of angina, or that they're experiencing it. Angina can be easy to treat in some cases, but it can also indicate something more serious. One thing is for certain — angina can't be ignored.

Angina is the number one reason that people seek medical attention, and it's fairly common. Still, many don't really now what angina is and what you can do to treat it.

What exactly do you need to know about angina?

What is Angina?

From the Latin angere, which means "to choke," angina refers to pain and intense pressure in the chest.  The sensations are produced by inadequate blood flow to the muscles of the heart, leaving them starving for oxygen.  Angina is one of the most common complaints that spurs patients to seek medical care and can be triggered by a variety of circumstances, from a large meal to psychological stress. 

People who suffer from angina have an underlying issue with their heart, usually coronary heart disease (CHD).  Also known as coronary artery disease, CHD is the top killer in the United States.  The arteries that supply the heart with oxygen-rich blood are, over time, narrowed and constricted by a build-up of waxy plaque.

What Does an Attack Feel Like?

Most people describe angina pain as a feeling of intense pressure or of being squeezed.  It usually begins behind the sternum, the flat bone in the middle of the chest, but the sensation can spread to the arms and shoulders and to the neck and jaw.  

The pain is typically a "heavy" feeling, not a sharp or stabbing pain and it is neither worsened nor lessened by deep breathing or increased movement.

An attack of angina may also be accompanied by signs of intense anxiety such as labored breathing, nausea, and sweating.

Is All Angina the Same?

There are actually four types of angina: stable, unstable, variant, and microvascular.  The labels are applied based on the triggers for attacks and how they are able to be treated.

Stable angina is predictable and fairly easy to relieve.  It's usually caused by increased physical activity and the episodes are brief, under five minutes.  The pain is similar to indigestion in most cases and can be relieved by resting or taking medication.

Unstable angina, on the other hand, is very unpredictable.  It can happen during intense physical exertion or it can occur while a person is resting, even sleeping.  The episodes can last up to a half an hour or more and medication does little, if anything, to relieve the pain.  

As such, it is treated as a medical emergency and requires immediate attention in a hospital setting.

See Also: How Much Do You Know About Heart Attack?

Variant angina is severe and can also occur when a person is resting, but it does respond to medication.  Unlike the other types of angina that are brought on by increased demands on the heart, variant angina occurs when the coronary arteries spasm or contract.  This contraction usually occurs close to an area of hardened plaque and more often than not is found in the right coronary artery.

Microvascular angina can be more intense than all the other types of angina and is usually accompanied by systemic symptoms such as trouble sleeping and low energy.

How Do You Know If It's Angina Or A Heart Attack?

Any type of chest pain should be evaluated by a doctor to determine the cause.  Stable angina can be managed fairly simply, but unstable angina requires further investigation and intervention.  There are several diagnostic tests that are ordered to determine whether serious attention is necessary.

Diagnostic Tests

The simplest is an electrocardiogram (EKG).  It's a painless test that shows the electrical activity of the heart, as well as how many times it beats per minute and whether it is beating with a regular or irregular rhythm.  Depending on the patterns displayed, doctors can identify signs of heart damage and malfunction.

Some people with angina have normal EKG readings, so the next diagnostic tool is a stress test.  Through physical exercise or, for those who are unable to exercise, a medication that increases the heart rate, stress is placed on the heart to see how it performs.  Images can be made of the heart during the stress test to see how well blood is supplied to heart and to see how well the heart supplies blood to the body.

A more invasive test is coronary angiography.  During this procedure, a catheter inserted into a blood vessel and maneuvered up to the coronary arteries.  Once placed, a special dye is released into the bloodstream.  As the dye spreads through the coronary arteries, special x-rays are taken.  The dye reacts to the x-rays and presents a vivid picture of the blood flow, permitting doctors a clear view of any obstructions in the arteries.

Another method of visualizing the arteries is a CT scan, or computed tomography angiography.  Like angiography, it uses dye and a special scanner to graph blood flow, but the dye is inserted through an IV line instead of a catheter.  The scanner itself also moves around the entire body, allowing a 3D picture of the heart to be created.

How is Angina Treated?

While unstable angina requires complex intervention, stable angina can be treated and managed fairly simply.  For the immediate pain of an attack, nitroglycerin is usually prescribed.  These tiny pills in their dark glass bottles are carried constantly by people who suffer angina.  The pills are placed under the tongue and dissolve quickly, rapidly absorbing into the bloodstream and relaxing constricted blood vessels. 

See Also: What Are The Real Symptoms Of A Heart Attack?

Like so many other conditions, smoking is a key contributor to the disease.  Quitting smoking can go a long way in reducing the risk for CHD and in relieving constricted blood vessels.  People should also eat a healthy and varied diet.  There is plenty of back and forth on what type of diet is best for a healthy heart.  Some say low-fat; others say it's not fat that's the problem, but the highly-processed fats that are prevalent in Western diets that are the issue.  Regardless, moderation and variety are key.  Finally, exercise is necessary.  People with angina should consult with their doctors to determine an appropriate regimen of physical activity that will help with weight loss and good cardiovascular health.