ANGINA

What Is Angina?
If you feel pressure or a squeezing in your chest, it may be angina. It
can feel like a heart attack, but often it's a warning sign.
The chest pain happens because there isn't enough blood flowing to
part of your heart. It's a symptom of heart disease, and it's occurs
when something blocks the arteries or there's a decreased blood flow
in the arteries that bring oxygen-rich blood to your heart.
Angina usually goes away quickly. Still, it can be a symptom of a life-
threatening heart problem. Call your doctor if you have it. It's
important to find out what's going on and to talk about what you can
do to avoid a heart attack.
There's a lot you can do to stop it from happening. Usually, medicine
along with lifestyle changes can control it. If it's more severe, you
may need surgery, too. Or you may need what’s called a stent, a tiny
tube that props open arteries.
There are different types of angina:
Stable angina is the most common. Physical activity or stress can
trigger it. It usually lasts a few minutes, and it goes away when you
rest. It isn't a heart attack, but it can be a sign that you're more likely
to have one. Tell your doctor if this happens to you.
Unstable angina. You can have this while you're at rest or not very
active. The pain can be strong and long-lasting, and come back again
and again. It can be a signal that you're about to have a heart attack, so
see a doctor right away.
Prinzmetal's angina (also called variant angina) is rare. It might
happen at night while you're sleeping or resting. The heart arteries
suddenly tighten or narrow. It can cause a lot of pain, and you should
get it treated.
Symptoms of Angina
Chest pain is the symptom, but it affects people differently. You may
feel:
 Aching
 Burning
 Discomfort
 Feeling of fullness in the chest
 Heaviness
 Pressure
 Squeezing

You’re likely to have pain behind your breastbone, but it can spread to
your shoulders, arms, neck, throat, jaw, or back.
It's possible to mistake an aching or burning for heartburn or gas.
Men often feel pain in their chest, neck, and shoulders. Women may
feel discomfort in their belly, neck, jaw, throat, or back. You may also
have shortness of breath, sweating, or dizziness.
One study found that women were more likely to use the words
"pressing" or "crushing" to describe the feeling.
Stable angina often gets better with rest. Unstable angina may not,
and it could get worse.
Possible Causes Of Angina
Angina is usually due to heart disease. A fatty substance called plaque
builds up in your arteries, blocking blood flow to the heart muscle.
This forces your heart to work with less oxygen. That causes pain.
You may also have blood clots in the arteries of your heart, which can
cause heart attacks.
Other, less common causes of chest pain include:
 A blockage in a major artery of the lungs (pulmonary embolism)
 An enlarged or thickened heart (hypertrophic cardiomyopathy)
 Narrowing of a valve in the main part of the heart (aortic
stenosis)
 Swelling of the sac around the heart (pericarditis)
  Tearing in the wall of the aorta, the largest artery in your body
(aortic dissection)

Questions for Your Doctor

 Do I need any more tests?
 What type of angina do I have?
 Do I have heart damage?
 What treatment do you recommend?
 How will it make me feel?
 What can I do to try to prevent a heart attack?
 Are there activities I shouldn't do?
 Will changing my diet help?

Angina Treatment
It depends on how much damage there is to your heart. For people
with mild angina, medicine and lifestyle changes can often
help blood flow better and control symptoms.
Your doctor might prescribe medicines to:
 Widen blood vessels, letting more blood flow to the heart
 Slow the heart down so it doesn't have to work as hard
 Relax blood vessels to let more blood flow to the heart
 Prevent blood clots

If meds aren't enough, you may need to have blocked arteries opened
with a medical procedure or surgery. This could be:
Angioplasty /stenting: The doctor threads a tiny tube, with a balloon
inside, through a blood vessel and up to your heart. Then, he inflates
the balloon inside the narrowed artery to widen it and restore blood
flow. A small tube called a stent may be left inside the artery to help
keep it open. The stent is usually permanent and made of metal. It can
also be made of a material that the body absorbs over time. Some
stents have medicine that helps keep the artery from getting blocked
again.
The procedure usually takes less than 2 hours. You’ll probably stay
overnight at the hospital.
Coronary artery bypass grafting (CABG), or bypass surgery. The
surgeon takes healthy arteries or veins from another part of your body
and uses them to go around the blocked or narrowed blood vessels.
You can expect to stay in the hospital about a week after you have
this. You'll be in the intensive care unit for a day or two while nurses
and doctors keep a close eye on your heart rate, blood pressure, and
oxygen levels. You'll then move to a regular room to recover.
Taking Care of Yourself
You can still lead an active life, but it's important that you listen to
your body. If you feel pain, stop what you’re doing and rest. Know
what triggers your angina, like stress or intense exercise. Try to avoid
things that tend to set it off. For example, if large meals cause
problems, eat smaller ones and eat more often. It's important to talk to
your doctor to have your medications changed or to be evaluated for
further testing or procedures if you are feeling pain. Because angina
can be an ominous sign, it is important to get fully evaluated.
These lifestyle changes may help protect your heart:
Stop smoking . It can damage your blood vessels and increase
your heart disease risk.
Eat a heart-healthy diet to lower your blood pressure and cholesterol
levels. When those are out of normal range, your chance for heart
diseasecan rise. Eat mainly fruits and vegetables, whole grains, fish,
lean meat, and fat-free or low-fat dairy. Limit salt, fat, and sugar.
Also:
 Use stress-relieving measures like meditation, deep breathing,
or yogato relax.
 Exercise most days of the week.
 See your doctor regularly.

If you have chest pain that is new or unusual for you, and you think
you may be having a heart attack, call 911 right away. Don't wait.
Quick treatment is very important. It can protect you from more
damage.
What to Expect
Angina raises your risk of having a heart attack. But it’s treatable.
Consider it a warning sign and make smart choices.
Talk with others who have it. That may help you learn how to feel
better.
Your family, too, may need support to help them understand your
angina. They'll want to know what they can do to help.