Angina - FAQs

What is Angina?

Angina Pectoris ("angina") is a recurring pain or discomfort in the chest that happens when some part of the heart does not receive enough blood. It is a common symptom of coronary heart disease, which occurs when vessels that carry blood to the heart become narrowed and blocked due to atherosclerosis Angina feels like a pressing or squeezing pain, usually in the chest under the breast bone, but sometimes in the shoulders, arms, neck, jaws, or back. Angina is usually triggered by exertion. It is usually relieved within a few minutes by resting or by taking prescribed angina medicine.

What Triggers Angina?

Episodes of angina occur when the heart's need for oxygen increases beyond the oxygen available from the blood nourishing the heart. Physical exertion is the most common trigger for angina. Other triggers can be emotional stress, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.

Does Angina Mean a Heart Attack is about to Happen?

An episode of angina is not a heart attack. Angina pain means that some of the heart muscle in not getting enough blood temporarily--for example, during exercise, when the heart has to work harder. The pain does NOT mean that the heart muscle is suffering irreversible, permanent damage. Episodes of angina seldom cause permanent damage to heart muscle.

In contrast, a heart attack occurs when the blood flow to a part of the heart is suddenly and permanently cut off. This causes permanent damage to the heart muscle. Typically, the chest pain is more severe, lasts longer, and does not go away with rest or with medicine that was previously effective. However, the symptoms of a heart attack are varied and may be considerably milder.

When someone has a repeating but stable pattern of angina, an episode of angina does not mean that a heart attack is about to happen. In contrast, when the pattern of angina changes--if episodes become more frequent, last longer, or occur without exercise--the risk of heart attack in subsequent days or weeks is much higher.

What Can I Do to prevent angina?

The underlying coronary artery disease that causes angina should be attacked by controlling existing risk factors. These include cigarette smoking, high blood pressure, high blood cholesterol levels, and excess weight. If the doctor has prescribed a drug to lower blood pressure, it should be taken as directed. Taking these steps reduces the likelihood that coronary artery disease will lead to a heart attack.

Stop Smoking:

People who smoke a pack of cigarettes a day have more than twice the risk of heart attack as those who have never smoked. In fact women who smoke are two to six times more likely to suffer a heart attack than non smoking woman. Although low-tar and low-nicotine cigarettes may reduce the lung cancer risk somewhat, they do not lessen the risks of heart diseases or other smoking related diseases. The only safe and healthful course is not to smoke at all. There is nothing easy about giving up cigarettes. If you can't quit the first time, keep trying.

Eat Properly:

Sometimes angina can occur after heavy meals. These attacks can be avoided by eating less, and watching the intake of rich foods. The steps that control coronary heart disease could be: losing excess weight, choosing foods low in salt and sodium, monitoring cholesterol, and limiting alcohol intake.

Being overweight increases your risk of further heart problems, even if there are no other risk factors. The more overweight you are, the higher your level of risk.

Salt and sodium both affect blood pressure, and must be watched. You should consume no more than about 1 teaspoon) of salt a day. This includes ALL salt--that in processed foods or added in cooking or at the table If you drink alcohol, you should have no more than one drink a day. Extra cholesterol and fat in the diet causes build up inside blood vessels leading to coronary heart disease. And, once you have coronary heart disease, elevated blood cholesterol increases your risk of a future heart attack

Stay Active:

Exercise is still important. Exercise can increase the level of pain-free activity, relieve stress, improve the heart's blood supply, and help control weight.

It is important to work with your doctor to develop an appropriate exercise plan. Many doctors tell angina patients to gradually build up their fitness level--for example, start with a 5-minute walk and increase over weeks or months to 30 minutes or 1 hour. The idea is to gradually increase stamina by working at a steady pace, but avoiding sudden bursts of effort.

If you've been inactive for awhile, start slow, and look for opportunities to become more physically active throughout your day:

  • Use the stairs--up and down--instead of the elevator. Start with one flight of stairs and gradually build up to more.
  • Park a few blocks from the office or store and walk the rest of the way. Or if you ride on public transportation, get off a stop or two early and walk a few blocks.
  • Instead of eating that extra snack, take a brisk stroll around the neighbourhood.
  • Mow your own lawn.
Take Your Medications:

Angina is often controlled by drugs. The most commonly prescribed medicine for angina is Nitro-glycerine, which relieves pain by widening blood vessels. This allows more blood to flow to the heart muscle and also decreases the work load of the heart. Nitro-glycerine is taken when discomfort occurs or is expected. Doctors frequently prescribe other medications like Beta blockers, Calcium channel blockers to be taken regularly, that reduce the heart's workload.

In case medication fails to control angina, your doctor may recommend surgery or angioplasty if drugs fail to ease angina or if the risk of heart attack is high