What is
angina?
Angina (say: "ann-gye-na") is a squeezing pain
or a pressing feeling in the chest. It is most often caused by
blockages in the arteries that supply blood to your heart.
This is called coronary artery disease, or heart disease. The
symptoms you describe to your doctor will help your doctor
decide if you need to be tested for heart disease. Your doctor
will also check if you have any conditions that can increase
your chance of heart disease. These conditions
include:
- high
blood pressure
- diabetes
- smoking
- high
cholesterol level
- menopause in women
- family
members who have had heart disease at a young age
If you have heart disease, your angina can be
treated by treating the heart disease.
How do I know if
my pain is angina?
Angina can bother you when you are doing
activities like walking, climbing stairs, exercising or
cleaning. The pain of angina may make you sweat or make it
hard to catch your breath. You may feel pain in your arm or
neck as well as in your chest. If the pain is mild, it may go
away after a minute or so of rest. If the pain is more severe,
medicine may be needed. A medicine called nitroglycerin often
is used to treat severe angina.
Some people have angina
that comes on with a certain level of activity and goes away
easily. They may have this kind of angina for a long time.
This is called stable angina.
When the pattern of
angina changes a lot, it's called unstable angina. This is a
sign of danger. Angina in someone who hasn't had it before,
more episodes of angina with less exertion, and angina that
comes on while you're resting are also danger
signs.
Unstable angina may be the first sign of a heart
attack. If you get angina, you should call your doctor or go
to the nearest emergency room right away. Another sign of
danger is chest pain that doesn't go away with rest or after
taking medicine. If you have chest pain that doesn't go away,
go to the emergency room right away.
What tests might
my doctor do?
An electrocardiogram, sometimes called an EKG
or ECG, is a simple test that can show if your heart or
arteries have been damaged. If the EKG is done while you are
having angina, it can also show if your pain is caused by a
problem with your heart.
The next step after an EKG may
be a stress test. Often, this test is done while you walk on a
treadmill. Your doctor will look at your stress test to see if
it's abnormal when you exercise. Your doctor may also have
x-rays of the heart taken before and after you exercise. These
pictures can show if an area of the heart is not getting
enough blood during exercise. If this is so, it may mean that
the arteries supplying blood to your heart are
blocked.
Another important test is cardiac
catheterization. In this test, a very long and very thin tube
is inserted through an artery in the arm or leg and then
guided into the heart. Dye is injected into the arteries
around the heart. X-rays are taken. The x-rays will show if
any of the arteries that supply the heart are
blocked.
How can I prevent
heart disease?
The best ways to prevent heart disease are to
control high blood pressure, diabetes or a high cholesterol
level and, if you smoke, to stop smoking. Maintaining a
healthy diet, a healthy weight and a regular exercise program
can help you avoid heart disease.
If you already have
heart disease, the steps listed above are important to help
keep the problem from getting worse.
How is heart
disease treated?
Most people with heart disease take medicine to
control their condition. Medicines called beta-blockers,
calcium channel blockers and nitrates can help relieve angina.
Taking low-dose aspirin every day can reduce the chance of a
second heart attack in people who have already had one. Your
doctor will tell you whether you should take any of these
medicines.
What about
surgery?
Angioplasty is a surgical treatment for heart
disease. Angioplasty uses a tiny balloon to push open blocked
arteries around the heart. The balloon is inserted in an
artery in the arm or leg. A stent (a small metal rod) might be
put into the artery where the blockage was to hold the artery
open.
Another surgical treatment for heart disease is
bypass surgery. Pieces of veins or arteries are taken from the
legs and sewn into the arteries of the heart to bring blood
past a blockage and increase the blood flow to the heart.
Bypass surgery is usually done when angioplasty isn't possible
or when your doctor feels it's a better choice for
you.
Are there side
effects and other risks to the treatment of heart disease?
All medicines may have side effects. Aspirin
may cause upset stomach. Nitrates may cause a flush (redness
in the face) and headaches. Beta-blockers cause tiredness and
sexual problems in some patients. Calcium channel blockers may
cause constipation and leg swelling. Fortunately, most
patients don't have side effects from these medicines. If you
have side effects after taking a medicine, tell your
doctor.
Surgery, such as angioplasty or bypass surgery,
also has potential risks. The major risks can include heart
attack, stroke or even death. These are rare and most patients
do well. After angioplasty, you can probably expect to return
to your previous activity level, or even a better activity
level, within a few days. It takes longer (a few weeks or
months) to recover from bypass
surgery.
How do I know
which treatment is right for me?
Your doctor will help you decide which
treatment is best for you.
Does heart disease
ever go away?
Heart disease doesn't go away, but by working
with your doctor, you can live longer and feel
better.
