ANGINA PECTORIS

BASIC INFORMATION

DESCRIPTION

Angina pectoris is chest pain or discomfort due to a

decrease in the blood (and oxygen) supply to the heart

muscle (myocardium). Angina may be stable (symptoms

are predictable), or unstable (symptoms are unexpected

and usually occur while at rest). Angina affects

adults of both sexes.

FREQUENT SIGNS & SYMPTOMS

• Tightness, squeezing, pressure, fullness, ache, or pain

in the center of the chest. Pain may feel like indigestion.

• Discomfort or pain may also occur in the neck, jaw,

shoulder, arm, or back.

• Symptoms may occur with exercise, strong emotions,

heavy meals, or with temperature extremes. Some persons

have angina while resting.

CAUSES

Angina occurs when the heart needs more blood and

oxygen and is unable to get what it requires. This is

called ischemia. Coronary artery disease (CAD) is the

main cause. In CAD, one or more of the arteries supplying

blood to the heart is narrowed or blocked. Angina

also occurs if the blood does not carry enough oxygen.

RISK INCREASES WITH

• High blood pressure, atherosclerosis, diabetes, high

cholesterol, personal or family history of heart disease.

• Obesity, inactivity, smoking, or excess alcohol use.

•Metabolic syndrome (a group of risk factors).

PREVENTIVE MEASURES

Prevention involves preventing the coronary artery disease

that leads to angina. Don’t smoke. Get treatment for

chronic disorders such as diabetes, high blood pressure,

and obesity. Exercise regularly. Reduce high cholesterol

with diet or drugs.

EXPECTED OUTCOMES

Most angina symptoms can be relieved with lifestyle

changes and/or drug therapy. Other treatment may be

needed to correct underlying diseases.

POSSIBLE COMPLICATIONS

Heart attack, unstable angina, and/or death.

DIAGNOSIS & TREATMENT

GENERAL MEASURES

• Your health care provider will do a physical exam and

ask questions about your symptoms. A number of medical

tests will be done to assess heart function and to

diagnose any underlying disorder.

• Treatment usually involves drug therapy to relieve

angina symptoms, slow the progress of heart disease,

and prevent complications.

• If drugs cannot control the angina, there are other

treatment options. They include balloon angioplasty to

open blocked coronary arteries, stenting (a tiny metal

tube or coil is placed in the artery to keep it open), or

surgery to bypass severely blocked coronary arteries.

• Don’t smoke. Find a way to quit that works for you.

• Avoid angina triggers, if possible, that increase the

heart’s workload, such as anger, temperature extremes,

high altitude (except in commercial airline flights), or

sudden bursts of activity.

• To learn more: American Heart Association, local

branch listed in telephone directory, or call (800) 242-

8721; website: www.americanheart.org.

MEDICATIONS

•Nitroglycerin relieves acute symptoms of angina or it

can be used before activities. It does not affect symptoms

of other disorders. It can work within seconds to

relieve pain. Keep it with you for immediate use.

•Drugs to prevent blood clots will be given after procedures

such as balloon angioplasty or stenting.

• Other drugs for coronary disease, such as aspirin,

beta-blockers, cholesterol-lowering drugs, ACE

inhibitors, or calcium channel blockers may be prescribed.

If they are, it is important to follow the prescribed

drug regimen.

ACTIVITY

• Learn to adjust activities to lessen angina attacks.

• Don’t use angina as an excuse not to exercise. A regular

moderate exercise routine (determined by your

health care provider) can help to control symptoms.

DIET

• Low-fat, low-cholesterol diet is often recommended.

•Weight loss diet if overweight.

NOTIFY OUR OFFICE IF

• You or a family member has symptoms of angina

pectoris.

• Angina pain lasts longer than 10 to 15 minutes,

despite rest and treatment with nitroglycerin.

• You wake from sleep with chest pain that does not

go away with 1 nitroglycerin tablet. If these attacks continue,

report them, even if nitroglycerin relieves them.