Changing Lifestyles, Changing Habits: When You have Angina
Angina is almost always a symptom of coronary heart
disease. Its most common characteristic is pain in the chest. The pain occurs
when there’s either a sharp decrease in blood supply to the heart, an increased
demand for blood to the heart (which can occur during exercise, for example) or
a combination of both factors.
According to the American Heart Association, more than 6
million people in the US currently have angina, and there are an estimated
350,000 new cases of angina diagnosed each year.
People who have angina describe it in various ways:
pressure, heaviness, constriction, squeezing or tightness in the chest. The
symptoms can range from mild to severe and can include
- Shortness of breath
- Nausea or vomiting
- Sweating or cold or clammy skin
- Light-headedness or extreme weakness
Sometimes angina is not just in the chest but can be felt
in the neck, jaw, upper back, shoulders, arms, elbows or upper abdomen.
What’s the cause?
The heart needs oxygen to function. Oxygen travels to the
heart in the blood. When the passages through the arteries that carry blood to
the heart muscles become narrow, blood does not travel to the heart as well as
it should and angina pain may occur. This narrowing is called atherosclerosis.
It’s generally caused by the buildup of cholesterol on the inside walls of the
arteries. Recent studies indicate that inflammation in the lining of the
arteries and the development of clots are factors that contribute to angina.
Triggers for angina pain include
- Increased physical activity (the most common trigger)
- Extreme cold or heat
- Heavy meals
- Emotional stress
- Consumption of alcohol
In other words, angina pain is caused by activities that
make your heart work hard. Having an episode of angina pain does not mean that a
heart attack will definitely occur. If the heart muscle is deprived of oxygen
long enough, the muscle will die, causing a heart attack. However, if the
factors that caused the angina pain (activity, stress, etc.) are stopped, the
angina pain can stop. In this situation, the heart muscle may not die, and a
heart attack is prevented. Also, if angina is treated by medical professionals,
a heart attack may be prevented.
Following your angina treatment plan
Your particular treatment plan for angina is based on the
coronary artery disease risk factors you have. The most important thing you can
do to prevent and treat coronary artery disease itself is to reduce your risk
factors. The factors that you can control or manage to the best of your ability
- High blood pressure (hypertension)
- High levels of blood cholesterol
- Excess weight
- Inactive or sedentary lifestyle
The following are risk factors that cannot be changed:
- Family history of atherosclerosis
- Gender. Prior to menopause, women are less likely than
men to have coronary artery disease. Within a few years after menopause, women
are as likely and, in some situations, more likely than men, to be at risk for
angina and heart attack.
Sticking with the treatment plan from your doctor is the
best way to keep coronary artery disease from getting any worse. It has been
shown in various studies that making necessary lifestyle changes can even
reverse some of the damage caused by coronary artery disease.
Factors that decrease your risk of heart
Having angina gives you a strong wake-up call that you need
to make some healthy choices that can decrease your risk of heart attack.
If you’ve had angina for any period of time, you’ve
probably found some changes have been easier to make than others. The following
are some of the challenges in improving your atherosclerosis risk factors.
Quitting smoking is extremely hard for most people.
If you smoke now, and have been having a hard time quitting, talk to your doctor
or other members of your healthcare team for advice about smoking cessation
medications and programs.
on a regular basis can also be
difficult. If you have trouble remembering to take your medicine, try to set up
a routine for taking it at the same time every day. Pair it with mealtimes,
brushing your teeth, etc., so that these activities will help you remember. If
you experience side effects from medication, be sure to talk with your doctor
about them. Most important of all, don’t ever stop medication on your own. If
for some reason you think you need to stop a medication, talk it over with your
Changing the way you eat is a big part of your
treatment plan. You may already know that eating high fiber, lower fat foods,
including plenty of fruits and vegetables, is the best way to go. But are you
clear about the best kinds of fat to eat? Do you know how to avoid saturated and
trans fat, and how to include mostly monounsaturated fats in your diet? If your
cholesterol, weight or blood sugars are above the recommended limits, talk with
your doctor about ways to bring these risk factors under control.
The American Heart Association recommends a diet that gets
no more than 30 percent of its calories from fat and only 10 percent from
saturated fat. Talk with your doctor or other members of your healthcare team
about these recommendations, and about how you can achieve and maintain this
type of diet.
Reading food package labels is an excellent way to see
which foods to eat and how much of them to eat. Labels are required to tell you
what kind of fat, how many calories and how much fiber the product contains.
Other nutritional information about salt, protein and carbohydrate content is
also provided on the labels.
Exercise is important for people with angina, but it
should be done only with the advice of your doctor and other members of your
healthcare team. Since strenuous exercise can trigger an angina attack, you’ll
want to start an exercise program gradually and build up as time goes on. Work
closely with your doctor to develop a safe program you’ll stick with, one that
fits your abilities and schedules.
is important, but it’s often the last thing a lot of people want to focus on.
Sitting quietly for 10 or 20 minutes per day (longer if you choose) and
concentrating on your breath as it goes in and out is a simple way to relax your
mind and body. Other ways include doing yoga or other stretching exercises, t’ai
chi, qigong or biofeedback. Talk to your healthcare team members if you’d like
to pursue some of these or any other activities that can help you reduce stress.
Remember, if your angina pain becomes more severe than
usual, lasts longer than usual or doesn’t respond to medication as usual,
emergency medical treatment IS necessary.
Patient education information from The National
Institutes of Health, the American Heart Association and the National Heart,
Lung and Blood Institute.