51. Angina: What It Tells You About Your Heart

The symptoms of angina are:

  1. Squeezing pressure or heaviness or mild ache in the chest.

  2. A feeling that you’re choking or shortness of breath.

  3. A feeling of aching in the chest muscles, jaw, one or both arms, neck and/or back.

  4. A sensation of heaviness, tingling, or numbness (most commonly in the left arm).

  5. A feeling of gas in the upper abdomen and lower chest.

Many people who experience angina for the first time fear they’re having a heart attack. Here’s why angina and heart attack are mistaken for each other.

  1. Both can be caused by a buildup of fatty plaque (atherosclerosis) in the heart arteries, blocking or slowing delivery of blood to the heart.

  2. In both, the pain can be felt in the chest, arms, shoulders, and/or neck.

  3. Both may be brought on by extreme physical exertion.

  4. Both are most prevalent in men who are 50 and older and women who are past menopause.

But there is a key difference. A heart attack leaves damaged or injured heart muscle in its wake; angina does not. Rather, anginal pain is a warning sign of a potential heart attack. The discomfort indicates that the heart isn’t getting enough blood and oxygen needed for a given level of work.

A doctor can diagnose angina as stable or unstable based on: your description of the painful episode; tests such as a stress test (a measurement of heart function taken while you exercise on a treadmill); and observation for a day in the hospital. Unstable angina, a symptom of coronary artery disease, requires immediate attention.

Exertion or physical work is associated with an angina attack. So is walking rapidly uphill, emotional shock, anger or excitement, and hurrying up the stairs.

High blood pressure, obesity, diabetes, high cholesterol, smoking, or a family history of atherosclerotic heart disease increases the odds of angina. (See Tip 57 for a description of heart attack signs.) If you’ve experienced angina, the following steps can head off further attacks.

  1. Consult your doctor or cardiologist. He or she will probably prescribe nitroglycerin or another medication to temporarily dilate, or widen, the coronary arteries. Nitroglycerin takes effect within a minute or two. A low-dose daily aspirin may also be prescribed.

  2. Don’t smoke. Nicotine in cigarettes constricts the arteries and prevents proper blood flow.

  3. Avoid large, heavy meals; eat lighter meals throughout the day.

  4. After eating, rest or engage in some quiet activity.

  5. Minimize exposure to cold, windy weather.

  6. Lower your LDL (bad) cholesterol level, if high. Follow a low-saturated fat diet. Take lipid-lowering medicines if prescribed.

  7. Avoid sudden physical exertion, such as running to catch a bus.

Chapter 2
  1. Major Medical Conditions:

  2. Prevention, Detection, and Treatment