ANGINA PECTORIS

Angina pectoris is a symptom relating to heart muscle discomfort because of severe reduction of blood supply to that heart muscle. It is related to oxygen depravation to that muscle because of obstruction in the artery to the muscle, ie. the coronary artery, because of fixed obstruction relating to fatty plaque in the coronary artery. Heart rhythms such as too fast heart rate or too slow may also interfere to blood supply to the heart muscle causing angina. Spasm of the coronary arteries may provoke angina. Reduction of oxygen in the blood stream from other causes may also provoke angina.

The sensation that is provoked is often described as a pressure sensation or tightness in the middle of the chest. It may be described as a fist in the chest, an elephant standing on one's chest, a rope around the chest or a squeezing sensation. Indigestion may often be misinterpreted and may well be angina.

The discomfort or pain is often precipitated by stressful situations such as exercising, carrying heavy objects like suitcases, laundry, garbage or groceries. It may be precipitated by vacuuming, making beds, shoveling snow, sexual intercourse, isometric activity such as painting or carpentry. The symptoms may be felt as indigestion in the middle of the chest with the same features precipitating the symptom. The discomfort may be felt in other areas in that it may radiate up into the jaw, either the right or left or both, to the shoulder and down the inside of the arm, either the right or the left. At times the discomfort may be felt in the middle of the back or by the shoulder bone. It has been seen in the jaw and seen by dentists and it has been seen in the wrist as arthritis.

Women may present with different symptoms such as fatigue, shortness of breath, burning in the chest, throat pain, indigestion or classic central chest pressure.

The symptom is often accompanied by marked shortness of breath which may make the individual wish to sit up if he is in a lying position. Often the patient will develop marked sweating which is described as a cold sweat which is either full body or often forehead sweating. Nausea is a common component of certain types of angina pectoris. A feeling of impending doom is commonly observed. Sometimes palpitations are noted when persons are experiencing angina pectoris. Feeling weak and lightheaded may accompany the sensation described.

The symptom of angina pectoris is always serious and means the blood supply to a portion of the heart muscle is compromised. If one is doing some activity, then one should stop that activity and sit down and contact the doctor. The addition of medicine Page 3 Angina Pectoris Such as Nitroglycerin either under one's tongue or as a spray inside the mouth should be done. The use of Nitroglycerin effectively changes heart size which reduces the oxygen needed by the heart muscle. Relief of angina is seen in 1-2 minutes. with Nitroglycerin under the tongue or with Nitroglycerin spray. Repetition of the use of Nitroglycerin should be used every two minutes for two to three times if necessary. If this does not effectively relieve the discomfort then obtaining medical care in the emergency department or by calling 911 would be recommended.

Development of similar symptoms at rest is more ominous, such as awakening at night with the discomfort. This is called nocturnal angina and your doctor and/or cardiologist should be advised of your symptoms. Rest angina and nocturnal angina should prompt early advice from your physician or cardiologist.

If you have had a diagnosis of angina pectoris made and your angina has changed in that it requires less of an activity to produce it then again one should inform your physician or cardiologist of it's change in nature. Angina pectoris means that heart muscle is not getting adequate blood supply. The result of this is loss of heart muscle and having a heart attack which has serious consequences. Lost heart muscle can never be replaced once a heart attack has occurred. Attention to this symptom complex is paramount in that many alternatives are now available to the patient with angina pectoris. Management of this symptom complex is best determined by your physician or cardiologist. Medications such as Nitroglycerin agents, beta blockers, or calcium channel blockers may be used. Treatment such as coronary angioplasty, coronary stenting or coronary bypass surgery are some of the avenues which your physician and/or cardiologist may recommend.

The management of angina pectoris is important to prevent heart attacks. Unfortunately, about 10% of heart attacks go unnoticed and are picked up on subsequent visits to the physician. It is suggested that individuals over the age of 40 see their physician at regular intervals and have exercise testing performed. In the United States approximately 300,000 people will die in a given year with their first episode of angina pectoris going on to a full heart attack. Only individuals who see their physicians on a regular interval are going to be able to reduce this large number of deaths. Those individuals at increased risk, ie. high blood pressure, diabetes, smokers, strong family history of heart trouble can only be recognized better if they seek medical attention and are properly evaluated.

The statements provided in this report are for information only.  This is not intended to be medical advice.  Each individual may react differently depending on a variety of circumstances.  It is therefore imperative you consult your physician prior to following any of the contents of this report.  CardioDoc.net and CardioDoc.org disclaim any and all liability.