Have you ever heard of Angina? Or heard someone complaining of chest pain? Or even suffer from chest pain yourself?
Even if you haven’t, you might know someone who suffers from it. Angina is more common than you might think but it is not a reason for you to be too alarmed or scared.
Angina or angina pectoris is a type of chest pain caused by reduced blood flow to the heart and it is a symptom of coronary artery disease.
This type of pain can often manifest as squeezing, pressure, heaviness, tightness, or pain in your chest. Some people with angina symptoms say angina feels like a vise squeezing their chest or a heavyweight lying on their chest. This type of chest pain needs to be checked and followed by a doctor and it may require treatment.
Angina is relatively common. However, it can be often mistaken for other types of chest pain, such as the discomfort of indigestion. Therefore, it’s important to seek medical attention when you find yourself feeling unexplained chest pain.
Types of angina:
There are different types of angina, depending on its causes and symptoms:
Stable angina is the most common and can be triggered by physical activity or stress. It doesn’t last long, usually just a few minutes, and it stops after you rest. You should check with your doctor, as it can be a sign of a future heart attack.
Unstable angina manifests when you are resting or not very active. It’s usually strong and long-lasting, and it may come back again and again. You should be aware of this type as it may indicate that you are about to have a heart attack, so see a doctor right away.
Microvascular angina, which is more common in women, concerns chest pain but no coronary artery blockage and it usually lasts more than 10 minutes.
Prinzmetal's angina (variant angina) is a rare type that might happen at night while you're sleeping or resting if your heart arteries suddenly tighten or narrow. The pain is very intense and strong, and it requires treatment.
SymptomsIf you have Angina you might feel any of the following sensations in your chest:
- burning or aching
Other uncommon symptoms include:
There is no exact duration of the symptoms as they all depend on the type of angina.
Be aware of noticing any severe or persistent chest pain and if you do, seek emergency care.
Symptoms in femalesAngina may result from CHD (Coronary Heart Disease) or MVD (Coronary Microvascular Disease). According to the American Heart Association (AHA), since females are affected by MVD more than males they may experience different symptoms accompanying angina, such as:
Considering that cardiovascular disease is the main cause of death among females in the United States (almost half of these are African American females), the AHA strongly encourages females who suffer from these symptoms to seek help.
When to see a doctorHaving chest pain is not uncommon. However, if it surpasses a few minutes and you don’t feel like it’s going away after some rest or your angina medications, it may be a sign you’re having a heart attack. So, you should call 911 or seek emergency help.
If this is the first time you experience chest pain or discomfort, it is best to check with your doctor about what may be causing it so that you can get treatment. Also, if you've been diagnosed with stable angina and you feel like it’s getting worse, seek medical attention immediately, as it may be evolving to something more serious.
Risk factorsAny of the following are risk factors that can increase your risk of coronary artery disease and angina:
- Tobacco use, damages the interior walls of arteries and allows deposits of cholesterol to collect and block blood from flowing.
- Diabetes, by speeding up atherosclerosis and increasing your cholesterol levels, becomes another risk factor.
- High blood pressure, over time, damages arteries by accelerating the hardening of the arteries.
- High blood cholesterol, increases your risk of angina and heart attacks. A high level of triglycerides, a type of blood fat related to your diet, also is unhealthy.
- Family history of heart disease. If you have coronary heart disease or heart attacks in your family history, you're at a greater risk of developing angina.
- Older age. Men older than 45 and women older than 55 have a greater risk than younger adults.
- Lack of exercise, contributes to high cholesterol, high blood pressure, type 2 diabetes, and obesity which are all risk factors.
- Obesity, brings high blood cholesterol levels, high blood pressure, and diabetes, increasing your risk of angina and heart disease.
- Stress, when it’s too much, as well as anger, can also raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina.
Angina can make doing some normal activities, such as walking, more difficult and uncomfortable. However, the most dangerous complication that it can cause is a heart attack.
Some of the signs and symptoms of a heart attack are:
- Pressure, fullness, or a squeezing pain in the center of your chest that lasts for more than a few minutes
- Pain extending beyond your chest to your shoulder, arm, back, or even to your teeth and jaw
- Increasing episodes of chest pain
- Nausea and vomiting
- Prolonged pain in the upper abdomen
- Shortness of breath
- An impending sense of doom
TreatmentsThere are numerous treatments you can follow to reduce pain, prevent symptoms, and lower the risk of a heart attack. If you ask your doctor, he will most likely recommend you to take some medication, improve your lifestyle choices, a surgical procedure, or a combination of these.
Better lifestyle choices:
- cessation of the use of tobacco
- managing weight
- regularly checking cholesterol levels
- resting when necessary
- regular physical activity
- learning how to handle or avoid stress
- having a diet rich in fruits, vegetables, whole grains, low-fat or no-fat dairy products, and lean sources of protein
MedicationsConcerning medication, nitrates (nitroglycerin, for example) are often prescribed for angina because they prevent it or reduce its intensity by relaxing and widening the blood vessels.
Other drug options include:
- calcium channel blockers
- angiotensin-converting enzyme inhibitors
- oral antiplatelet medications
- statins, which are cholesterol-lowering medicines
Medication aiming to manage high blood pressure helps angina as well, as these treatments lower blood pressure and cholesterol levels, slow the heart rate, relax blood vessels, reduce strain on the heart, and prevent blood clots formation.
Alternatives other than surgeryUnfortunately, medication is not enough in some cases. So, other treatments may be recommended. Some examples are:
- Enhanced external counterpulsation therapy, in which you have to wear a device like a blood pressure cuff to improve oxygen flow to the heart.
- Spinal cord stimulators, block the sensation of pain, but without improving heart health.
- Transmyocardial laser therapy, consists of the stimulation of the growth of new blood vessels or enhancement of blood flow in the heart.
Surgical proceduresIn some necessary cases, your doctor might recommend you a procedure, possibly an angioplasty, with a stent placement; alternatively, a coronary artery bypass grafting, in which a surgeon uses a healthy artery or vein from another part of the body to bypass narrowed arteries in your heart.
Some ways can help you prevent angina, and these are similar to the ones that improve angina’s symptoms, including:
- Quitting smoking.
- Monitoring and controlling high blood pressure, high cholesterol, and diabetes.
- Eating a healthy diet and maintaining a healthy weight.
- Increasing your physical activity
- Reducing your stress level.
- Limiting alcohol consumption to two drinks or fewer a day for men, and one drink a day or less for women.
- Getting the annual flu shot to avoid heart complications from the virus.
Alternative medicine and home remedies for Angina
A healthier lifestyle
Some better lifestyle options, such as the improvement of your diet, regular physical activity, and the practice of relaxation techniques will help you reduce your stress response which, consequently, can help improve blood flow to your heart and reduce angina.
A healthier diet
Your diet should be rich in whole grains, fruits, and vegetables and it should be low in saturated fat. This will be great for your heart and easier for you to keep your weight under control. To prevent or treat heart disease, the American Heart Association recommends the following:
- Eat a variety of nutritious foods and low-fat dairy products.
- Eat at least 2 servings of fish per week.
- Lower the use of salt in your food.
- Limit alcohol intake to 2 drinks per day for men and 1 drink per day for women.
- Reduce your consumption of beverages and foods with added sugars.
- Practice regular physical activity
Given the fact that stress is a big risk factor for angina and heart disease, and that it is very present in our fast-paced lifestyles, relaxation techniques become very important. To reduce stress, consider practicing meditation, progressive muscle relaxation, breathing exercises, yoga, self-hypnosis, or biofeedback.
Nutrition and Dietary Supplements
In addition to a well-balanced diet and physical activity, many supplements can help reduce your chances of developing heart disease, including angina.
There has been ongoing research on particular supplements to see if they effectively reduce the pain from angina. Do not supply or try to treat yourself without the supervision of your doctor. The following have been used in studies. Your doctor will help you figure out which one is the best for you.
- L-carnitine may help reduce symptoms of angina. L-carnitine can potentially interact with blood-thinning medications such as coumadin and thyroid hormone, and possibly increase seizure risk in patients with a history of seizures, so be aware.
- Coenzyme Q10 (CoQ10) is important for heart health and it has been a suggested option if you want to exercise without pain. Since, high doses of this enzyme may interfere with some blood thinners, talk to your doctors if you already take other blood thinners.
- Arginine or l-arginine is another amino acid that may improve blood flow and increase exercise tolerance in people with angina. L-arginine can increase bleeding and lower blood pressure. However, this supplement can interfere with some other medications and it can be inappropriate for patients suffering from genetic or kidney disorders. It is greatly important to ask your doctor before taking it.
- Magnesium may help reduce chest pain caused by exercise, and lower blood pressure but it also may cause diarrhea, so talk to your doctor before taking it.
HerbsThe use of herbs is an old approach to treating disease and improving body strength, there is a great possibility of effectively treating various health concerns. However, herbal remedies can trigger side effects and can interact with other herbs, supplements, or medications. This is why you should take herbs under the supervision of your doctor who specializes in wholistic medicine. This is especially if you have angina and are taking additional prescriptions.
Luckily, there are several different herbs that you can take for the treatment and prevention of heart disease, which will also help you reduce your cholesterol, blood pressure, and other risk factors.
Herbs that may be helpful for angina include:
- Hawthorn (Crataegus monogyna): Has been used traditionally to treat heart disease. Some results were the improvement of blood flow to the heart and the ability to exercise with lesser pain. It remains necessary to continue trials, as there have been noted some side effects.
- Kudzu ( Pueraria lobata ): has been used in Chinese medicine for centuries to treat heart disease and it was shown to reduce the frequency of angina in people, but the trials were poorly designed. More research is needed, as it can also cause side effects and interact with other drugs.
- Terminalia arjuna, an herb used in Ayurvedic medicine, was shown to reduce the number of angina attacks and increase exercise capacity. Again, more studies are needed.
- Suxiao jiuxin wan is widely used in China for angina. One study found that it reduced symptoms and frequency of acute angina attacks compared with nitroglycerin.
HomeopathyAnother alternative form of treatment is homeopathy. It may be used to help reduce your risk of heart disease, along with other medications. However, you should not use it to replace immediate medical attention for unstable angina, new-onset chest pain, or chest pain that has changed in intensity, frequency, or other characteristics.
Few studies have examined the effectiveness of specific homeopathic remedies. Nevertheless, professional homeopaths would recommend appropriate therapy to lower high blood pressure and cholesterol. Homeopaths will take into account your constitution type before prescribing you a remedy, as they consider a person's constitution to be his or her physical, emotional, and intellectual makeup. An experienced homeopath will assess all of these factors when determining the most appropriate remedy for you as an individual.
AcupunctureTo finish, studies using acupuncture to treat angina have found mixed results. Some showed no benefits, while others have found that acupuncture may help reduce the frequency of angina attacks and the need to use nitroglycerin. There have been quite a few studies and discoveries concerning acupuncture. For example, one Chinese study found that pressing fingertips to an acupuncture point located at the sternum at nipple height during a stable angina incident was as effective as taking nitroglycerin and that it also worked faster than taking pills. When combined with conventional treatment another study found it to relieve angina symptoms and improve electrocardiography test results.
Angina is not a disease and it is more common than you might have thought. Plenty of people live with it and still live a long and active life, by managing it with medication and a healthy lifestyle. You can take advantage of effective medical treatments and lifestyle changes to manage angina or prevent it from returning. Don’t forget, the most important thing is to have your angina investigated by your doctor to manage your risk of future complications, such as heart attack.