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Health Topics
Angina Pectoris

This is a recurring pain, pressure or feeling of constriction in the chest that may spread to the neck and arms and is usually it is usually brought on by exercise and relieved by rest.
It occurs when the heart is not receiving enough blood flow via the coronary blood vessels. When these vessels become narrowed and blocked, not enough blood reaches the heart muscle. As a result of this, metabolic by-products can build up in the muscle and cause pain. Other cardiovascular conditions such as narrowing of the heart valves can also cause Angina by increasing the strain on the heart. Other triggers for Angina include emotional stress, extreme temperatures, excessive alcohol intake and cigarette smoking.

An episode of Angina is not a heart attack. The latter occurs when the blood flow to a part of the heart is suddenly cut off completely, causing permanent damage to the heart muscle. Heart attack chest pain is more severe the Angina pain and is not relieved by rest or medication. Angina indicates that heart disease is present and increases the risk of a heart attack but it does not mean that a heart attack is about to happen.

The first symptom of Angina is often only a vague pain that is usually located under the sternum (breastbone). Some patients experience a tight, gripping or crushing pain. The feeling may spread to the left shoulder and down the inside of the left arm to the fingers. It can even travel to the back, into the throat, jaws and teeth and occasionally down the right arm. Angina pain is often mistaken for indigestion.

Patients with Angina usually need tests to see how badly the coronary arteries are narrowed or blocked. Surgery may be necessary to restore adequate blood flow to the heart. Medication may be adequate for many patients. They are also encouraged to alter their lifestyle to control the number of angina attacks. This could involve controlling physical activity, adopting healthy eating habits, moderating alcohol intake and not smoking. Aspirin may also be recommended to stop blood clots forming. Glyceryl trinitrate is the usual drug prescribed to relieve Angina. It is now normally administered by a sub-lingual spray or by a tablet that is placed under the tongue. It relieves the Angina by dilating the blood vessels and increasing the blood flow to the heart. Beta-blockers may also be prescribed to be taken regularly. These drugs reduce the heart rate and blood pressure, which decreases the amount of work the heart muscle has to do. Calcium channel blockers may also be prescribed and these improve the blood flow to the heart and reduce the heart’s workload.

Nutritional supplements should only be used if the dietary vitamin intake is inadequate. Vitamin E may have cardioprotective benefits by way of its antioxidant and blood thinning actions. Coenzyme Q10 can help improve Angina and lower blood pressure. Hawthorn is a herb that can improve circulation to the heart and Ginkgo Biloba may improve blood flow, thin the blood and have antioxidant properties.

Angina patients should always be compliant with their medication. A medical alert bracelet or identity disc should be worn and may save a life in an emergency. Smokers should quit! Obesity puts extra strain on the heart so weight reduction can help Angina in obese patients. Special exercise regimes can be very helpful as the exercise increases the circulation and helps to strengthen the heart muscle. Stress should be avoided and alcohol consumption should be reduced.


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Kevin McCormack B.Sc. Pharm. MPSI