The heart is the muscle responsible for pumping blood throughout the body. Blood transports oxygen, which is essential for the proper functioning of all your organs, including your heart. If the heart does not receive enough oxygen, pain (angina) occurs as a sensation of tightening or a burning sensation in the middle of the chest (pectoris). Angina is also variously described as an oppressive sensation in the chest, tingling in the arm or extreme fatigue.

Angina is most often caused by the presence of fatty deposits in arteries (atherosclerosis). These deposits partially block the passage of blood in the arteries. During exercise or in very stressful situations, arteries are unable to provide enough oxygen to the heart due to this blockage, and so an angina attack occurs.

The fatty deposits are mostly made of cholesterol. Cholesterol is found principally in animal fat: meat, seafood, butter, and eggs. (See Cholesterol, also published by Vigilance Santé). Cholesterol tends to deposit more quickly in arteries of people who smoke, or do little or no exercise.

An angina attack usually lasts only a few minutes. The pain generally subsides quite rapidly once the person rests or takes a drug. It is NOT A HEART ATTACK. It is short lasting and does not damage the heart. It is, however, a sign that something is wrong and should not be ignored.

Diagnosis
Since angina attacks do not usually last long, how do doctors make a diagnosis if they are not there to witness an attack? Angina attacks:

  • are induced by major efforts, stress, intense fear, and exposure to cold;
  • disappear if the individual rests;
  • are accompanied by dizziness and shortness of breath.
Pain Locations
Main
Secondary

Of course, everybody experiences angina attacks differently. These symptoms, however, are the most common.

A physician can also provoke an angina attack by having the individual perform a strenuous exercise (exercise tolerance test). The physician can also check if the heart's arteries are blocked by having X-rays taken after injecting a dye in the patient's blood. Finally, if drugs relieve the pain, then obviously the attack is caused by angina.
Since the stomach is located in the lower part of the chest, relatively close to the heart, angina pain may be mistakenly attributed to stomach problems. The pain from stomach problems, however, usually follows meals and is relieved by antacids.

Can angina be cured?

NO. There is no cure, at present, for angina. It may, however, be controlled by taking these measures:

  • stop smoking (tobacco promotes artery blockage);
  • eat less fat;
  • control arterial pressure, if elevated;
  • maintain a healthy weight (excess weight makes the heart work harder);
  • exercise moderately (the heart is a muscle and exercising helps it develop strength and keeps it healthy);
  • avoid stress and overworking;
  • avoid exposure to extreme cold;
  • eat smaller meals and limit coffee intake.

When artery blockage is not too extensive, these measures may make the angina disappear completely. If the blockage is more severe, an antianginal drug may control the condition. In very serious situations, however, surgery (bypass) may be required to replace blocked arteries.

Antianginal drugs

Several drugs can be used to control or prevent angina. These drugs reduce the heart's oxygen needs by reducing heart work. Some are taken on a regular basis, while others are used only during an attack. Nitroglycerin is probably the best known of these drugs. Placed under the tongue or sprayed in the mouth, it can relieve an attack, or it can be taken daily to prevent attacks (available in ointment, patch, and tablets).

Angina must be controlled to prevent myocardial infarction (heart attack). Most people with angina can lead normal lives and control their symptoms by adopting healthy habits, and taking medication if necessary.

For more information or for support :

The Heart and Stroke Foundation of Canada

www.heartandstroke.com

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