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WHAT IS ANGINA?

Angina is different from a heart attack even though sometimes people tend to confuse them.  It is usually seen more commonly in men than in women and in older people.  Again in Jamaica our cardiologists are seeing a new trend developing more persons are coming in with angina and the patients are getting younger.

Angina is also caused by the narrowing of blood vessels in the heart, that is, the coronary arteries being blocked.  It can also be caused by heart valves and heart muscle complications.  Angina Pain usually does not last long and can ease within ten (10) minutes with rest if you are not on medication for it.

Symptoms

•   Chest pain or discomfort right at the front of the chest (a tightness in the chest) especially when you do strenuous activity such as walking up a hill or climbing stairs

•    Uncomfortable pain in the stomach, neck, jaw or in the arms

•   Pain triggered by stressful situations like a nightmare or intense arguments     ( e.g. quarrels with the wife or  that annoying co worker)

•  A heavy meal or cold winds can also trigger the pain

• Getting breathless easily should also be investigated even if there is no pain

•   Getting pain when bending or eating are not common symptoms but should also be investigated.  (DON’T LEAVE IT TO CHANCE IT MAY NOT BE OLD AGE OR GAS!!)

The Investigations “WORK UP”

• To investigate the cause of the angina, blood tests will be taken.  Causes could vary from high blood cholesterol or glucose level to anaemia or even thyroid or kidney problems.

•    Heart Tests will be done.  Usually the doctor will start out with a regular resting electrocardiogram (ECG), which often times will be normal.  Then s/he will proceed to a stress test ECG (exercise on the treadmill while your heart rate and ECG tracing is monitored).  If the angina is confirmed your doctor will say that the stress test was positive meaning that there were changes on your ECG during the test.

• The next step then is the Coronary Angiography.  Done using x-ray, dye is injected into the coronary vessels to ascertain if there is any blockage of the arteries and how severe the blockages are.

Treatment

•    Change in life style.  This is the part we usually hate, lose the weight, change the diet, exercise more

• Medication such as GTN for the pain.  It may come in tablets or spray and goes under the tongue to be absorbed immediately into the blood stream.  GTN reduces the pain within a minute or two.

•  Statin drug to lower blood cholesterol

•  Aspirin which works as a blood thinner to reduce the chance of a heart attack

• Beta blocker drugs to regulate the heart rate by preventing it going faster whenever you do strenuous activities or exert yourself.  This reduces the heart needing more oxygen which usually causes the angina pain.  Beta blockers are also believed to protect the heart muscles to prevent further complications

• Your doctor may choose to give you other drugs which may fall in one of three (3) categories:

 Nitrate drugs-  These are similar to GTN

 Potassium channel blockers – These work similar to the Nitrates

Calcium channel blockers- These drugs reduce the burden on the heart while increasing blood flow by relaxing the coronary arteries.  It also reduces and controls the heart rate both at rest and upon exertion respectively.

• The more drastic procedures, angioplasty and surgery only come into contention if the above approach fails.  Just as with a heart attack a coronary angioplasty or coronary artery bypass grafting (CABG) may be done.

Patients should know that stents and open heart kits are sold external to the hospital and often times at a more reasonable cost.  Therefore for an elective surgery, like anything else shop around.  

CARDIOVMEDS will contact and deliver directly to your physician to ensure we get what is best for you without your family members being hassled