Angina is generally defined as a brief episode of chest pain caused by an insufficient supply of blood, and therefore oxygen, to the heart. This lack of blood is known as ischemia, and is usually caused by coronary artery disease.
In many people, angina occurs with exertion (especially after meals) or other stressful situations, as the heart and other tissues demand more oxygen under these circumstances. In older people, angina can show up as shortness of breath rather than pain. In some cases, ischemia can occur without obvious symptoms and will only be detected with heart monitoring equipment.
There are two main types of angina. Stable angina is pain that is predictable (for example, if it occurs every time you climb a long, steep flight of stairs). If someone has angina even when they’re resting, or if their chest pain becomes more frequent or severe, they are said to have unstable angina. People with unstable angina usually must be hospitalized until their condition improves because they are considered at risk for a heart attack. They will be given drugs or other treatment to minimize this risk.
If you have angina, you may recognize what triggers your symptoms, and can attempt to avoid these situations. However, medical treatment is also needed. There are two goals:
To alleviate angina, a physician will generally recommend that you carry nitroglycerin tablets or spray.
You may also be prescribed drugs known as beta-blockers or calcium channel blockers, which lower the blood pressure, help reduce the heart’s need for oxygen, and prevent constriction of blood vessels. You may also have to wear a nitroglycerin patch to keep your blood vessels open.
To reduce coronary artery disease and the likelihood of angina, lifestyle changes will also be recommended, especially the elimination of smoking. You may also need to take other medications that are designed to reduce atherosclerosis and blood clotting.
If all these measures are not effective, your doctor could recommend a surgical procedure, such as angioplasty or bypass grafting, to treat the cause of your angina.