Body & Fitness

State of the heart

**How to recognise and deal with angina attacks

**It’s not a pleasant feeling – the squeezing pain snakes its way across your chest, sometimes into your shoulders, neck and jaw, and you feel as if your veins have filled with concrete. You have to stop whatever you are doing and wait until the feeling passes or until medication kicks in. In the meantime, you have to put up with the horrible sensation and breathlessness.

This is how one person has described angina to me, although everyone who has this condition may experience different symptoms. It’s a very common sign of heart disease and some people can live with it for years. It can affect their quality of life, making it difficult to do everyday activities like walking up stairs or doing housework.If you’ve got angina there is a possibility you may go on to have a heart attack or other heart problems. But you can also treat a diagnosis of angina as a wake-up call and opportunity to make changes that will improve your heart health.

**What causes angina?

**It’s the result of fatty deposits building up in the lining of your arteries. This can be caused by a variety of factors, including smoking, high blood pressure, poor diet, high levels of bad blood cholesterol, being overweight or having a family history of poor heart health.If these deposits completely block your arteries then blood can’t get through to your heart and you’ll have a heart attack.

However, in some people the deposits may only cause a partial blockage, which means your heart can beat as usual most of the time. But if you exert yourself physically and your heart needs more blood to cope with the demands you’re putting on it, then the deposits can cause problems because the extra blood can’t get through the clogged arteries. As a result, you get pain. It’s usually in the chest but it may also spread to your arms, neck and shoulders. It’s possible to have angina pain in these areas but not your chest.

**Angina or heart attack?

**This can be tricky, particularly if, like my friend, you have never had an angina attack before and don’t recognise the symptoms. With angina, the pain will often ease if you stop what you are doing and rest, or take angina medication you’ve been prescribed. It may only take a few minutes to feel better.With a heart attack, the pain doesn’t go away if you rest or take medication. Because it is crucial to get medical help as soon as possible when you are having a heart attack, you shouldn’t spend too long trying to work out if it’s an angina attack or something more serious. The National Heart Foundation says that if the pain is not relieved by taking three doses of angina medication spread out over 15 minutes, you should dial 111 and ask for an ambulance.

**How is angina diagnosed?

**Your doctor might be able to make a diagnosis based on your description of your symptoms, or else you may be asked to have an exercise ECG, which involves your heart being monitored while you walk on a treadmill. other medical tests include taking your blood pressure and measuring blood-cholesterol levels.Your specialist may also want to do an angiogram, a procedure which involves putting a catheter, or very fine tube, into your coronary arteries, injecting them with a kind of dye and then x-raying them. This helps to pinpoint any blockages.

**Did you know?

**In some people angina attacks can be brought on by getting very angry or upset, or even by consuming a very heavy meal.

**What’s the treatment?

**oaking lifestyle changes can ease symptoms and prevent your angina getting worse. They may also help to reduce your chances of having a heart attack. Things you can do include:

  • Quit smoking.

  • Lose weight if necessary.

  • Keep your cholesterol levels down.

  • Control your blood pressure.

  • Exercise. This can be difficult because physical exertion is often what triggers an angina attack. Talk to your doctor about ways of staying physically active.

  • Eat healthily. Include lots of fruit, vegetables and wholegrain cereals in your diet and cut down on salt, processed food and saturated fats.

Your doctor may prescribe angina medication – usually tablets or a spray that you take or use as soon as you experience symptoms. You may also be prescribed drugs to be taken regularly, not just when you have an attack. These include beta blockers, which reduce the workload on your heart, or drugs which lower your cholesterol levels.

The New Zealand Heart Foundation recommends people with angina take a low dose of aspirin (75mg to 100mg) each day to prevent blood clotting. Ask your GP about this. If your angina is severe, a specialist may want to perform surgery, such as coronary artery bypass surgery or an angioplasty procedure. This involves inserting a catheter with a tiny balloon at the end of a major artery, often in the groin. The balloon is briefly inflated, which opens up the narrowed artery.

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