Know Your Heart

Chest pain is one of the most common reasons people visit their doctor, and with good reason: It could signal a heart attack. If you’ve been diagnosed with angina-as nearly 10 million Americans have- think of it as your heart-health wake-up call and follow your doctor’s orders to keep yourself in the best possible health and prevent a heart attack.

Your Body’s Early Warning System

Angina is defined as chest pain or discomfort caused by heart disease. It is, according to the American Heart Association (AHA), a symptom of the condition known as myocardial ischemia. Pain occurs when the myocardial (the heart muscle) gets insufficient blood and oxygen (ischemia). It is often the first obvious sign of heart disease.

Angina generally signals that you have narrowing in one, or possibly more, of your coronary arteries. These are the large blood vessels that carry oxygen-rich blood to your heart.

“Angina is an alarm,” explains Amir Lerman, M.D., professor of medicine at the Mayo Clinic’s Chest Pain and Coronary Physiology Clinic in Rochester, MN. “It’s the heart’s way of telling you that it’s not getting enough oxygen.”

Know the Causes and Your Risks

The chief cause of reduced blood and oxygen flow is atherosclerosis, the build-up of cholesterol-laden plaques on the interior walls of your arteries. As plaques grow, they restrict blood flow. This causes a heart attack- and usually irreversible damage to your heart muscle. Several risk factors accelerate the formation of plaques. Some of these factors are beyond your control. For example, if you have a family history of heart disease, you’re more likely to develop it. Age is another risk factor: The older you are, the longer you’ve been around for the plaque to build up.

But other risk factors are in your control. Smoking, being overweight and eating a diet high in salt can contribute to high blood pressure, which damages the thin layer of protective cells that line the interior surface of blood vessels. “These cells maintain healthy blood flow,” says Dr. Lerman. “They release substances into the artery to prevent blood clots, inflammation, the constriction and arteries and other processes that lead to plaques.” Damage to these protective cells can contribute to the buildup of plaque within coronary arteries.

Watch for Angina Symptoms

Feeling tightness and pressure in your chest (right below the breastbone) are classic angina symptoms. You might also experience pain, numbness or tingling in your jaw, shoulders, arms and fingers, or sweating, breathlessness, nausea and fatigue, especially if you’re a woman.

“Symptoms of heart disease can be very vague,” explains Stephen A. Siegel, M.D., clinical assistant professor of cardiology at the NYU Langone Medical Center in New York City.  “That’s why people with indigestion sometimes worry they are having a heart attack.” Unfortunately, this works both ways. “Some people who die from a heart attack didn’t get help because they thought it was only indigestion,” Dr. Siegel adds. It is always good to be cautious.

Is It Stable?

“Stable” angina is characterized by symptoms that come on only when your heart has to work harder than usual, during exercise or stress, for example. Stable angina that’s triggered by activity and goes away with the rest generally signals that your heart is getting enough oxygenated blood, so you don’t experience symptoms during leisurely activities. Often, when symptoms do arise, the triggers are very predictable and manageable.

The most common trigger is physical activity. Emotional factors such as anger, fear or anxiety can also set off angina, particularly in women. In fact, any form of excitement that increases the heart’s demand for oxygen and the rate of blood flow can cause an angina episode.

Over time, you’ll learn to gauge the level of exertion that triggers symptoms. You can be active enough to get close to-but not beyond-this level, and use medication to stop pain if you overdo it. If you notice that angina is coming on in new situations, however, call your doctor. An example: You find walking across the room causes pain when it didn’t two months ago.

Angina, Remedy MD, Healthy Living Guide

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