Angina Attack

It's hard to say anything nice about coronary heart disease. But it's not impossible.

For as mean and ugly and nasty as America's number one killer may be, at least it often gives its victims a warning. No, you don't get an engraved notice in the mail. What you are likely to get is a recurrent pressing, squeezing, or burning pain in the chest. Doctors call this warning pain angina pectoris-angina for short.

This pain (which sometimes spreads to the shoulders, arms, neck, jaw, or back) is due to a lack of oxygen in the heart muscle.

It is typically triggered by exercise, emotional upset, packing away a large meal, or any circumstance that creates extra demand on the heart. The heart muscle isn't getting enough oxygen because it isn't getting enough blood. It's not getting enough blood because the arteries have been narrowed by fatty deposits clinging to their walls. Doctors call this condition atherosclerosis.

Not all chest pain is brought on by inadequate blood supply to the heart, nor is all inadequate blood supply to the heart due to atherosclerosis. Only if you undergo a few (painless) medical tests can a doctor determine the nature of your problem. If it is true angina you are suffering and the cause is atherosclerosis, you've just received a serious warning. You should even be grateful for the message, because if you heed the warning and take action now, you might avoid the more serious consequences of heart disease.

Angina is not to be taken lightly. If you have angina, you should be under a doctor's care. He may prescribe medications for you, such as nitroglycerin, which can be slipped under the tongue during or in anticipation of an attack. The medicine will increase the flow of blood to the heart. Your doctor will undoubtedly suggest many changes in aspects of your lifestyle that might have put your heart in danger in the first place.

While you are eating low-fat and low cholesterol meals, exercising regularly using a program your doctor has prescribed for you, and doing all the things you should be doing to get your heart and blood vessels back in top working order, you can also be taking immediate action to lessen your chances of angina attacks.

Above all, avoid the temptation to cheat on your low-fat diet. Feasting on such things as pork chops, french fries, and ice cream can bring on the pain of angina. This simple connection between fat and angina pain was made back in the 1950s in an informal study at the University of Pennsylvania. A doctor there fed glasses of pure cream to 14 angina sufferers and immediately induced chest pains in 6 of them. And subsequent studies have driven home the point again and again: Fat attacks the heart.

Exercise presents a dilemma to angina sufferers. A lack of exercise often plays a role in the development of atherosclerosis. But huffing and puffing brings on chest pain. What should you do? Some studies show that exercising just to the point of pain carries no risk. In fact, studies show that regular exercise should improve your tolerance - you will be able to exercise longer before the pain starts. Other studies show that it is uncommon for a heart attack to occur during exertion. So go ahead - if you have your doctor's permission- and exercise. Just make sure you start slowly and don't overdo. There are a number of other things you can do to turn off those angina attacks. If you smoke, there's no question that you need to kick the habit - fast. Both nicotine and carbon monoxide contribute to the worsening of coronary heart disease- and make angina symptoms more severe.

The good news for angina sufferers is that the clogged arteries that cause such pain can be cleared. With a long-term commitment to following the program of drugs, low-fat diet, and exercise that your doctor outlines for you, you could add many pain-free years to your life.

Angina pectoris has been compared to the heart screaming for more oxygen. Because of hardened arteries, the heart doesn't get enough oxygen-carrying blood. And what are hardened arteries?

They are arteries that have filled up, or partially filled up, with fatty plaque.

The medical term for hardening of the arteries is atherosclerosis. The disease begins with a striped patch on the inside wall of the artery, on which bits of cholesterol and other substances in the blood collect. These substances then harden and thicken, progressively narrowing the space in which the blood can flow. The coronary arteries, those arteries connected to the heart, can be narrowed by as much as 70 to 90 percent and the heart will still have enough blood to meet its needs, at least when it's resting. But when exercise, emotional demands, or a heavy meal make the heart beat faster - requiring more oxygen - the reduced blood flow may no longer be adequate.

Doctors call this condition myocardial ischemia, and the symptoms may be shortness of breath or chest pain. That's when we say the heart starts to "scream." That's angina. If the artery becomes completely blocked, an even worse scenario may occur- a heart attack. For this reason, all angina sufferers should be under a doctor's care.