Angina


Diagnosis of angina

To get to the bottom of your chest pain, your doctor will begin by taking a family history, asking about your symptoms, and doing a physical exam.

At Dignity Health, your cardiologist may also use a combination of the following to diagnose angina and identify its cause:

  • Analysis of the location, triggers, and timing of your chest pain: these things can indicate whether it is stable or unstable angina.
  • EKG (electrocardiogram): this test shows your heart’s electrical activity, along with heart rate and rhythm.
  • Echocardiogram: this test uses sound waves to make images of the heart, providing a view of blood flow and any related damage to the heart or surrounding tissues.
  • Stress test: monitoring your heart while you walk or run on a treadmill gives your doctor a sense of how your heart performs under stress and can simulate situations that trigger your angina.
  • Blood tests: testing your blood can show any substances in the blood that indicate heart disease, infection, or damage.
  • Coronary angiography: this test looks for artery blockages using dye injections and X-ray imaging.
  • Heart imaging through a chest X-ray or CT scan: this helps your doctor see your lungs.

Treatment

Doctors relieve the pain that accompanies angina by treating its source, which is usually heart disease. Your treatment for angina may include a combination of medications, procedures, or lifestyle changes.

Lifestyle changes, such as increasing regular exercise, changing your diet, and stopping smoking, are often the most critical steps that you can take to reduce your risk of developing or exacerbating heart disease.

When lifestyle changes are not sufficient, your doctor may turn to medications or procedures.

Medications

Medications are usually used to treat angina when lifestyle changes alone are not sufficient. They are used to lower blood pressure, prevent blood clots, and expand the blood vessels. Medications that you may be prescribed include:

  • Aspirin to reduce the ability of blood to clot.
  • Beta-blockers to inhibit the effects of the hormone epinephrine (adrenaline) to help the heart beat slowly and reduce blood pressure.
  • Blood pressure-lowering medications.
  • Calcium channel blockers to relax and widen blood vessels and increase blood flow to the heart.
  • Clot-preventing drugs make your blood platelets less likely to stick together, which helps limit clotting.
  • Nitrates relax and widen your blood vessels, which allows more blood to get to your heart. You can take nitrates when you are experiencing angina-related discomfort or before doing something that may trigger angina, such as exercising.
  • Statins are used to lower blood cholesterol.

You will work with your doctor to determine which medication(s) will work best for your specific condition.

Procedures

In some cases, angina will require a medical procedure to treat it. Some of the procedures Dignity Health doctors perform to treat angina include:

  • Coronary angioplasty and stenting to widen and improve blood flow through the coronary arteries.
  • Coronary artery bypass graft surgery (or heart bypass surgery) to reroute blood flow around a restricted artery.
  • External counterpulsation (ECP) to increase blood flow to the heart. This requires multiple treatment sessions in which cuffs similar to blood pressure cuffs are placed around the calves, thighs, and pelvis to increase blood flow to the heart.

Recovery

Angina is not the same as a heart attack, but it is a sign that you could be at high risk of having a heart attack in the future.

After being evaluated for angina, your doctor will work with you to come up with a plan to prevent future episodes and address underlying conditions with medication or other treatments.

You can also work with your doctor on a plan for lifestyle changes such as diet and exercise to keep your heart healthy and manage your symptoms.

Lifestyle changes, medication, and careful monitoring can help you live a heart-healthy life in which your angina is controlled, stable, predictable, or symptom-free.

Angina symptoms in women

Some women with angina have different experiences than the classic angina symptoms common in men. This can lead to delays in treatment.

Some of the symptoms of angina that are more common in women include:

  • Chest pain that feels more like stabbing than pressure
  • Shortness of breath
  • Nausea
  • Pain in the abdomen, neck, jaw, or back in addition to chest pain

If you think that you may be experiencing angina, talk with your cardiologist to get to the bottom of your discomfort and back doing the activities you love.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.