Living With - Angina - Living With

Angina is not a heart attack, but it is a signal that you are at greater risk of having a heart attack. The risk is higher if you have unstable angina. For this reason, it is important that you receive follow-up care, monitor your condition, and understand your condition so you know when to get medical help. Your doctor may recommend heart-healthy lifestyle changes and cardiac rehabilitation to help manage angina.

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\n Receive routine follow-up care \n
- Angina - Living With

You may need follow-up visits every 4 to 6 months for the first year after diagnosis of angina and every 6 to 12 months as long as your condition is stable. Your care plan may be changed if your angina worsens or if stable angina becomes unstable. Unstable angina is a medical emergency.

Your doctor may recommend cholesterol-lowering statins as part of your long-term treatment, especially if you have had a heart attack.
Ask your doctor about when you can resume normal physical activity, such as climbing stairs.
Ask your doctor whether sexual activity is safe for you. People who have unstable angina or angina that does not respond well to treatment should not engage in sexual activity until their heart condition and angina are stable and well managed.
Talk to your medical team about vaccinations to prevent the flu and pneumonia.

Return to Treatment to review possible treatment options for your angina.

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\n Monitor your condition \n
- Angina - Living With

To monitor your condition, your doctor may recommend the following tests or procedures:

Blood pressure checks to ensure that your blood pressure is in a healthy range. Keeping your blood pressure under control can help your angina.
EKGs to detect changes in heart health after treatment or for monitoring the heart during exercise as part of cardiac rehabilitation.
Repeat lipid panels to see if blood cholesterol levels are at healthy levels. A lipid panel should be done every year and also 2 to 3 months after any change in treatment.
Stress testing to assess your risk for complications either before or after starting angina medicines. Stress tests can also make sure your heart is strong enough for physical and sexual activity.

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\n Adopt heart-healthy lifestyle changes \n
- Angina - Living With

Angina is a symptom of ischemic heart disease. Your doctor may recommend the following heart-healthy lifestyle changes to help you manage angina:

Heart-healthy eating. Following a healthy eating plan, including limiting alcohol, can prevent or reduce high blood pressure and high blood cholesterol, helping you reduce angina symptoms and maintain a healthy weight. You should avoid large meals and rich foods if heavy meals trigger your angina. If you have variant angina, drinking alcohol can also be a trigger.
Aiming for a healthy weight. If you have overweight or obesity, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you manage the risk factors for angina.
Being physically active. Before starting any exercise program, ask your doctor about what level of physical activity is right for you. Slow down or take rest breaks if physical exertion triggers angina.
Managing stress. If emotional stress triggers your angina, try to avoid situations that make you upset or stressed.
Quitting smoking. Smoking can damage and tighten blood vessels, make angina worse, and raise the risk of life-threatening complications. Visit Smoking and Your Heart and the NHLBI\u2019s Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you may call the National Cancer Institute\u2019s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).

Your doctor may recommend these heart-healthy lifestyle changes as part of a larger cardiac rehabilitation program that your doctors oversee.

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\n Prevent repeat angina events \n
- Angina - Living With

Stable angina usually occurs in a pattern. After several events, you will learn what causes the pain to occur, what the pain feels like, and how long the pain usually lasts. To help learn your angina\u2019s pattern and triggers, keep a log of when you feel pain. The log helps your doctor regulate your medicines and evaluate your need for future treatments. When you know what triggers your angina, you can take steps to prevent or lessen the severity of events.

Know the limits of your physical activity. Most people who have stable angina can continue their normal activities. This includes work, hobbies, and sexual relations. Learn how much exertion triggers your angina so you can try to stop and rest before the chest pain starts.
Learn how to reduce and manage stress. Try to avoid or limit situations that cause anger, arguments, and worry. Exercise and relaxation can help relieve stress. Alcohol and drug use play a part in causing stress and do not relieve it. If stress is a problem for you, talk with your doctor about getting help.
Avoid exposure to very hot or cold conditions, because temperature extremes strain the heart.
Eat smaller meals if large meals lead to chest pain.

Tell your doctor right away if your pattern changes. Pattern changes may include angina that occurs more often, lasts longer, is more severe, occurs without physical exertion, or does not go away with rest or medicines. These changes may be a sign that your symptoms are getting worse or becoming unstable.

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\n Seek help for angina that does not improve \n
- Angina - Living With

Not all angina improves with medicines or medical procedures. If your symptoms continue, your doctor may change your medicines or therapies to help relieve your chest pain. Additional treatments for hard-to-treat angina include:

Enhanced external counterpulsation therapy (EECP) to improve the flow of oxygen-rich blood to your heart muscle, which may help relieve angina. EECP uses large cuffs, similar to blood pressure cuffs, on your legs. The cuffs inflate and deflate in sync with your heartbeat. You typically get five 1-hour treatments per week for 7 weeks. Side effects may include back or neck pain and skin abrasions.
Spinal cord stimulators to block the sensation of pain. Emerging research suggests that this technology can help people be more physically active, feel angina less often, and have a better quality of life.
Transmyocardial laser therapy to stimulate growth of new blood vessels or improve blood flow in the heart muscle. It can relieve angina pain and increase your ability to exercise without discomfort. This laser-based treatment is done during open-heart surgery or through cardiac catheterization. Rarely, your doctor may recommend this treatment in combination with CABG.

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\n Know your medicines \n
- Angina - Living With

You should know what medicines you are taking, the purpose of each, how and when to take them, and possible side effects. Learn exactly when and how to take nitroglycerin or other short-acting nitrates to relieve chest pain. Then talk to your doctor about the following:

Any other medicines you are taking, including vitamins and nutritional supplements. Some medicines can cause serious or life-threatening problems if they are taken with nitrates or other angina medicines. For example, men who take nitrates, including nitroglycerin, for their angina should not take medicines for erectile dysfunction without checking with their doctor first.
Any side effects you may experience. Do not stop taking your medicines without talking to your doctor first.
How to store your medicines correctly and when to replace them.

What\u2019s the safest and most effective way to use short-acting nitrates like nitroglycerin to treat stable angina events?

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Here are some tips for taking short-acting nitrates.

Use the short-acting nitrate immediately before any planned exercise or physical exertion.
Watch for side effects such as flushing, headache, or dizziness. Find a place to sit down or something to hold on to if you feel dizzy.
After 5 minutes, if the pain has not gone away, take another dose.

Call 9-1-1 if the pain continues after taking a second dose. This could be a symptom of unstable angina, which is a medical emergency.

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\n Learn the warning signs of serious complications and have a plan \n
- Angina - Living With

Sometimes it is hard to tell the difference between unstable angina and a heart attack. Angina can be a sign of increased risk of stroke. Angina can also trigger sudden cardiac arrest. These are medical emergencies.

If you think that you or someone else is having the following symptoms, call 9-1-1 immediately. Every minute matters.

Heart attack

Signs of heart attack include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes, or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm. Women may also have chest pain and pain down the left arm, but they are more likely to have symptoms such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw. Read more about the signs and symptoms of a heart attack.

Stroke

If you think someone may be having a stroke, act F.A.S.T. and do the following simple test.

F\u2014Face: Ask the person to smile. Does one side of the face droop?

A\u2014Arms: Ask the person to raise both arms. Does one arm drift downward?

S\u2014Speech: Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?

T\u2014Time: If you observe any of these signs, call 9-1-1 immediately. Early treatment is essential.

Read more about the signs and symptoms of a stroke.

Sudden cardiac arrest

It is possible for a spasm causing angina to trigger arrhythmia. This can lead to sudden cardiac arrest. Fainting is usually the first sign of sudden cardiac arrest. If you think someone may be in cardiac arrest, try the following steps.

If you see a person faint or if you find a person already unconscious, first confirm that the person cannot respond. The person may not move, or his or her movements may look like a seizure.
You can shout at or gently shake the person to make sure he or she is not sleeping, but never shake an infant or young child. Instead, you can gently pinch the child to try to wake him or her up.
Check the person\u2019s breathing and pulse. If the person is not breathing and has no pulse or has an irregular heartbeat, prepare to use an automated external defibrillator as soon as possible.

Living With - Angina - Living With

\n \n Receive routine follow-up care \n - Angina - Living With

\n \n Monitor your condition \n - Angina - Living With

\n \n Adopt heart-healthy lifestyle changes \n - Angina - Living With

\n \n Prevent repeat angina events \n - Angina - Living With

\n \n Seek help for angina that does not improve \n - Angina - Living With

\n \n Know your medicines \n - Angina - Living With