Angina

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Angina is a pain or cramplike sensation in the chest that occurs when the heart muscle can't get the oxygen it needs. Healthy arteries expand to accommodate increased blood flow when the heart needs more oxygen. When the blood vessels serving the heart (coronary arteries) are clogged with fatty deposits, as is the case in coronary artery disease, not enough blood can get through them. Increased physical exertion, emotional distress or exposure to extreme temperatures can trigger episodes of angina.

Angina occurs more often in people over age 30, and the prevalence increases with age. It is also more common in men than in women. Since angina is an indication of underlying coronary artery disease, the factors that lead to the narrowing of the arteries also increase the risk of angina. These factors include high blood cholesterol, high blood pressure, smoking, obesity and a family history of heart disease.

Angina commonly starts as a sensation of pressure, burning or aching deep in the center of the chest beneath the breastbone. The pain can radiate to the neck, shoulder, jaw, wrist and back. Nausea, sweating, lightheadedness and shortness of breath sometimes accompany angina as well. Episodes can last anywhere from two to 15 minutes and subside with rest. Angina can also occur without symptoms.

Angina medications work in two ways:

1. Increase blood flow to the heart - These drugs relax the blood vessels during an angina attack to allow blood to flow more easily. The most commonly used medication for this is nitroglycerin.

2. Reduce the heart's demand for oxygen - These drugs lessen the heart's workload so that angina is less likely to occur. These medications include beta blockers and calcium channel blockers to decrease blood pressure, reduce heart rate and decrease the heart's workload.

• Eat a low-fat, low-cholesterol diet.
• Get regular exercise and maintain a healthy weight.
• Quit smoking.