Angina

WHAT YOU SHOULD KNOW:

Angina happens when your heart does not get enough blood and oxygen. The arteries that feed the heart may become narrowed or blocked and not let enough blood flow to the heart. Symptoms of angina include chest pain or pressure, pain or discomfort in the arms, jaw, neck, back, or shoulders, and shortness of breath. Other symptoms are nausea or vomiting, fatigue, sweating, or dizziness. Stable angina usually develops when you exert yourself and goes away quickly with rest. Unstable angina may occur at rest or more often than usual. It may be more severe and last longer, and may not go away with rest or medicines. Unstable angina is an emergency and may be a warning sign that you are at risk for a heart attack.

AFTER YOU LEAVE:

Medicines:

• Aspirin: Ask your primary care provider (PHP) if you should take aspirin to prevent blood clots. If you cannot take aspirin, your PHP can give you a prescription medicine instead. These medicines may increase your risk of bleeding, including stomach bleeding.
  
  
• Nitrates: These medicines open the arteries to your heart so the heart gets more oxygen. Nitrates come in 2 forms. There is a long-acting form to prevent angina. There is also a short-acting form called nitroglycerin that is used to treat an angina attack. Take nitroglycerin under your tongue when you develop angina symptoms. If you are taking nitrates, you should not take certain medicines used to treat impotence problems. They may interact with your nitrates and cause your blood pressure to drop.
  
  
• Beta blockers: These cause the heart to beat more slowly and decrease blood pressure, decreasing the amount of oxygen the heart needs. They also help open up the blood vessels in the heart.
  
  
• Calcium channel blockers: These medicines relax the muscles in the arteries of the heart, increasing blood flow to the heart.
  
  
• Statins: These medicines are used to lower cholesterol levels. This prevents further narrowing of the blood vessels in your heart.
  
  
• Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your primary healthcare provider or cardiologist as directed:

Write down your questions so you remember to ask them during your visits. Keep a diary or a calendar with details about your chest pain. Every time you have pain or symptoms, record what the pain is like, how long it lasts, and how severe it is. Also record what brings on the pain, and what makes it go away. Bring this with you every time you see your PHP or cardiologist.

Cardiac rehabilitation:

Your primary healthcare provider or cardiologist may recommend that you attend cardiac rehabilitation (rehab). This is a program run by specialists who will help you safely strengthen your heart and prevent more heart disease. The plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Caregivers will also check to make sure any medicines you are taking are working. The plan may also include instructions for when you can drive, return to work, and do other normal daily activities.

Activity:

• Triggers: Pay attention to your symptoms and find out what seems to make your angina worse. Avoid activities that trigger an angina attack.
  
  
• Sex: You may have sex when you feel ready, unless your PHP tells you not to. Do not have sex if you are tired or if you have just eaten a big meal. Do not have sex if the room temperature is too cold or too hot. If you get chest pain during sex, stop. Talk to your PHP if you have questions or concerns.

Manage angina:

• Maintain a healthy weight: When you weigh more than is healthy for you, your heart must work harder. You are at higher risk for serious health problems. Talk to your PHP about a weight loss plan if you are overweight.
  
  
• Eat healthy foods: Eat a healthy diet, with lots of fruits, vegetables, and whole grains. Avoid food high in saturated fat and cholesterol. You may also be told to limit the amount of salt you eat.
  
  
• Do not smoke: Smoking can further damage your heart, as well as your lungs.

For more information:

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

Contact your primary healthcare provider or cardiologist if:

• Your skin is itchy or you get a rash.
  
  
• You are dizzy or nauseated after you take your medicine.
  
  
• You have trouble breathing while resting.
  
  
• You have new or worse swelling in your feet or ankles.
  
  
• You are bleeding from your gums or nose.
  
  
• You have questions or concerns about your medicine, condition, or care.

Seek care immediately or call 911 if:

• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing
  
  
• Your angina is happening more frequently, lasting longer, or causing worse pain.
  
  
• You have chest pain that does not go away after you take medicine as directed.
  
  
• You lose feeling in your face, arms or legs, or suddenly feel weak.
  
  
• You have blood in your urine or bowel movements, or vomit blood.

Learn more about Angina (Discharge Care)