Angina is chest pain that occurs when the heart needs more oxygen than it is getting. This is usually caused by a partial blockage of a coronary artery. When the chest pain is stable, it can be controlled with short periods of rest and medication. When episodes of pain are more frequent, more painful and less likely to be relieved by rest and medication–a condition known as unstable angina–a heart attack may be imminent.
Congestive heart failure refers to a weakening of the heart’s pumping action, caused by injury or disease, which can lead to a dangerous buildup of fluids in the lungs, ankles or elsewhere in the body.
According to data from the 2005 Behavioral Risk Factor Surveillance System, 19.6 percent of Americans age 65 and over have had a heart attack or are diagnosed with angina or congestive heart failure. When early signs such as high cholesterol and high blood pressure are included, a large portion of the population, young and old, are living with heart disease.
For either of these early conditions, there are required behavioral changes; these include regular exercise, a heart-healthy diet, weight control and avoidance of cigarette smoke, both first- and second-hand. Patients should also monitor both cholesterol and blood pressure carefully and take prescribed medications.
Even with normal cholesterol and blood pressure, some individuals suffer a heart attack or discover that they have angina. At this point, the need for dramatic lifestyle changes becomes critical.
Angina occurs because tightening of coronary arteries prevents normal blood flow to the heart. The pain can be triggered by anything that causes the heart to work harder–physical activity, emotional stress, cold weather, and/or a big meal. To relieve angina attacks, a prescription called nitroglycerin should be carried at all times and placed under the tongue at the time of an attack. However, it is not advised to limit physical activity or exercise because of fear of a heart attack but the angina should be a guide, resting until the symptoms go away.
When angina becomes difficult to control, many patients undergo balloon angioplasty or coronary artery bypass graft surgery to restore normal blood flow through coronary arteries. These procedures are also used as emergency treatment for a heart attack.
Either a heart attack or a heart procedure is emotionally and physically traumatic. Nevertheless, doctors like to get patients up and moving around as soon as possible. Cardiac rehabilitation typically starts in the hospital, and most doctors recommend or prescribe it after the return home.
In addition, regular supervised exercise strengthens the heart and reduces the risk of a future heart attack. It is also good treatment for congestive heart failure. According to one study, heart attack patients who attended cardiac rehabilitation had a 50 percent increased chance of being alive three years later compared to those not participating.
Unfortunately, many Americans living with heart disease–whatever the form or severity–fail to pay attention to the advice about what they should or should not do. Many even become lax about taking their prescribed medications.
If you have any questions, talk with your doctor or pharmacist about options to help you manage your symptoms or options to lower your risk of heart disease.
Kerri T. Musselman, PharmD
