Stamford Hospital's Center for Integrative Medicine and Wellness
Complete support in understanding and implementing lifestyle change to manage heart disease is available through the Integrative Cardiology Program at Stamford Hospital's Center for Integrative Medicine and Wellness. Our program offers multiple lifestyle techniques to complement and support standard medical therapies for the treatment of heart disease and we will create individualized programs tailored to your specific needs. 
Angina
Chest pain, or angina pectoris, is the most common symptom of coronary artery disease. Angina is described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing or painful feeling. Often, it can be mistaken for indigestion.
Angina is usually felt in the chest, but may also be felt in the shoulders, arms, neck, throat, jaw or back. If you have this symptom, take notice. If you've never been diagnosed with heart disease, you should seek treatment immediately. If you've had angina before, use your angina medications as directed by your doctor and try to determine if this is your regular pattern of angina or if the symptoms are worse.
You should call 911 and come to the Emergency Room for chest pain lasting more than five minutes.
What Causes Angina?
Angina occurs when the blood flow to an area of the heart muscle is decreased, impairing the delivery of oxygen and vital nutrients to the heart muscle cells. When the heart is deprived of oxygen it produces lactic acid that builds up in the muscle and causes pain.
Though primarily a symptom of coronary heart disease, angina can occur in the absence of coronary narrowings. Some people with aortic stenosis, severe anemia or thickened heart muscles can have angina without coronary obstruction.
What Are the Types of Angina?
The types of angina are:
Stable angina. The pain is predictable and present only during exertion or emotional distress, disappearing with rest.
Unstable angina. This may signal an impending heart attack. Unstable angina is pain that is more severe or more frequent than your regular angina or pain that occurs while at rest. The angina may occur more frequently, more easily at rest, feel more severe, last longer, or come on with minimal activity. Although this type of angina can often be relieved with oral medications (medicine taken by mouth), it is unstable and may progress to a heart attack. Usually more intense medical treatment or a procedure is required.
Prinzmetal's angina. This is when angina occurs at rest, when sleeping, or when exposed to cold temperatures. In these cases, the symptoms are caused by decreased blood flow to the heart's muscle or from spasm of the coronary artery. The majority of people with this type of angina also have coronary artery disease. These spasms occur close to the blockage.
How Is Angina Evaluated?
Your doctor will order one or more of a series of tests to determine the underlying cause of the angina and the extent of coronary artery disease, if present. These tests include:
How Is Angina Treated?
The treatment you receive depends on the clinical presentation and the severity of the underlying problem, namely the amount coronary blood flow insufficency and damage to the heart muscle. Options may include:
Lifestyle changes--For most people with mild angina, a combination of medications and lifestyle changes can control the symptoms and slow or stop the progression of coronary artery disease. Lifestyle changes are directed at cigarette smoking cessation, diet change, exercise, weight loss and relaxation techniques.
Medication--Medications used to treat angina work by reducing the heart's need for oxygen, improving risk factors like high cholesteral or high blood pressure, or preventing blood clot formation.
Interventional or surgical prodecures--For people with more serious or worsening angina, your doctor may recommend treatment to open or bypass blocked arteries. These include:
Angioplasty and Stenting
Coronary Artery Bypass Grafting (CABG) Surgery
Transmyocardial revascularization (TMR)
External counterpulsation (EECP)
What Should I Do if I Have Angina?
With any type of chest discomfort, stop what you are doing and rest. If the discomfort lasts for more than five minutes, call 911 and go to an emergency room.
If you have been prescribed a medication called nitroglycerin to treat your angina, take one tablet and let it dissolve under your tongue. If using the spray form, spray it under your tongue. If you still have discomfort after five minutes call 911 and take another dose of nitroglycerin.
If you think you are having a heart attack, do not delay. Call for emergency help right away. Do not drive yourself to the hospital. Consider taking an aspirin. Quick treatment of a heart attack is very important to lessen the amount of damage to your heart.
For more information or to make an appointment please call
1-877-233-WELL (9355).