Q: I’m confused. A friend has been told he suffers from angina but didn’t have a heart attack. If angina is chest pain and a heart attack causes chest pain, what am I missing here?
A: Angina is discomfort or chest pain felt when the heart muscle fails to receive a sufficient supply of oxygenated blood. The condition may be described as pressure or a squeezing pain in the chest. The pain or pressure may radiate to the shoulders, neck, jaw, back, or arms. The feeling may vary from feeling that there is a heavy weight on the chest to indigestion. The severity can vary, as can the duration of an attack. Angina is a symptom of coronary artery disease (CAD) which is a common heart disease. CAD occurs when plaque builds up in the arteries that provide blood to the heart, causing a reduction in the flow of blood. Other symptoms may include shortness of breath, sweating, dizziness, nausea, fatigue, and dizziness.
There are essentially three types of angina. The first is stable angina, the most common form. It occurs when the heart is called upon to work hard and the oxygen requirement increases. This type may last as long as five minutes and should disappear quickly following resting or taking medication prescribed for the condition. Unstable angina can occur without stress, exercise or exertion when there is no reason for the heart to require additional oxygen, and may or may not go away with rest or medication. It may last as long as 30 minutes. Lastly, there is variant angina, a condition that occurs at rest, is often severe, and may be relieved by medication. This latter form is rare and is caused by the heart blood vessels going into spasm.
Risk factors for angina include smoking or long-term exposure to second hand smoke which can damage the walls of the arteries, hypertension, high cholesterol levels, diabetes, a lack of exercise, stress, obesity, the aging process and a family history of the disorder.
Treatment may include lifestyle changes such as diet modifications, discontinuing smoking if appropriate, weight reduction, learning stress reduction techniques, and more.
A heart attack implies permanent damage to the heart muscle. The heart requires a constant supply of oxygen-rich blood to function properly. In those individuals with coronary artery disease (CAD), arteries become narrowed and blood cannot flow as well as it should. Plaque builds up and may rupture which can, in turn, allow blood clots to form. If a clot blocks the artery, the heart cannot receive the oxygenated blood it requires, and permanent damage occurs. That’s a heart attack. There are other situations in which an attack can occur, but the one described is most common.
Healing of the heart muscle occurs following an attack and generally takes about eight weeks. Scars form in the damaged area but the new scar tissue doesn’t contract, implying the ability of the heart to pump oxygenated blood is lessened following each attack.
Symptoms of a heart attack include pain or discomfort in the chest that can radiate to the throat, jaw, back or arm, weakness and anxiety, shortness of breath, fullness or a feeling of indigestion, a rapid heartbeat, sweating, and anxiety – similar to those of someone with angina. The most successful timing for treating a heart attack is within the first two hours following symptoms. Any time beyond that potentially increases the damage.
Testing may include an EKG, lab work, and an echocardiogram – again, similar to angina. Drugs administered at a health care facility may include aspirin or other antiplatelets to prevent blood clotting and thrombolytic therapy to dissolve any clots.
Your friend should follow his physician’s or cardiologist’s advice and make those changes necessary to get him on the road to recovery.