Coronary Artery Disease/Ischemic Heart Disease (Angina)

Coronary artery disease (atherosclerosis) is the chronic process by which cholesterol is deposited in the walls of the arteries, decreasing blood flow (and oxygen) to the heart. Activity increases the demand of tissues for oxygen and, as in times of physical stress or anxiety, the heart picks up the pace by beating faster and more vigorously. A heart attack occurs when blood flow to the heart is so significantly cut off that part of the muscle dies. This is a very dangerous situation and can lead to sudden death.

Treatment

Doctors treat the symptoms of low blood flow to the heart muscle (angina) with three main types of drugs: aspirin, nitroglycerine, and beta-blocker drugs. Sublingual nitroglycerine is the drug of choice, acting in about two minutes. Nitrates increase the blood flow to the ischemic heart muscle. Beta-blockers prevent angina by reducing oxygen requirements of the heart during exertion and stress.

During an ischemic attack, aspirin is the third agent given, as it blocks the clumping of platelets in blood vessels, opening them to allow more blood flow when needed.

If you think your chest pain may be angina, you likely fit one of these profiles and have one or more of the major cardiac risk factors. If you don’t, consider another cause of your chest pain. If you experience what you think might be angina, see a doctor immediately as you may actually be having a heart attack or your symptoms may be a warning sign of an impending heart attack. If help is on the way and you are experiencing angina, take an aspirin and a nitroglycerine tablet, use oxygen (if available), limit your activity, and relax.