Angina

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Have you ever had a normal day interrupted by chest pain, or woken up in the middle of the night by pains near your heart or other parts of your upper body? When this happens, you may be suffering from angina or another form of chest pain. The first thing many think of is that they are having a heart attack. They may be right, and chest pain is nothing to take for granted. However, there are quite a few other potential causes for angina as well. The important thing to remember is that pain is your body’s way of letting you know that something is not right, and should never be ignored. Knowledge is power, as they say, so let’s see what we can learn about angina and the possible causes behind it.

What is Angina?

Angina is a very common form of chest pain, and is caused by a condition known as ischemia, which is an insufficient amount of oxygenated blood to the heart muscle. Officially titled angina pectoris, angina is typically characterized by a heaviness in the chest, often accompanied by a choking sensation and pain that may radiate into the arm, shoulder, or jaw, usually on the left side of the body. It is most often triggered by physical exertion or by stressful emotional tension.

Angina or other kinds of chest pain are one of the most common reasons for visits to hospital emergency rooms. Millions of Americans seek emergency care for chest pain each and every year. Most angina is cardiac-related, and a condition called atherosclerosis is usually the culprit. Atherosclerosis involves narrowing of the arteries due to the build up of fatty deposits. Thus, it makes it more difficult for enough oxygen-rich blood to reach the heart, especially under stressful conditions. This temporary lack of blood to the heart muscle causes the chest pain. Angina is not a heart attack, but it definitely can precede one, so any chest pain should be taken seriously, even though the cause may be other than a heart-related issue. Angina itself is a warning that something is wrong, and it seldom causes direct damage to the heart muscle.

What Are the Causes of Angina?

There are two main categories of Angina: Angina of effort, and Variant angina.

  • Angina of effort is by far the most pervasive type, and is most commonly caused by atherosclerosis resulting in angina pain due to insufficient amounts of oxygenated blood to the heart. Atherosclerosis itself can cause a lack of blood to the heart muscle, but when the need is increased due to elevated heart activity, such as during exercise or emotional stress, the angina that occurs is called angina of effort.
  • Variant angina is much less common, and while it may be found in folks with atherosclerosis, it is independent of this condition. It is also not the result of increased demands on the heart. Research is ongoing, but the best thinking at the present time indicates that variant angina is caused by coronary artery muscle spasms that are not severe or long lasting enough to cause a heart attack. Dietary magnesium may help with variant angina (see below).

The major reason why there is so much angina and chest pain in the United States is due to the frighteningly high amount of atherosclerosis found in the general population. This is due to two main factors. The first is “The Standard American Diet (SAD),” which is high-fat, high-sodium, high-sugar, and low-fiber. This combination is very damaging and dangerous for the heart, not to mention a major factor in stroke, cancer, diabetes, and other debilitating diseases that run rampant in our society. The second factor is our love affair with a passive, inactive lifestyle that leads to very little physical exercise. These two huge health issues are largely responsible for massive amounts of angina and the resulting heart disease that is the number one killer in the United States.

What About Other Types of Chest Pain?

While angina is the most common form of chest pain, there are quite a few other forms as well, many of them having symptoms that are similar to angina. They can basically be broken down into cardiac and non-cardiac causes:

  • Cardiac-related chest pain:
    • Heart attack: A heart attack itself will cause chest pain. This may involve angina that is more severe and long-lasting than normal. Most angina symptoms last from 1-20 minutes, but some heart attack victims will experience them longer. However, do not assume that this is always the case. A crushing feeling in the chest, and/or pain that radiates into the left side of the upper body, along with shortness of breath and profuse sweating, may be angina, or it may be a heart attack in progress. Heart attack signs can vary from person to person, so the length or severity of the symptoms is not always an accurate predictor. Do not take anything for granted. Seeking fast emergency care may save your life.
    • Pericarditis: This condition involves inflammation of the pericardium (sac surrounding the heart), often due to a viral infection. Sharp, piercing chest pain may result, that typically worsens with movement, along with a possible fever and nausea or intestinal discomfort
    • Aortic dissection can also cause chest pain. This rare but life-threatening condition is caused by separation of the layers composing the aorta, the main artery leading from the heart. It is characterized by intense and sudden pain in the chest and back, and is often brought on by uncontrolled hypertension or a traumatic blow to the chest.
    • Coronary spasms, also known as Prinzmetal’s angina, can also trigger chest pain. These may occur for undetermined causes, or due to excessive amounts of stimulants such as caffeine or nicotine. This may be an independent condition, or accompany coronary disease.
  • Noncardiac chest pain:
    • Panic attack: This anxiety disorder characterized by intense fear or paranoia, is often associated with chest pain, along with other symptoms such as excessive perspiration, rapid heartbeat, and shortness of breath. In fact, many sufferers of panic attacks end up in the emergency room thinking they are having a heart attack.
    • Heartburn: Severe indigestion and heartburn is accompanied by chest pain in some individuals.
    • Lung conditions: Pleurisy (inflammation of the membranes of the lung) can cause significant chest pain, especially upon coughing or inhaling. Other lung conditions that can result in chest pain include a collapsed lung (pneumothorax), high blood pressure in the arteries of the lung region (pulmonary hypertension), or respiratory conditions such as asthma or pneumonia. Pulmonary embolism is a potentially life threatening situation whereby a blood clot becomes lodged in an artery leading to the lung. It may also produce severe chest pain.
    • Costochondritis is a malady that involves inflammation of the cartilage in the rib cage. Also known as Tietze’s syndrome, it may cause severe and sudden chest pain, leading some to believe they are having a heart attack.
    • Many other conditions or injuries can manifest significant chest pain as well. These may include:
      • Pulled muscles
      • Fibromyalgia
      • Pinched nerve
      • Cracked or broken rib
      • Gallstones
      • Pancreatitis
      • Shingles
      • Esophageal spasms
      • Some cancers

What Steps Should I Take If I am Having Angina?

Angina or other chest pain should never be dismissed without finding out what is causing it. Unfortunately, most angina, especially in the Western World, is related to an unhealthy heart. Since this is potentially deadly situation, if you are having bouts with angina I would find out why without delay. There are several common tests available to determine the general health of your arteries and heart. They are not foolproof, and cannot be totally relied on to give you the total picture, but they can provide some valuable indicators. I am a firm believer in natural alternatives to mainstream medicine, and at the end of this article we will discuss some preventative measures that can help treat and avoid the number one reason for angina: cardiovascular disease. However, if tests indicate serious blockage of cardiac arteries, you have a life-threatening situation on your hands, and such options as surgery or medication may be appropriate, with the less invasive alternatives as a support system alongside these allopathic therapies. The most common procedures to diagnose heart disease are:

  • Electrocardiogram (ECG): This tests the electrical impulses in your heart, to determine if they are normal. When the heart muscle is damaged, either through atherosclerosis or an actual heart attack, readings will often indicate an abnormality.
  • Stress tests: These are usually performed in a doctor’s office, and test the heart under stress. Patients are given an ECG while walking on a treadmill or pedaling a stationary bicycle. More advanced stress tests involve taking pictures of the cardiovascular system with the help of a radioactive dye. Be careful, as some folks can have allergic reactions to the dye.
  • Blood tests can be helpful as well. One of the most common measures levels of certain enzymes that are found in the heart muscle. If the heart is damaged, by a heart attack for example, these enzymes can leak from the heart into the blood. This test is most accurate within hours after a suspected heart attack.

If tests indicate blockage of the coronary arteries, there are a slew of options available. The list of possible surgical or medicinal therapies is long, and the choices can be very confusing. It is at times like this when it really pays off to have a working relationship with a health care provider that knows you and your body well, and can help you to sort out what is best for you. I wouldn’t suggest just taking one doctor’s word for it that you need open-heart surgery, but at the same time it wouldn’t be wise to not get an appropriate treatment that could save your life.

How Can I Proactively Treat or Prevent Angina and the Underlying Causes Myself?

The most obvious course of action is to eat a natural, wholesome diet that will help you avoid heart disease, and to make sure that you get plenty of exercise. These lifestyle choices will make the most difference of any “treatments” that are available to you. However, not all of us have been so wise. Some other suggestions include:

  • Get plenty of magnesium in your diet. This mineral is excellent for your heart, and helps electrical impulses in all your muscles to work more efficiently. If you supplement, make sure the magnesium is bound to citrate, malate, or aspartate. Many lower quality supplements are bound to oxide, and this makes the magnesium much less bioavailable.
  • Garlic is also wonderful for your heart. It can help to lower potentially harmful LDL cholesterol, as well as raise the friendly HDL cholesterol.
  • Many folks have also had success using red yeast (Cholestin) supplementation in their diets. It has long been used in Chinese medicine to improve heart health.

If you suffer from angina or other heart pain, the most important thing you can do is to find out why—what is the underlying cause? From there, educate yourself on your possible options for remedying the situation. Above all, never give up. Your body is an amazing organism that has unlimited potential for healing itself no matter how bad your current health may be.

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