What brings on the pain? Most angina starts with exercise. Physical effort brings it on, and rest relieves it. Your doctor will wish to know how much exercise produces the pain, and how long it lasts after you start to rest.
Angina is graded according to how much exercise you can take before the pain starts, so try to estimate how many stairs you can climb, how far you can walk on a flat surface, or up a slope, or whether you can run for a bus, dig in the garden, or make love. Don’t hesitate to list all the times you have noticed the pain: your doctor will not be embarrassed.
For some people, angina occurs while they are resting, or even wakes them out of a sleep. This is a serious sign, and needs urgent assessment in a coronary care unit. Prompt investigation and treatment can prevent an imminent heart attack.
The same goes for angina that doesn’t go away immediately upon rest, or keeps returning several times a day. If your pain is coming more often than it was, is more severe, or is lasting longer, see your doctor immediately.
The next question is: What do you do when the pain starts? Do you try to walk through it, or stop until it goes away? The correct answer is always to stop and let it subside completely. The pain is a sign that the heart is trying to cope with an imbalance between the supply of oxygen to the heart muscle and the oxygen needed for it to fulfill the demands on it for energy.
Suffice it to say here that this imbalance must be corrected quickly if damage to the heart muscle is to be avoided—and the fastest way to do that is to rest. Resting quickly eases the demands made on the heart.
When the demand of the heart for oxygen exceeds the supply, the condition is called ischemia—the medical term for lack of blood to an organ. Because of this, angina is sometimes given the label of “ischemic heart disease.”
Gone are the days when you would be handed a few pills to put under your tongue and told to live with the pain. If angina is suspected, the cause must be determined and, if possible, treated. Thus there will be routine blood tests to rule out problems such as anemia; there will be different electrocardiographic tests, including twenty-four-hour monitoring and treadmill tests, to pinpoint defects in the coronary artery system and the extent of any ischemia; there may be radioisotope or echocardiography tests to show how the heart muscle is beating; and finally an angiogram to see if bypass surgery is feasible.
*8\86\8*
