What the pain feels like, symptoms you experience when you have chest pain, such as high blood pressure, and any symptoms you experience afterwards, such as nausea or dizziness. How often you experience chest pain, where you feel pain or discomfort, the severity of the pain and how long the pain lasts. Dietary changes or foods you ate two to three days prior to experiencing chest pain or indigestion. Also note any beverages such as coffee, tea, and soda, and how frequently you drink them per day or per week. New exercise regimes or recreational activities that cause physical exertion. Any stressful environments, work or relationships that may be causing symptoms of chest pain. Any other conditions you may have or any illnesses you may have had, such as a fever or cold, prior to experiencing chest pain. Any drugs, medications, supplements, herbs or home remedies you are currently using or may have used in the past two weeks. If your chest pain is interfering with your daily activities.
Stable angina: Stable angina is the most common type which follows a regular pattern, such as when it occurs and what factors may trigger it. It usually occurs after stress or physical activity and may last one to 15 minutes. Stable angina isn’t a heart attack, but suggests that a heart attack is more likely to occur in the future. If you have stable angina, you can learn its pattern and predict when the pain will occur. The pain usually goes away a few minutes after you rest or take your angina medicine (usually nitroglycerin, taken sublingually or under the tongue). Variant angina: Variant angina is rare. A spasm in a coronary artery causes this type of angina. Variant angina usually occurs while you’re at rest, and the pain can be severe. It usually happens between midnight and early morning. Smoking is a major risk factor for this type of angina. Medicine can relieve this type of angina. Unstable angina: Unstable angina doesn’t follow a pattern and it may occur more often and be more severe than stable angina. It often occurs while the person is at rest. This type is very dangerous as it suggests that a heart attack may happen soon and requires emergency treatment. Unstable angina also can occur with or without physical exertion — it often happens without physical activity. Rest or medicine may not relieve the pain. Microvascular angina: Microvascular angina can be more severe and last longer than other types of angina. It is often noticed during routine activities and times of psychological stress. Symptoms include shortness of breath, sleep problems, fatigue and lack of energy. Medicine may not relieve this type of angina.
Ask your doctor about an ECG if you experience angina pain and have had heart problems in the past or have a strong history of heart disease in your family. Make sure your healthcare provider knows about all the medications you are taking, as some can interfere with test results. Exercising or drinking cold water immediately before an ECG may cause false results.
Your doctor also may recommend a blood test to check for low levels of hemoglobin in your blood. Hemoglobin is an iron-rich protein in red blood cells. It helps the blood cells carry oxygen from the lungs to all parts of your body. If your hemoglobin level is low, you may have a condition called anemia.
Aim to drink at least eight ounces of water every two hours. [8] X Research source 2 liters of water is the daily recommendation for the average adult. If you take caffeinated beverages, take 1 liter of water for every cup (1 fluid oz. ) of caffeine. If you are taking blood-thinning medications or diuretics (water pills) for angina pain, ask your doctor about how much water you should consume. Not getting enough water can also lead to dehydration. Dehydration can cause headaches, irritability, dizziness, irregular heartbeat and shortness of breath. Non-caffeinated, glucose-free sports drinks with electrolytes can help alleviate dehydration as well.
Avoid caffeine, nicotine, alcohol and sugary drinks four to six hours before sleeping. These can act as a stimulant to keep you awake. A quiet, dark, and cool environment can help promote sleep. Use heavy curtains or an eye mask to block light. Light is a powerful cue that tells the brain that it’s time to wake up. Keep the temperature comfortably cool (between 65 and 75°F or 18. 3 to 23. 9°C), and keep the room well ventilated. Make sure your bedroom is equipped with a comfortable mattress and pillows. Change your sheets and pillow covers often. If you have trouble breathing, try to prop your head up on a pillow to improve air flow. Struggling to fall asleep just leads to frustration. If you’re not asleep after 20 minutes, get out of bed, go to another room and do something relaxing until you are tired enough to sleep. Avoid activities such as work or exercise three to four hours prior to sleeping. Physically and psychologically stressful activities can cause the body to secrete the stress hormone cortisol, which is associated with increasing alertness. Try listening to relaxing music or doing some light reading a few hours before sleeping. Having a regular sleep schedule helps to ensure better quality and consistent sleep. Try to set a routine by going to bed early and waking up early to set your body’s internal clock. If you have congestive heart failure in addition to angina you may need to elevate the bed with pillows when you sleep so that your head is above your heart.
Think about ways you can walk while you work, such as standing while talking on the phone. Take five minute breaks between work to stretch your arms and legs. The muscle activity needed for standing and other movement seems to trigger important processes related to the breakdown of fats and sugars within the body. When you sit, these processes stall and your health risks increase. When you’re standing or actively moving, you kick the processes back into action.
Slow, deep breathing in a quiet environment. Breath in through your nose and out through your mouth. Try and feel the diaphragm muscle when you breath in order to stimulate the parasympathetic nervous system. Focus on positive outcomes. Restructure priorities and eliminate unnecessary tasks. Reduce use of electronic devices. These may cause eye-strain and trigger headaches. Use humor. Research has found humor to be an effective way to deal with acute stress. Listen to relaxing music.
Talk with your healthcare practitioner or a registered clinical exercise physiologist (RCEP) before starting an exercise program. Ask for specific program recommendations to improve cardiovascular fitness, increase muscle strength and endurance, and improve range of motion. An extended warm-up and cool-down may reduce the risk of angina or other cardiovascular complications following exercise. Warming up and cooling down are important parts of every exercise routine. They help the body make the transition from rest to activity and back again, and can help prevent soreness or injury, especially in older people. Choose low-impact activities such as walking, cycling or water exercises, which involve large muscles groups and can be done continuously. If your fitness level is low, start with shorter sessions (10 to 15 minutes) and gradually build up to 30 minutes five or more days per week. [16] X Expert Source Shervin Eshaghian, MDBoard Certified Cardiologist Expert Interview. 26 June 2020. Perform light-resistance circuit training and whole-body range-of-motion exercises two to three days per week. Closely monitor your intensity level and stay within your recommended target heart-rate zone. Take frequent breaks during activity if needed. Stop exercising immediately if you experience angina. Contact your physician if you experience chest pain, labored breathing or extreme fatigue. Don’t eat for two hours prior to exercise. Drink plenty of fluids before, during and after a workout. If nitroglycerin has been prescribed, always carry it with you, especially during exercise.
Digital monitors are the best choice for most people. Practice using the monitor with your doctor or nurse to make sure you are taking your blood pressure correctly. A digital blood pressure monitor will not be as accurate if your body is moving when you are using it. Also, an irregular heart rate will make the reading less accurate. Your arm should be supported, with your upper arm at heart level and feet on the floor with your back supported and legs uncrossed. It’s best to measure your blood pressure after you rest for at least five minutes. Blood pressure should not be checked right after experiencing stress, exercise, tobacco exposure, or consuming foods or beverages, such as coffee, that can raise blood pressure. If your blood pressure monitor shows a reading of more than 120/80 mmHg, you may have moderate hypertension. If it shows a reading higher than 140/90 mmHg, you may have high blood pressure and should tell your doctor. All adults should have their blood pressure checked every one to two years if their blood pressure was less than 120/80 mmHg at their most recent reading.
Taking frequent showers or showers longer than 15 minutes is not recommended as it can cause dry skin.
Avoid alcoholic drinks if you are: someone recovering from alcohol addiction, pregnant or breastfeeding women, someone with a family history of alcoholism, someone with liver disease, or someone taking one or more medications that interact with alcohol.
Refined carbohydrates such as white bread, pastries and donuts Fried foods Sugar-sweetened beverages such as soda or energy drinks Red meat such as veal, ham or steak and processed meats such as hot dogs Margarine, shortening and lard
Grapes Pineapples Strawberries, blueberries and cherries Oranges Pomegranates Apples
Leafy vegetables such as spinach, kale, collard greens, lettuce and cabbage Broccoli Green beans Sprouts Carrots Tomatoes
Eggs Flaxseed Fatty fish such as salmon, tuna, mackerel and shrimp Poultry meats such as quail, turkey and chicken Nuts such as walnuts, almonds, and Brazil nuts
You can also use these oils for salad dressings.
Eat a teaspoon of wild honey in the morning every day. You can also add ½ teaspoon of honey to decaffeinated tea or glass of water and drink the mixture, up to three times per day. Make sure the honey does not contain added sugars, as these sugars can increase the risk of diabetes when used for a long period.
Vitamin C can be taken as a dietary supplement with a recommended dose of 500 mg split into two or three times daily. You can also add vitamin C-rich foods to your daily diet. Good natural sources of vitamin C are: Sweet red or green peppers Citrus fruit such as oranges, pomelo, grapefruit, limes or non-concentrated citrus juices Spinach, broccoli and Brussel sprouts Strawberries and raspberries Tomatoes Mango, papaya and cantaloupe Since smoking depletes vitamin C, smokers may need an additional 35 mg per day.
The recommended dosage for niacin are 14 to 18 mg per day, whether taken as a supplement or through a food source. Do not take a higher dosage unless recommended by your doctor. People with coronary artery disease, severe or unstable angina should not take niacin without their doctor’s supervision. Large doses can raise the risk of heart rhythm problems. The best food sources of vitamin B3 are found in beets, brewer’s yeast, beef liver, beef kidney, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts. Bread and cereals are usually fortified with niacin. In addition, foods that contain tryptophan, an amino acid the body converts into niacin, include poultry, red meat, eggs, and dairy products. Niacin is available as a tablet or capsule in both regular and timed-release forms. The timed-release tablets and capsules may have fewer side effects than regular niacin. However, the timed-release versions are more likely to cause liver damage. Doctors recommend periodic liver function tests when using high doses (above 100 mg per day) of niacin.
Natural food sources of magnesium are salmon, mackerel, halibut, tuna, dark chocolate, dark leafy greens, nuts, seeds, brown rice, lentils, soybeans, black beans, chickpeas, avocado, and bananas. Calcium can inhibit the absorption of magnesium supplements, so it is better to use more readily absorbed forms such as magnesium bicarbonate and magnesium oxide. 100 mg of magnesium supplements is recommended to be taken two to three times daily. Adults should get at least 280–350 mg of magnesium daily. Symptoms of magnesium deficiency may include agitation and anxiety, restless leg syndrome (RLS), sleep disorders, irritability, nausea and vomiting, abnormal heart rhythms, low blood pressure, confusion, muscle spasm and weakness, hyperventilation, insomnia, and even seizures. Excessive intake of magnesium can have adverse effects and reduce calcium absorption, so it is important not to overdose. Ask your doctor what dosage will be right for your individual needs.
Resveratrol is available as a liquid extract, capsules or tablets at most pharmacies and nutrition stores. The recommended dosage for resveratrol is 30 to 45 mg after meals, up to three times per day.
Squeeze half a lemon into a cup of warm water and drink this mixture on an empty stomach in the morning. You may also add lemon juice as flavoring to your regular foods.
Eat one clove of raw garlic in the morning. If you do not like eating raw garlic, you can add minced or chopped garlic as a flavoring to your meals. Garlic supplements are also available at most pharmacies and nutrition stores. The recommended dosage for aged garlic extract is 600 to 1200 mg daily, divided into two to three doses. Garlic capsules or tablets should contain 0. 5–1. 5% of alliin or allicin to be beneficial, at a dosage of two 200 mg tablets, three times a day. People using prescription or blood-thinning medications, or those with ulcers and thyroid problems, should ask their doctor before using garlic or garlic supplements.
Do not take more than 4 gram of ginger per day without asking your doctor. Ginger should not be used with blood-thinning, hypertension or diabetic medications. Ginger can be added to your diet in many ways. You can boil 2–4 grams of ginger in a 1 cup of water to make unsweetened ginger tea. You can also take a ginger supplement, which are available at most pharmacies or add chopped ginger to your food.
Ask your doctor before using ginseng, especially if you are using prescription medications to manage angina. Your doctor will help determine the right dosage for you.
Turmeric and curcumin supplements are considered safe when taken at the recommended doses. The recommended dosage for adults is 400–600 mg, up to three times per day. Taking large amounts of turmeric for long periods of time may cause stomach upset and, in extreme cases, ulcers. People who have gallstones or obstruction of the bile passages should talk to their doctor before taking turmeric. Add 1 teaspoon of turmeric powder to a cup of warm milk to create a heart-healthy drink that can be taken one to three times per day. You can also add a pinch of turmeric powder to your cooking for flavor. Ask your doctor before using turmeric if you are taking blood-thinning or diabetes medications.
You experience new or recurrent angina symptoms more often. You experience angina pain while sitting or resting. You have trouble taking your heart medication You feel tired, faint or lightheaded more often. You experience an irregular heartbeat, low (below 60 beats per minute) or high (above 120 beats per minute) blood pressure. You experience any other unusual symptoms that may be related to angina.
During an angioplasty, a small balloon is expanded inside the coronary artery to help compress the blockage and expand the artery wall. A wire mesh tube called a stent is sometimes implanted to keep the artery wall expanded. The procedure can last for two to three hours. Ask your doctor if an angioplasty may help your condition.
You typically receive 35 one-hour treatments over a period of seven weeks. EECP therapy can be performed by a licensed therapist or physician.
Anti-platelet drugs, also called blood-thinners, such as aspirin. Take the baby strength (81 mg) aspirin or cut the regular strength (325mg) aspirin in half. Take one pill once a day with food. Studies have shown that taking aspirin decreases your risk of a cardiovascular disease. [46] X Research source Hennekens CH, Buring JE, Sandercock P, et al. Aspirin and other antiplatelet agents in the secondary and primary prevention of cardiovascular disease. Circulation 1989; 80:749. ACE inhibitors to treat hypertension and high blood pressure Beta-blockers to treat hypertension, irregular heartbeat, angina pain and to prevent a heart attack. Calcium channel blockers for angina pain and hypertension Diuretics (water pills) to flush out excess sodium Statins to lower cholesterol Nitroglycerin pills or nitrates to stop an angina attack
The signs and symptoms of a heart attack How to use medications when needed, such as nitroglycerin How to access emergency medical services in your community The location of the nearest hospital that offers 24-hour emergency heart care. Call 911 if you experience unstable angina, a heart attack, or loss of consciousness. You should also call 911 if the pain lasts longer than usual or if the pain returns a few minutes after taking medication.
This medicine should be used exactly as directed by your doctor. Do not take more than the prescribed dose, do not take it more frequently, and do not take it for a longer time than your doctor ordered. If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take double doses. When you begin to feel an attack of angina starting such as chest pains, tightness or squeezing in the chest, sit down. Use a nitroglycerin tablet or spray as directed by your doctor. You may become dizzy, lightheaded, or faint soon after using a tablet or spray, so it is safer to sit rather than stand while the medicine is working. If you become dizzy or faint while sitting, take several deep breaths and bend forward with your head between your knees. Remain calm and you should feel better in a few minutes. Nitroglycerin sublingual tablets usually give relief in one to five minutes. Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed. They work much faster when absorbed through the lining of the mouth. Place the tablet under the tongue or between the cheek and gum, and let it dissolve. Do not eat, drink, smoke, or use chewing tobacco while a tablet is dissolving. If the pain is not relieved, you may use a second tablet five minutes after you take the first tablet. If the pain continues for another five minutes, a third tablet may be used. Ask your doctor or nurse how to properly use a nitroglycerin oral spray if prescribed. You may administer one or two sprays of nitroglycerin oral spray at the onset of chest pain. If the pain continues after five minutes, a third spray may be used. You must wait five minutes after the first one or two sprays before using a third spray. If you still have chest pain after a total of three tablets or three sprays, contact your doctor or go to a hospital emergency room right away. Do not drive yourself and call 911 if necessary. Tell your doctor if you have any other respiratory or heart conditions. Also alert your doctor if you are using any other medications, supplements, herbal or home remedies, or if you experience an allergic reaction to nitroglycerin. Nitroglycerin should not be used for severe or unstable angina, during a heart attack, to treat low blood pressure or for people with anemia. Call 911 if you or someone with angina experiences a heart attack. Consult your doctor and see if nitroglycerin interacts with any of you current medication.
