Angina (Chest Pain) Living With
Angina is not a heart attack, but it is a signal that you are at greater risk of having a heart attack. The risk is higher if you have unstable angina. For this reason, it is important that you receive follow-up care and understand your condition so you know when to get medical help.
Receive routine follow-up care
You may need follow-up visits every 4 to 6 months for the first year after diagnosis of angina and every 6 to 12 months as long as your condition is stable. Your care plan may be changed if your angina worsens or if stable angina becomes unstable. Unstable angina is a medical emergency. Your doctor may recommend cholesterol-lowering statins as part of your long-term treatment, especially if you have had a heart attack.
- Ask your doctor about when you can resume normal physical activity, such as climbing stairs.
- Ask your doctor whether sexual activity is safe for you. People who have unstable angina or angina that does not respond well to treatment should not engage in sexual activity until their heart condition and angina are stable and well managed.
- Talk to your medical team about vaccinations to prevent the flu and pneumonia.
Adopt heart-healthy lifestyle changes
Angina is a symptom of heart disease. Your doctor may recommend the following heart-healthy lifestyle changes to help you manage angina:
- Choose heart-healthy foods. Following a healthy eating plan, including limiting alcohol, can prevent or reduce high blood pressure and high blood cholesterol, helping you reduce angina symptoms and maintain a healthy weight. You should avoid large meals and rich foods if heavy meals trigger your angina. If you have variant angina, drinking alcohol can also be a trigger.
- Aim for a healthy weight. If you have overweight or obesity, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you manage the risk factors for angina.
- Be physically active. Before starting any exercise program, ask your doctor about what level of physical activity is right for you. Slow down or take rest breaks if physical exertion triggers angina.
- Manage stress. If emotional stress triggers your angina, try to avoid situations that make you upset or stressed.
- Quit smoking. Smoking can damage and tighten blood vessels, make angina worse, and raise the risk of life-threatening complications. Visit Smoking and Your Heart and the NHLBI’s Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you may call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
Your doctor may recommend these heart-healthy lifestyle changes as part of a larger cardiac rehabilitation program that your doctors oversee.
Prevent repeat angina events
Stable angina usually occurs in a pattern. After several events, you will learn what causes the pain to occur, what the pain feels like, and how long the pain usually lasts. To help learn your angina’s pattern and triggers, keep a log of when you feel pain. The log helps your doctor regulate your medicines and evaluate your need for future treatments. When you know what triggers your angina, you can take steps to prevent or lessen the severity of events.
- Know the limits of your physical activity. Most people who have stable angina can continue their normal activities. This includes work, hobbies, and sexual relations. Learn how much exertion triggers your angina so you can try to stop and rest before the chest pain starts.
- Learn how to reduce and manage stress. Try to avoid or limit situations that cause anger, arguments, and worry. Exercise and relaxation can help relieve stress. Alcohol and drug use play a part in causing stress and do not relieve it. If stress is a problem for you, talk with your doctor about getting help.
- Avoid exposure to very hot or cold conditions, because temperature extremes strain the heart.
- Eat smaller meals if large meals lead to chest pain.
Tell your doctor right away if your pattern changes. Pattern changes may include angina that occurs more often, lasts longer, is more severe, occurs without physical exertion, or does not go away with rest or medicines. These changes may be a sign that your symptoms are getting worse or becoming unstable.
Seek help for angina that does not improve
Not all angina improves with medicines or medical procedures. If your symptoms continue, your doctor may change your medicines or therapies to help relieve your chest pain.
- Enhanced external counterpulsation therapy (EECP) improves the flow of oxygen-rich blood to the heart muscle, which may help relieve angina. EECP uses large cuffs, similar to blood pressure cuffs, on your legs. The cuffs inflate and deflate in sync with your heartbeat. You typically get five 1-hour treatments per week for 7 weeks. Side effects may include back or neck pain and skin abrasions.
- Spinal cord stimulators block the sensation of pain. Emerging research suggests that this technology can help people be more physically active, feel angina less often, and have a better quality of life.
- Transmyocardial laser therapy stimulates growth of new blood vessels or improve blood flow in the heart muscle. It can relieve angina pain and increase your ability to exercise without discomfort. This laser-based treatment is done during open-heart surgery or through cardiac catheterization. Rarely, your doctor may recommend this treatment in combination with coronary artery bypass grafting.
Know your medicines
You should know what medicines you are taking, the purpose of each, how and when to take them, and possible side effects. Learn exactly when and how to take nitroglycerin or other short-acting nitrates to relieve chest pain.
- Talk to your doctor about any other medicines you are taking, including vitamins and nutritional supplements. Some medicines can cause serious or life-threatening problems if they are taken with nitrates or other angina medicines. For example, men who take nitrates, including nitroglycerin, for their angina should not take medicines for erectile dysfunction without checking with their doctor first.
- Tell your doctor about any side effects. Do not stop taking your medicines without talking to your doctor first.
- Learn how to store your medicines correctly and when to replace them.
- Learn how to take short-acting nitrates safely.
- Take them immediately before any planned exercise or physical exertion.
- Watch for side effects such as flushing, headache, or dizziness. Find a place to sit down or something to hold on to if you feel dizzy.
- After 5 minutes, if the pain has not gone away, take another dose.
- Call 9-1-1 if the pain continues after taking a second dose. This could be a symptom of unstable angina, which is a medical emergency.