By Dr. Norman K. Brown
UTU Medical Consultant
“Doctor, I have this pain in the center of my chest, which feels like pressure or tightening. It starts when I am exerting myself or under stress, and subsides completely when I stop to rest for just a minute or two.”
I have heard this complaint many times over almost 50 years now. This is a classic description of what is called “angina pectoris” or “pain chest” — or “angina” for short. It is due to one or more narrow spots in an artery or arteries which supply blood to our heart muscle.
Despite the fact that our hearts contain blood all the time, each section of heart muscle derives its oxygen and nutrients from branches of this separate circulation called the coronary arteries.
Early in my medical practice, when I heard this story, I knew the diagnosis almost right away, and I would prescribe nitroglycerine to open the arteries partially during the pain.
But down deep in my own emotions, I knew that most such patients would be at risk of future heart attack(s), heart failure, and even death in coming months and years. Now fast forward 50 years and the treatment of this serious and often progressive condition has been totally changed, so I, and you, if diagnosed with angina pectoris, can be highly optimistic, even deep down.
Working hard to control weight, exercise, diet, smoking, high blood pressure and diabetes always helps and these efforts continue to be the preventive cornerstones in fighting this disease. But now, in addition, just in my medical lifetime, amazing new medications (for blood pressure, cholesterol, heart rhythm, blood clotting), operations (bypasses, angioplasties — stretching the arteries’ narrow spots with a catheter, stents — pieces of tubing which hold a coronary artery open), electrical stimulators (for rhythm problems — pacemakers, defibrillators) have been developed to change the entire effect of coronary heart disease on you and me as patients with this condition.
What do I recommend? I advise the same “blood-vessel-healthy” lifestyle efforts for stroke prevention (see my separate article on strokes on the “Health care” page of the UTU website at www.utu.org), plus a baby aspirin a day for most of us. Discuss this with your own physician.
I was so pleased to read in a recent issue of the UTU News about four UTU members’ New Year’s resolutions addressing smoking cessation. Keep it up! These are long-haul approaches. But what about the short term?
Please consult your doctor if you even think you are having pains something like the above-described angina. If such pains develop severely and/or suddenly, call 911 since the pain is telling you, and your doctor, that a portion of your heart muscle is suffering a lack of blood supply and urgent action may save that muscle, just as urgent action can save your brain tissue in the parallel reduced blood supply situation called a stroke.
Think about the arteries throughout your body as a transportation system for delivering supplies, oxygen and nutrients to your body. Just as high quality care of the rails helps to keep trains running efficiently and safely, so too your arteries will respond to the quality care you give them.