Managing Angina: Symptoms and Treatment Options

Angina pectoris

Dear Director He,
I have been experiencing symptoms of angina for the past few months.
The symptoms have been intermittent, and I have undergone X-rays, an electrocardiogram (ECG), and an echocardiogram.
The doctor prescribed medication, which I have been taking for two months, but I still occasionally feel pain, although it is less severe.
What should I do? Should I continue taking the medication? Additionally, my cholesterol level is 210.
Is there a connection? Thank you for your guidance amidst your busy schedule.
Sincerely,
A Confused Patient

Liou, 40~49 year old female. Ask Date: 2008/11/09

Dr. He Dongjin reply Cardiology

Hello, first of all, I'm not sure if your symptoms are truly angina.
Generally speaking, angina is less common at your age, but chest tightness is quite common.
It is advisable to undergo an exercise electrocardiogram, nuclear medicine imaging, or even a 64-slice computed tomography scan for a definitive diagnosis.
If a diagnosis is confirmed, further treatment or ongoing medication for high cholesterol should be considered.
I recommend that you seek further evaluation and discuss this with your physician.
Changhua Hospital cares about your health.

Reply Date: 2008/11/09

More Info

Managing angina can be a complex process, especially when symptoms persist despite treatment. Angina pectoris is a type of chest pain caused by reduced blood flow to the heart muscle, often due to coronary artery disease. Understanding your symptoms and treatment options is crucial for effective management.

Symptoms of Angina
Angina symptoms can vary from person to person, but they typically include:
- Chest Pain or Discomfort: Often described as a feeling of pressure, squeezing, fullness, or pain in the center or left side of the chest. This discomfort may also radiate to the shoulders, neck, arms, back, teeth, or jaw.

- Shortness of Breath: This may occur with or without chest discomfort.

- Nausea or Fatigue: Some individuals may experience nausea, sweating, or fatigue during an angina episode.

Treatment Options
1. Medications: Common medications prescribed for angina include:
- Nitrates: Such as nitroglycerin, which help to widen blood vessels and improve blood flow to the heart.

- Beta-blockers: These reduce the heart's workload and lower blood pressure.

- Calcium Channel Blockers: These help relax and widen blood vessels.

- Antiplatelet Agents: Such as aspirin, which help prevent blood clots.

- Statins: To manage cholesterol levels, especially since you mentioned having a cholesterol level of 210, which is considered borderline high.

2. Lifestyle Changes: Making changes to your lifestyle can significantly impact your heart health:
- Diet: Adopt a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins while limiting saturated fats, trans fats, and cholesterol.

- Exercise: Regular physical activity can improve cardiovascular health. Consult your doctor about a safe exercise plan.

- Weight Management: Maintaining a healthy weight can reduce the strain on your heart.

- Smoking Cessation: If you smoke, quitting is one of the most significant changes you can make for your heart health.

3. Monitoring and Follow-Up: Since you have been experiencing ongoing symptoms, it is essential to maintain regular follow-up appointments with your healthcare provider. They may need to adjust your medication or explore other treatment options, such as:
- Coronary Angioplasty and Stenting: A procedure to open narrowed arteries.

- Coronary Artery Bypass Grafting (CABG): Surgery to create a new path for blood to flow to the heart.

Cholesterol and Angina
Your cholesterol level of 210 is a factor to consider in your overall heart health. High cholesterol can contribute to the buildup of plaques in your arteries, leading to coronary artery disease, which is a common cause of angina. It is essential to discuss with your doctor whether you should start or continue taking statins or other medications to manage your cholesterol levels effectively.

Conclusion
In summary, it is crucial to continue taking your prescribed medications as directed by your healthcare provider, even if your symptoms seem to fluctuate. Regular communication with your doctor about your symptoms, medication effectiveness, and any side effects is vital for managing your angina effectively. Additionally, implementing lifestyle changes and monitoring your cholesterol levels can significantly improve your heart health and overall well-being. If you experience severe or worsening symptoms, seek medical attention promptly.

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