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Angina
Dorothy Tscheng, BScPhm,
Drug Information Pharmacist, Drug Information and Research Centre,
Toronto
Angina is chest pain (sometimes described as discomfort or pressure)
due to a condition called coronary heart disease. In order for
the heart to function properly, blood must bring oxygen flow
to bring oxygen to the heart muscle. Angina results when the
heart needs more oxygen than it is getting, for example during
exercise or when under emotional stress. This is often due to
a narrowing of the heart’s blood vessels (’atherosclerosis’)
or when blood vessels supplying the heart muscle vigorously contract
(’coronary artery spasm’). Other causes of angina
may include exposure to extreme temperatures, consumption of
alcohol and cigarette smoking.
Each person might describe angina pain differently. It may be
described as actual pain, persistent indigestion, uncomfortable
pressure or squeezing/tightness in the chest. Sometimes the symptoms
are felt in parts of the body distant from the heart, such as
the jaw, neck, back, shoulders or arms. Angina symptoms usually
last a few minutes and go away with rest. People with ’stable’ angina
have episodes of chest pain that occur predictably (for example,
during exercise), while those with ’unstable’ angina
may have symptoms that occur at unexpected times or when at rest.
Immediate rest is the most important thing to remember when
symptoms occur. Nitroglycerin is often used to treat an attack.
Nitroglycerin relaxes the blood vessels in the heart, thereby
increasing the blood and oxygen supply to the heart muscle. Nitroglycerin
is available as tablets or a spray to be used under the tongue.
Other medications that lower blood pressure or reduce the heart
rate (pulse) can be prescribed to help prevent angina symptoms
from occurring. These include agents known as ’beta-blockers’ and ’calcium-channel-blockers’.
Aspirin is commonly used by people with angina to prevent the
formation of clots inside blood vessels, which can lead to angina
symptoms. Surgical procedures that widen or bypass narrowed arteries
may be considered if medications fail to control symptoms.
If at anytime you use three doses of nitroglycerin within 15
minutes (or as directed by your doctor), and your angina symptoms
are still present, it is very important that you go a hospital
emergency department right away. It is also important that you
see your doctor if you have stable angina and the pattern or
frequency of your symptoms increase. The dose of your medication
may need to be adjusted or a new medication may be required to
help relieve the symptoms.
For more information on angina, visit the Heart and Stroke Foundation
of Canada at www.heartandstroke.ca.
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The information in this newsletter was prepared and reviewed
by pharmacists for the Canadian Pharmaceutical Journal.
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Ask Your Pharmacist newsletter is produced through
an unconditional educational grant from APOTEX/PACE. |
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