Angina attacks can come on very suddenly and are often painful and worrying. But there are several ways to prevent and treat angina.

What is Angina?

The pain commonly occurs at times when the heart is working hard, such as during exercise, and diminishes with rest. However, attacks may also occur at times of inactivity or even during sleep. Angina is sometimes an indication of increased risk of heart attack (myocardial infarction)–especially if the pattern of the attacks increases in frequency or becomes more irregular.

 

Angina symptoms

Angina pain often begins below the breastbone and radiates to the shoulder, arm or jaw. It may be accompanied by shortness of breath, temporary nausea, lightheadedness, irregular heartbeat and anxiety.

If you think you might have angina, see your GP. If you have chest pain that lasts for 15 minutes or is accompanied by shortness of breath and nausea, dial 999 straight away. While waiting for the ambulance to arrive, take 300mg soluble aspirin immediately.

Anyone with angina symptoms who consults a doctor is likely to be given a prescription for glyceryl trinitrate. This can come as tablets or, more commonly, a spray to be used under the tongue. Glyceryl trinitrate can help people deal with the onset of a heart attack, easing chest pain and tightness by increasing the supply of blood and oxygen to the heart.

 

Angina attack: What to do first

Sit down and rest if you’re standing, walking or running at the time of the attack.

If you're lying down, sit or stand up, to take the pressure off the nerve in your heart that is signalling pain. Speak to your doctor as angina when resting is a sign that you may be at higher risk of a heart attack.

If you’re stressed, excited or anxious, try to calm yourself. Like physical stress, mental stress can increase your heart's demand for oxygen, so try out some stress-relieving techniques.

 

Natural angina treatments

Omega-3 fatty acids protect the heart and blood vessels. These are found in fish oil capsules, though if you eat oily fish–such as trout, salmon or sardines–twice a week, you don't need to take capsules. Check with your doctor before taking fish oil supplements to make sure they won't interact with any other medications you may be taking. Look for a supplement that provides 1000mg combined EPA/DHA (eicosapentaenoic and docosahexaenoic acids) a day.

Several studies have shown that a clove of garlic a day can lower high cholesterol and there is evidence that garlic also reduces the tendency of blood to clot–another heart benefit. Eat it raw for maximum effect, or crushed in a salad dressing. If you can't stand the smell, garlic capsules offer similar health benefits. Take according to manufacturer's instructions; do not exceed a dose of 6g dried clove equivalent a day.

Folic acid and vitamin B12 are vitamins that lower raised levels of homocysteine, a substance in the blood that may increase your risk of heart disease. The best source of these vitamins may be dietary–some studies have questioned the benefits of supplements. Eat plenty of meat, fish or eggs for B12 and leafy vegetables and citrus fruits for folic acid. Other research suggests that you can cut your risk of heart disease by taking 400mcg of folic acid and 0.5mg of vitamin B12 a day.

 

How to prevent angina

Work out an exercise program with your doctor's guidance as regular exercise can help to ward off angina pain.

If you smoke, quit. The nicotine in cigarettes constricts the arteries, triggering angina or making it worse. And stay away from smoky environments, too.

Try and give up coffee. In several recent studies, coffee intake has been linked to raised homocysteine levels, which can increase the risk of angina attacks.

After eating a large meal, rest or engage in a quiet activity. When you consume a heavy meal, the body diverts extra bloodflow to the digestive tract to aid digestion, so the heart receives less oxygen and is more vulnerable to an attack.

Don't stay outdoors in cold weather. Cold air stimulates muscular reflexes that can cause angina.

Avoid sudden physical exertion, such as running to catch a bus or lifting a heavy object.

Try to maintain a healthy body weight. Eat at least 7 portions of fruit and vegetables a day (5 of vegetables and 2 of fruit) and plenty of wholegrain cereals. Cut down on fatty foods, particularly fried foods, biscuits and milk chocolate (dark chocolate is OK in moderation as it's rich in anti-oxidants); and choose skimmed or low-fat milk. Eat lean meat in preference to fatty cuts and fish at least twice a week. Keep spreads and oils to a minimum and vary them–olive oil for salad dressings and a polyunsaturated margarine, for example.

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