Heart Health Heart Health Basics

Angina (Chest Pain)

What should I do if the angina has changed recently?
If you have a history of coronary artery disease and your previously stable angina pattern has changed, an appointment with the treating physician should be made immediately. Changes in how you typically experience angina may suggest progression of coronary artery disease and the need for additional therapy or intervention.

How is my chest pain evaluated by a physician?
The physician begins with a medical history and physical examination. An electrocardiogram (a test which measures electrical flow through the heart to measure the functioning of the muscle -- referred to as either an EKG or ECG) and blood tests are usually part of the initial evaluation. If your physician suspects coronary artery disease, you will likely be referred to a heart specialist, although some primary care physicians will continue to evaluate you themselves. The next step is a treadmill stress test, which determines if your chest pain can be brought on by exercise and if there is evidence of coronary artery disease. After the stress test, there are many different diagnostic and treatment options. If the stress test is positive, many patients will undergo a cardiac catheterization.

How is angina treated?
There are several treatment options: lifestyle and diet changes, drug therapy, catheter-based intervention procedures, such as balloon angioplasty, and surgery. Usually several options will be used simultaneously. The decision on what treatments to use is usually complicated and is based on a consideration of many factors, such as

• type of symptoms the patient is having
• severity of symptoms
• number of vessels blocked
• nature of the blockage
• patient's responsiveness to medication
• patient's family and medical history, such as type of employment, age, associated medical problems
• patient's preference for treatment

Is exercise a good idea if I have a history of angina?
This question should be addressed to your treating physician because every patient is different. However, several general statements can be made. There is no reason why someone with coronary artery disease cannot exercise. It should not be a sudden effort but rather a gradual increase in intensity. For example, walk until you begin to experience angina; stop and rest until the pain subsides: then resume the activity again. However, any exercise program must be done under the supervision of the treating physician.

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