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Can you tell me what stable angina is? 

What is stable angina?

Stable angina, also known as angina pectoris, is a type of chest pain or discomfort that occurs when the heart muscle doesn’t get enough oxygen-rich blood. This is typically caused by a buildup of plaque in the coronary artery, which reduces blood flow to the heart muscle. Stable angina is considered “stable” because the pattern and severity of the symptoms are consistent and predictable – this means you know what triggers the pain, like exercise or climbing the stairs, and how to resolve it, like by taking a break.

Symptoms of stable angina typically include:

  • Chest pain or discomfort, which may feel like a squeezing, pressure, or fullness in the chest
  • Pain or discomfort in the arms, jaw, neck, back, or stomach
  • Shortness of breath
  • Nausea or dizziness

These symptoms usually occur during physical activity or emotional stress, and they can be relieved by rest or by taking medications such as nitroglycerin.Stable angina is a serious condition that requires medical attention. Treatment options may include medications such as beta blockers, calcium channel blockers, and statins to reduce the risk of plaque buildup and improve blood flow, lifestyle changes such as exercise, diet, and stress management, and procedures such as angioplasty or coronary artery bypass surgery.

It’s worth noting that stable angina is different from unstable angina, which is characterized by a change in the pattern or severity of symptoms, and requires immediate medical attention as it may be an early warning sign of a heart attack.

What causes stable angina?

Stable angina is typically caused by a buildup of plaque in the coronary artery, which can block or reduce blood flow to the heart muscle. The plaque is made up of cholesterol, fatty substances, inflammatory particles, and other materials that can accumulate in the artery wall.

There are several factors that can contribute to the development of plaque in the coronary artery and increase the risk of stable angina, including:

  • High blood pressure: High blood pressure can cause damage to the blood vessels, which can lead to the formation of plaque.
  • High cholesterol: High levels of LDL (bad) cholesterol can contribute to the buildup of plaque in the artery.
  • Smoking: Smoking damages the walls of the blood vessels, increases oxidative stress, and boosts the risk of plaque formation.
  • Diabetes: Diabetes creates tremendous inflammation, increases the risk of plaque formation, and damages the blood vessels.
  • Age: As people age, they are at a higher risk of plaque formation just due to accumulating damage.
  • Family history: A family history of heart disease increases the risk of stable angina.
  • Obesity
  • Lack of physical activity
  • Poor diet
  • Stress

It’s worth noting that the presence of any of these risk factors does not necessarily mean that an individual will develop stable angina, but the risk increases with the number of risk factors present. People with multiple risk factors should be more vigilant about monitoring their health and also reduce any risk factors possible.

What are the symptoms of stable angina?

The symptoms of stable angina typically include:

  • Chest pain or discomfort: This may feel like a squeezing, pressure, or fullness in the chest, and it may spread to the arms, jaw, neck, back, or stomach. The pain may be mild or severe, and it usually lasts for a few minutes.
  • Shortness of breath: This can occur along with chest pain or discomfort, or on its own.
  • Nausea or dizziness: These symptoms can occur along with chest pain or discomfort.
  • Fatigue: Some people may experience a feeling of weakness or fatigue with stable angina.

Stable angina symptoms are typically triggered by physical activity, even mild activity, or emotional stress, and they can be relieved by rest or by taking medications such as nitroglycerin. If symptoms change in frequency, duration, or severity, it could indicate unstable angina which requires immediate medical attention as it may be an early indicator of a heart attack. Also, some people may not have typical chest pain as a symptom and the only symptom they have could be shortness of breath, pain in their back, shoulder, or jaw, or even sudden anxiety triggered by activity.

What are the risk factors for stable angina?

There are several risk factors for stable angina, including:

  • High blood pressure: High blood pressure stresses the blood vessels, which can lead to the formation of plaque.
  • High cholesterol: High levels of LDL (bad) cholesterol can contribute to the buildup of plaque in the artery.
  • Smoking: Smoking damages the walls of the blood vessels, increases inflammation, and encourages plaque formation.
  • Diabetes: Diabetes creates tremendous oxidative stress throughout the body, increases the risk of plaque formation and damages the blood vessels.
  • Age: As people age, they are at a higher risk of plaque formation.
  • Family history: A family history of heart disease increases the risk of stable angina.
  • Obesity: Being overweight or obese increases the pressure on blood vessels and the added strain can lead to symptoms of angina.
  • Lack of physical activity: People who are physically inactive have a higher risk of developing stable angina.
  • Poor diet: Eating a diet high in saturated fats, cholesterol, and salt can increase the risk of stable angina.
  • Stress: High levels of stress can increase the risk of stable angina and also act as a trigger.
  • Previous heart attack or other cardiovascular disease: A history of heart attack or other cardiovascular disease can increase the risk of stable angina.

It’s worth noting that the presence of any of these risk factors does not necessarily mean that an individual will develop stable angina, but the risk increases with the number of risk factors present. People with multiple risk factors should be more vigilant about monitoring their health and also take steps to reduce any risk factors they have control over.

How is stable angina diagnosed?

Stable angina is typically diagnosed by a healthcare provider through a combination of a physical examination, a review of symptoms, and diagnostic tests. The diagnostic tests that may be used to diagnose stable angina include:

  • Electrocardiogram (ECG): An ECG is a test that records the electrical activity of the heart. It can show if the heart is getting enough blood and oxygen and detect any abnormalities in the heart’s rhythm.
  • Stress test: This test is done while the patient is exercising on a treadmill or stationary bike. It helps to identify if there are changes in the heart’s rhythm or blood flow during physical activity.
  • Blood tests: Blood tests can help to check for markers of heart damage and to check independent risk factors such as cholesterol and glucose levels.
  • Coronary angiogram: This is a test that uses X-ray imaging and contrast dye to create detailed images of the coronary artery. It’s used to identify blockages or narrowed areas in the coronary artery that may be causing stable angina.
  • CT Coronary angiogram: This test uses computed tomography to create detailed images of the coronary artery and identify blockages or narrowed areas in the coronary artery that may be causing stable angina.

Based on the results of these tests, a healthcare provider can make a diagnosis of stable angina and develop an appropriate treatment plan. If the test results are inconclusive, additional tests may be needed to confirm the diagnosis.

How is stable angina treated?

Treatment for stable angina typically includes a combination of medications, lifestyle changes, and in some cases, procedures. The specific treatment plan will depend on the individual and the severity of their condition.

Medications:
  • Nitrates: These medications, such as nitroglycerin and isosorbide dinitrate, help to widen the blood vessels and improve blood flow to the heart. Thse are used in the moment to relieve symptoms of angina.
  • Beta blockers: These medications, such as propranolol and atenolol, help to slow the heart rate and reduce the workload on the heart, thus preventing angina episodes.
  • Calcium channel blockers: These medications, such as amlodipine and diltiazem, help to relax the coronary artery and improve blood flow to the heart. This is intended to reduce the number of angina episodes.
  • Statins: These medications, such as atorvastatin and simvastatin, help to lower cholesterol levels and reduce the risk of plaque formation in the coronary artery. This is intended to reduce the risk of angina and other coronary artery disease.
Lifestyle changes:
  • Diet: Eating a healthy diet that is low in saturated fat, cholesterol, and salt can help to reduce the risk of plaque formation in the coronary artery, reduce blood pressure, and help you to lose weight if needed.
  • Exercise: Regular gentle physical activity can help to improve cardiovascular health and reduce the risk of stable angina
  • Weight management: Maintaining a healthy weight can help to reduce the risk of both stable and unstable angina.
  • Stress management: Managing stress through techniques such as meditation, yoga, or counseling can help to reduce the risk of stable angina.
  • Avoid smoking and limit alcohol consumption
Procedures:
  • Angioplasty: This procedure uses a small balloon to widen the coronary artery and improve blood flow to the heart. This is considered a temporary measure, but can be curative if lifestyle modifications are also adopted.
  • Coronary artery bypass surgery: This procedure involves grafting a healthy vessel from another part of the body to bypass a blocked coronary artery and improve blood flow to the heart. This treatment is considered curative with lifestyle modification.

It’s important to note that the treatment plan should be tailored to the specific needs and circumstances of each patient. It’s essential to work closely with healthcare provider to monitor the progress and adjust the treatment accordingly.

What is the long-term outlook for people with stable angina?

The long-term outlook for people with stable angina depends on several factors, including the severity of the condition, the effectiveness of treatment, and the individual’s overall health. With proper treatment and lifestyle changes, many people with stable angina are able to manage their symptoms and reduce the risk of complications.

However, it’s important to note that stable angina is a chronic condition that requires ongoing management. People with stable angina are at an increased risk of developing other cardiovascular conditions, such as heart attack or heart failure. Regular follow-up appointments with a healthcare provider are important to monitor the condition, adjust treatment if necessary, and catch any potential complications early.

Lifestyle changes such as eating a healthy diet, proper hydration, regular exercise, and not smoking, can help to reduce the risk of complications and improve the long-term outlook for people with stable angina. Additionally, taking medications as prescribed and monitoring of blood pressure, cholesterol and glucose levels is essential to manage the condition effectively.

It’s also important to be aware of the symptoms of unstable angina and seek medical attention immediately if symptoms change in frequency, duration, or severity, as unstable angina can be a sign of a heart attack. With proper treatment and management, people with stable angina can often lead normal lives and continue to engage in most of the activities they enjoy.

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Amy Neuzil
Amy Neuzil

Dr. Amy Neuzil, N.D. is a leading expert in MTHFR and epigenetics, and she is passionate about helping people achieve optimal health and wellness for their genetic picture. She has helped thousands of people overcome health challenges using a simple, step-by-step approach that starts with where they are today. Dr. Neuzil's unique approach to wellness has helped countless people improve their energy levels, lose weight, and feel better mentally and emotionally. If you're looking for a way to feel your best, Dr. Amy Neuzil can help. Contact her today to learn more about how she can help you achieve optimal health and wellness.

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