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Iíve been told I have angina. How significant is that and should I be worried?

Angina Pectoris is defined as pain coming on with exertion relieved with rest or nitroglycerin and occurring in the center of the chest radiating to the arms, neck or shoulder. This is a classic kind of chest pain that one get when thereís a blocked artery in the heart. We are well aware, however, that other disorders may cause a similar kind of pain, including disorders of the esophagus, heart, gallbladder and sometimes musculoskeletal problems. The list of medical problems that can masquerade as serious heart disease is indeed quite long. Also, experience tells us that many patients with heart disease do not have angina pectoris or have some variation of this syndrome. Unfortunately, most people with heart disease have no symptoms whatsoever and their first symptom will be a heart attack or sudden death.

Angina pectoris when due to blocked arteries in the classical sense, must be evaluated quickly, and in my opinion is definitely a symptom with potentially lethal outcomes. Any chest pain above the waist must be regarded as a potential heart disorder. Evaluation should be carried out immediately and includes a good physical exam, a stress test, possibly a nuclear stress test and often an echocardiogram, chest film and lab work. Depending on the outcomes of these studies, further evaluation with a heart catheterization is most often necessary.

If there is a blocked artery, current approaches include using a stent to correct this disorder, managing the patient with medications or doing a by pass procedure. In any event, the finding of a blockage in a coronary artery means that the patient has atherosclerotic vascular disease and will have to cope with this problem for the rest of his life. Reduction of risk factors includes, stopping smoking, losing weight, exercising, controlling cholesterol and managing high blood pressure, diabetes or other co-existing medical problems. It is of the absolute essence that any chest pain be evaluated in any individual with the thought that a potential heart problem exists. It is especially critical that the symptom of angina pectoris as described more than two hundred years ago in 1768 by a physician named Heberdon, be evaluated immediately. The symptom of chest pain brought on with exertion and relieved with rest or nitroglycerin is the classic symptom of coronary heart disease.

The situation of coronary heart disease becomes even more complex given the fact that many people do not have this symptom but in fact have some other chest pain above the waist or shortness of breath, weakness, sweating, a feeling of hopelessness or sometimes even back pain. Fatigue also is a very common presentation for patients with coronary heart disease and is second only to shortness of breath in terms of presenting symptoms of our patients.

Fortunately, for all of us, we now have the technology to accurately determine the course of angina pectoris and properly treat it. Furthermore, making the diagnosis of coronary heart disease and treating it aggressively, lowers the mortality risk immensely in this disorder.


Galichia Medical Group, P.A.
2600 N Woodlawn
Wichita, KS 67220

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