Chapter # 4 Angina. Know what to do if you feel angina

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1 Chapter # 4 Angina Know what to do if you feel angina You will learn: 1) What angina is 2) How angina affects you 3) How to prevent and manage angina during exercise Chapter 4 Angina pg. 23

2 What is Angina? Angina is a warning sign that your heart is under stress. When there is not enough blood and oxygen getting to your heart (see Figure 1 below), you may feel pain or discomfort in one or more areas listed below. You may also feel shortness of breath, feel very tired (fatigue) or have nausea. You may feel pain (discomfort) in the: Chest Jaw Arms Upper back Throat Shortness of breath Fatigue 1A 1B Figure 1 A. In a blocked coronary artery the heart does not receive enough blood and oxygen. Figure 1B. In a normal coronary artery the heart receives enough blood and oxygen. Angina occurs when part of one of your coronary arteries (the arteries that bring blood and oxygen to your heart) is blocked. Your coronary arteries can get blocked when plaque collects over time. Plaque is a waxy substance made of fat, cholesterol and calcium. 3 Types of Angina There are 3 types of angina: stable, unstable, and silent Stable angina Stable angina may occur when you exercise too hard, when you feel stressed or after a heavy meal. You can predict when stable angina will occur. Most often, your symptoms last or less and are relieved by rest or Nitroglycerin (a medicine that helps with angina). Chapter 4 Angina pg. 24

3 Unstable Angina Unstable angina may occur at any time even when you are resting or sleeping. You cannot predict when unstable angina will occur. Your symptoms can last for up to 30 minutes. Call 911 if you have unstable angina. An ambulance can take you to the Emergency Department. Do not drive yourself or have a loved one drive you to the Emergency Department. An ambulance is equipped with life-saving tools and medicine. Silent Angina (or Silent Ischemia) Silent angina (also known as silent ischemia) is when your heart does not get enough blood and oxygen, but you do not feel any symptoms. You will not know if you are having silent angina. A simple test called an electrocardiogram (ECG) will show if your heart is getting enough blood and oxygen. See Chapter 8 Your Heart & Heart Disease for more information about ECGs. Silent angina is more likely to occur if: You do not warm up before you exercise You have diabetes Be sure to warm up before you exercise. Be sure to warm up before exercise to lower your risk of angina How Angina Affects You How you feel angina can differ from how others feel it. It is important to know how angina affects you. To be safe, answer the questions below and record your answers. You will need to be able to describe how angina affects you to notice if it changes. Where on your body do you feel angina? When do you feel angina? What are you doing when you feel angina? How long does your angina last? What takes your angina? How often do you feel angina? Chapter 4 Angina pg. 25

4 When you describe how angina affects you, it is also important to rate how much pain or discomfort you feel when you have angina. Knowing how much pain or discomfort you feel will: 1) Help your doctor know how to manage your angina 2) Help you know if your angina is getting better or worse Rating of Perceived PAIN (Borg) Nothing at all Extremely weak (just noticeable) Very weak Weak Moderate Strong Very strong Extremely strong Figure 2. Borg rating of perceived pain scale The Borg Rating of Perceived Pain Scale (see Figure 2) can help you describe your pain or discomfort. The scale goes from 0 to 10 and some of the numbers have verbal ratings as well. Know How to Prevent and Manage Angina During Exercise There are many things you can do to help prevent angina during exercise. Take your cardiac medicines as prescribed by your doctor Warm-up for 5-10 minutes before you exercise. See Chapter 2 Safe Exercise for more details Follow your exercise prescription. See Chapter 3 Aerobic Exercise Prescription for more details If you get angina during exercise, follow the steps on the next page to make sure you keep your heart safe. See your doctor if you: Experience a change in your symptoms Have new symptoms Feel angina more frequently or at a lower level of physical activity If you experience angina that does not go after 3 sprays of Nitroglycerine, call 911. Chapter 4 Angina pg. 26

5 If You Feel Angina During Exercise Slow your exercise pace for 1 minute If angina does not go If angina goes Stop exercising, sit down and wait 1 minute Continue exercising at that slower pace Continue on if you have no angina Sit down and take your Nitroglycerine as prescribed by your doctor. Rest for 5 minutes Take a second Nitroglycerine and rest If angina goes after taking 1 spray of your Nitroglycerine, talk to your doctor and Cardiac Rehab team to see if it is safe for you to return to your exercise the same day. Even if your angina goes after taking 2 sprays of your Nitroglycerine, do not return to exercise the same day. Call your doctor if these symptoms are new or different for you. Take a third Nitroglycerine and rest If your angina does not go after your third Nitroglycerine, Call 911 for help Chapter 4 Angina pg. 27

Chapter # 3 Aerobic Exercise

Chapter # 3 Aerobic Exercise Know how your aerobic exercise program works You Will Learn: 1) What aerobic exercise is and why it is important 2) The components of your aerobic exercise program 3) Why it