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Getting tough with angina

This heart ailment can put a chokehold on patients' lifestyles, but a new program with a wrestling motif plans to reduce this bully's power to disrupt daily activities.

By SUSAN ASCHOFF, Times Staff Writer
© St. Petersburg Times
published July 16, 2002

ST. PETERSBURG -- Sometimes it happens when the day is more eventful than usual. Other times it comes in the quiet of the night, when he is awakened by the sudden, crushing pain in his chest.

"I have no fear other than, is this the one? Am I having a heart attack?" says Paul Michael Downing, 65, of St. Petersburg. He pops a nitroglycerin pill, or two, and the pain dissipates. He has suffered another angina attack.

Angina affects 6.4-million people in the United States, many of whom downsize their lives to avoid the unpredictable pain and shortness of breath experienced in an attack.

Angina is a temporary blockage of blood flow caused by narrowed arteries, damaged heart muscles, congestive heart failure or other coronary artery disease that cannot be treated with surgery. The heart is not receiving sufficient oxygen. In a heart attack, there is no oxygen supply. Angina attacks might be triggered by stress, exertion, eating, hot or cold temperatures and smoking.

This month a national program to help angina sufferers and their families kicks off in Tampa/St. Petersburg and nine other U.S. cities. Sponsored by the Preventive Cardiovascular Nurses Association, "Get Tough on Angina" also boasts the macho appeal of World Wrestling Entertainment star Edge as a spokesperson.

Locally, free forums on angina are scheduled at 6-8 p.m. today and 1:30-3:30 p.m. Friday at St. Anthony's Hospital, 1200 Seventh Ave. N, in St. Petersburg. To register or for information, call 1-866-488-1212 or go to Dr. Jeffrey Witt, director of the Heart and Vascular Institute in St. Petersburg and an assistant clinical professor of medicine at the University of South Florida, will discuss the condition and its treatments.

"Get Tough," the first program of its kind in the nation, was created after a survey found that more than half of chronic angina patients have difficulty with the most basic daily tasks, from grocery shopping to picking up a grandchild to climbing a flight of stairs.

"Angina limits activity, even the amount of food they can eat," says Helen King, a cardiovascular nurse at the Heart and Vascular Institute and a forum speaker. "But their lifestyle can be managed so they don't become cardiac cripples."

Changes in diet, moderate exercise, scheduling of activities to avoid overexertion and medication can limit the number and severity of angina attacks, she says.

Though the condition can be treated, patients continue to experience erratic chest pressure and pain. Some feel faint or nauseated during an attack. About two-thirds will still have symptoms despite drug therapy. As many as one-fourth of the people who suffer heart attacks will develop angina.

Always, there is the fear, says Downing, a retired stockbroker.

"It limits you psychologically," he says. "I'm supposed to walk every day and every day I walk I get chest pain. It's not going to go away."

Downing, who has had a heart attack and triple bypass surgery, says he has learned to recognize the difference between a heart attack and an angina attack. If the pain persists longer than 10 to 15 minutes and after a couple of nitroglycerin pills, he's going to the hospital, he says.

"You learn what you need to do. I don't panic."

But he still struggles with angina's control over his choices. He often forgoes a walk, he says, for fear of another attack.

The survey found more than 60 percent of angina patients rate their quality of life as "fair" or "poor," even though more than 80 percent have made significant lifestyle changes to avoid the pain.


Angina attacks occur when your heart is not receiving the oxygen it needs. This can happen in two ways.

First, even though the usual amount of blood might be flowing through the coronary arteries, the blood might not have enough oxygen to support the extra work the heart is doing during exercise or emotional stress.

Second, the amount of blood flowing through the heart might be less than before because the arteries of the heart have become partially blocked. This means less oxygen -- therefore, less fuel for making energy -- reaches the heart.


Many people describe angina as a viselike, crushing, or squeezing sensation behind the breastbone. Some people might also feel pain, or an unusual feeling in the jaw, teeth, shoulder, back, or radiating down the arm. Still others might experience numbness or feel as if they're having indigestion.

If this type of pain is more severe than you've ever felt, if it makes you feel faint or nauseated, causes you to break out in a cold sweat, or is unrelieved by the short-acting nitroglycerin your doctor might have prescribed, you might be having a heart attack. Call 911 or your local emergency number right away.


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