Angina pectoris is the term used to describe the disorder associated with chest pain or chest discomfort. It is due to an imbalance of oxygen supply and demand to the heart muscle and is often the first sign of coronary disease. The need for oxygen may increase, as it does with exercise, excitement, eating a heavy meal or exposure to cold. The amount of oxygen available in the bloodstream can be reduced due to the narrowed vessels supplying the heart muscle with blood and oxygen.

Angina can occur suddenly or gradually and usually lasts for a short time (5 to 15 minutes). The discomfort usually occurs in the mid-chest area and can radiate to the back, neck, arms, jaws, shoulders and upper abdominal area. The discomfort is frequently described as vague "aches," "sensations," or "feelings." It has also been described as "pressure," "burning," "squeezing," heaviness," "smothering," "tightness" and "indigestion." Other symptoms associated with angina are shortness of breath, sweating, nausea, belching and apprehension.

Management of this disorder is directed toward correcting the imbalance of oxygen supply and demand. If you are engaging in some activity, you should stop the activity and rest, which may relieve the discomfort. Drugs can be used to increase blood flow and oxygen to the heart muscle.

Nitroglycerin tablets are commonly used for anginal discomfort. After you sit or lie down, place the tablet under your tongue for immediate absorption and relief. If there is no relief after five minutes, a second nitro tablet is placed under the tongue. If you get no relief after another five-minute interval, place a third tablet under your tongue. If you still get no relief with this sequence of three nitroglycerin tablets, call 911 immediately and go to the nearest Emergency Room. Nitroglycerin tablets can cause you to experience a headache and a "flushed" feeling. You should carry the nitroglycerin with you at all times. It should be kept in the original dark bottle and should be replaced when it has expired. Other medications known to treat angina are: calcium channel blockers, beta blockers and long-lasting nitrates. When predictable angina becomes unpredictable in its course, it is called unstable angina. This disorder requires more aggressive therapy. You should notify your primary care physician or our office if your symptoms occur more frequently or the pattern changes.