Understanding your angina symptoms

“This experience has taught me that I need to take care of my own heart, just like I take care of my patients’ hearts every day.”

-Frances, nurse practitioner, chronic angina patient
Illustration comparing a narrow artery and a healthy artery. In a narrow artery blood flow is reduced. In a healthy artery blood flows freely.

Angina is a chronic condition that needs to be managed over time

Chronic angina is angina that keeps coming back. Learning as much as you can about your chronic angina may help you feel more in control.2

Angina means your heart needs more oxygen

Your heart is a muscle. It needs oxygen to work. The arteries of your heart, also known as coronary arteries, provide oxygen-rich blood to your heart muscle so it can pump blood out to the rest of your body.1

Angina may be a symptom of a heart problem called coronary heart disease (CHD), also known as coronary artery disease (CAD).1,3

In CHD, the blood vessels in your heart become stiff and narrow. Angina usually comes on when too little oxygen reaches your heart muscle.1

Symptoms of angina

Chronic angina is chest pain, discomfort, or pressure that may happen because of1,4:

  • Exercise
  • Extreme temperatures
  • Mental or emotional stress
  • Walking in cold weather, uphill, or after eating

These are not all of the possible causes of angina. Talk to your cardiologist about which activities are sources of angina for you.

What does angina feel like?

People experience angina in different ways1,4,5:

  • Some describe a feeling of uncomfortable pressure, squeezing, tightness, or burning in the chest
  • Some feel pain in the shoulder, arm, back, neck, or jaw
  • Others may feel out of breath, faint, tired, or as if they have indigestion

In women, angina can be different6:

  • The pain may be sharp, throbbing, or burning
  • They may experience pain in the neck or throat area more often
  • Shortness of breath is also common

Make a list of the symptoms you experience with angina and discuss them with your doctor. As an addition to your treatment, your cardiologist may be able to provide tips on how to prevent angina from occurring.

References:

  1. Angina. National Heart Lung and Blood Institute website. www.nhlbi.nih.gov/health/dci/Diseases/Angina/Angina_WhatIs.html. Updated June 1, 2011. Accessed July 10, 2017.
  2. Angina can be stable or unstable. The Society for Cardiovascular Angiography and Interventions website. http://www.secondscount.org/heart-condition-centers/info-detail-2/angina-can-be-stable-unstable#.WPjLf_krJhG. Updated November 12, 2014. Accessed July 10, 2017.
  3. Coronary Artery Disease - Coronary Heart Disease. American Heart Assocation website. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsp#.WWOq2YTyuUk. Updated April 26, 2017. Accessed July 10, 2017.
  4. Angina pectoris. American Heart Association website. www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Angina-Pectoris-Chest-Pain_UCM_437515_Article.jsp. Accessed July 10, 2017.
  5. Morrow DA, Boden WE. Stable ischemic heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2012:1210-1254.
  6. D’Antono B, Dupuis G, Fortin C, Arsenault A, Burelle D. Angina symptoms in men and women with stable coronary artery disease and evidence of exercise-induced myocardial perfusion defects. Am Heart J. 2006;151:813-819.

Are you talking to your doctor about your angina?

It's important to have open conversations about your symptoms and activity levels to provide your doctor the information needed to help manage your angina. The results from the APPEAR study showed that cardiologists reported a lower angina frequency in their patients with coronary artery disease (CAD).1


In the APPEAR study of 1257 stable CAD patients from the ACC PINNACLE REGISTRY*1:

Illustration of APPEAR study CAD patients’ results

1/3 of stable CAD patients (n=411) followed by cardiologists reported angina in the prior month1

APPEAR study physicians image of a doctor with a stethoscope

The physicians for this group were asked how many of their patients reported angina in the previous month, and the results showed:

Graph of APPEAR Study results

Of the 1/3 of patients who reported angina in the prior month, angina was under-recognized 43% of the time by their cardiologists1,2

*APPEAR (Angina Prevalence and Provider Evaluation of Angina Relief) is a cross-sectional study of stable CAD patients (N=1257) enrolled between 2013-2015 from 25 US cardiology practices participating in the ACC PINNACLE registry. 8% (n=96) reported daily/weekly, 25% (n=315) reported monthly, and 67% (n=846) of patients reported no angina using the Seattle Angina Questionnaire.

PINNACLE (Practice INNovation And CLinical Excellence) is cardiology’s largest outpatient quality improvement registry, with over 3 million patients across 127 US sites. Gilead provided funding for this investigator-initiated study.1,3,4

Under-recognition was defined as the physician reporting a lower frequency of angina that the patients had reported using the Seattle Angina Questionnaire (SAQ) domain.

CAD=coronary artery disease.

References:

  1. Shafiq A, Arnold SV, Gosch K, et al. Patient and physician discordance in reporting symptoms of angina among stable coronary disease patients: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study. Am Heart J. 2016;175:94-100.
  2. Qintar M, Spertus JA, Gosch KL, et al. Effect of angina under-recognition on treatment in outpatients with stable ischaemic heart disease. Eur Heart J Qual Care Clin Outcomes. 2016;2(3):208-214.
  3. Eapen Z, Tang F, Jones P, et al. Variation in performance measure criteria for Million Hearts™ significantly affects practice rankings: results from 3,630,462 outpatients in 127 US practices from the NCDR® PINNACLE registry. J Am Coll Cardiol. 2014;63(12):A1297.
  4. Outpatient Registries. American College of Cariology website. http://cvquality.acc.org/NCDR-Home/registries/outpatient-registries. Accessed July 7, 2017.

Meet patients who understand

See how others, like you, have chosen to help take control of their chronic angina. Explore videos featuring patients’ personal accounts of their treatment journey with Ranexa.

Watch how real patients are managing their angina.

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