The gripping chest pain that is angina

Although conventional medications for angina may help to relieve the intense chest pain of this heart disorder, they do very little to halt the physiological mechanisms behind it. Vitamins, minerals and natural remedies may improve the condition - or at least keep it from worsening.

What It Is
When your heart isn't getting enough blood and oxygen, the crushing, squeezing pain of angina is typically the result. Usually the pain begins below the breastbone and radiates to the shoulder, arm or jaw, increasing in intensity until it reaches a plateau and then diminishes. Attacks can last up to 15 minutes.

What Causes It
Angina is a direct result of a buildup of plaque (atherosclerosis) in the arteries that supply the heart with blood. Like any other muscle in the body, the heart needs blood and oxygen to do its work of pumping blood throughout the circulatory system.

With atherosclerosis, the arteries may be wide enough to provide sufficient blood flow during rest, but they can’t supply enough oxygen-rich blood when physical activity increases the demand on the heart. Any exertion - climbing stairs, running for the bus. even having sex - can trigger some angina attacks. Other cases of angina occur when a small blood clot forms on the surface of a blood vessels plaque and temporarily blocks a coronary artery: this is a heart attack. Angina may also result if a coronary artery goes into spasm.

Symptoms

• Crushing or squeezing chest pain
• Weakness
• Sweating
• Shortness of breath
• Palpitations
• Nausea
• Light-headedness

When to Call a Doctor

• If you have any of the above symptoms for the first time.
• If there is any change in the normal pattern of your angina attacks - for example, if they increase in frequency, intensity or duration, or if they are brought on by new activities.
• If an angina attack is severe, you are having a heart attack - call an ambulance immediately.
• Reminder: If you have a medical condition, talk to your doctor before taking supplements.

How Supplements Can Help
The supplements described here can all be used together or alone. They can also complement your prescription angina medications - but never stop your heart medication without first consulting your doctor.

The antioxidant effect of vitamins C and E can help prevent cell damage: vitamin C aids in the repair of the arteries injured by plaque, and vitamin E blocks the oxidation of LDL ('bad') cholesterol, the initial step in the formation of plaque. In addition, some people with heart disease have low levels of vitamin E as well as the mineral magnesium, which may inhibit spasms of the coronary arteries.

The amino acid arginine plays a role in forming nitric oxide, which relaxes artery walls. One study found that taking it three times a day allowed people with angina to exercise at moderate intensity for longer without chest pain. Carnitine, an ammo-acid-like substance, allows heart muscle cells to use energy more efficiently and the ammo acid taurine may regulate heart rhythm abnormalities.

Like carnitine, the nutritional supplement coenzyme Q10 benefits the heart muscle, reducing its workload, and the herb hawthorn improves blood flow to the heart. Essential fatty acids may be effective in lowering cholesterol levels and keeping arteries flexible.

What Else You Can Do

• Eat a low-fat, high-fiber diet: use extra virgin, cold-pressed olive oil instead of butter.
• Don't smoke, and avoid smoky places.
• Learn to relax. Such techniques as meditation, tai chi and yoga may reduce the frequency and intensity of angina attacks.
• Join a support group. Determine what brought you to this point in your life and what you can do to begin reversing the disease.

Case Study

A heartfelt tale
Michael M, a surgeon, first felt twinges in his chest as he was taking part in a five-kilometer race. 'Must be the heat or indigestion', he thought. But later, when the pain literally stopped him in his tracks as he was running upstairs, he knew something was wrong.

A year later, after many painful episodes of angina, a heart attack and a coronary bypass, he began to feel chest twinges again. He realized that this new angina was a warning that the whole process could easily repeat itself unless he made some drastic changes.

Dr M embraced his new lifestyle as seriously as anything he'd ever done. He walked every day and reduced the fat in his diet; he practiced meditation and the Chinese martial art tai chi. In addition, he took his holidays as a number of three-day weekends rather than one long (and often stressful) trip. Finally, he learnt about vitamins, minerals, herbs and antioxidants.

Now, virtually symptom-free and 9 kilograms lighter, Dr M looks a decade younger than his 64 years. 'I'd been giving health advice for years', he says. 'The time finally came when I had to say: Physician, heal thyself.'

Did You Know?
Oily fish, such as salmon, sardines, mullet and herring, are particularly beneficial to heart health. But they should be fresh and preferably steamed or poached, as canning and high frying temperatures damage the oils.