Angina

Angina, which is chest pain caused by decreased blood flow to the heart muscle, was rare until about 100 years ago.

Causes

Changes in our diet and lifestyle started to catch up with us and cause the arteries (pipes carrying blood) that feed the heart muscle itself to start blocking up.

These blockages cause heart attacks and angina. When they block the arteries going to the brain they can cause a stroke.

These problems are now the most common cause of death in the U.S. and Europe.

Diagnosis

Many benign (not dangerous) things can also cause chest pain, and these are more common causes of chest pain in those under 45 years of age.

These include chest wall (muscle and cartilage) pain, which is also called costochondritis.

• Benign Causes

  • Chest Wall Pain

    If the pain is reproduced or affected by pushing over the ribs and muscle in the area of the pain, it is likely chest wall pain and not dangerous (ribs are thick, and pushing on them won’t cause pain in the heart or lungs below).

    This pain will sometimes be worse with a deep breath, but if this is occurring (especially with a lung infection or cough) see your doctor to check for pneumonia or pleurisy.

  • Heartburn

    If the chest pain is relieved by drinking an ounce or 2 of antacid (e.g., Maalox or Mylanta), it is likely stomach or acid reflux related (see Heartburn and Indigestion for treatment information).

• Angina

  If the pain is worse with exertion, and/or associated with shortness of breath or chest tightness, the risk of it being angina is increased.

  • If this is new and occurring now, call 911, chew up an aspirin and sit back and rest.
  • If it is a chronic and ongoing problem, see your physician.

Either way, if you have chest pain, see your doctor (or go to the emergency room if new or sudden onset).

Most often it will be nothing and you’ll be reassured, but if it is a heart attack or blood clot to the lungs and you miss it, you may be dead.

With chest pain, better safe than sorry.

Treatment

If you suspect you have angina, you should be followed by a physician who can diagnose and treat it.

If angina is proven, use the chest pain medications and even the cholesterol lowering medications (which are NOT needed or helpful in most cases where they are prescribed when no heart disease is present).

• Heart Bypass Surgery

  Sometimes bypass surgery will be required.

  However, some doctors are quick to recommend heart bypass surgery in cases where the research suggests it is not helpful. In such cases, using heart stints is preferable (minor surgery and pretty safe).

  If bypass surgery is recommended, get a second opinion from a cardiologist. If they feel it is If it is not an emergency situation, and it's OK to wait on surgery, try the other options below.

  Risks of Bypass Surgery

  A key risk is the possibility of stunning brain cells during surgery, though much of this can be prevented by antioxidants (which can often be found in a good vitamin powder) plus lipoic acid 300 mg a day. I prefer to begin these at least a week before surgery (but even a day before helps) and continue for a month after.

  In one study, taking ribose was associated with a dramatic drop in heart bypass mortality. I recommend that you take 5 grams 3 times a day for as long as you can before surgery (even 1 day before helps) and for 6 weeks after.

• Diet & Nutrition

  • Eat a high fiber, high vegetable, low red meat diet.
  • Eat at least 3-4 portions a week of added salmon and tuna.
  • Avoid sugars (Stevia is OK).
  • Consume grains that are only whole grains.

• Exercise

  Exercise as OK’d by your physician. This helps your heart and body to heal.

• Supplements & Medication

  • For Heart Disease

    Many nutrients are important for heart health. See the important discussion on nutritional treatments for heart disease.

    In 6 weeks, these treatments may increase your heart efficiency and often improve heart function, lessening the angina.

    The treatments include taking:

    • Ribose
    • Coenzyme Q10
    • B complex vitamin
    • Acetyl L-carnitine
    • Magnesium orotate
    • Pomegranate extract

    Pomegranate extract was associated with a remarkable 35 percent improvement in blood vessel size after 1 year (vs a 9 percent worsening in the placebo group).

  • For High Cholesterol

    Learn how to lower an elevated cholesterol. If on cholesterol-lowering medications, be sure to take Coenzyme Q10 (at least 200 mg a day).

    These medications deplete this nutrient, and the Coenzyme Q10 deficiency can cause fatigue and muscle pain followed by heart failure — which the doctor will blame on your heart disease. Your doctor means well, but no one is paying to be sure they learn about this.

    Though I consider the cholesterol medications (statins) to be a bad idea — the word scam comes to mind — if no heart disease is already present, once someone has been diagnosed with angina (or if you have diabetes) these statin medications can be life-saving and, in these cases, a very good treatment to use.

    A much healthier way to lower cholesterol is with red rice yeast and by optimizing thyroid function, and, in men, optimizing testosterone.

  • For Chest Wall / Muscle Pain

    • Natural Supplements

      • Willow Bark and Boswellia

        Willow bark and Boswellia may be very helpful for most kinds of inflammatory pain.

        Though often helpful with the first dose, they are more effective over time. They increase in effectiveness over the first week of use and then even more over 6 weeks.

      • Curcumin, Boswellia, DLPA and Natto

        Another amazing herbal mix that is excellent for pain is called Curamin. Take 1 capsule 3x day (you can often lower the dose by 6 weeks of use).

      • Comfrey

        A special topical comfrey is also wonderful for muscle pain.

    • Medications

      • Tylenol

        Tylenol is OK to use for the pain, but aspirin related medications like Ibuprofen can cause stomach irritation or ulcers and actually worsen the chest pain over time.

      • Lidoderm Patches

        Lidoderm patches (like Novocaine in a patch) by prescription are excellent.

        Put the patch(es) over the painful area for 16 hours a day (though the box says 12 hours).

        They may start to work in ¹⁄₂ hour, but give them 2 weeks to become optimally effective.

    • Other Therapies / Advice

      • Hot Compress

        If the pain is chest wall tenderness, a hot compress for up to 20 minutes 4 times a day can help the muscle relax.

      • Relax Your Chest Muscles

        Learning to relax your chest muscles (we may keep them tight during stress) can be very helpful.

      • Hot Baths and Showers

        A hot bath (or shower) also helps. Better still is to add 2 cups of Epsom Salts to your bath water.

      • Treat Indigestion & Reflux

        The indigestion/reflux pain can trigger chest wall muscle pain and vice versa in a reflex arc.

  • For Angina Pain

    Follow your physician’s advice for this important problem.

    Natural options to consider which may help heal the problem include:

    • External Counter Pulsation

      A natural option to consider that may help heal the problem is external counterpulsation.

      This safe and simple technique helps your heart to grow new blood vessels to bypass the old blocked ones naturally.

      The economics didn’t work (invasive cardiology like surgery is one of the biggest revenue centers in most hospitals) and it has been slow to catch on.

      Fortunately, many health insurers will pay for the treatment.

    • Intravenous Chelation

      This series of intravenous treatments was found to markedly decrease angina in studies in the 1950’s, and was used without going through the usual placebo controlled studies. Because of this, it became very controversial, with many natural physicians using it and standard practitioners attacking them for this.

      It is very safe (safer than aspirin) but costs over $5,000 for the series of injections (not covered by insurance).

      A placebo controlled trial is underway to test its effectiveness. However, many people have had wonderful results with it, so it should be considered before having non-emergency heart bypass surgery performed.

    I would begin with the External Counter Pulsation, and consider using both together.

More Information Online

• External Counter Pulsation (Cedars Sinai)