Living with Angina
A big part of living with angina is the acceptance that life may never be exactly the same again. Apart from any changes you may have to make to the way you live, you have to accept that taking drugs is also going to be a part of your life.
Instead of hoping that by doing nothing it will all go away, you have to find a way to accept that your life can still be very good. You will still be able to do a lot of things you enjoyed before, by using the drugs in the right way and following the advice to lower your risk factors.
This means taking control of your angina and not letting it control you.Using your GTN
Some people think that if they have to use their tablets or spray a lot it means that they are worse; others think that by not using their spray it means they are better. Neither of these ways of thinking is going to help you.
Explain to those around you about using your GTN. This will alleviate their fear and also give you reassurance that you will get help if you need it.
Accepting the use of your GTN spray or tablets will give you much more freedom and take away fear of pain coming on. If you use your GTN and it wasn’t necessary, the worst thing likely to happen to you is a headache.
GTN should be used before doing an activity or even when you are in fear of an attack coming on.
For information on how to take your GTN visit "How to take your GTN"
Anxiety and panic attacks
Some people become very anxious when they have been diagnosed as having angina.
Anxiety or panic attacks are usually brought on by a tiny thought that goes through your mind sometimes without you even really recognising it. A fearful or negative thought triggers a rush of adrenaline that causes real physical symptoms as it increases the heart rate by as much as walking up a hill does.
As you become aware of these unpleasant symptoms you start to feel that there is something wrong and the symptoms worsen. By now the heart is beating fast, you may be sweating and breathless and even feeling some chest pain. This is often what we may feel when we are having a panic attack.
Learning to cope with these feelings will give you the power to control the very unpleasant symptoms involved and help you to deal with what is actually happening.
For more information on ways of controlling anxiety, visit "Controlling your Anxiety".
Keeping active
Keep active by pacing yourself
Any form of exertion can bring angina on; climbing stairs, carrying shopping, walking up a slope or hurrying. These are things that we can not really avoid in usual circumstances.
You may find you have to pace yourself in your daily activities so that you do not overdo it one day and then have to rest and feel unwell the next. Breaking bigger jobs up into smaller tasks makes this easier.
In the same way you can break up a walk into distances you know you can manage, even if it means using your spray to do so.
The added benefit of keeping active
Keeping active has been proven to be of great benefit to angina sufferers.
It is also known that we very quickly become unfit if we stop keeping active. Anything requiring effort will be harder for the heart to cope with, and so angina will come on more quickly. Ask your doctor or practice nurse about exercising and keeping active if you are unsure. They can give you some advice about exercising safely.
When to see the doctor
You should see your doctor urgently if:
- You are getting angina for the first time
- The pain / breathlessness is getting worse and occurring more frequently
- The pain / breathlessness happens when you are not doing anything
When to call 999
If your chest pain is more severe than usual and persists longer than 20 minutes in spite of treatment with GTN it is possible you may be having a heart attack.
What do do if you get chest pain/discomfort
Stop what you are doing, sit down if possible
Take your GTN spray (1-2 puffs) under your tongue
Rest until the pain goes away, then continue what you were doing at a slower pace
...if the pain does not go away within 5 minutes, take another 2 puffs of GTN spray
...if the pain does not go away after a further 5 minutes, take another 2 puffs of GTN spray
...if the pain continues after a further 5 minutes (that is 15 minutes since the onset of your pain) phone 999 for an ambulance
If the pain gets worse or you develop other symptoms (for example, breathlessness, sweating, palpitations, nausea) phone 999 for an ambulance
This may be an emergency situation where getting help quickly could be vital.
Friends, family and work
Many people find it hard not to be overprotective of their loved one. Try to understand that they are only concerned for you. If you bring your angina out into the open, and discuss it, you will all know what to do.
Some people can not continue to work, due to safety reasons, e.g. pilots and divers or those whose jobs are excessively physically or mentally demanding. It may be necessary to retrain or finding alternative duties at your workplace.
When your job is mentally demanding or stressful it is important to learn some stress management skills, including time management. A simple rule of thumb regarding time management is one third sleep one third work and one third social and leisure activities.
Heavy jobs at home can be dealt with a little at a time but don’t let the thought of them cause anxiety.
Sex
Some people lose interest in sex or come to fear it. This may be because of fear of having a heart attack or a very bad attack of angina. It may be that a person feels their role with their partner has changed.
The stress on the heart during sexual intercourse is equal to walking briskly up and down two flights of stairs of 13 steps each. If no pain or undue breathlessness occurs then intercourse should be problem free.
You can take your GTN either before or during sexual activity in the same way you would use it for any other activity.
Generally sex with an unfamiliar partner, after a heavy meal, when intoxicated or when fatigued is more likely to bring on angina.
Some people find their desire for sex altered or experience impotence. This can be a side effect of beta-blockers so speak to your doctor about it.
Talking to your partner about how you feel and any worries you may have will make it easier for you both to deal with the situation before it becomes a problem. Sometimes simple solutions can be found such as using different positions. If you or your partner have any questions or concerns regarding your sexual relationship try to talk to your doctor.
Driving
If you ever experience angina while driving, stop the car safely – immediately.
For safety reasons the Driver and Vehicle Licensing Agency (DVLA) has strict guidelines about who may and may not drive. For further information on driving if you suffer from angina, visit "
Driving with Angina".
Flying and travel insurance
You are allowed to fly as a passenger as long as your angina is stable. If you require assistance or early boarding you should notify the airline in advance. Make sure you are not carrying heavy luggage and that you have your medication, especially GTN in your hand luggage.
You have to declare having angina or coronary heart disease when seeking travel insurance to ensure that you have the appropriate cover when abroad.
To protect yourself when flying always:·
- Drink plenty of fluids
- Avoid alcohol
- Get up regularly for short walks
- Make sure you have plenty of legroom, book in advance if need be
- Stretch and move your feet and legs regularly when sitting
Further useful information for people with angina
- Always check with the pharmacist that ‘over the counter’ remedies are safe to be used with your tablets before buying
- Alcohol may increase side effects of headache with GTN
- Beware of grapefruit as it reacts with several heart medicines. No more than one portion of grapefruit / juice per day is recommended
- GTN patches can be helpful as a back up to other medication especially overnight - you should discuss this your doctor
- Avoid moving or carrying heavy objects; ask someone to help you
- Eating a large meal can increase the work the heart has to do by 20%. Change your routine so that you can have a rest after eating or eat smaller meals more often and avoid angina
- Angina is often worse in cold or windy weather, so wrap up warmly and don’t overdo things
- A lowered pulse rate is normal with beta-blockers. If tiredness and fatigue becomes a problem, the doctor will probably try lowering the dose
- You must keep taking your tablets as and when prescribed, even if you are going to the hospital for tests or to see a specialist, unless specifically asked to do differently
- If you are going to use a mobile phone in an emergency, you must tell the emergency services operator exactly where you are so that the call is diverted to a local centre
- Do not be afraid to seek medical help if you have severe angina or possible symptoms of a heart attack
The information on this page has been adapted from the Chest, Heart and Stroke Scotland leaftlet "
Living with Angina"