Angina - what to ask your doctor
What to ask your doctor about angina and heart disease; Coronary artery disease - what to ask your doctor
Angina is pain, pressure, or other sensation in the chest that happens when your heart muscle is not getting enough blood and oxygen.
You sometimes feel it in your neck or jaw. Sometimes you may notice only that your breath is short.
Below are some questions you may want to ask your health care provider to help you take care of your angina.
Questions
What are the signs and symptoms that I am having angina? Will I always have the same symptoms?
- What are the activities that can cause me to have angina?
- How should I treat my chest pain, or angina, when it happens?
- When should I call my provider?
- When should I call 911 or the local emergency number?
How much exercise or activity can I do?
- Do I need to have a stress test first?
- Is it safe for me to exercise on my own?
- Where should I exercise, inside or outside? Which activities are better to start with? Are there activities or exercises that are not safe for me?
- How long and how hard can I exercise?
When can I return to work? Are there limits to what I can do at work?
What should I do if I feel sad or very worried about my heart disease?
How can I change the way I live to make my heart stronger?
- What is a heart-healthy diet? Is it OK to ever eat something that is not heart healthy? What are some ways to eat healthy when I go to a restaurant?
- Is it OK to drink any alcohol?
- Is it OK to be around other people who are smoking?
- Is my blood pressure normal?
- What is my cholesterol and do I need to take medicines for it?
Is it OK to be sexually active? Is it safe to use sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis)?
What medicines am I taking to treat or prevent angina?
- Do they have any side effects?
- What should I do if I miss a dose?
- Is it ever safe to stop any of these medicines on my own?
If I am taking aspirin, clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient), or another blood thinner, is it OK to take ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or other pain medicines?
It is OK to take omeprazole (Prilosec) or other medicines for heartburn?
When people have chest pain, they're often concerned they're having a heart attack. I'm Dr. Alan Greene and I'd like to talk to you for a moment about the different kinds of chest pain and when it may be an emergency. It turns out, there are lots of different kinds of chest pain. In fact, almost everything in the chest can hurt in one way or another. Some of the causes are really nothing more than a minor inconvenience. Some of them though are quite serious, even life threatening. You can have chest pain sure from the heart, but also from pneumonia. You can have chest pain from asthma. You can have chest pain from a blood clot in the lungs. It can be from nothing more than a strain of some of the muscles between the ribs, or nerves. You can also have chest pain that comes from acid reflux of from a stomach ulcer, gallstones. Many, many things can cause chest pain. You want to call 911 if you are having sudden, crushing chest pain or if your chest pain radiates into the jaw or the left arm. You want to call 911 if your chest pain also causes shortness of breath, or dizziness, nausea, or vomiting. You want to call 911 if you know you have heart disease and you do occasionally have pain but your pain is getting significantly worse than it is ordinarily. Or comes on with less activity than it does otherwise. But whatever the cause of chest pain, unless you're sure what causing it, it's worth contacting your physician to find out what may be going on. It's not a symptom to ignore.
References
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718
Bonaca MP, Sabatine MS. Approach to the patient with chest pain. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 35.
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014 Apr 22;129(16):e462. PMID: 23166210
O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2013 Sep;62(11):1039. PMID: 23256913
Version Info
Last reviewed on: 8/23/2022
Reviewed by: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
