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Is exercise that’s too intensive resulting in your angina?

Navy Hospitalman Kiana Bartonsmith checks a patient’s heart rate at Naval Branch Health Clinic Kings Bay in Georgia, one of Naval Hospital Jacksonville’s six health care facilities. (U.S. Navy photo by Jacob Sippel) Navy Hospitalman Kiana Bartonsmith checks a patient’s heart rate at Naval Branch Health Clinic Kings Bay in Georgia, one of Naval Hospital Jacksonville’s six health care facilities. (U.S. Navy photo by Jacob Sippel)

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Coronary artery disease is the most common type of heart disease and the leading cause of death in the United States for both men and women. Arteries carry oxygenated blood throughout the body including to the heart muscle. Over time, plaque can build up in the arteries, which harden and constrict blood flow to the heart. When the heart does not get enough blood, the body’s response is angina. Angina is experienced as a feeling of tightness or pressure in the chest that can also radiate out to the neck, jaw, back, or shoulders. Women may also experience nausea, shortness of breath, or fatigue. Angina can be exercise-induced or caused by other symptoms of heart disease.

“Any time the heart’s demand for oxygen is greater than the supply, there is a chance for angina,” said Dr. Jamalah Munir, a cardiologist at Fort Belvoir Community Hospital. “Angina most commonly occurs during physical exertion, such as walking quickly up a hill or flights of stairs.” Increases in blood pressure or stress, abnormally fast heart rhythms, severe illness, or anemia can also raise the risk of experiencing angina, she added.

Preventing coronary artery disease is the goal, Munir said. This means eating a whole-food, plant based diet with minimal animal products, as well as exercising regularly, sleeping well, reducing stress, and refraining from smoking.

Even with these preventive measures, exercise can induce angina even in presumably healthy individuals. “When you exercise, your heart needs more oxygen and nutrients,” said Munir. “If the demand outstrips the supply, the result is angina.”

Someone with angina would experience a dull sensation rather than a sharp pain, which typically comes on gradually during exercise and can improve with rest, she added. Nitroglycerin, a medication that relaxes the arteries and increases blood flow, can alleviate chest tightness and pressure.

“Should you experience persistent angina while at rest or at lower levels of activity, seek medical care immediately for a possible heart attack,” Munir cautioned.

The temptation might be to think that if exercise induces angina, the safest course of action would be to remain on the couch. Munir disagrees, stating that when it comes to daily exercise, it doesn’t have to be intense or done all at once. “Some people complain that they can’t make it to the gym for a full workout, but if they walk for 10 minutes after each meal, that adds up to 30 minutes a day.” Moderate exercise combined with strength training, stretching, meditation, or yoga practice is all important to cardiovascular health, she added.

A physician can test for indicators of coronary artery disease – high blood pressure, abnormal heart rhythm, or high cholesterol – that contribute to angina. Medications can stabilize or reduce these symptoms when combined with other healthy habits such as regular exercise.

“If the combination of medication and lifestyle changes isn’t effective, invasive procedures such as coronary stents and open heart bypass surgery are options to consider,” said Munir.

To protect health, especially the heart, “dietary and lifestyle modification are the cornerstone of prevention and treatment of coronary artery disease,” she added. “Incorporating small changes into your lifestyle can make a big difference.”

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