Stress Induced Angina

Doctor,

I have angina which the cardiac rehab staff is believed to be caused by anxiety since the doctors have ruled out other possibilities and since I recently had bypass surgery.  What medical and non-medical interventions are available for reducing this anxiety/angina, which specific treatments to you feel are most promising and what has been your experience/success in addressing this problem?

[Cleveland Clinic, MD]

Dear Jason,
I assume that instead of angina you mean chest pain.  The term angina suggests that the chest pain is due to ischemia (lack of blood flow) and the treatment for this is to improve the blood flow through medical or surgical intervention.  Nonanginal chest pain can be difficult to treat.  There are multiple factors as to why someone is experiencing this type of pain.  All potential medical causes (e.g. gastroesophageal reflux, costocondritis, etc. )should be excluded first.  

For pain related to anxiety the source of the anxiety should be identified.  Is the person afraid of dying?  Are there stressful situations in the home or work life due to the illness, or that have been ignored when the individual was sick but now need to be addressed?  Group support may be helpful and psychological counseling may be needed in some situations.

You can find relief from your chest pain but the first steop is addressing what is causing it.  See your doctor to make sure there is not a medical reason.  If anxiety is thought to be the source try to identify what is causing the anxiety and work on resolving that.  If no cause can be found medications for anxiety may be needed.  Best wishes.