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Non-medical interventions
Dear Doctor:
What are the potentially most effective ways to alleviate angina during exercise through non-medical means such as exercise and diet or what ever? Is there a particular exercise regimen that has been more successful than others? Is it bad to exercise if having angina? I appreciate your help.
What are the potentially most effective ways to alleviate angina during exercise through non-medical means such as exercise and diet or what ever? Is there a particular exercise regimen that has been more successful than others? Is it bad to exercise if having angina? I appreciate your help.
Hi Steve,
I checked out your site. I guess that it's true that you learn something every day - I had never heard of Antiphospholipid Syndrome.
You have a terrific sense of humor - I think that's another ingredient for survival and recovery which I overlooked.
Yes, trying to push back coronary heart disease with exercise is risky business - there is no doubt about it. You could end up dead, with a further damaged heart, or suffer problems such as you have.
I look at the mild heart attack which I had as a warning. If I didn't change the conditions that got me to that point where I had had the event and discovered that I had coronary artery blockages, I certainly shouldn't try to exercise my way out of it.
Of course you can't yet change the factors of heredity. In my case, my mother had several heart attacks leading to bypass surgery at age 57 and death of congestive heart failure at 64. And she had followed a low fat diet for at least 20 years and controlled her blood pressure with medication.
In my case, I haven't gone back to the same old working grind. I now work enough to live, don't work overtime, and take the summers off to concentrate on my health and the enjoyment of life.
I have lost weight, not as much as I would like, but hope to get closer to an ideal weight this summer. My diet has improved. Much less meat, non-fat much of the time, more fruits and vegetables.
After seeing what Lipitor has done to my cholestorol readings I have become a total believer in that drug and believe that it will suck the excess lipids right out of my coronary arteries. I do believe that anyone that's at risk for CAD should be on a statin drug like this.
As far as the outdoor exercise regimen goes, perhaps it's not for everyone, but has great benefit for me, even if it may be risky. Saturday I climbed to the top of Mt. Pilchuck, which is a small mountain about 5,000' tall, not to far from the city of Seattle. The top half of it was still all snow and it was a beautiful day. Once up there I could see the entire Puget Sound.
I was careful to warm up slowly for the first half hour and tried to keep my heart rate below 120 b.p.m. for the whole ascent.
Doing something like this gives my a feeling of physical and spiritual well being for several days afterward. Way too much pleasure to concern myself about the risks.
Whether I have changed enough and can continue to change the factors that brought me to the brink with Coronary Heart Disease remain to be seen. Can I avoid my mother's fate or will I even be less successful? Will I further damage my heart from the type of activity I engage in? Will I have another heart attack or experience Sudden Death? Will my 70% occluded Circumflex artery close completely or block suddenly from a clot causing major hear damage? Once we have been put on notice, these are thoughts that cross our minds.
In the meantime, I think that I will just get up in the mountains as much as I can, take a pill for cholestorol and one for B.P., watch my diet as much as I can, relax, and enjoy every day that I have as much as I can.
Best Wishes,
Bill
I checked out your site. I guess that it's true that you learn something every day - I had never heard of Antiphospholipid Syndrome.
You have a terrific sense of humor - I think that's another ingredient for survival and recovery which I overlooked.
Yes, trying to push back coronary heart disease with exercise is risky business - there is no doubt about it. You could end up dead, with a further damaged heart, or suffer problems such as you have.
I look at the mild heart attack which I had as a warning. If I didn't change the conditions that got me to that point where I had had the event and discovered that I had coronary artery blockages, I certainly shouldn't try to exercise my way out of it.
Of course you can't yet change the factors of heredity. In my case, my mother had several heart attacks leading to bypass surgery at age 57 and death of congestive heart failure at 64. And she had followed a low fat diet for at least 20 years and controlled her blood pressure with medication.
In my case, I haven't gone back to the same old working grind. I now work enough to live, don't work overtime, and take the summers off to concentrate on my health and the enjoyment of life.
I have lost weight, not as much as I would like, but hope to get closer to an ideal weight this summer. My diet has improved. Much less meat, non-fat much of the time, more fruits and vegetables.
After seeing what Lipitor has done to my cholestorol readings I have become a total believer in that drug and believe that it will suck the excess lipids right out of my coronary arteries. I do believe that anyone that's at risk for CAD should be on a statin drug like this.
As far as the outdoor exercise regimen goes, perhaps it's not for everyone, but has great benefit for me, even if it may be risky. Saturday I climbed to the top of Mt. Pilchuck, which is a small mountain about 5,000' tall, not to far from the city of Seattle. The top half of it was still all snow and it was a beautiful day. Once up there I could see the entire Puget Sound.
I was careful to warm up slowly for the first half hour and tried to keep my heart rate below 120 b.p.m. for the whole ascent.
Doing something like this gives my a feeling of physical and spiritual well being for several days afterward. Way too much pleasure to concern myself about the risks.
Whether I have changed enough and can continue to change the factors that brought me to the brink with Coronary Heart Disease remain to be seen. Can I avoid my mother's fate or will I even be less successful? Will I further damage my heart from the type of activity I engage in? Will I have another heart attack or experience Sudden Death? Will my 70% occluded Circumflex artery close completely or block suddenly from a clot causing major hear damage? Once we have been put on notice, these are thoughts that cross our minds.
In the meantime, I think that I will just get up in the mountains as much as I can, take a pill for cholestorol and one for B.P., watch my diet as much as I can, relax, and enjoy every day that I have as much as I can.
Best Wishes,
Bill
I agree with what was said about diet, exercise and a general healthy life style. I would not take on any mountains without a full medical evaluation and a doctors permission. But walking provides a very high level of cardiac rehab as well as reductions in lipids and improvements in breathing.
I caution the over exertion because the level of damage from one person to another after a heart attack is night and day. I had my first heart attack and luckily the symptoms were extream and I was able to be transported to the hospital. Damage was minimal. I felt positve, had anginna and kept pushing for a speedy recovery. Back to work, the old grind, positive attitude, but did not know that I had a blood clotting disorder called Antiphospholipid Syndrome.
Six months later I had an episode of Sudden death, was kept going with CPR for 45 min snd spent a number of weeks in a coma. The resuults, Brain Injury, an EF of 17 and a shattered life. four years later of walking, exercise, diet and very close monitoring by some great doctors I have built my EF back up to 30, learned to walk and talk again, just started to drive.
Guess what I am saying is we look at the heart and dont see the effects of having it stop. Anoxic brain damage is a sad event that causes you o loose all independance, loose your life as you know it and make you a burden to your family as well as destroy you financialy. Dont put off reporting all symptoms immediatley, following medical advice but also pushing yourself for recovery. the costs are to great. Dieing is fast and perminant. Perminant brain damage lasts a life time. So many people move from the Cardiac unit in the hospital to the Neuro unit then to a rehab facility, then to a nursing home to just lay there for ever. It sucks, but most people dont want to discuss that real an common ending to heart desiese. Dont ignore the symptoms, the cost is greater than death.
Steve
Still in it for the long haul.
Who is Steve? http://hometown.aol.com/AMAmail/Steve.html
Antiphospholipid Syndrome http://hometown.aol.com/AMAmail/Anti.html
I caution the over exertion because the level of damage from one person to another after a heart attack is night and day. I had my first heart attack and luckily the symptoms were extream and I was able to be transported to the hospital. Damage was minimal. I felt positve, had anginna and kept pushing for a speedy recovery. Back to work, the old grind, positive attitude, but did not know that I had a blood clotting disorder called Antiphospholipid Syndrome.
Six months later I had an episode of Sudden death, was kept going with CPR for 45 min snd spent a number of weeks in a coma. The resuults, Brain Injury, an EF of 17 and a shattered life. four years later of walking, exercise, diet and very close monitoring by some great doctors I have built my EF back up to 30, learned to walk and talk again, just started to drive.
Guess what I am saying is we look at the heart and dont see the effects of having it stop. Anoxic brain damage is a sad event that causes you o loose all independance, loose your life as you know it and make you a burden to your family as well as destroy you financialy. Dont put off reporting all symptoms immediatley, following medical advice but also pushing yourself for recovery. the costs are to great. Dieing is fast and perminant. Perminant brain damage lasts a life time. So many people move from the Cardiac unit in the hospital to the Neuro unit then to a rehab facility, then to a nursing home to just lay there for ever. It sucks, but most people dont want to discuss that real an common ending to heart desiese. Dont ignore the symptoms, the cost is greater than death.
Steve
Still in it for the long haul.
Who is Steve? http://hometown.aol.com/AMAmail/Steve.html
Antiphospholipid Syndrome http://hometown.aol.com/AMAmail/Anti.html
Assuming that your situation has been assessed by a cardiologist and you have no further options for revascularization or perhaps bypass surgery has been presented as your only option and you are refusing it, I believe that angina can be pushed back over time with daily exercise, diet, & stress reduction.
After a heart attack last year, an angiogram showed that I had a total occlusion of my right coronary artery. My cardiologist failed to enter it to perform angioplasty, so the two options that I was presented with were to have bypass surgery or live with it. I decided to live with it and to try to mitigate the effects of it which were a reduction of physical ability and angina symtoms during exercise and periods of stress.
One year later, I am in better physical condition than I have been in 10-15 years. A couple of days ago, I hiked up 1,800' in a little more than an hour to see the parasails launching and jogged back down. In August I am planning on climbing Mt. Adams here in Washington State.
I think that the reason that I am doing well is because I started hiking within two weeks after my heart attack and hiked almost every day for 2 1/2 months. During the winter, when I went back to work, I walked three miles every day on a route with a couple of good hills and back-country skied on the weekends.
It's important to know your limits. You could easily push yourself into a heart attack or damage your heart, which I hope that I haven't done. A couple of times, early on, I did too much and got so generally tired and had so much angina aching in my chest that I thought that I had come dangerously close to pushing myself into a heart attack situation.
I would advise picking up a heart rate monitor from a sporting goods store. Get out and walk and find out where your angina kicks in. In my case, I could initially hike steadily with a H.R. up to 105-110 without experiencing significant angina. Now I set the top limit for 120 and let my H.R. go up to 130 for short periods.
Try to keep yourself below were you feel symptoms and don't push yourself until you get overly tired. Keep nitro handy, but you shouldn't be in a situation where you ever need to use it. I have never used it, but always carry it. Also, early on, a small amount of beta blocker might be necessary or helpful. Too much will defeat your ability to exercise. I found that half of a 25mg atenolol was helpful in the first six months after my M.I., but I no longer take it.
I hope that you have hills or mountains where you live. Walking uphill is the most important ingredient, I believe. It can give you good strong aerobic exercise without overreving your heart like jogging does. If your heart rate gets too high or you experience angina, you can always stop and look at the trees for a minute or so. Doing a stair-stepper in a gym, watching the financial news, will do nothing to relieve stress like being outdoors.
Of course you need to be on a low-fat diet and a good statin drug like Lipitor. Also, drinking lots of water is important and some supplements like B-vitamins and Folic Acid are probably helpful. Eating fruits, grains, and salads and cutting out the meat and anything that won't rot is also very important.
Another thing to consider is that there will be good weeks and bad weeks. I started encountering added beats and skipped beats after exercise last fall for about three months and still get them occasionally under periods of stress. I had a couple of scary syncope events, which I believe were caused by medication and perhaps caffiene and alcohol.
I guess that I won't know for certain if I made the correct choice for several years, but am firmly on this course of action now. I am taking the whole summer off to hike, climb, and generally have fun and work on my health. I hope to be in great shape by the end of the summer.
The angiogram also showed a 70% blockage of my circumflex. Fortunately my cardiologist became so obsessed with opening my RCA that he didn't go back and do angioplasty or stent the cicumflex. I now believe that I can slowly push back that blockage, and that if it had been stented, I would have a much more unstable condition. But time will tell and I am aware that I am gambling with my life.
I do believe that you can push back that angina and stimulate some collateral circulation by:
1. Daily walking/hiking/skiing.
2. A statin drug.
3. Low fat diet with plenty of fruits.
4. Stress reduction - consider cutting back on your work.
Good Luck,
Bill
After a heart attack last year, an angiogram showed that I had a total occlusion of my right coronary artery. My cardiologist failed to enter it to perform angioplasty, so the two options that I was presented with were to have bypass surgery or live with it. I decided to live with it and to try to mitigate the effects of it which were a reduction of physical ability and angina symtoms during exercise and periods of stress.
One year later, I am in better physical condition than I have been in 10-15 years. A couple of days ago, I hiked up 1,800' in a little more than an hour to see the parasails launching and jogged back down. In August I am planning on climbing Mt. Adams here in Washington State.
I think that the reason that I am doing well is because I started hiking within two weeks after my heart attack and hiked almost every day for 2 1/2 months. During the winter, when I went back to work, I walked three miles every day on a route with a couple of good hills and back-country skied on the weekends.
It's important to know your limits. You could easily push yourself into a heart attack or damage your heart, which I hope that I haven't done. A couple of times, early on, I did too much and got so generally tired and had so much angina aching in my chest that I thought that I had come dangerously close to pushing myself into a heart attack situation.
I would advise picking up a heart rate monitor from a sporting goods store. Get out and walk and find out where your angina kicks in. In my case, I could initially hike steadily with a H.R. up to 105-110 without experiencing significant angina. Now I set the top limit for 120 and let my H.R. go up to 130 for short periods.
Try to keep yourself below were you feel symptoms and don't push yourself until you get overly tired. Keep nitro handy, but you shouldn't be in a situation where you ever need to use it. I have never used it, but always carry it. Also, early on, a small amount of beta blocker might be necessary or helpful. Too much will defeat your ability to exercise. I found that half of a 25mg atenolol was helpful in the first six months after my M.I., but I no longer take it.
I hope that you have hills or mountains where you live. Walking uphill is the most important ingredient, I believe. It can give you good strong aerobic exercise without overreving your heart like jogging does. If your heart rate gets too high or you experience angina, you can always stop and look at the trees for a minute or so. Doing a stair-stepper in a gym, watching the financial news, will do nothing to relieve stress like being outdoors.
Of course you need to be on a low-fat diet and a good statin drug like Lipitor. Also, drinking lots of water is important and some supplements like B-vitamins and Folic Acid are probably helpful. Eating fruits, grains, and salads and cutting out the meat and anything that won't rot is also very important.
Another thing to consider is that there will be good weeks and bad weeks. I started encountering added beats and skipped beats after exercise last fall for about three months and still get them occasionally under periods of stress. I had a couple of scary syncope events, which I believe were caused by medication and perhaps caffiene and alcohol.
I guess that I won't know for certain if I made the correct choice for several years, but am firmly on this course of action now. I am taking the whole summer off to hike, climb, and generally have fun and work on my health. I hope to be in great shape by the end of the summer.
The angiogram also showed a 70% blockage of my circumflex. Fortunately my cardiologist became so obsessed with opening my RCA that he didn't go back and do angioplasty or stent the cicumflex. I now believe that I can slowly push back that blockage, and that if it had been stented, I would have a much more unstable condition. But time will tell and I am aware that I am gambling with my life.
I do believe that you can push back that angina and stimulate some collateral circulation by:
1. Daily walking/hiking/skiing.
2. A statin drug.
3. Low fat diet with plenty of fruits.
4. Stress reduction - consider cutting back on your work.
Good Luck,
Bill
If you are having chest pain during exercise that is believed to be due to real angina (that is insufficient blood flow to the heart), you should not be exercising to that degree. You need to have a medical evaluation (sooner rather than later). Diet and exercise have a role in disease prevention and health maintanence, not in the acute treatment of angina.
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