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Angina

What is Angina?

Angina pectoris, literally, "choked chest", is thoracic pain caused by a fleeting deficiency in blood delivery to the myocardium (heart muscle). This can be due to a decrease in myocardial blood flow, an increase in the requirement for oxygen, or an increase in blood viscosity. The myocardial cells are weakened by the temporary lack of oxygen, but do not die.

Angina is the main symptom of ischaemic heart disease. Prolonged or more severe cases of angina can be a precursor to a heart attack and should receive urgent medical attention. Angina attacks may recur for years.

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Angina pain...

Both the typical and variant forms of angina may be manifested by sudden, severe pain in the chest (under the sternum) that often spreads up to the neck and left shoulder and down the left arm.

There may be a feeling of tightness/pressure in the chest, there may also be pain between the shoulder blades.

Common causes of Angina attacks...

The pain of angina is commonly induced by exercise, emotion or eating and is often associated with ECG changes. At first, angina may only be evident during periods of exercise or emotional stress, resolving when the activity ceases. A heavy meal, cold weather, and various other circumstances that require the heart to work harder may bring on angina. Later, it may occur even at rest. The underlining pathology is usually advanced atherosclerosis of the coronary blood vessels.

In contrast, variant angina is apparently caused by vasospasm of the coronary blood vessels and may or may not be associated with severe atherosclerosis. Patients with variant angina develop chest pain while at rest. The vasospasm is usually related to anxiety, platelet adhesion, rouleaux formation and magnesium insufficiency with calcium transport problems in the cardiac muscle. Stress-induced spasms of the coronary arteries causes the blood vessels to narrow, or, increased physical demands on the heart increase the need for oxygen and nutrients over and above supply - depriving the muscular wall of the heart of oxygen.

Another cause of coronary vasospasm may be due to stress-induced release of unesterified arachidonic acid, which triggers a leukocyte respiratory burst with the release of free radicals i.e. superoxide anion, hydrogen peroxide, hydroxyl radical and singlet oxygen.

These free radicals have the ability to inhibit prostacyclin and enhance the breakdown of endothelium derived relaxing factor (nitric oxide) which is a potent vasodilator and platelet aggregation inhibitor. This would lead to vasospasm, thrombosis and atherosclerosis. Thus the use of free radical scavengers such as Lipoic acid, Vitamin E and Selenium should be of great benefit.

It is interesting to note that Magnesium deficiency potentiates free radical production; therefore, a Magnesium supplement is essential. Other possible causes are infections which may induce excessive release of tumour necrosing factor (TNF) - a cytokine with powerful inflammatory properties known to effect heart muscle.

Key vitamins and minerals important to the cardiovascular system...

The scientific literature suggests that several key vitamins and minerals are vitally important to the functional integrity of the cardiovascular system. These are Bioflavonoids, Coenzyme Q10, Bromelain, Essential Fatty Acid's, Magnesium, Potassium, Pangamic acid, Vitamin E, C, B3, B5, B6, Taurine, Selenium, Proline, Lysine, Glutathione, Lipoic acid, Carnitine, Carnosine.

Weight loss and insulin sensitivity control are required for normal blood lipid levels and cardiovascular function. Implementing an eating regime to reduce blood lipids is important - the Insulin Zone System is ideal. The Insulin Zone System consists of eating good quality carbohydrates, protein and fat in the ratio of 40:30:30. If body fat percentage is >35% for a female or >22% for a male a Ketogenic fat loss program will be needed - the proportions are 20:50:30. Obese people are unable to benefit from the Insulin Zone System because their body fat maintains circulating levels of fatty acids that perpetuate insulin resistance. Contributing factors to angina are atherosclerosis, arteriosclerosis, stress, high fat diet, sedentary lifestyle, obesity, smoking, caffeine, alcohol, type A personality, diabetes and a low fibre diet. You can, therefore, alter your lifestyle to avoid a major cardiac catastrophe.

Improving oxygenation of the heart muscle is a priority...

Coenzyme Q10 improves cellular oxygen utilisation resulting in more efficient energy production and reduced cardiac stress, thus relieving angina symptoms. Coenzyme Q10 also prevents additional heart damage caused by lack of oxygen. Dimethylglycine (DMG) enhances oxygen utilisation, increases tissue oxygenation and cellular energy levels, also reducing cardiac stress and angina symptoms. L-Citrulline, L-Lysine, Glutathione and Vitamin E regulate nitric oxide levels, in turn this regulates vasospasm of the coronary arteries. Lipoic acid, Glutathione and Vitamin E act as antioxidants for the cell - protecting structure and function.

Improving circulation to the heart is a necessity in the treatment of angina. Ginkgo Biloba has anti-platelet, antioxidant and anti-inflammatory properties for the maintenance of micro- and peripheral circulation. L-Lysine is essential for Carnitine production which boosts energy production, reduces fat and triglyceride levels in the blood, increases oxygen uptake and stress tolerance. Promoting Carnitine production has been shown to help angina and beneficially modulate cholesterol levels. Lysine also reduces atherosclerosis, through its ability to inhibit the binding of lipoprotein A to vascular endothelium. Taurine facilitates the metabolism of Calcium, Magnesium, Potassium and Selenium - lowering blood pressure by suppressing Renin-angiotensin feedback. Selenium activates Glutathione - protecting cellular structures during ischaemic hypoxia. Magnesium diglycinate reduces vasospasm, balances nervous control of the heart, whilst maintaining normal fatty acid metabolism and glucose/insulin control.

Nutritional support for the heart is essential to optimise cardiovascular function. Magnesium dilates coronary vascular tissue, reduces oxidant stress, improves cardiac energy production, reduces platelet aggregation and regulates heart contractility. Taurine stabilises the heartbeat by correcting arrhythmias. A deficiency of Potassium may cause or be associated with glucose intolerance, hypercholesterolemia and irregular heartbeat, and additional Potassium is needed if taking cortisone, diuretics, or high blood pressure medication. SOD is a powerful antioxidant. Selenium deficiency has been linked with heart disease (cardiomyopathy and hypercholesterolemia). Vitamin E strengthens the immune system and heart muscle, improves circulation, and destroys free radicals. Increased intake of antioxidants reduces ischaemic damage. Coenzyme Q10, Vitamin E and a Taurine supplement  reduces anginal episodes and improves cardiac function. Pangamic acid is a good antioxidant, and it stimulates the carriage of oxygen to the blood from the lungs, and from blood to the muscles and vital organs. Pangamic acid helps detoxification and stimulates anti-stress hormones. It extends the life span of cells in the body, and encourages the body to deal efficiently with stress and helps with angina.

If atheroma is suspected, or diagnosed, supplement with Omega 3 essential fatty acids (prevents hardening of the arteries), Vitamin E and Garlic oil, which inhibit platelet aggregation, reduce blood pressure, and improve circulation. Vitamins B6, B12 and Folic acid protect against the accumulation of the atherogenic amino acid homocysteine, acknowledged as the major risk factor in the development of heart disease. Lecithin acts as a fat emulsifier and phosphatidylcholine reduces fat and triglyceride levels in the blood. Vitamin C, Lysine, and Proline supplementation reverse atheroma and reduce pain.

Hawthorn berries strengthen the heart, lower blood pressure, relax the arteries, and are a good herbal tonic and may be taken with most orthodox drugs. Motherwort, Lemon balm, and Lime blossom are good heart and circulatory tonics. Crataegus oxycanthus, a herb with specificity for heart tissue and arteries, has been found to reduce blood pressure, cholesterol and angina attacks. It also has anti-atherosclerotic activity.

Acute homoeopathic prescribing may help. Tarentula is for constricting pains, relieves heart complaints (angina and heart disease). Lachesis is indicated for weak circulation, relieves left-sided complaints, circulatory and vascular problems. Cactus is for a constricted chest and consequent trouble breathing. Lilium is for a bursting feeling in the heart, with palpitations and some pain in the right arm. Naja is indicated for an irregular pulse, accompanied by anxiety and fearfulness. Glonoinum is for a fluttering heart, a sensation of blood rushing, difficulty breathing, and faintness, which are made worse by heat.

Nutritional and Herbal support for Angina include:

Multipower - Nutritional support for the heart is essential to optimise cardiovascular function. A comprehensive multi-vitamin, with herbs and digestive enzymes specifically for New Zealanders.

Advanced Antioxidant - Including Lipoic acid, Glutathione and Vitamin E. Antioxidants for the cell to protect structure and function. Antioxidants' free radical scavenging activity, delays the ageing process and provides protection for your bodies cells against the damaging effects of free radicals produced by our own metabolism and from the environment. Leanne considers Antioxidants to be like an insurance package.

Circulate - Contains Hawthorn berries, Ginger, Garlic, Ginkgo, and Cayenne. Used for raised lipids, raised cholesterol, raised blood pressure, poor circulation, Raynaud's disease, angina, intermittent claudication, cold hands and feet, and atherosclerosis.

Cholesterol Balance - To lower cholesterol levels. This product was formulated and recommended by internationally recognised doctor and author Dr James Balch. It contains a number of natural ingredients, including Garlic, Guar gum seed, Guggul extract, Tocotrienols (from red palm oil), Policosanol, the mineral Chromium and the Vitamins E & C. Use with regular exercise to improve blood circulation and help reduce cholesterol. Research indicates that the ingredients in the unique Cholesterol Balance formula combine to produce beneficial effects on mild to moderately raised cholesterol.

Coenzyme Q10 - Improves cellular oxygen utilisation resulting in more efficient energy production and reduced cardiac stress, thus relieving angina symptoms. Also prevents additional heart damage caused by lack of oxygen.

Omega 3 Fish Oil - The 0mega 3 fatty acids, mainly found in certain seafood's, have been clearly shown to offer some protection against heart disease. They help reduce abnormal blood clotting, high cholesterol and blood pressure - all factors which contribute to this condition.

Heart Care - A product designed to help improve heart function & circulation, assist with the lowering of homocysteine levels (an indicator of heart disease risk) & increase oxygen carrying capability.

Cayenne Hawthorn with Vitamin E - Synergistic formula promotes & assists healthy heart function & circulation. Contains ingredients that will increase circulation, stabilise blood pressure, help lower cholesterol and prevent & treat arteriosclerosis.

Important points on Angina...

Make sure your diet is well-balanced and contains plenty of water soluble fibre i.e. fibrous vegetables, fruit, nuts, seeds, whole grains e.g. brown rice or oats, oat bran, rice bran, flaxseeds and psyllium. Eat plenty of raw food, almonds, olive oil and oily fish i.e. sardines, herring, pink salmon, trout, tuna and mackerel. These foods contain the essential fatty acids, are low in fat, and contain nutrients needed for normal heart function. Raw garlic aids the functioning of the circulatory system, and helps treat the condition. Garlic, onions and lecithin are good additions to your diet. They effectively reduce cholesterol. Cook with ginger, onions, and garlic. Supplement with olive leaf or eat bitter olives. Increase the intake of potassium, magnesium and taurine rich foods.

Improve digestion by either taking digestive enzymes, or apple cider vinegar (one teaspoon in water), with meals. Eat 5 or 6 meals per day that are a balance of good quality carbohydrates, fats and protein. Eat at less 2 fatty fish meals per week (salmon, tuna, sardines). Avoid constipation by a high fibre diet or acidophilus fibre supplementation.

The Food and Drug Administration (FDA) recently approved nitroglycerin in spray form. It can be used on or under the tongue for the control of angina attacks. This drug is commonly prescribed to relieve chest pain and to improve the oxygen supply to the heart. Nitroglycerin is primarily used in sublingual tablets. These tablets are placed under the tongue at the first sign of chest pain. If the tablets cannot be dissolved due to dry mouth, try the spray form. Side effects include headache, weakness, and dizziness; these will usually disappear with continued use of the drug.

The FDA asserts that one aspirin a day can reduce the risk for heart attack; however, a Harvard Medical School newsletter states that there is insufficient evidence to support this. If you do use aspirin, keep in mind that it can cause internal bleeding and stomach ulceration. There are a number of herbs that can help to thin the blood i.e. Ginger, Garlic and Ginkgo.

Eliminate stimulants such as coffee, chocolate and tea, which contain caffeine. Also avoid tobacco, alcohol, sugar, margarine, red meat, saturated fats, fried foods, processed and refined foods, soft drinks, and white flour products such as white bread. Avoid the herb liquorice.

Avoid stress. Excessive noise for more than 30 minutes can increase blood pressure and can effect the heart for up to 30 minutes after the noise subsides.

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The Naturopathic Team
Ideal Health

Disclaimer: The health information presented here has been written for the New Zealand health consumer. It is of a general nature and is only intended to provide a summary of the subjects covered and is intended to be used for educational and general information purposes only. It is not intended as medical advice or as a means to diagnose, treat, cure or prescribe for any particular condition or disease. You assume all responsibility for the treatment which may be undertaken as a result of the information on this site, or treatment recommended by any other party. While all care has been taken to ensure the accuracy of the information, no responsibility or liability is accepted, and no person should act in reliance on any statement contained in the information provided. All health ailments should be treated by a qualified health professional.


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