Questions and Answers about Chest Pain
Q: Is it safe to exercise at home if I have angina? I feel anxious about triggering an episode of chest pain.
A: Exercise is one of the best things you can do for your heart, says Richard Krasuski, M.D. Discuss your risk factors and goals with your doctor before you start. He or she will analyze your test results, give you an exercise prescription and will likely point you to a supervised exercise program for people with heart disease—the safest bet when starting out.
Q: How much exercise should I start with?
A: If you haven't exercised much in the past, it's best to start slow, with 15 minutes of leisurely walking three times per week. When your doctor OKs it, the goal will be to get your heart working a bit harder. Thirty minutes a day of moderate exercise such as brisk walking or riding a stationary bike can do the trick.
Q: How do I prevent pain during exercise?
A: Your doctor will probably recommend taking a fast-acting nitrate before you exercise. This will prevent pain by widening your arteries and improving blood flow. Always take a break if you feel angina coming on. When exercising outside of a program, choose a gym or work out with a friend. This way, in the event of an emergency, someone is there to help. Stretch beforehand, stay hydrated, start slowly, work up to your peak and then cool down.
Q: Can I still do housework if it causes pain?
A: Yes, but break activities up. Shop for food on one day and do other chores another day. When cleaning the house, dust the furniture or vacuum in the morning and change the sheets later that evening. Avoid strenuous activities such as heavy lifting. Beware of extreme temperatures and air pollution—they can trigger angina. Always have your fast-acting nitrates and aspirin with you just in case; these are your rescue medications.
Q: Do I have to change the way I eat?
A: A heavy or fatty meal can trigger angina, so don't overindulge. Ask your doctor to recommend a registered dietitian to help you develop a heart-healthy eating plan.
In theory, large amounts of caffeine might trigger angina. But two or three cups of coffee or tea a day appear to be harmless. Alcohol—two drinks daily for men, one for women—can benefit the heart. But it may interact with heart medications, so ask your doctor.
Q: What can I do if stress triggers my angina?
A: Try deep breathing and meditation, and seek counseling for anxiety and depression. Avoid stressful situations and if stress is unavoidable—you're a nervous flier, for instance—your doctor may recommend taking a fast-acting nitrate beforehand.