Harvard Heart Letter

Heart beat: Post-heart attack angina common, and commonly untreated

Heart beat

Post""heart attack angina common, and commonly untreated

After the hubbub of a heart attack has faded, one of the goals of treatment is preventing angina, the chest pain or tightness caused by one or more cholesterol-clogged arteries. Banishing angina is a sign that arteries are getting healthier. It also provides some peace of mind, since the twinges of angina sometimes feel like a new heart attack brewing. Yet in a study of nearly 2,000 heart attack survivors, one in five was still plagued by angina a year later "" some daily. It was most likely to persist among smokers who weren't able to kick the habit after their attacks or individuals with new or continuing depression. Half of those with angina weren't taking a nitrate, one of the best angina stoppers available, and one-third weren't taking a beta blocker, which should be standard for almost all heart attack survivors.

Cardiac rehabilitation is an excellent way to speed recovery from a heart attack and give angina the boot. Several months of supervised exercise strengthens the heart, arteries, lungs, and muscles. Exercise, along with counseling and peer support, also helps fight depression. And the close follow-up with doctors and nurses is an excellent way to fine-tune medications.

Most people get great care while they are having a heart attack and immediately afterward. Once back home, though, the urgency fades and treatment sometimes lags. Enrolling in a cardiac rehabilitation program is a terrific way to keep that from happening.

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