Keeping well (self-management)
- Accepting your diagnosis
- Reducing your risk of heart disease
- Stress, anxiety and panic attacks
- Keeping active: benefits of physical activity, pacing yourself and tips on exercising
If you have been told that you have angina then there may be lots of thoughts and questions going through your mind and you may wonder what the future is going to be like.
- A big part of living with angina is the acceptance that life may never be exactly the same again. Apart from any changes you may have to make to the way you live, you have to accept that taking drugs is also going to be a part of your life. You may also worry that your angina may be something worse such as a heart attack or that you are going to die.
- Instead of hoping that by doing nothing it will all go away, you have to find a way to accept that your life can still be very good. You will discover that you can still do a lot of things you enjoyed before, by using the drugs in the right way and following the advice to lower your risk factors and reduce your overall risk of heart disease. This means taking control of your angina and not letting it control you.
You can help yourself by making changes to your life in areas that are known to increase the risk of developing or worsening coronary heart disease. Many of these are so-called lifestyle changes and include:
- Eating a healthy balanced diet
- Not smoking
- Monitoring your weight and your waist size
- Monitoring your alcohol intake
- Keeping active
- Controlling your blood pressure and cholesterol levels
- Managing stress levels
Detailed information on all these topics is found in the Reducing your risk of heart disease section.
You may become very anxious after being diagnosed with angina. Anxiety, or panic, attacks are usually brought on by a tiny thought that goes through your mind, sometimes without you even really recognising it.
- Anxiety can affect you in many different ways, physically, emotionally and behaviourally. It's possible to mistake symptoms of anxiety for illness. Learning to recognise your symptoms of anxiety, and knowing the difference between anxiety- related chest pain and angina, will help you to control them and understand what is actually happening.
- If you work and your job is mentally demanding or stressful it is important to learn some stress management skills, including time management. A simple rule of thumb regarding time management is to split your day into thirds: one third sleep, one third work and one third social and leisure activities.
- You may find it useful to learn relaxation techniques and practice breathing control exercises. These can help minimise the effects that stress and anxiety have on your life.
Try to pace yourself e.g. heavy jobs (such as gardening and decorating) at home can be dealt with a little at a time, but don't let the thought of them cause anxiety.
As well as making any necessary lifestyle changes to lower your risk factors and reduce your overall risk of heart disease, keeping active can actually help to control your angina.
The heart is a muscle and it needs to be exercised to keep it strong. When you are sitting still it hardly has to work at all. The less you do the less you become able to do. The more unfit you become the more your angina can affect you and this can make you more anxious about activity bringing angina on.
- Most people are advised to do some form of physical activity regularly, within the limitations of their angina. Physical activity includes jobs around the house and garden as well as more active exercise such as walking or swimming.
- Pace yourself: your aim is to gradually increase what you can do, in small stages.
- You should not try and work through pain and or breathlessness. You should never be so out of breath that you can't carry out a conversation.
- You should stop if you feel pain / severe breathlessness and use your GTN spray / tablets if necessary.
- Choose an activity that keeps you moving and makes you breathe in more air e.g. swimming, walking, cycling or dancing.
- Avoid any exercise that involves staying in the same place and straining to lift or move something such as heavy weight lifting. This strains your heart and increases your blood pressure.
- Vigorous competitive sports e.g. rugby, football and squash are not recommended.
- Skiing is also not recommended due to the combination of high altitude, physical effort, cold air and emotional factors.
- Swimming is normally a suitable exercise if you have stable angina. However you should not dive into freezing cold water and should enter the water within your depth. Heated pools are obviously preferable.
- Do something you enjoy!
Remember to speak to your doctor if you are in any doubt about what you can do.
If you are unsure about how much activity you can manage, or have unstable angina, it is advisable to speak to your doctor about what you can do.
Benefits of regular physical activity
It is easy to become unfit if you stop being active. Anything requiring effort will be harder for the heart to cope with, and your angina may come on more quickly.
The downward spiral of inactivity can soon take hold and it a can be a long slow process to gradually build up again to be able to do what you want to be able to do.
Some hospitals run angina rehabilitation programmes of structured activity to help you build up your level of activity.
Other benefits include:
- The more you do the more you are able to do
- Strengthens your heart
- Can reduce frequency and severity of angina
- Reduces anxiety and depression
- Reduces tension, encourages relaxation and sleep
- Gives a sense of well being and confidence
- Helps to control cholesterol
- Helps you to lose weight
- Helps to lower high blood pressure
- Keeps you supple and more mobile
- Strengthens muscles, joints and bones
Any form of exertion can bring angina on e.g. climbing stairs, carrying shopping, walking up a slope or hurrying.
- You may find you have to pace yourself in your daily activities so that you do not overdo it one day and then have to rest and feel unwell the next.These are things that most people can't really avoid. You don't want to avoid doing every day things for fear of angina coming on. Keeping active, by doing your normal day to day activities, is an important step in taking control of your angina.
- Breaking bigger jobs up into smaller tasks makes this easier. There is no reason why the whole lawn has to be cut in one day, or a room cleaned or decorated at once.
- In the same way you can break up a walk into distances you know you can manage, even if it means using your GTN to do so.
Tips on exercising
- Try to do some form of activity every day as part of your normal routine
- Spend five to ten minutes warming up gently, ready to exercise
- Spend five to ten minutes cooling down after exercise
- Aim to gradually increase what you do in small stages
- Remember it is not a competition – you are in control
- Avoid rushing and holding your breath