DEAR DR. DONOHUE: I am 56, a woman and have angina. I don’t understand it too well. I have never smoked, and I am not overweight. I’d get chest pains if I hurried to catch a bus or to get on an open elevator. When it first started, my doctor gave me a medicine to put under my tongue when the pain hap- pened. It worked well. I don’t have to use it much anymore. Is that a good sign? Am I destined to have a heart attack? — J.A.
ANSWER: Angina (pronounced ANN-juh-nuh or ann-JEYE-nuh) is squeezing chest pain that comes on when a person is active and leaves when that person rests. Being active can mean walking, jogging, clean- ing, doing the washing, weeding or digging. It comes about because one or more of the heart arteries is plugged with plaque — a mound of cholesterol and fat on the inside artery wall. At rest, enough blood makes its way to the heart. With activity, the heart can’t get enough blood because of the plaque. The heart makes its lack of blood known by chest pain that also might be felt in the neck, the jaw or the arms, or only in those places.
Angina, one of the signs of coronary (heart) artery disease, affects 17 million Americans. Smoking, obe- sity, inactivity, high blood cholesterol, high blood pres- sure and a family history are some of the major fac- tors that cause its development. You don’t smoke and never did. How about your cholesterol, blood pressure and weight? If those things need to be addressed, they trump all other treatments.
In spite of controlling the above factors, many still have to take medicines — medicines that dilate arter- ies or make the heart beat slower, or ones that lower blood pressure or cholesterol. The medicine you put under your tongue was nitroglycerin. Long-acting varieties of that medicine and long-acting other
artery dilators might be the reason why you don’t need nitroglycerin as much as you did. That is a good sign. Clogged heart arteries can be opened with a bal- loon-tipped catheter or by bypassing the clog with an artery graft. You might not ever need such proce- dures.
You’re not doomed to have a heart attack. The treatment you’re now getting is designed to prevent one.
The booklet on coronary artery disease provides information on this No. 1 North American illness. Readers can obtain a copy by writing: Dr. Donohue — No. 101W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My grandson recently had scarlet fever. In my day, this was a very frightful disease. My daughter has taken a ho-hum attitude toward it. What are its complications? — W.B.
ANSWER: Scarlet fever is a strep throat with one addition — a red skin rash. That’s the only difference between the two. Penicillin is its treatment.
When treated early, there should be no complica- tions from it. If not treated, then it can have the same complication that strep throat has — rheumatic fever.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475.
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