Was That Heartburn or Angina? The Warning Signs for Heart Disease

Don't let the pipes in your body get clogged

By Roberta H. Anding, MS, Baylor College of Medicine and Texas Children’s Hospital
Edited by Kate Findley and proofread by Angela Shoemaker, The Great Courses Daily

Have you ever experienced something that felt like heartburn? Professor Anding explains how to detect the warning signs for cardiovascular disease.

Close up of male with heartburn pain
Coronary artery disease, the most common cause of angina, is caused by plaque in the blood vessels building up, restricting blood flow, and depriving the heart muscle of oxygen. Photo By namtipStudio / Shutterstock

What Is Angina?

Angina is severe chest pain that’s generally considered to be a lack of blood supply or oxygen to the heart muscle. Sometimes people describe it as discomfort, pressure, heaviness, or a tight feeling rather than a sharp pain. 

Angina can be either stable or unstable. Aside from the chest, pain can be experienced in the upper abdomen, back, jaw, neck, or shoulders, so what you might confuse as heartburn could actually be angina.

Stable angina is often experienced in times of emotional stress or physical exertion. If you exercise first thing in the morning and feel this tightness in your chest, you might think you weren’t warmed up or give another excuse, but pay attention to those symptoms. 

Angina can be made worse with cold weather or by having a full stomach, but it’s generally no more than three to five minutes in duration. Sometimes it’s accompanied by nausea, sweating, and shortness of breath, but typically it gets better with rest. 

If it’s unstable angina, it occurs even at rest and lasts longer than stable angina. If you are taking prescribed medication for heart disease, it often becomes ineffective in terms of reducing pain, discomfort, and other symptoms.

Nutrition’s Role in Angina Prevention

The most common cause of angina is coronary artery disease. As plaque in the blood vessels builds up, blood flow is restricted and deprives the heart muscle of oxygen. 

Atherosclerosis, on the other hand, means that the walls of the arteries become damaged in some way, shape, or form. Some people believe it could be cigarette smoking or a chronically poor diet, but specifically the oxidation of low-density lipoprotein (LDL) cholesterol, colloquially known as “bad cholesterol” because it can build up in the arteries, may indeed be one of the damaging factors in terms of damage to arterial walls. 

After this arterial wall is damaged, our immune system comes to the rescue. It sends white blood cells, sometimes known as leukocytes, to correct the problem and help absorb the oxidized LDL. 

Specifically, this is under the direction of monocytes and macrophages, two types of white blood cells which actually trigger a cycle of events that involve inflammation and, ultimately, the development of plaque. This level of inflammation is a major disease risk for the development of heart disease. 

When it comes to treatment, it’s important to include food with anti-inflammatory compounds such as nuts and dark berries in your diet. Omega-3 fatty acids found in fish and flaxseed also help reduce inflammation.

Once the inflammation has started, the LDL cholesterol readily enters the arterial walls and stimulates the production of cytokines, another inflammatory compound. This process causes damage to the arterial walls, sending in a “rescue team” of white blood cells and igniting the whole process of inflammation. 

Once the arterial wall becomes inflamed, cholesterol plaque is deposited in the walls of the artery, causing the smooth muscles of the artery cells to enlarge and form what is known as a fibrous cap over the affected area. Inflammation is a key finding in many chronic illnesses.

Reading the Warnings

As this plaque builds up, it reduces blood flow and increases blood pressure. Think about the pipes in your house. 

Perhaps you’ve had the experience when your sink is backed up, and the Roto-rooter person comes and cleans your pipes. In reality, that’s what’s happening in our arterial walls. 

As the blood flow becomes constricted, the pressure to pump that blood through the arteries becomes increased. Blood pressure increases, and like the sludge that builds up in your pipes, it increases the pressure within the arterial walls.

This process often starts in childhood, and in studies done with adolescents, the buildup is found in most arterial walls. The problem is that early on, most people do not experience symptoms, and it’s not generally detected by most diagnostic tests other than some blood cholesterol markers. 

Of the 24 million individuals in the United States diagnosed with heart disease, often the first symptom is a heart attack or sudden cardiac death.

“That’s tragic when we’ve got all these warning signs coming along the way letting us know that there’s trouble coming,” Professor Anding said.

When you get your blood work done and you have high cholesterol or your triglycerides are high, think about that like a warning sign that something’s wrong in your car. You wouldn’t ignore the flashing red light saying you’re out of oil or gas. 

You’d pay attention because you don’t want to deal with the consequences. Dietary interventions play a key role in the prevention of cardiovascular disease, and exercise and diet often go together like peanut butter and jelly—good apart, but much better together.

This article was edited by Kate Findley, Writer for The Great Courses Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for The Great Courses Daily.

Professor Roberta H. Anding is a registered dietitian and Director of Sports Nutrition and a clinical dietitian at Baylor College of Medicine and Texas Children’s Hospital. She also teaches and lectures in the Baylor College of Medicine’s Department of Pediatrics, Section of Adolescent Medicine and Sports Medicine, and in the Department of Kinesiology at Rice University.

About Kate Findley 437 Articles
Kate is a writer, novelist, and blogger living in Los Angeles. She has been writing for The Great Courses since 2017. It incorporates her two favorite things: writing and learning.