Angina

Angina is a sudden feeling of pain or tightness in your chest which is often brought on by physical activity or stress. It happens when your heart muscle doesn’t have enough blood supply to cope with the extra demands on it. Angina causes chest pain, that may spread to your neck, jaw, arm and back, but will usually stop after a few minutes’ rest.

It’s usually a sign of coronary heart disease, where the arteries supplying blood to your heart muscle have become furred-up and narrowed. If so, you may also be at an increased risk of a heart attack or stroke.

Angina is more common in men and older people.

With treatment and lifestyle changes, it’s often possible for you to continue your everyday activities.

Symptoms include:

• Heaviness or tightness in your chest
• Pain or ache in your chest, neck, jaw, arms and back
• Sometimes, breathlessness

If you have stable angina, these symptoms will pass after you have rest a few minutes. If symptoms continue, get worse, or you feel sweaty, you may have unstable angina or another serious condition such as a heart attack.

If you have chest pain that lasts for more than a few minutes, you should seek urgent medical attention.

Your doctor will ask about your chest pain and check your general health.

If they suspect angina they may refer you for tests, including:

• An exercise ECG, to see how your heart works during exertion
• A coronary angiogram
• A heart scan

These tests can check for narrowed arteries. It can also rule out any other possible heart problems which may cause your angina symptoms.

Angina results from poor blood supply to your heart muscle.

There are different types of angina, but it’s mostly caused by coronary heart disease (CHD). This is when fatty deposits, called atherosclerotic plaques, build up in your arteries and cause narrowing.

This restricts blood flow to your heart muscle, especially at times when it needs extra blood and oxygen.

An angina attack can be brought on by:

• Physical exercise
• Emotional stress
• Cold weather
• A meal

Other rarer causes of angina include:

• Varian angina, where an artery supplying your heart muscle goes into spasm
• Microvascular angina, which can occur during exercise but not because of CHD
• Heart valve problems
• Hypertensive heart disease

For many people, an angina attack can be quickly managed by taking a medication called glyceryl trinitrate to improve blood flow. You’ll be given this to use at the first sign of an attack and also before exertion.

You may also be prescribed:

• Medications to reduce angina symptoms, such as beta-blockers or calcium-channel blockers
• Medications to help prevent a heart attack or stroke, including aspirin, statins and ACE inhibitors and blood-pressure lowering drugs

Your doctor will advise lifestyle changes including:

• Following a healthy diet
• Moderating alcohol
• Exercising
• Stopping smoking

Your doctor may need to refer you to a consultant cardiologist (who specialises in the heart and circulation).

They may recommend:

• Coronary angioplasty – a procedure to clear blocked arteries
• Heart by-pass surgery