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Let's Talk Angina

Angina is a pain or discomfort felt in your chest, which is usually caused by coronary heart disease. Some people feel the pain in their arm, neck, stomach or jaw.

Angina often feels like a heaviness or tightness in your chest, and this may spread to your shoulders, arms, neck, jaw, back or stomach as well. Some people describe a feeling of severe tightness, while others say it’s more of a dull ache. Some people experience shortness of breath and/or nausea.

What causes angina?

Angina is usually caused by coronary heart disease. When the arteries that supply your heart muscle with blood and oxygen become narrowed, the blood supply to your heart muscle is restricted. This can cause the symptoms of angina. Angina symptoms are often brought on by physical activity, an emotional upset, cold weather or after a meal. The episodes usually subside after a few minutes.

Other causes of angina

There are two other causes of angina:

  • Vasospastic angina (also known as Coronary artery spasm or Prinzmetal’s angina) happens when a coronary artery supplying blood and oxygen to your heart goes into spasm.

  • Microvascular angina (sometimes also known as cardiac syndrome X) usually occurs when you're exerting yourself, for example when you're physically active, or have had an emotional upset. With microvascular angina, your coronary arteries will appear normal when they're investigated, and there will be no evidence of the atheroma (fatty build-up in your arteries) that usually causes angina.

Your doctor may be able to tell whether you have angina from the symptoms that you describe. Alternatively, they may want to carry out a health check or send you for some tests such as an ECG, coronary angiogram or heart scan.

Angina treatment

  • There is medication available that may help control your symptoms. Your doctor might also suggest you take medication to reduce your risk of a heart attack or stroke.

  • Some people need treatments such as a coronary angioplasty or heart bypass surgery to help treat their coronary heart disease and angina.

  • Living a healthy lifestyle can help manage your symptoms and is also a very important part of your treatment.

  • Some medications can be used to help prevent angina episodes. This includes nitrates, which can be used as a fast-acting or long-acting angina treatment

What should I do if I get chest pain?

If you've not been diagnosed with angina and experience chest pain, call the emergency services immediately.

If you've already been diagnosed with angina, you may experience angina pain or discomfort that you can manage by taking your glyceryl trinitrate (GTN) spray or tablets, and resting. However, it could be a heart attack so if you feel:

  • a crushing pain, heaviness or tightness in your chest.

  • a pain in your arm, shoulder, throat, neck, jaw, back or stomach.

  • become sweaty, feel light-headed, sick or become short of breath

You can take these steps:

  1. Stop what you're doing and sit down and rest.

  2. Take your GTN spray and tablets, according to your doctor or nurse’s instructions. The pain should ease within a few minutes – if it doesn’t, take a second dose.

  3. If the pain does not ease within a few minutes after your second dose, call the emergency services immediately

If you’re not allergic to aspirin, chew one adult tablet (300mg). If you don’t have any aspirin or you are not sure if you're allergic to aspirin, you should rest until the ambulance arrives.

Even if your symptoms don’t match the above but you suspect you’re having a heart attack, call the emergency services immediately.

Can I prevent angina?

Unfortunately you can’t reverse coronary heart disease which causes angina, but you can help delay your arteries narrowing. To do this it's important to:

  • stop smoking

  • control high blood pressure

  • reduce your cholesterol level

  • be physically active

  • achieve and maintain a healthy weight

  • control your blood glucose if you have diabetes

  • eat a healthy, balanced diet and only drink moderate amounts of alcohol

Everyday life with angina

Many people with angina have a good quality of life and continue with their normal daily activities. Your doctor or nurse will be able to advise you on your daily activity and any lifestyle changes you may need to make.

Living an active lifestyle is also really important to help stop your coronary heart disease from getting worse.

Angina is usually caused by the arteries supplying blood to the heart muscles becoming narrowed by a build-up of fatty substances.

SOURCE: British Heart Foundation - Angina - Causes, symptoms & treatments

NHS - Angina


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