Angina

What is angina?

Angina is the term given to chest pain or discomfort which happens when the blood supply to your heart becomes restricted. It is a symptom of coronary heart disease, not an illness in itself. Angina is your heart’s way of complaining that it is not getting enough oxygen during physical exertion or stress.

This temporary shortage of oxygen (called an ‘angina attack’) to your heart muscle does not result in permanent damage to your heart. It usually passes when you stop the activity that brought it on or after taking medication. Many people learn to recognise how much activity will bring on their angina. This more common form is called stable angina.

However, if angina happens during rest or isn’t consistently relieved by medication, it is known as unstable angina. Unstable angina happens when the blood supply to the heart is severely restricted. This type of chest pain is unpredictable. Unstable angina can happen even if you’ve never had angina before, or it can be a symptom of your stable angina worsening. If you are experiencing symptoms during rest or at night and they are not relieved by medication, you must call 999 for an ambulance.

What are the symptoms of angina?

Angina symptoms differ from person to person, but angina is typically experienced as a discomfort in the middle of your chest, starting as a dull pain or ache.

Sufferers often describe experiencing heaviness, burning, tightness, constriction, squeezing or a sensation of pressure on the chest.

Symptoms may spread to your throat or neck, jaw, shoulders or between your shoulder blades. You may also experience numbness, tingling, aching, or heaviness in one or both of your arms.

Finally, some angina sufferers experience symptoms that are very similar to heartburn and indigestion.

How is angina diagnosed?

To diagnose angina, a doctor will do an assessment of your overall health. This will be done in a rapid-access chest pain clinic, a cardiology clinic or by your GP.

During your assessment, you can expect:

• Questions about what your symptoms are, what brings them on, and what relieves them.
• Checks for risk factors of heart disease.
• An ECG test to get a record of the electrical activity of your heart when you are at rest.
• Blood tests for anaemia, diabetes, and high cholesterol to rule out other possible causes of your symptoms.

How is angina treated?

Angina treatment aims to control symptoms, help you stay active, improve your quality of life, and help to reduce further damage and worsening of the narrowing to your coronary arteries.

This can mean: making positive and lasting lifestyle changes, taking medicines to relieve symptoms, and/or for some people, surgical interventions. Your care practitioner or care team will help you to find the best treatment for you, based on your overall health and how bad your symptoms are.

If you have frequent angina attacks, you will probably need to take a combination of medications to help relieve your symptoms. Your doctor will help you to find the most effective combination for you.

One common type of angina medication is called Glyceryl trinitrate (GTN). GTN can be taken in tablet or spray form to help control your angina during an attack. It can take effect within 1-2 minutes.

Making lifestyle changes to improve angina

Developing and maintaining a healthy lifestyle is an important way to control angina symptoms. It helps to prevent your symptoms from getting worse, and also reduces the risk of a heart attack or stroke.

Making consistent, small changes to your lifestyle can make a big difference to your overall health and wellbeing, as well as helping with ongoing angina symptoms.

These changes might include:

• Doing regular exercise and making an effort to be more physically active
• Eating a healthy diet – plenty of fruit and vegetables, low salt intake, and keeping alcohol within recommended limits
• Maintaining a healthy weight

Visit our Living with a Heart Condition section for more information about how to manage your condition at home, how to stay well and reduce your risk of future heart conditions.