angina heart

Angina describes pain that is felt in the centre of the chest, as heaviness or tightness that sometimes spreads to the arms, neck or jaw. It has been described as an oppressive pain, burning, pressurising or squeezing and can be mistaken for indigestion. Symptoms can last from just a few minutes to 10-15 minutes. For some, the tightness is severe and for others not much more than a mild discomfort.

Angina occurs when your heart muscle doesn't get the blood supply and oxygen that it needs. Angina is typically brought on by physical activity (for example, walking up hill on a cold day) or emotional upset. These are times when your heart muscle needs more oxygen. Getting an attack of angina while you are resting, or when you are asleep signifies a more serious situation.

What to do if you get an attack

If you get an attack of angina, you should stop and rest until the pain has passed. There is helpful medication to relieve the discomfort. If you still have the chest pain after 15 minutes, you should get medical attention by dialling 999.

What causes angina?

Oxygen and nutrients for the heart muscle itself are supplied by the coronary arteries. The coronary arteries can become narrowed by the gradual build up of cholesterol deposits (plaques) by the process known as atherosclerosis. In time, the artery can become so narrow that it cannot deliver enough oxygen containing blood to the heart muscle when its demands are high - such as when you are physically exercising. The pain or discomfort that happens as a result is angina.

You are at risk of developing atherosclerosis if:

You have a high blood cholesterol level.
You smoke cigarettes.
You have high blood pressure.
You take little physical activity.
You are diabetic.
You are overweight or obese.
You have a family history of relatives having a heart attack or angina (before the age of 65).

Difference between angina and a heart attack

There is a key difference between angina and heart attack. In angina, blood flow is reduced, especially when the heart has to do more work. This temporarily reduced blood flow leads to chest discomfort. In a heart attack, blood flow to part of the heart muscle is suddenly cut off when a coronary artery is blocked. The resulting chest pain is more severe and lasts longer and does not go away with rest. Angina attacks usually do not permanently damage the heart muscle. A heart attack does.

Many people with angina have never had a heart attack, although angina can develop after one.

Stable angina is when the angina that comes on with exercise is predictable and well controlled with drugs.
Unstable angina is when angina comes on with less and less exercise, or even while you are resting. Often the intensity of angina increases too. This pattern often comes before a heart attack and needs urgent treatment.

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