Symptoms of angina
The most common symptom of angina is a feeling of pain or discomfort in your chest. The pain can feel tight, dull or heavy.
The pain can spread from your chest to your left arm (or both arms), neck, jaw and back. In some cases, the pain is similar to indigestion.
Chest pain may also occur with:
- breathlessness
- feeling sick (nausea)
- feeling unusually tired
- dizziness
- restlessness
Some people may experience breathlessness without any obvious chest pain.
The pain is usually triggered by physical activity or stress (but can occur at rest). It typically only lasts for a few minutes. This is often known as an angina attack.
When to seek medical help
Dial 999 to request an ambulance if you experience chest pain and you haven't previously been diagnosed with a heart problem.
If you have an angina attack and you've previously been diagnosed with the condition, take the medication prescribed for you.
If there is no improvement five minutes after taking your recommended treatment - call 999 and ask for an ambulance.
Types of angina
The two main types of angina are stable angina and unstable angina.
- stable angina – where angina attacks are brought on by an obvious trigger (such as exercise) and improve with medication and rest
- unstable angina – where angina attacks are more unpredictable (occurring more often or getting more severe), occurring with no obvious trigger and continuing despite resting and medication
Stable angina isn't life-threatening on its own. However, it's a serious warning sign that you're at increased risk of developing a life-threatening heart attack or stroke.
Some people develop unstable angina after previously having stable angina. Others experience unstable angina with no history of having angina before.
Unstable angina should be regarded as a medical emergency. It’s a sign the blood supply to your heart muscle has suddenly got worse. This increases your risk of having a heart attack or stroke.
If the blood supply to the heart muscle is stopped completely a heart attack occurs.
Why angina happens
Most cases of angina are caused by atherosclerosis. This is the hardening and narrowing of arteries. It happens as a result of a build-up of fatty substances known as plaques. This can restrict the blood supply to the heart and trigger the symptoms of angina.
Your risk of getting atherosclerosis increases with:
- getting older
- smoking
- obesity
- eating a diet high in saturated fats
- having high blood pressure
- having poorly controlled diabetes
Treating angina
Treatment for angina aims to:
- relieve the symptoms during an angina attack
- reduce the number of angina attacks that a person has
- reduce the risk of a heart attack or stroke happening
A number of medications can be used. Some of these are only taken when needed, while others are taken every day.
Surgery to widen or bypass the narrowed arteries may be recommended if the symptoms don't get better with medication.
Complications
A major concern for people with angina is that their atherosclerosis will continue to get worse. This can lead to the blood supply to their heart becoming blocked. This could trigger a heart attack. A blockage of the blood supply to the brain could trigger a stroke.
You can considerably reduce your risk of developing these complications by making lifestyle changes.
For example, if you're obese and you smoke, you can significantly reduce your risk by stopping smoking and maintaining a healthy weight.