Angina is chest tightness due to problems with the blood supply to the heart. Do you find yourself having chest discomfort? Do you know its cause? Read on to find out if it may be angina.
Angina is a common heart condition in which the blood supply to the muscle of the heart is reduced, usually by disease of the coronary arteries. Plaques build up in the arteries around the heart which obstruct the flow of blood and limit the amount of oxygenated blood able to reach heart muscles. At rest, the heart needs a comparatively low blood supply, but during exercise or emotion the heart’s demand for blood increases dramatically so that symptoms of chest tightness or breathlessness develop. The tightness or breathlessness usually subsides after exercise.
The most common symptom of angina is a vague chest discomfort which occurs during physical activity and sometimes emotional stress. The discomfort may also spread to the arms or jaw and usually subsides after the physical activity stops. Cold weather may make anginal symptoms worse.
If you have these symptoms at rest (i.e. not doing exercise), this may indicate the narrowing in the arteries is severe or one of the arteries has thrombus (clot) in it. In this case we advise you seek immediate medical attention or call 999 as it could be the sign of a heart attack or unstable angina. This outcomes are better if assessed early.
Angina is often suspected from symptoms, but tests are usually required to be clear of the diagnosis. An electrocardiogram (ECG) should be performed and the first line test is usually a CT coronary angiogram, though an exercise tolerance test (ETT), stress echocardiogram or stress perfusion cardiac MRI are all alternative non-invasive options.
Sometimes an invasive coronary angiogram will be required but often imaging is undertaken beforehand.
There are many different options available for the treatment of angina. Identification of risk factors (hypertension, raised cholesterol and diabetes) is very important as are lifestyle changes including stopping smoking, reducing alcohol and a sensible balanced diet alongside cardiac rehabilitation.
There are a range of medications that are useful including beta-blockers and calcium channel blockers. Other options include nitrates, nicorandil, ranolazine and ivabradine. You may need a GTN spray which can be squirted under the tongue for rapid relief of chest pain.
The other main treatment for angina is angioplasty and stent insertion. This often produces relief from angina. Whether this is appropriate will be discussed with you by your Cardiologist who will look at your angiogram to decide whether the narrowing of blood vessels is at a stage that a stent needs to be inserted.
If there are lots of narrowing in different places, or the narrowing is in places that are difficult to treat with stents, then you may be offered coronary artery bypass surgery (CABG). This is open heart surgery and arteries and veins from the inside of your chest and your legs are used to bypass blockages in the coronary arteries.
Angina is common but can be treated successfully. An expert Consultant Cardioloigst is crucial to discuss the different options with you and come up with the optimal management plan. Our expert cardiologists are available for consultation on any day of the week and weekends as well.
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