Symptoms - Angina

Angina is the medical term for chest pain or discomfort that comes from the heart. The usual cause is narrowing in the blood vessels (arteries) supplying blood to the heart and this means that the heart muscle is unable to get enough blood. There are some other causes, which are all much less common. These include problems with the heart valves and hypertrophic cardiomyopathy.

Angina usually feels like pressure or squeezing in the middle of the chest. Occasionally, the feeling spreads to the arms, neck and jaw. When an angina attack occurs, people sometimes feel sweaty and short of breath. There are many types of chest discomfort that are not angina and these include heartburn and lung inflammation.

You are more likely to get angina if you:

• smoke any form of tobacco
• have high blood pressure
• have a high blood cholesterol level
• take little physical activity, or
• have diabetes.

What makes angina happen?
Angina occurs when the heart cannot get enough blood. For example, walking on the flat might not cause any problems, but climbing a flight of stairs or running might cause it to happen. Angina may also happen when people are very anxious or stressed or in very hot or cold weather.

What is stable angina?
People with stable angina have episodes of chest discomfort that are usually predictable (for example, usually occur when walking up a steep hill). The chest discomfort is relieved with rest, or by using a spray given to you by your doctor (a nitrate).

If you have these symptoms, you should see your doctor. Your doctor will discuss any further tests you might need and what sort of treatment might be required. Usually treatment will involve changes in your lifestyle (such as stopping smoking and doing more exercise) and drugs to help control your symptoms. You might also need tests to see whether you need an angioplasty or stent to open up the blocked artery or a bypass operation (CABG) to improve the blood supply to the heart.

What is unstable angina?
This is angina that is unexpected and will usually occur at rest. This might be the first time you have angina, or night be more severe and last longer than your usual attack. Usually, unstable angina is caused by a blood clot in the blood vessel to the heart so severely reducing the blood supply.

Unstable angina should be treated as an emergency. People with new, worsening or persistent chest discomfort should be evaluated immediately in a hospital emergency department. They are at increased risk for:

• A heart attack (myocardial infarction [MI])
• cardiac arrest leading to sudden death.