Angina/Chest Pain
Overview
Angina is pain or discomfort that may feel like heaviness, pressure, tightness or squeezing in your chest. Different people experience angina in different ways. Angina is a type of chest pain or discomfort that is a sign of an underlying heart problem, usually coronary artery disease (CAD). Symptoms can vary from mild to severe. Some people with angina feel chest discomfort or shortness of breath but have no pain at all. Although angina is quite common, it can be hard to distinguish from other types of chest pain, such as indigestion.
Angina can stop and start, and episodes of angina can last anywhere from seconds to minutes. It often happens when your heart is working harder than usual, such as during physical exertion, emotional stress or after a heavy meal. During these times, your heart needs more oxygen rich blood than the narrowed arteries can deliver. There’s usually no permanent muscle damage caused by angina. The pain often fades away with rest or medication.
If you experience angina when you’re resting, this is a sign that the condition is getting worse and you should seek medical attention.
Symptoms
- Chest discomfort or heaviness/crushing chest feeling
- Shortness of breath
- Pain in the arm, neck, shoulders, back with chest tightness or pressure
Causes and types of angina
Stable Angina: Stable angina is usually brought on by an increased demand on the heart, for example exercising. When we exercise, our heart needs more oxygenated blood but narrowed arteries slow down the amount of blood that can be delivered. Angina can also be brought on by other non-physical causes such as emotional stress, heavy meals, smoking and cold temperatures.
Unstable Angina: Unstable angina is caused by a sudden narrowing of the arteries; this can be a result of fatty deposits that rupture and further block an already narrow artery. Unstable angina can also be caused by a blood clot that significantly reduces the blood flow to the heart, either partially or totally blocking the artery.
If you experience angina at rest, or if your angina is not relieved by your usual medications, you may have unstable angina. It is important to seek emergency medical attention at your nearest hospital. If the blood flow to your heart is not corrected quickly, you can suffer a heart attack.
Risk Factors
Since angina is mostly caused by coronary artery disease, the risk factors for both are much the same.
- Smoking: Continued smoking, a history of smoking or exposure to second hand smoke can increase the risk of developing IHD. Smoking damages the walls of the arteries, this allows deposits of plaque and cholesterol to collect on the damaged wall and reduce the flow of blood to the heart. Smoking also increases the risk of spasms of the arteries and blood clots which can both lead to sudden myocardial ischaemia.
- Diabetes: Both type 1 and type 2 diabetes increase the risk of not only ischaemic heart disease, but also other heart related issues.
- High blood pressure: High blood pressure can lead to an accelerated rate of atherosclerosis which may cause damage to the coronary arteries.
- High cholesterol and trigylcerides: Cholesterol and triglycerides, both types of fats, are largely responsible for plaque deposits in the coronary arteries that reduce the blood flow to your heart.
- Obesity: Obesity increases the risk of other factors such as diabetes, high blood pressure and high cholesterol, all of which can increase your risk of ischaemic heart disease.
- Increased waist circumference: Waist measurements of more than 89cm for women, and 102cm for men, increase the risk of other factors such as high blood pressure, diabetes and heart disease.
- Older age: The risk for angina increases with age, men over 45 and women over 55 are at greater risk of angina than younger adults.
- Lack of exercise: A sedentary lifestyle contributes to obesity and is linked to increased cholesterol and triglyceride levels. Performing regular exercise, where your heart rate is elevated, maintains good heart health and is associated with lower risk of heart conditions, such as ischaemic heart disease and heart attack.
Prevention
Reducing the risk factors for angina and coronary artery disease can help to either prevent or control angina. Medications can also be used to help manage your symptoms to enable a more active lifestyle.
- Quit smoking or any other tobacco use.
- Have regular check ups with your GP and specialist to make sure other health conditions are well managed – such as blood pressure and diabetes.
- Eat a healthy diet and maintain a healthy weight.
- Increase your physical activity with the help of your GP. Try to get involved in group or family activities to make exercising fun and a normal part of your routine.
- Reduce your stress levels (exercise can help with this!)
- Limit how much alcohol you consume, especially on a daily basis. Men should aim for less than two drinks a day, women one drink or less.
- Keep up to date with your flu vaccinations. This can help to protect your heart from damage caused by the influenza virus.
