Angina – signs, symptoms and treatment

Angina – signs, symptoms and treatment

Updated January, 2021.

Angina is chest pain that occurs when the blood supply to the muscles of the heart is restricted. It usually happens because the arteries supplying the heart become hardened and/or narrowed. The pain is usually triggered by physical activity or stress and typically only lasts for a few minutes. This is often referred to as an angina attack.

Angina can also be a sign that you are more likely to have other heart related illnesses or potentially a stroke.

What are the symptoms of angina?

  • A feeling of pain or discomfort in your chest that may be tight, dull or heavy.
  • Pain that spreads from your chest to your left arm, neck, jaw and back.
  • Pain is similar to indigestion in some cases
    Chest pain may also occur with:
    • breathlessness (some people can have this without any chest pain)
    • feeling sick (nausea)
    • feeling unusually tired
    • dizziness
    • restlessness

When to seek medical help:

  • If you experience chest pain and you haven’t previously been diagnosed with a heart problem of any kind
  • If your Angina medication is not working. If you’ve previously been diagnosed with the condition, take the medication prescribed for you (glyceryl trinitrate or GTN usually in spray or small tablet form). A second dose can be taken after five minutes if the first dose doesn’t have any effect.
  • If there’s no improvement five minutes after the second dose, call 999/112 and ask for an ambulance.

What are the causes of Angina?

Angina is usually caused when the arteries supplying blood to the heart become narrowed by a build up of fatty substances. When exercising, heart required more blood flow and this is not available due to the narrowed arteries.

There are two types of angina, called stable and unstable angina. The symptoms of these two types are similar, but there are some important differences.

Attacks of stable angina usually occur when the heart is forced to work harder – for example, during physical activity or emotional stress. In some cases, the pain can also develop after eating a meal or during cold weather. These are known as angina triggers. The symptoms of stable angina usually improve if you rest for a few minutes.
Unstable angina is more unpredictable. It can develop without any obvious triggers and can persist even when you’re resting. Attacks of unstable angina may last longer than a few minutes and don’t always respond to treatments used for stable angina. People with these symptoms should go straight to hospital or phone 999/112 for an ambulance.

The narrowing of the arteries can develop over many years, typically 20-30 years, as a result of lifestyle choices and activity levels. Angina is statistically more common in men, Asians and the older population. It is estimated that 1 in 5 people over 60 years old in the UK have some degree of angina.

What medications are used for Angina?

The most common medication prescribes is GTN (glyceryl trinitrate) in a spray or tablet form. It is sprayed or placed under the tongue where it is absorbed by the bloodstream more quickly than if swallowed.

Other medications prescribed in some cases include aspirin to thin the blood, beta-blockers to slow the heart rate and thereby reduce the oxygen demands of the heart  or statins to reduce cholesterol.

How is Angina diagnosed?

To correctly diagnose the cause of angina, an Electrocardiogram (ECG) is usually done in a hospital. This records the electrical activity of the heart, which is used to diagnose heart abnormalities such as arrhythmias (irregular rhythms) or to show ischemia (lack of oxygen and blood) to the heart. The results of this test helps ensure that the patient is given the correct medication that addresses the cause of their angina.

To find out more about ANGINA come on one of our courses or look at the British Heart Foundation website.

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