Angina

Symptoms

The main symptom of angina is chest pain. Some people also have other symptoms.

Chest pain could be angina if it:

• feels tight, dull or heavy – although some people (especially women) may have sharp, stabbing pain
• spreads to your arms, neck, jaw or back
• is triggered by physical exertion or stress
• stops within a few minutes of resting

Other symptoms

Angina can also cause:

• breathlessness
• feeling sick (nausea)
• pain in your lower chest or belly – similar to indigestion
• feeling very tired

Some people have these symptoms without obvious chest pain.

Causes

Angina is usually caused by the arteries supplying blood to the heart muscles becoming narrowed by a build-up of fatty substances. This is called atherosclerosis.

Things that can increase your risk of atherosclerosis include:

• an unhealthy diet
• a lack of exercise
• smoking
• increasing age
• a family history of atherosclerosis or heart problems

Angina can also be caused by other conditions affecting the heart and arteries.

Diagnosis

You may need to have several tests to diagnose angina.

Seeing a GP

If you see a GP after an attack of chest pain, they may ask about:

• the symptoms you had
• what you were doing when the symptoms started
• your lifestyle – for example, what your diet is like and if you smoke or drink
• your family's medical history – heart problems can run in families

They may also do some checks to assess the likelihood of a heart problem, such as:

• measuring your blood pressure
• calculating your body mass index (BMI) – this involves measuring your weight and height
• measuring your waist size
• blood tests to check your cholesterol (blood fats) level

If they think you might have angina or another heart problem, they may refer you to hospital for some tests.

Tests in hospital

You may have tests to check if you have angina and assess your risk of more serious problems like heart attacks or stroke.

You may have:

• an electrocardiogram (ECG) – a test to check your heart's rhythm and electrical activity
• a coronary angiography – a scan taken after having an injection of a dye to help highlight your heart and blood vessels
• an exercise ECG – an ECG carried out while you're walking on a treadmill or using an exercise bike
• blood tests

Treatment Options

You'll probably need to take several different medicines for the rest of your life.

You may be given medicine to:

• treat attacks when they happen (only taken when needed)
• prevent further attacks
• reduce the risk of heart attacks and strokes

If medicines are not suitable or do not help, an operation to improve blood flow to your heart muscles may be recommended.

When To See A Doctor

If you have not been diagnosed with angina, get an urgent GP appointment if you have an attack of chest pain that stops within a few minutes of resting.

They can check if it might be a heart problem and refer you to a hospital for tests.

Call for an ambulance if you have chest pain that does not stop after a few minutes. This could be a heart attack.

Living with angina

If it's well controlled, there's no reason why you cannot have a largely normal life with angina.

You can usually continue to do most of your normal activities.

You'll probably need to make healthy lifestyle changes, such as:

• having a balanced diet
• cutting down on alcohol
• stopping smoking if you smoke
• losing weight if you're overweight
• exercising regularly – gentle exercises are usually safe

This can help reduce your risk of heart attacks and strokes.