What is Angina?

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Angina is an uncomfortable feeling, tightness, heaviness or pain in your chest, which may spread to your arms, neck jaw, shoulders, back or stomach. People sometimes describe the feeling as a dull, persistent ache. The symptoms are not the same for everyone. Some people may feel the pain or tightness only in their arm, neck, stomach or jaw. For some people the pain or tightness is severe, while others may feel nothing more than a mild discomfort or pressure.

You might experience angina if is a cold day, or if you are walking after a meal. Being very upset can sometimes trigger an angina episode too. Or you may get angina if you are exerting yourself, including during physical exercise. So Angina often comes on when you are physically active.

The symptoms of angina usually fade after a few minutes of rest, or after taking medicine such as glyceryl trinitrate (or GTN). Angina can be classed as stable, which comes on with a particular amount of activity, but is well controlled with medicines and does not become more frequent of more sever. Or,it can be unstable, which is when you have symptoms that you have just developed for the first time, or angina which was previously stable but has recently got worse or changed in pattern. It is important to seek medical advice as soon as possible about any changes in your symptoms, as it may mean that you require further tests or treatment.

How will I know if the pain in my chest is angina?

Many episodes of chest pain or discomfort have nothing to do with the heart. Short, sharp, stabbing pains can often be muscular pains. Some people feel discomfort in their chest when they are tense or anxious. Indigestion that comes on shortly after a heavy or spicy meal can sometimes cause discomfort in the chest. Severe anaemia can also cause chest pain.
If you have chest pain, it is vital to talk to our doctor as soon as possible, so that he or she can assess you to find out why you are getting the pain.

What causes angina?

To establish the causes of angina, we need to understand how the heart works. Your heart is a muscle that pumps blood around your body, delivery oxygen and other nutrients to all of your cells. Your heart muscle needs its own supply of oxygen and nutrients so that it can pump blood around your body.

Your heart gets its blood supply from the coronary arteries. There are three main coronary arteries and the circumflex artery – on the outside of the heart. These divide many times so that the blood reaches all the parts of your heart’s muscular wall.

In time your arteries may become so narrow that not enough blood can flow throgh to your heart muscle.  The chest pain you feel is the when your arteries cannot deliver enough blood to your heart muscle.

Angina and Heart Attacks

The artery may become so narrow that it doesn’t allow enough blood through to your heart muscle. When you are being physically active, you may feel discomfort or pain in the chest. This pain is angina. The amount of pain or discomfort you feel does not always reflect how badly your coronary arteries are affected.

Having coronary heart disease can lead to a heart attack. A heart attack happens when a coronary artery becomes blocked by a blood clot. This usually happens because the atheroma in the artery wall has become unstable. A piece may break off (rupture) and a blood clot may form around it. The clot can block the artery completely, starving the heart muscle of blood and oxygen, and causing irreversible damage o some of the heart muscle.

What is the difference between angina and a heart attack?

It can be very difficult to tell if your pain or symptoms are due to a heart attack or angina, as the symptoms can be similar. If you have angina, your symptoms usually ease or go away after a few minutes of rest, or after taking a medicine such as GTN. If you are having a heart attack, your symptoms are less likely to ease or go away after resting or taking medicine.

If you have not already been diagnosed with angina or coronary heart disease and you get chest pain, you should call an ambulance (112) and seek immediate medical assistance.

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