Your Health   -    A to Z of Common Medical Conditions

Angina

Description -  Also known as “angina pectoris”, angina is characterised by an aching discomfort felt in the centre of the chest brought on by effort and relieved by rest. The pain may radiate into the arms and jaw. Angina can also be bought on by excitement, emotion and eating. The pain may be quite severe or quite mild. It is often mistaken for indigestion (see Indigestion/Ulcer/Heartburn). The pain is usually due to blockage of the coronary arteries, which results in an insufficient supply of blood to the heart muscle. (See Atherosclerosis.) The amount of effort required to bring on angina may depend upon the severity of the disease and can vary from taking a few steps across a room to climbing a long hill pulling a golf trolley or running in a marathon. Cold weather and walking into a wind can also make angina worse. In its most dangerous form, unstable angina, the pain may be felt at rest. In some patients, particularly diabetics, there may be blocked coronary arteries depriving the heart muscle of blood but no warning pain (silent ischaemia). Other conditions, such as hyperthyroidism (see Thyroid problems), disease of the aortic valve and anaemia, can also bring on angina. Any person experiencing a first episode of chest pain, or any chest pain, for which there is no obvious reason, should seek immediate medical attention. 

Management   -  All patients with chest pain should see a doctor. If angina is suspected , smoking, of any kind, should be stopped immediately. Smoking significantly increases the likelihood of sudden death in people with coronary artery disease even more so than in the general population. Indeed, smoking is a severe risk factor in any arterial disease (See atherosclerosis).  Most doctors will investigate all new cases of angina and give advice on such matters as diet, exercise, stress and alcohol intake. Regular progressive exercise can increase the period before which angina comes on and, thus, improve the patient’s mobility and life enjoyment. Angina can vary, in severity, from those patients with chronic stable angina who can have it for 20, even 30, years with no trouble, to those whose angina is severe and unstable who need almost immediate bypass surgery. Doctors prescribe a variety of medications for angina some of which can have harmful interaction with herbal products (e.g. Calcium antagonists and grapefruit juice). Anyone considering the use of a herbal remedy should check with the doctor to make sure that such a potentially serious interaction does not exist. Many people with angina use glyceryl trinitrate under the tongue in tablet or spray form to relieve the chest pain.

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