Angina

What is Angina?

Having a tight feeling in your chest can be worrying, especially if it’s persistent or you have noticed a sudden in frequency. Angina is the “doctors name” for pain from the heart caused by poor blood supply. Angina can develop into a heart attack if left untreated and must be fully investigated as quickly as possible. Learn more about the causes of Angina below and the angina treatment that could be available to you. Angina can be a warning sign of other heart-related issues, so discovering more information and getting the opinion of your doctor is always recommended.

Angina is the feeling of a tightness in the chest or pain that typically radiates to the jaw and down the left arm. This can feel like a lot of pressure is on your chest, similar to the feeling of a heavy weight present. Your chest may feel like it’s being squeezed and may stop after a few minutes. Some patients may not feel these typical symptoms and may experience only the feeling of indigestion which can make the diagnosis of angina very difficult. Angina is an early warning sign of conditions such as coronary heart disease or heart valve disease like aortic stenosis and should never be ignored.

Angina can be managed with medications and changes to your lifestyle. Depending upon the cause of the Angina, certain treatments such as coronary stenting or coronary bypass surgery may be advised. This decision is usually made by performing a coronary angiogram which looks at the pattern of narrowing in the heart arteries. Many people do live a normal life with stable angina, and it may not lead to any worsening heart conditions, however, if you have unstable angina where the symptoms become more regular, unpredictable, and do not stop after a few minutes of rest, you should seek emergency advice and treatment as soon as possible.

Some of the common causes of angina are related to family history as well as lifestyle, including Atherosclerosis, where the arteries leading to your heart narrow from a build-up of fatty substances. This can be caused by:

• Hereditary angina – where you have a family history of heart conditions or atherosclerosis
• Smoking
• An unhealthy diet
• Excessive alcohol consumption
• Lack of exercise
• High cholesterol
• Older age

If you are male or female, the symptoms will be similar, however, women are more likely to have symptoms relating to feeling dizzy, sick, or breathless. Microvascular angina is also more common in women. If you have been diagnosed with coronary heart disease, experiencing angina will be more common. You may also notice symptoms of angina during cold weather, emotional stress or immediately after any physical activity.

Angina Treatment

Getting treatment for angina involves first being diagnosed. If you are experiencing any of the symptoms, you should visit your GP and they will be able to go through your symptoms and check your overall health. There are tests including an ECG, a heart screening or a coronary angiogram that help further to diagnose any potentially bigger problem.

Symptoms and Causes of Angina

The usual cause of Angina is reduced blood flow to the heart, and you may have angina if you experience any of the following symptoms:

• Pressure on your chest
• Tightness or squeezing feeling in your chest
• Dull ache in your chest
• Dizziness
• Shortness of breath
• Fatigue
• Sweating
• Feeling sick

The tightness feeling may spread from your chest to your arms and sometimes you can feel a dull ache in your neck and back, as well as near to your jaw. Some people may experience angina after strenuous physical exercise that then stops after a few minutes of resting. This is a common form of angina called stable angina and is usually predictable as it will happen after certain activities where you’ve experienced this before. However, other types of angina can be more serious and require emergency treatment.

Unstable angina is where the episodes you have experienced before become far less predictable and take longer to stop. Where you may have had a dull ache and chest pain for 5 minutes before, this can last even longer. The risk here is the heart becomes starved of oxygen which may lead to a heart attack. You should seek medical attention quickly if the symptoms persist and/or worsen.

Other types of angina include Vasospastic angina and Microvascular angina. Vasospastic angina is rarer and can happen when you are at rest such as at night. This is where a coronary artery goes into spasm causing it to narrow or tighten, restricting blood flow. Microvascular angina is caused by spasms in the smallest coronary arteries that can restrict the blood flow.

If you are diagnosed with angina, you can lead a normal life if certain lifestyle changes are made, such as quitting smoking or eating a more balanced diet. Angina treatment can include medication such as nitrate sprays, pills, and patches. These can help also reduce your risk of a heart attack or stroke. You may need to take more than one type of medicine to help with angina symptoms, and usually taken when having an angina attack. Nitrate spray or GTN can also be prescribed as tablets that dissolve in the mouth. Beta-blockers and calcium channel blockers may also be prescribed to slow your heartbeat and relax arteries. These medications help to manage day-to-day living with angina, however, if the medication prescribed doesn’t help to reduce symptoms or they become worse, you may require emergency treatment and even surgery.

Surgery can involve either a coronary artery bypass graft (CABG) or coronary angioplasty. A CABG involves moving a section of blood vessel from one part of the body to another to reroute blood flow in a blocked section that could be causing angina. A coronary angioplasty widens a narrowed section with a stent insertion, helping to open the artery to help with blood flow.

Here at The Keyhole Heart Clinic, we can provide a second opinion on a recent diagnosis you may have had relating to angina and provide further tests. We perform major surgery for those with heart conditions including aortic valve stenosis and mitral valve stenosis, and during a consultation, we can recommend whether surgery is the best solution for your circumstances.

If you have questions about your condition and want to learn more about how we can help with keyhole heart surgeryfor those who will benefit from it, please get in touch today.

Angina FAQs

What are the warning signs of angina?

If you experience a tight chest that is under pressure, shortness of breath, or a dull ache in the chest, arms, neck or back, these can all be related to angina. If the symptoms persist or become more frequent and unpredictable, meaning it takes longer to rest after an angina attack occurs, you will need to seek further medical help. In serious cases, you will need to call 999 as it may be a warning sign of a heart attack.

How does a doctor test for angina?

A few simple tests will help to check your heart health. Important blood tests include your blood cholesterol, blood sugar and renal function. An ECG helps to look at your heart rhythm and can also detect poor heart blood supply or old heart attacks. An echocardiogram will look at the function of your heart muscle and heart valves. A Ct coronary angiogram or an invasive angiogram will give a road map of your heart arteries and will help to identify any blocks or coronary narrowing which may require treatment.

Can you live a long life with angina?

Yes, if managed properly, those with angina can lead normal lives and they may not develop worsening symptoms until much later in life. Every individual is different however, and it will be depending on lifestyle changes if angina causes are from poor diet, excessive alcohol or lack of exercise, as well as the correct course of medication. Inserting a stent across the narrowing can be useful in certain circumstances, and surgery is required if the pattern of disease is located in certain areas of the heart arteries or if multiple heart arteries are affected. Generally, surgery offers a much better long term solution and multi-vessel keyhole coronary bypass surgery is performed by our lead surgeon at The Keyhole Heart Clinic.

Is angina hereditary?

If you have a family history of heart conditions or atherosclerosis, this can pass to you. If you begin to experience angina symptoms, your family history will be taken into consideration as well as many other angina causes that are relatable.

At The Keyhole Heart Clinic, we can help with identifying your treatment options as well as provide world-class care and advice for a range of cardiac conditions. If you need assistance, please contact us by completing our online enquiry form, or calling us today.